Introduction

This volume examines an important historical problem, namely, how governments, progressive groups, and professional associations were co-opted by the ideologies and fashionable scientific claims of contemporary eugenicists. It links the troubled eugenics history in western Canada to further developments on the international stage and examines the manifold legacies of eugenics—for example, its inhumane diagnostic and treatment thrust in psychiatry and medicine, the widespread and enduring conceptual undertones in official legal texts and government policies, and the detrimental consequences for patients and asylum inmates, who had been forcefully sterilized or whose partnerships and marriages were prohibited by professional caregivers and sometimes even family members—through more recent movements for compensation by its victims in Canada and abroad. This book represents an important and essential endeavour that examines several related topics in the history of eugenics together with the history of mental health and psychiatric developments in an international format that allows for comparisons between detailed case studies from several Canadian provinces, US states, and European countries spanning the first half of the twentieth century. Methodologically, it represents a collection of international case studies on eugenics that in themselves consider the social discourses, government policies, and long-term consequences of eugenics, as well as its ensuing cultural influences and profound legacies. This book thereby aims at providing a historical and likewise critical analysis of eugenics in western Canada through the assembled detailed case studies. These allow for the comparison of scientific and social trends as well as an understanding of the variations in decision-making processes on both the governmental and professional level, and further cultural and discourse contextualization of such developments with similar processes in Germany, Europe, and the United States. The book also examines the ways in which eugenics discourses were themselves influenced by legal and political discussions, as well as scientific and media representations, and the eugenic and often racist effects on both official policy and prevailing social attitudes through a variety of policy and institutional case studies. These include examinations of, among others, sterilization, public health nursing, sexual and reproductive health, neuropsychiatric and medical research practices, police searches and legal trials, official compensation programs, and media representations in contemporary newspapers, broadcast speeches, and films. The historical case studies are followed by two comparative commentaries, from a community activism and a disability studies angle, and finally a contextualizing conclusion.

This volume is based largely on the papers presented and discussed at the first joint conference of the International Society for the History of the Neurosciences (ISHN) and Cheiron (the International Society for the Behavioural and Social Sciences).¹ This volume results from previous research pursued by a group of Canadian and international historians and interdisciplinary scholars assembled in the Living Archives on Eugenics in Western Canada, a Community-University Research Alliance initiative, which has been supported by the Social Sciences and Humanities Research Council of Canada.² The workshop at this conference was entitled “Eugenics and Psychiatry—Analyzing the Origin, Application, and Perception of Early Forced Sterilization Programs from a Medical History Viewpoint,” with Robert A. Wilson and Frank W. Stahnisch acting as the convenors. The workshop, held at the Banff Centre for the Arts in Banff, Alberta, brought together historians, philosophers, psychologists, sociologists, and disability scholars to discuss the knowledge basis and sociocultural background in the public mental health sector spanning from the late 1880s to the early 1970s.

In order to analyze this problem field in a more comprehensive fashion, scholars working on Canada’s eugenics situation, as well as its international counterparts, were invited to contribute to this volume to discuss the effect of brain psychiatry and developments in the neurological sciences within the socioeconomic contexts of the time.³ These contextualizing chapters round out the professional perspectives (from nurses and eugenics board members) and the disability studies and media analysis angles, as well as the consequences of coerced sterilization and experimentation, which had not been addressed or discussed at the conference workshop itself.

This book can thereby offer new insights through a decidedly comparative approach and through its focus on psychiatry and its role in the “eugenics movement.” The volume focuses primarily on the history of eugenics developments in western Canada as a whole, yet with a specific concentration on Alberta and its far-reaching forced sterilization program. Where applicable, chapters also include discussions of the sterilization program and legal context of the province of British Columbia as well as the indirect, medicine-, and public health–driven eugenics activities in Saskatchewan (see, for example, chapters 2, 3, and 5 and the conclusion). Chapter 5, for instance, entitled “Eugenics in Manitoba and the Sterilization Controversy of 1933,” offers intriguing insights on the differences between Manitoba and the rest of western Canada in terms of political, religious, social, and feminist discourses, thus providing an important comparative perspective. These historical developments are then related to their international contexts, particularly regarding the dimension of psychiatry, neuroscience, and medicine.

