Forced sterilization has been recognised as crime against humanity if the action is part of a widespread or systematic practice by the Rome Statute Explanatory Memorandum, which defines the jurisdiction of the International Criminal Court.
Although far less well-known than the Nazi eugenics and American eugenic sterilization programs, two Canadian provinces performed compulsory sterilization programs with eugenic aims. Canadian compulsory sterilization operated via the same overall mechanisms of institutionalization, judgement, and surgery as the American system. One notable difference is in the treatment of non-insane criminals. Canadian legislation never allowed for punitive sterilization of inmates.
In 1995, Leilani was awarded $750,000CAD and $230,000CAD in damages for her wrongful and humiliating labeling as a moron and her subsequent sterilization. Since the victory, another 1300 cases have been opened, several of them concerning individuals who may have actual mental disabilities. It is unlikely they will be awarded any settlements based on stigmatization, but they may win suits based on involuntary sterilization, which is now considered battery under Canadian law.
Additionally, the substantial immigration rate of the 1910s and 1920s spurred a feeling of xenophobia among the Protestant, educated elite of British Columbia. Slavic immigrants in particular were accused of having very high incidence of undesired characteristics, which are now generally attributed to culture shock and language barriers. The aversion to "abnormal" or "strange" people coupled with the perceived societal drain caused by immigrants, the deformed, mentally ill, and mentally disabled created an environment conducive to the enactment of a sexual sterilization act.
Thus, in July 1933, five years after Alberta, British Columbia passed its own sexual sterilization act. A three member Eugenics Board comprised of a psychiatrist, a social worker, and a judge was given the duty of authorizing the sterilization of any institutionalized person who was deemed capable of propagating undesirable social characteristics. Since such social problems as criminality, prostitution, and addiction/alcoholism were believed to have a biological (and thus heritable) cause, almost any institutionalized individual could be found eligible. Although the records concerning BC's Sexual Sterilization Act have since been lost or destroyed, it is thought that 'only' a few hundred individuals were operated upon before the law was silently repealed in 1973.
Canadian sterilization laws were only enacted in Alberta and British Columbia, which could be attributed to their Protestant denominations. Pope Pius XI of the Roman Catholic Church denounced surgical intervention in reproductive matters, making the more Catholic regions (such as Ontario, Quebec, or the Maritime provinces) an inhospitable place to lobby for eugenic sterilization of the disabled. The introduction of progressive, left-leaning governments in Alberta and B.C. also had a hand in strengthening eugenic legislation. Left-leaning parties were eager to embrace new ideas, especially those that held a promise of economic turnaround.
Recent court discussions in Manitoba have investigated the legality and ethical permissibility of involuntary sterilization of the mentally disabled. Focusing on those individuals found legally incompetent, the 1990 and 1992 reports outlined the scenarios where an involuntary sterilization could be warranted. As stated by the 1990 discussion, three conditions are necessary for an individual to undergo any medical procedure.
Individuals who are legally incompetent include minors and sufficiently-disabled adults.
The discussion reached a consensus that involuntary sterilization (or sterilization with substituted consent) is only permissible if it has an explicit positive effect on the physical or mental health of the individual: this is called therapeutic sterilization. One such case involved was a seriously disabled girl with an aversive phobia to blood, who was scheduled to undergo a hysterectomy. The rationale of the surgery was not eugenic, but rather to protect the girl from the direct mental trauma that would likely arise upon initiation of menses. This judgement was seen to be on the very threshold between therapeutic and nontherapeutic surgical intervention.
This discussion also cites a landmark case in substituted consent known as the Mrs. E. vs. Eve case. In it, a mother, "Mrs. E.", wished to have her moderately intellectually disabled daughter "Eve" sterilized to save her the emotional distress potentially caused by pregnancy and childbirth. Additionally, it was argued that Eve would neither be capable of using any other method of contraception, nor caring for a child should she become pregnant. Since the sterilization was not explicitly therapeutic and carried grave physical harm and an intrusion on Eve's rights, Mrs. E. could not be given the authority to have her daughter sterilized. It was then explored whether or not the government itself could make the decision, using parens patriae jurisdiction. Parens patriae allows the government to make authorizations in the "best interests" where no other source of consent can be attained; this includes children and mentally disabled persons. In the Eve case, the risks were deemed too high and the benefits too obscure to authorize a nontherapeutic sterilization via parens patriae jurisdiction, since a surgical sterilization is an irreversible procedure.
