Foreword

Guel A. Russell

At the International Summit on Human Gene Editing in Washington, DC, held December 1–3, 2015, scientists advocated caution, declaring that the clinical implementation of gene editing would be “irresponsible” at present. They recommended proceeding with thoughtfulness and care “to assess the many scientific, ethical, and social issues associated with human gene editing” until there would be a broad societal consensus about the appropriateness of any proposed change.¹ This was not surprising with such formidable editing tools of “unprecedented ease and precision” as CRISPR-Cas9 (Clustered Regularly Interspaced Short Palindromic Repeats), which could alter human heredity and affect the germ line. Of particular note was a reference to being “part of a historical process that dates from Darwin and Mendel’s work in the 19th century” and the question that motivated the meeting: “How, if at all, do we as a society want to use this capability?”²

That historical process gave rise to “eugenics”—the devastating social movement of the first half of the twentieth century that emerged in the wake of the rediscovery in 1905 of Bohemian monk and naturalist Gregor Mendel’s (1822–84) genetic discoveries.³ How society manipulated that knowledge to create a pseudo-science sanctioned by medicine and the law embodies cautionary lessons. The present volume, Psychiatry and the Legacies of Eugenics: Historical Studies of Alberta and Beyond, provides a critical analysis of the consequences that resulted when genetics, psychiatry, and deeply embedded societal biases and institutional self-interests converged. This approach contributes to a greater understanding of not only the historical complexity of the mechanisms that underlie eugenics but also the contemporary social issues that may arise from genetics. In the narrative process, the questions raised in the individual chapters and the continuous threads brought out in the introductory overview and conclusions by the editors are most timely. Eugenics is not a closed book of past history. It casts a long shadow over both science and society in the Western world and, in fact, also globally.

Historically, the eugenics movement found in the emerging science of classical Mendelian genetics supportive evidence for the utopian theory of the Victorian polymath Francis Galton (1822–1911) of improving society through “selective breeding” of “hereditary genius.”⁴ In the United States, however, under the influence of Charles Davenport (1866–1944), the first director of the Eugenics Record Office at Cold Spring Harbor, New York, positive eugenics became negative “dysgenics.” The emphasis shifted to prevention of the breeding of those perceived as genetically “defective.” These were not only the inmates of institutions and the physically disabled, but the socially and mentally inadequate, as well as the economically disadvantaged, consisting largely of women and children. Categorized by psychologists and psychiatrists as “unfit” or “degenerate,” ranked on the basis of intelligence quotient (IQ) tests,⁵ and diagnosed by neurologists and psychiatrists as “feeble-minded,” they were perceived as a parasitic burden on society and seen to pose a threat to the germ plasm (gene pool) as a whole.⁶ With heredity as the root cause, systematic control of reproduction through compulsory sterilization became a convenient solution to economic, social, moral, and behavioural problems, yet ignored their complexity.

An important aim of the studies assembled in this book is to draw attention to the key role of psychiatrists and clinical psychologists in the interests of spurious societal and institutional benefit. Historically, they provided the ranking, the labels, and the justification to influence the law as to who would be segregated in institutions, involuntarily sterilized, or prevented entry, in the case of immigrants from eastern and southern Europe. Although the primary focus here is on the application of eugenic ideals to the mental health systems and psychiatric institutions in western Canada, the treatment of the subject balances individual experiences, specific cases, and comprehensive critical analyses place eugenics within a broader context of international links. The studies highlight how German-speaking psychiatrists and neurologists during the Nazi period in Europe developed their eugenics programs based on preceding theories from Victorian Britain and methodologies from North America. The contributors to this edited collection demonstrate how the basic eugenics assumptions, arguments, and forms of implementation (e.g., stigmatizing labels, sexual segregation, compulsory sterilization) were continuous despite geographical, political, and cultural differences.

It is highly significant that geneticists, and even ardent progressive eugenicists like Henry J. Muller (1890–1976), despite their enthusiasm for its utopian ideal, had quickly identified the eugenic fallacy in attributing social behaviour, economic, class, and gender differences to inborn causes and heritability, to the exclusion of environmental influences (such as economic depression), as well as its dependence on the subjective, unreliable evidence of “pedigree charts.”⁷

The increasing criticisms of eugenics views by geneticists and biologists for lack of scientific evidence did not halt the tragic consequences of, first, legalized compulsory sterilization in North America and, then, the elimination of those deemed “unworthy of life” in the euthanasia program of Nazi Germany.⁸ What gave rise to bioethics as a discipline was the need to safeguard against such violations of individual rights, whether those of patients or of experimental subjects, in vulnerable segments of society. The editors did not limit contributions to the first half of the twentieth century, however; chapters cover the postwar period too, when eugenics was discredited and genetics separated itself from this precursor “pathological science.”⁹

This volume leaves no doubt that a view of eugenics as a purely historical phenomenon would miss the insights into its powerful legacy and minimize its fundamental relevance to current parallel problems. The potential danger is not the science of genomics, or gene editing on its own, any more than was the scientific introduction of Mendelian genetics into the fields of agriculture and biology. It is the possible resurgence of a form of “biological determinism,”¹⁰ a societal consensus whereby individuals are reduced to the sum of their genes alone, the complex connectome of genetics and environment is disregarded, and this reduction is extended to similarly account for differences in social groups or populations.¹¹ The focus here is on the relation of eugenics to psychiatry, what Stephen Jay Gould diagnosed in his book The Mismeasure of Man as the intrinsic problem: the “pervasive propensity in society” to “use numbers to rank people in a single series of worthiness, invariably to find that oppressed and disadvantaged groups—races, classes, sexes—are innately inferior and deserve their status.”¹²

In the encounter of genomic science and society, the most important safeguard is a critical account and detailed analysis of what occurred with eugenics. This book goes a long way toward bending the moral arc towards justice.¹³