During the twentieth century, Canada participated in two devastating world wars and experienced the economic catastrophe of the Great Depression,⁴ which led to the introduction of controversial public health and psychiatric measures. This book seeks to cast new light on the practice of eugenics through the lenses of psychiatry and clinical neurology. It argues that these medical discourses contributed in important ways to the development and adoption of eugenics policies and practices for solving perceived societal problems associated with “nervous degeneration” and “bad genetic stock,” as becomes quite visible in chapter 7 (“The “Eugenics Paradox”: Core Beliefs of Progressivism versus Relics of Medical Traditionalism—The Example of Kurt Goldstein”).

The book’s focus is hence on the role of psychiatry in the eugenics movement; further, it argues that the relationship between eugenics and psychiatry more generally allows a multi-directional beginning to be made on raising and answering intricate questions. These include, for instance, the presentation of psychologists and psychiatrists in their research programs, publications, and academic lectures (see chapters 2 and 7), struggles with the social and political effects of “modernity” in public discourse (in chapter 6), and promulgation and defences of particular “degenerative views” in psychiatry that underpinned widespread cultural beliefs about “the age of nervousness”⁵ in Europe and in the United States (chapters 6, 7, and 8). About one-fourth of the patients in psychiatric hospitals during the 1920s and 1930s were patients with physical forms of illnesses,⁶ and nurses and psychiatrists alike sought to promote new epidemiological research and care models for “nervous degeneration” (such as alcoholism, feeble-mindedness, epilepsy, neurasthenia), including answers to these social conditions being phrased in decidedly eugenic language: patient segregation, marriage counselling, and early ideas about forced sterilization (see chapters 3, 4, and 5). Many prominent psychiatrists now began to focus on “nervous degeneration” as a rhetorical means by which to promote their own eugenics agendas, particularly within debates about the consequences of urbanization. Hence, they acted as scientific under-labourers and as a new breed of medical experts in an increasingly politicized health-care field.

Taken together the chapters highlight how contemporary psychiatric and neurological views influenced the forms in which eugenics discourses influenced social and health policy along with public attitudes (particularly visible in chapters 4 and 8).

The works comprising this volume thus raise questions as to the motives of provincial and national governments in Canada as well as overseas in introducing pieces of eugenics legislation and forced sterilizations, health counselling programs, and so on. In this respect, how different were the medical communities in other countries in their reception of eugenics views, and to what extent did the medical profession become active in influencing eugenics legislation in different jurisdictions? What factors prompted psychologists, psychiatrists, and other physicians to collaborate in mutual research programs for policy initiatives and political programs? What were the intrinsic conceptual assumptions that fostered the bioscientific and genetic approaches in psychiatry and mental health, followed by the brain psychiatry of leading figures such as German clinical researcher Emil Kraepelin (1856–1926), his North American pupils, and counterparts like Adolph Meyer (1866–1950)? In what ways was the Canadian health-care system, especially in the western provinces, affected by widened international discussions in the United States, Britain, and central and northern Europe?⁷