The most infamous sterilization program of the 20th century took place under the most infamous regime of the 20th century: the Third Reich. One of the first acts by Adolf Hitler after achieving total control over the German state was to pass the Law for the Prevention of Hereditarily Diseased Offspring (Gesetz zur Verhütung erbkranken Nachwuchses) in July 1933. The law was signed in by Hitler himself, and over 200 eugenic courts were created specifically as a result of the law. Under the German law, all doctors in the Reich were required to report patients of theirs who were mentally retarded, mentally ill (including schizophrenia and manic depression), epileptic, blind, deaf, or physically deformed, and a steep monetary penalty was imposed for any patients who were not properly reported. Individuals suffering from alcoholism or Huntington's Chorea could also be sterilized. The individual's case was then presented in front of a court of Nazi officials and public health officers who would review their medical records, take testimony from friends and colleagues, and eventually decide whether or not to order a sterilization operation performed on the individual, using force if necessary. Though not explicitly covered by the law, 400 mixed-race "Rhineland Bastards" were also sterilized beginning in 1937.
By the end of World War II, over 400,000 individuals were sterilized under the German law and its revisions, most within its first four years of being enacted. When the issue of compulsory sterilization was brought up at the Nuremberg trials after the war, many Nazis defended their actions on the matter by indicating that it was the United States itself from whom they had taken inspiration. The Nazis had many other eugenics-inspired racial policies, including their "euthanasia" program in which around 70,000 people institutionalized or suffering from birth defects were murdered.
In the first part of the Showa era, Japanese governments promoted increasing the number of healthy Japanese, while simultaneously decreasing the number of people suffering mental retardation, disability, genetic disease and other conditions that led to them being viewed as "inferior" contributions to the Japanese gene pool.
The Leprosy Prevention laws of 1907, 1931 and 1953, the last one only repealed in 1996, permitted the segregation of patients in sanitariums where forced abortions and sterilization were common and authorized punishment of patients "disturbing peace". Under the colonial Korean Leprosy prevention ordinance, Korean patients were also subjected to hard labor.
The Race Eugenic Protection Law was submitted from 1934 to 1938 to the Diet. After four amendments, this draft was promulgated as a National Eugenic Law in 1940 by the Konoe government. According to Matsubara Yoko, from 1940 to 1945, sterilization was done to 454 Japanese persons under this law.
According to the Eugenic Protection Law (1948), sterilization could be enforced on criminals "with genetic predisposition to commit crime", patients with genetic diseases such as total color-blindness, hemophilia, albinism and ichthyosis, and mental affections such as schizophrenia, manic-depression and epilepsy. The mental sicknesses were added in 1952.
India's state of emergency between 1975 and 1977 included an infamous family planning initiative beginning April 1976, which involved the vasectomy of thousands of men and tubal ligation of women, either for payment or under coercive conditions. The son of then-Prime Minister Indira Gandhi, Sanjay Gandhi, was largely blamed for what turned out to be a failed program. A strong backlash against any initiative associated with family planning followed the highly controversial program, which continues into the 21st century.
The situation in China is the subject of a crackdown in which officials promoting enforced sterilization were jailed for their actions.
The eugenistic legislation was enacted in 1934 and was formally abolished in 1976. According to the 2000 governmental report, 21,000 were estimated to have been forcibly sterilized, 6,000 were coerced into a 'voluntary' sterilization while the nature of a further 4,000 cases could not be determined. The number sterilized may according to some be as high as 500,000. The Swedish state subsequently paid out damages to many of the victims.
The program was meant primarily to prevent mental illness and disease. In 1922 a state Institute of Racial Biology was founded in Uppsala and in 1927 Parliament began to deal with the first legal provisions on sterilisation. A new draft was produced in 1932, already taking into account sterilisation for general socio-prophylactic reasons, and even without the consent of the person concerned. The draft was adopted in 1934. Another law, passed in 1941, did not include any age of consent limit.
From 1950, the number of eugenic sterilisations under the 1935 legal provisions gradually decreased and between 1960 and 1970 voluntary sterilisations based on the wishes and in the interest of the persons concerned prevailed.