In particular, a substantial connection between the chapters concerning Alberta, western Canada, Germany, and other parts of Europe is revealed in the international eugenic, psychiatric, and anthropological trends in existence during the same period under investigation. Strong links can be seen between specific chapters, eliciting the interlinking of different themes and conceptual topics such as Victorian sensibilities and public mental health concerns; scientific ideologies as drivers of contemporary sterilization and counselling programs; the involvement of nurses, legal scholars, physicians, and superintendents in eugenic debates; public and media perceptions of eugenic principles and goals; the political, economic, and legal ambivalences between traditionalists and progressivists; and explicitly anti-modern attitudes and stances. The contributors’ antithetical reasoning vis-à-vis established scholarly norms and previous findings asserts a methodological approach that helps to bring out both similarities and comparative contrasts between North American, German, and European applications of eugenic thinking. The methodological approach used in this book makes visible the background of eugenics in German psychological science and psychiatry, particularly how eugenic programs were abetted by the conceptualizations of the brain and mental structure emerging in the historical period and intellectual milieu under consideration. Some of these models and theories promised and alluded to deeper understandings of psychological, intellectual, and cognitive factors in mental and public health. These theories however stood in a problematic context of racist ideologies and anthropological perspectives that focused primarily on the biological causes of degeneration in psychiatry and neurology, while neglecting the important social contexts at the time. With the breakthrough of Charles Darwin’s (1809–82) evolutionary concepts, many Victorians envisaged an active world of commerce and progress. The discourse of degeneration appeared to match up excellently with the contemporary thinking in Britain, and later other parts of Europe, of being at the cutting edge of an industrialized and affluent modern world. Nevertheless, by the end of the nineteenth century, evolutionary theories nurtured new fears of social, cultural, and racial decline and complete degeneration.⁸ Degeneration became an influential concept and well-entrenched trope for literary writers and philosophers as well. Derivative notions of degeneration, as in the fields of psychiatry and mental health, developed in line with other evolutionary ideas and became part of the astonishing imaginative resource that Darwin’s theory of the survival of the fittest had introduced.⁹

From this perspective, the book addresses an interdisciplinary readership of currently active psychiatrists, neuroscientists, mental health nurses, psychologists, and public health workers that will extend beyond the scholarly communities of historians, humanists, and mental health researchers. We are confident that this edited collection will interest a professional health-care and medical readership by offering new and complementary perspectives to the existing body of general literature on eugenics in North America.

CANADIAN EUGENICS

At the turn of the twentieth century, scientific and social discourses about eugenics, biological anthropology, and racial hygiene received increasing attention not only from psychiatrists, medical doctors, and social scientists but also from the general public.¹⁰ The early notions of eugenics had largely been developed and formed by the natural philosopher Francis Galton.¹¹ His views on the importance of the inheritance of biological, psychological, and sociological human traits greatly influenced British upper and middle classes, who by the end of the nineteenth century had begun to fear widespread societal degeneration. Low birth rates among the upper classes—and elevated rates among the lower classes—along with the considerable army casualties of the Boer Wars (1880–81; 1899–1902) and the poor health of the working class caused many British subjects to fear a “racial suicide” and thereby created a space for the eugenics movement to emerge.¹² Following Galton’s ideas, a considerable number of British eugenicists advocated for selective breeding by encouraging the “fit” to reproduce (positive eugenics) and limiting reproduction among the “unfit” (negative eugenics).¹³ This situation was not unique to Britain; eugenics began to spread in many parts of the Western world, including Canada. Eugenic programs worked to redefine human morality and social behaviours, as well as acceptable qualities of mental health and biological fitness.¹⁴ Concerns as to what would happen to society if the “unfit” were allowed to reproduce led to collective anxieties, which many Canadians of higher social standing shared. This concern was captured in a 1933 article by a prominent Manitoba physician, Byron M. Unkauf (1905–83), which helps to explain why so many middle-class Canadians eagerly accepted the “science” of eugenics: “Fifty years ago there were 64 mental defectives confined to institutions per 100,000 population, to-day there are 236. As a result . . . if the rate of increase of insanity continues for 75 years, half the population will be in asylums living off the other half.”¹⁵ This prospect also accounted for the fact that medical doctors and, particularly, alienists, psychiatrists, and neurologists were attracted to the specific answers that inheritance-oriented eugenic thought offered for problems of diagnosis and psychiatric treatment in medicine.¹⁶ The individual cases explored in this volume (see especially chapters 1 through 5) nevertheless present a rather common perception of eugenics as a late nineteenth- and early twentieth-century phenomenon.¹⁷

The widespread appeal of Social Darwinian political philosophies and the hereditary sciences in biology also led many regional governments in Canada and the United States to enact eugenics legislation, including sterilization laws, particularly in the first decades of the twentieth century.¹⁸ As is visible from the proceedings of the Select Standing Committee on Law Amendments, in the Canadian context, a large number of provincial governments voiced concerns over the effect of feeble-mindedness and mental deficiency on society.¹⁹ Often, these governments viewed individuals with inherited conditions as economic burdens. Owing to the economic downturn of the late 1920s and early 1930s, government officials were often quick to think that the cost of running mental institutions needed to be reduced. They frequently held that such individuals would threaten the health and well-being of the other residents of their provinces, an assumption based primarily on the Mental Hygiene surveys conducted in many Canadian provinces in the 1920s by the founder of the Canadian National Committee for Mental Hygiene (CNCMH), Dr. Clarence M. Hincks (1889–1966)—who, interestingly enough, had suffered from clinical depression himself.²⁰ These surveys, which had been commissioned by the provincial governments to assess the mental health status in the Canadian provinces, revealed that the extent of feeble-mindedness was high and that it was associated with many of the provinces’ prevailing social problems.²¹

While Canadian eugenics had originated in the late nineteenth century, similar to the United States it reached its peak in the 1920s and 1930s.²² The effects of the First World War, the Great Depression, and increasing immigration to Canada caused many middle-class Canadians to fear national degeneration, as such concerns about social degeneration had previously influenced British and American societies as well.²³ In the late nineteenth and early twentieth centuries, a significant number of new non-British immigrants settled in Canada. As historian Angus McLaren has previously shown, native-born Canadians were frightened not so much by the quantity of immigrants as by their biological and social “quality,” many having arrived from non–Anglo Saxon countries.²⁴ The influence of eugenic thought is likewise evident in Canadian immigration policies.²⁵ By 1900, such policies tended toward tighter immigration restrictions, and amendments to the Immigration Act following this period were laced with eugenic language.²⁶ With high numbers of immigrants entering Canada at this time, eugenicists believed that the country’s national character was under threat. High losses of life in the First World War similarly heightened fears of “race suicide” among middle-class Canadians. Many believed that the “best” men were losing their lives in the war, while the “unfit” remained at home and continued to reproduce.²⁷ The early years of the twentieth century also witnessed the ever-increasing power of the medical profession. In the years that followed, individuals such as Helen MacMurchy (1862–1953), a prominent women’s health activist, social reformer, and Toronto-trained physician, as well as Dr. Hincks, the aforementioned Ottawa mental health activist, greatly influenced public health reforms and eugenic policies in western Canada (see chapters 3, 4, and 5). Throughout the 1920s and early 1930s, fears of the unfit and feeble-minded had swept the country and many eugenicists, including MacMurchy and Hincks, called for sexual segregation and, eventually, the sterilization of the targeted populations.

By tracing this infamous history, the assembled contributions in this collection make a valuable research contribution to the ongoing scholarship about eugenics in the Canadian provinces. Historians and scholars such as Angus McLaren, Ian Dowbiggin, and Erika Dyck have previously given important overview accounts of the earlier development of eugenics, particularly in the western provinces.²⁸ With regard to the connection between the “old eugenics movement,” between the 1920s and the 1970s, and the new reproductive technologies in late twentieth-century medicine, one of the most influential works on eugenics in Canada remains Our Own Master Race: Eugenics in Canada 1885–1945.²⁹ In this book, McLaren explores the motives behind “race betterment” campaigns, supported by many Canadian social and medical eugenicists, and he shows that many prominent Canadians (including famous feminists, politicians, and social democrats, among others) had been fascinated by eugenic ideas. More recent studies have looked at the longevity of sterilization legislation in Alberta, arguing that by the time negative eugenics science had been discredited internationally, Alberta’s sterilization legislation had moved beyond the purview of the general public, allowing for the quiet continuation of such practices.³⁰ In recent years, McLaren and Dowbiggin have added new monographs on the foundations of reproductive health, including Dowbiggin’s The Sterilization Movement and Global Fertility in the Twentieth Century and McLaren’s Reproduction by Design: Sex, Robots, Trees, and Test-Tube Babies in Interwar Britain.³¹ The explanation of Alberta’s predominance in eugenics in Canada rests with the well-established scholarly arguments that eugenics was so robust as public policy in Alberta that it could counter the social and scientific decline elsewhere, thanks to immigration fears, an uninformed public, and a lack of broad knowledge about Nazi eugenics and the Holocaust, along with economic arguments.