As in Canada and the US, racial politics also became involved, as there was a strong belief in the connection between race and genetic integrity among leading scientists and those carrying out the sterilizations. The Swedish Racial Hygiene Society had been founded in Stockholm in 1909, and the 1934 works by Alva and Gunnar Myrdal was very significant in promoting the eugenic tendencies in practical politics. The authors theorized that the best solution for the Swedish welfare state ("folkhem") was to prevent at the outset the hereditary transfer of undesirable characteristics that caused the individual affected to become sooner or later a burden on society. The authors therefore proposed a "corrective social reform” under which sterilisation was to prevent "unviable individuals” from spreading their undesirable traits. In the later decades it was primarily the mentally ill who were forcibly sterilized.
The United States was the first country to concertedly undertake compulsory sterilization programs for the purpose of eugenics. The heads of the program were avid believers in eugenics and frequently argued for their program. They were devastated when it was shut down due to ethical problems. The principal targets of the American program were the mentally retarded and the mentally ill, but also targeted under many state laws were the deaf, the blind, people with epilepsy, and the physically deformed. Native Americans, as well as Afro-American women, were sterilized against their will in many states, often without their knowledge, while they were in a hospital for other reasons (e.g. childbirth). Some sterilizations also took place in prisons and other penal institutions, targeting criminality, but they were in the relative minority. In the end, over 65,000 individuals were sterilized in 33 states under state compulsory sterilization programs in the United States.
The first state to introduce compulsory sterilization legislation was Michigan, in 1897 but the law failed to garner enough votes by legislators to be adopted. Eight years later Pennsylvania's state legislators passed a sterilization bill that was vetoed by the governor. Indiana became the first state to enact sterilization legislation in 1907, followed closely by Washington and California in 1909. Sterilization rates across the country were relatively low (California being the sole exception) until the 1927 Supreme Court case Buck v. Bell which legitimized the forced sterilization of patients at a Virginia home for the mentally retarded. The number of sterilizations performed per year increased until another Supreme Court case, Skinner v. Oklahoma, 1942, complicated the legal situation by ruling against sterilization of criminals if the equal protection clause of the constitution was violated. That is, if sterilization was to be performed, then it could not exempt white-collar criminals.
Most sterilization laws could be divided into three main categories of motivations: eugenic (concerned with heredity), therapeutic (part of an even-then obscure medical theory that sterilization would lead to vitality), or punitive (as a punishment for criminals), though of course these motivations could be combined in practice and theory (sterilization of criminals could be both punitive and eugenic, for example). Buck v. Bell asserted only that eugenic sterilization was constitutional, whereas Skinner v. Oklahoma ruled specifically against punitive sterilization. Most operations only worked to prevent reproduction (such as severing the vas deferens in males), though some states (Oregon and North Dakota in particular) had laws which called for the use of castration. In general, most sterilizations were performed under eugenic statutes, in state-run psychiatric hospitals and homes for the mentally disabled. There was never a federal sterilization statute, though eugenicist Harry H. Laughlin, whose state-level "Model Eugenical Sterilization Law" was the basis of the statute affirmed in Buck v. Bell, proposed the structure of one in 1922.
After World War II, public opinion towards eugenics and sterilization programs became more negative in the light of the connection with the genocidal policies of Nazi Germany, though a significant number of sterilizations continued in a few states until the early 1960s. The Oregon Board of Eugenics, later renamed the Board of Social Protection, existed until 1983, with the last forcible sterilization occurring in 1981. The U.S. commonwealth Puerto Rico had a sterilization program as well. Some states continued to have sterilization laws on the books for much longer after that, though they were rarely if ever used. California sterilized more than any other state by a wide margin, and was responsible for over a third of all sterilization operations. Information about the California sterilization program was produced into book form and widely disseminated by eugenicists E.S. Gosney and Paul B. Popenoe, which was said by the government of Adolf Hitler to be of key importance in proving that large-scale compulsory sterilization programs were feasible. In recent years, the governors of many states have made public apologies for their past programs beginning with Virginia and followed by Oregon and California. None have offered to compensate those sterilized, however, citing that few are likely still living (and would of course have no affected offspring) and that inadequate records remain by which to verify them. At least one compensation case, Poe v. Lynchburg Training School & Hospital (1981), was filed in the courts on the grounds that the sterilization law was unconstitutional. It was rejected because the law was no longer in effect at the time of the filing. However, the petitioners were granted some compensation as the stipulations of the law itself, which required informing the patients about their operations, had not been carried out in many cases.