Since McLaren’s landmark study, other works have emerged using archival resources such as institutional records and patient files to offer important insights into the living conditions within contemporary institutions. Jana Grekul’s article “Sterilization in Alberta, 1928 to 1972: Gender Matters,” for example, explores the gendered treatment that eventually led to the sterilization of many individuals, primarily women.³² Other scholars, such as nursing historian Geertje Boschma, are concerned with the relationship families had with mental institutions after their family members had been admitted.³³ In recent years, historians have also focused on the complex relationship between the Catholic church and eugenics in Canada.³⁴ For example, Sebastien Normandin’s “Eugenics, McGill and the Catholic Church in Montréal and Québec, 1890–1942” maps out the groups that supported eugenics—particularly academics—and those that did not, especially the Roman Catholic church.³⁵ Normandin shows that while French Catholics criticized eugenic means, such as sterilization and birth control, they did not object to the goal of encouraging the “fit” to reproduce. Normandin’s discussion of the Catholic response to eugenics shows that religious opinion was also, historically, an important driving force for the social support or rejection of eugenics programs in North America and elsewhere.³⁶

With respect to socially progressive political programs and thought in the western Canadian province of Saskatchewan, historians such as Alex Deighton have recently worked out that, in contrast to its neighbouring provinces to the west—Alberta and British Columbia—Saskatchewan never enacted laws that legitimized negative eugenics measures.³⁷ These scholars have shown that despite the fact that Saskatchewan never implemented a centralized eugenics program, there was still enthusiasm for eugenics in the province during the 1920s and 1930s. An absence of legislation does not mean that eugenics would not have been popular—quite the contrary with respect to laws and practices that regarded marriage counselling and segregation practices of people perceived as “mentally unfit.” In the early twentieth century, such eugenic ideas played out in provincial institutions, where individuals deemed “mentally defective” were segregated.³⁸ Protagonists advocated for the relocation of those seen to be mentally defective to the “Home for Defectives” in Regina or, later (after 1914), to Saskatchewan’s first mental hospital, in North Battleford, not too far west of Saskatoon. Shortly after the end of the First World War, in 1921, the province in fact started to institutionalize the “mentally defective” at a newly constructed mental hospital outside the city of Weyburn.³⁹ The period from the 1920s to the 1930s proved to be the high point of eugenic thinking in Saskatchewan, stirred and fostered by what was seen as the recent success of Alberta’s Sexual Sterilization Act in 1928.⁴⁰ The two provinces had close agricultural, economic, and human resource connections, so that not a few inhabitants of Saskatchewan came to argue that their province should develop similar sterilization legislation as well.⁴¹

Politically, in 1929, the Conservative and Progressive coalition Co-operative Government came into power and championed the project of eugenics in Saskatchewan. Partially driven by technocratic thinking, it sought a greater role for state politics in public health, psychiatry, and medicine-related topics. As part of the government’s social medical agenda, the topic of “the sterilization of mental defectives” was included among an array of public health measures, including plans for state health insurance and free consultative medical (poly)clinics.⁴² Eugenic ideology was successively employed by hospital administrators who associated “mental deficiency” and “feeble-mindedness” with a host of social problems including crime and alcoholism.⁴³

Throughout the 1930s, eugenics legislation was perceived as a serious public health–related option for dealing with increasing mental health problems, alcohol addiction, social deviance, and insufficient institutional hospital support for psychiatric patients in the province. A sterilization bill was first developed in 1930 and did in fact pass the early stages required to be made into law, with just one vote against the parliamentary motion. Shortly before this statute could be legally formalized, however, the government was abolished and replaced by the Co-operative Commonwealth Federation (CCF), which withdrew the eugenics bill—a move that has been attributed to rising religious Catholic opposition.⁴⁴ Yet, as in other Canadian provinces that instituted not centralized eugenics programs “from above” but rather individual projects “from below” (as Erna Kurbegović also argues in chapter 5), Saskatchewan followed through with eugenic activities and endeavours by using institutionalization, counselling, and sexual segregation measures. Also in 1930, the province passed the so-called Mental Defectives Act, which became effective on February 1, 1931.⁴⁵ It allowed inhabitants of Saskatchewan to name individuals to a Justice of the Peace, who was to evaluate if they should be sent to a provincial training school. However, such a training school was never built, and the “mental defectives” were sent to the Weyburn Mental Hospital instead.⁴⁶ This led to an almost exponential increase of the patient population and hence extended social pressure to conceptualize other eugenic measures and forms of medical counselling in a decentralized form throughout the province. This development was only aggravated three years later, when new prevention legislation was established that mandated that all men who intended to marry were to receive a physical and mental exam by psychiatrists or family physicians, in order to prohibit the marriage of “imbeciles” and “idiots.” Later legislation, established in 1936 under the CCF government, further constrained “mentally defective” individuals and the “mentally ill” from marrying. Catholics in Saskatchewan had opposed the province’s “top-down” eugenics legislation in 1930 as conflicting with their religious convictions, yet often enough they endorsed such eugenics measures “from below” as counselling, sexual segregation, and anti-marriage legislation.⁴⁷ By the late 1930s, however, support for eugenics had declined in the province, and with the election of the CCF under Tommy Douglas (1904–86) in 1944, the new government promoted greater care and training for those deemed mentally defective.⁴⁸ More recently, there has been a renewed focus on the history of sexual sterilization in Saskatchewan, and Canada broadly, as a result of revelations from Indigenous women who were coerced to undergo tubal ligations at Saskatoon Health Region hospitals between 2005 and 2010.⁴⁹

While the works of the above scholars offer instructive new insights into the history of eugenics, the “checkered history” of eugenics of western Canada still remains to be added to—an undertaking that this volume embarks on by drawing scholarly attention particularly to the place of psychiatry, public mental health, and eugenically motivated research in the brain sciences.⁵⁰ For this endeavour, it is also necessary to understand past medical, social, and political processes. In the history of intellectual culture, these exchanges have been characterized in the existing scholarship as forming part of the political and social climate of the 1920s.⁵¹ However, in revising the narrative of the quiet longevity of sterilization practices in Alberta after the Second World War, the particular medical and mental health implications of the eugenics movement still have to be mapped and explored. Together, the chapters assembled here detail the ways in which medical, social, political, and religious factors overlapped when shaping the eugenics movements in western Canada and beyond. In Alberta, for instance, the pro-eugenics United Farmers Association was elected to office in 1921, while, in contrast, liberal-progressives formed the Manitoba government in 1927 and were rather critical and disapproving of the eugenics-related policy decisions made farther west.⁵²

The rural province of Alberta particularly stood out from the Canadian context, with its enactment of the Sexual Sterilization Act of 1928.⁵³ Such eugenics legislation was rare in Canada in the 1920s, though a number of state governments south of the border had passed similar laws.⁵⁴ Alberta’s legislation was rather exemplary in terms of the sociopolitical and legal discussions taking place at that time in other Canadian provinces, such as Manitoba and Saskatchewan, as discussed above,⁵⁵ the exchanges with international experts (from the United States, Britain, and Germany), and its long-standing existence (forty-four years!). Since the inception of the eugenics sterilization program, the Department of Public Health in the province of Alberta was particularly interested in and closely monitored the progress of the eugenics sterilization program, especially in the main hospitals of Edmonton (University Hospital), Calgary (Calgary General Hospital), and Ponoka (Provincial Mental Hospital).⁵⁶ The provincial sterilization program was only revoked in 1972, by the government headed by Premier Peter Lougheed (1928–2012), following wider political, social, and legal protest that questioned the juridical and moral grounds of the prevailing laws.⁵⁷ In the time of its existence, the Sexual Sterilization Act led to the forced sterilization of at least 2,835 Albertans who were deemed “mentally defective” or “unfit.”⁵⁸ Within Alberta’s eugenics program, many of the men, women, and children subjected to such negative eugenics methods came from socially vulnerable populations, including psychiatric patients, asylum inmates, prisoners, and Indigenous people. It is striking to note that even among these groups more women than men were sterilized, and many who were sterilized had been unemployed.⁵⁹ From the vast dimensions of the eugenics program in the province of Alberta, it becomes obvious that the Sexual Sterilization Act changed the lives of many; indeed, it affected the social and psychological situation of a large number of victims well beyond its repeal in the early 1970s.