States (27) that had sterilization laws still on the books (though not all were still in use) in 1956 were: Arizona, California, Connecticut, Delaware, Georgia, Idaho, Indiana, Iowa, Kansas, Maine, Michigan, Minnesota, Mississippi, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Oklahoma, Oregon, South Carolina, South Dakota, Utah,Vermont, Virginia, West Virginia, Wisconsin.
The Soviet Union imposed forced sterilization on female workers deported from Romania to Soviet labor camps. This occurred after World War II, when Romania was supposed to supply a reconstruction workforce (according to the armistice convention). India and China have also at various times implemented sterilization campaigns as a population control policy, though only the latter has made any previous overtures towards any potential eugenic motivations.
Czechoslovakia carried out a policy of sterilization of Roma women, starting in 1973. The dissidents of the Charter 77 denounced it in 1977-78 as a "genocide", but the practice continued through the Velvet Revolution of 1989. A 2005 report by the Czech government's independent ombudsman, Otakar Motejl, identified dozens of cases of coercive sterilization between 1979 and 2001, and called for criminal investigations and possible prosecution against several health care workers and administrators.
In October 1999, Margrith von Felten suggested to the National Council of Switzerland in the form of a general proposal to adopt legal regulations that would enable reparation for persons sterilised against their will. According to the proposal, reparation was to be provided to persons who had undergone the intervention without their consent or who had consented to sterilisation under coercion. According to Margrith von Felten:
The history of eugenics in Switzerland remains insufficiently explored. Research programmes are in progress. However, individual studies and facts are already available. For example:
The report of the Institute for the History of Medicine and Public Health "Mental Disability and Sexuality. Legal Sterilisation in the Vaud Canton between 1928 and 1985" points out that coercive sterilisations took place until the 1980s. The act on coercive sterilisations of the Vaud Canton was the first law of this kind in the European context.
Hans Wolfgang Maier, head of the Psychiatric Clinic in Zurich pointed out in a report from the beginning of the century that 70% to 80% of terminations were linked to sterilisation by doctors. In the period from 1929 to 1931, 480 women and 15 men were sterilised in Zurich in connection with termination.
Following agreements between doctors and authorities such as the 1934 "Directive For Surgical Sterilisation" of the Medical Association in Basle, eugenic indication to sterilisation was recognised as admissible.
A statistical evaluation of the sterilisations performed in the Basle women's hospital between 1920 and 1934 shows a remarkable increase in sterilisations for a psychiatric indication after 1929 and a steep increase in 1934, when a coercive sterilisation act came into effect in nearby National Socialist Germany.
A study by the Swiss Nursing School in Zurich, published in 1991, documents that 24 mentally-disabled women aged between 17 and 25 years were sterilised between 1980 and 1987. Of these 24 sterilisations, just one took place at the young woman's request.
Having evaluated sources primarily from the 1930s (psychiatric files, official directives, court files, etc.), historians have documented that the requirement for free consent to sterilisation was in most of cases not satisfied. Authorities obtained the "consent" required by the law partly by persuasion, and partly by enforcing it through coercion and threats. Thus the recipients of social benefits were threatened with removal of the benefits, women were exposed to a choice between placement in an institution or sterilisation, and abortions were permitted only when women simultaneously consented to sterilisation.
More than fifty years after ending the National Socialist dictatorship in Germany, in which racial murder, euthanasia and coerced sterilisations belonged to the political programme, it is clear that eugenics, with its idea of "life unworthy of life" and "racial purity" permeated even democratic countries. The idea that a "healthy nation" should be achieved through targeted medical/social measures was designed and politically implemented in many European countries and in the U.S.A in the first half of this century. It is a policy incomparable with the inconceivable horrors of the Nazi rule; yet it is clear that authorities and the medical community were guilty of the methods and measures applied, i.e. coerced sterilisations, prohibitions of marriages and child removals – serious violations of human rights.
Switzerland refused, however, to vote a reparations Act.