During a time when the great majority of provincial and state governments were either decommissioning or disregarding their sterilization laws—whether because of insufficient public finances, an increase in public scrutiny, or the discrediting of hereditary science (as Douglas Wahlsten describes in chapter 2)—Alberta’s expanding legislation appears to have been socially uncontested.⁶⁰ However, the study of eugenics in Canada has focused primarily on the political, social, and economic conditions that made eugenics laws possible (particularly in Alberta and British Columbia).⁶¹ Historians and scholars of eugenics have given several reasons as to why the forced measures were mostly given up in North American after 1945. First, eugenics policies became increasingly discredited in the postwar period because of their association with the murderous euthanasia programs that targeted psychiatric patients, handicapped individuals, and other “racially inferior” populations in Nazi Germany (see also chapter 8).⁶² Second, while Alberta took much longer to repeal its eugenics legislation, the support for such ideas had already declined in other Canadian provinces, such as Saskatchewan, by 1940.⁶³ Many Canadians stopped calling themselves eugenicists, even though eugenic thought did not disappear completely from their minds, and this is particularly so in medical fields such as psychiatry and clinically oriented human genetics.⁶⁴ Some of the chapters here, on the prevalence of eugenics in Canada in the postwar period, trace these developments. Third, the Eugenics Society of Canada that had formed in Ontario lost much of its financial support in the early 1940s and began to decline shortly after.⁶⁵ Family allowances were implemented in 1945, and the welfare state in Canada emerged shortly after the end of the Second World War.⁶⁶ The main purpose of such social welfare programs was twofold: to help families and to prevent another economic depression. Eugenicists opposed this type of state intervention because, supposedly, it benefitted those whom they deemed irresponsible, defective, and unfit.⁶⁷

Following these narratives, it is a main argument of this book that neuropsychiatrists’ concerns about pathologies and diseases—intrinsically linked to inheritable and genetic conditions—made these professionals and mental health administrators particularly prone to siding with the new science of eugenics in order to build their academic and social reputation. This book offers new insights based on its explicit focus on psychiatry and the field’s role in the eugenics movement especially in western Canada.

THE ISSUE OF PSYCHIATRY

In the early twentieth century, psychiatrists and doctors of nervous diseases were especially prone to accept the scientific and social offers of the eugenic tradition, first in Germany and the United States, then in Canada, and increasingly in other European countries.⁶⁸ Particularly influential in the emerging field of interdisciplinary psychiatry and neuroscience was Swiss-French psychiatrist Bénédict Augustin Morel (1809–73), whose Traité des dégénérescences physiques, intellectuelles et morales de l’espèce humaine et de ces causes qui produisent ces variétiés maladives (Treatise on degeneration) was fully dedicated to the social problems of the time, and Morel’s medical conceptualizations were taken up by many psychiatrists, alienists, and neurologists at the turn of the century.⁶⁹ Clinical psychiatrist Auguste Forel (1848–1931) and neuroanatomist and neurologist Constantin von Monakow (1853–1930) in Zurich, for example, integrated Morel’s approach and searched for morphological alterations in the human brain⁷⁰—an aspect of research that psychiatric epidemiologist and geneticist Ernst Ruedin (1874–1952) in Munich further prolonged into a thorough analysis of hereditary influences on mental health.⁷¹ These developments in psychiatry and mental health occurred in a profound cultural context of bourgeois fears about “nervous degeneration”—fears that were exacerbated after World War I when discourses about the “neurology of disaster” and brain psychiatry’s return to conditions of “nervousness,” “war neurotics,” psychiatric trauma, and hereditary disease loomed large in many Western countries.⁷² The cultural discourse of bourgeois fears led to an overall medicalization of the cultural discourse, as historian Joachim Radkau’s Das Zeitalter der Nervositaet (Age of nervousness) suggests.⁷³

The 1880s and 1890s can be seen as watershed years in the disciplinary formation of modern psychiatry and neurology, a period in which both fields were still seen as either belonging to one and the same discipline or as remaining parts of internal medicine.⁷⁴ As a number of medical and social historians point out, the cultural diagnosis of “growing nervousness” and “nervous degeneration” must be understood as a popular cultural leitmotif of the late nineteenth century.⁷⁵ Although this is now a fairly accepted view, it is valuable to note that “nervousness” was normally associated more with the mental health field. It therefore does not come as a surprise that Wilhelm Erb (1840–1929), one of the foremost neurologists, used the following terms to discuss the question:

There can be no doubt that the political, social and cultural circumstances, and anything else that may here be included, have an extraordinary influence on the human nervous system. Nervousness has indeed increased to an enormous degree. . . . Its causes can easily be found in the spirit of our day, in the modern way of life, in the progress and the sophistication of our culture, in the new creations of modern being, and indeed in social intercourse.⁷⁶

When Erb gave this academic lecture as the principal of the University of Heidelberg, he addressed the issue of “nervous degeneration” at the height of cultural restoration in the Wilhelminian Empire in Germany.⁷⁷ This is not surprising, although the audience listened to Professor Erb as the director of the Clinic for Internal Medicine and not as the kind of faculty member whom contemporaries had easily associated with the psychiatrists of their day. In his own scientific work, Erb (similar to Alois Alzheimer [1864–1915] in Germany and Forel in Switzerland at the same time)⁷⁸ had introduced a number of clinical signs and symptoms into medical diagnostics and psychosomatic medicine. Erb’s statement can thereby serve as an orientation through many of the contributions in this volume, which examine—from different biographical, institutional, and cultural perspectives—the material changes that contemporary psychiatric and neurological discourse associated with “nervous degeneration” and “bad genetic stock” brought about.⁷⁹ It must be noted, however, that this view reflected not only psychiatrists’ professional assumptions but also opinions, prevalent among middle- and upper-class populations on both sides of the Atlantic, that “cultural degeneration” had rapidly ensued.⁸⁰

A stronger concern for the individual body resulted in widespread medical reconfigurations, programs to sustain public health, and new cultural conceptions of psychiatric illness (often referred to as “inherited feeble-mindedness”).⁸¹ Irrespective of the somatic or psychic poles of this spectrum, the specific medical reconfigurations took place in a general framework of eugenic theorizing.⁸² Physicians concerned with the wider treatment of nervous diseases, as well as psychiatrists, were particularly likely to endorse the scientific ideas and social programs of the eugenic tradition that gained traction in Europe and in North America, so that when taking a closer look at psychiatry and neurology as new scientific disciplines toward the end of the nineteenth century, the “culturization” of medical discourses becomes more perceptible.

THE INTERNATIONAL EUGENICS MOVEMENT

Canadian and North American eugenics history can hardly be examined without taking the international trajectories of the modern eugenics movement into account. As noted above, this movement emerged at the turn of the nineteenth century, based largely on the anthropological work of Galton, who promoted “healthy living” and “social purity” through the implementation of both positive and negative eugenics practices.⁸³ The later nineteenth century witnessed the broad reception of Galton’s ideas regarding the heredity of human traits such as intelligence, feeble-mindedness, and criminality.⁸⁴ In 1910, in Cold Spring Harbor, New York, Charles B. Davenport (1866–1944) established the Eugenics Record Office (ERO), which soon became a major hub for biological and statistical research in eugenics for North America at large.⁸⁵ By 1917, fifteen US states had enacted sterilization laws; by 1937, that number was thirty-one.⁸⁶ Based on positivistic thinking and trust in hereditary science, as well as the social aspirations of the Progressive Era, the United States became the unrivalled international leader of the eugenics movement in the interwar period.⁸⁷

Although eugenics—as both a social and a scientific movement—had existed in Germany since 1905 (when the Munich Society for Racial Anthropology was formed with a deliberate eugenics mandate), and the politically changing governments of the Weimar Republic had applied eugenics-oriented policies to their health and social programs, it was only with the commencement of the Nazi period that Germany enacted racial and eugenics laws quantitatively and qualitatively more drastic than those in the United States.⁸⁸ On a national level, it was the Law for the Prevention of Offspring with Hereditary Diseases—passed in 1933—that permitted the sterilization of citizens all over Germany who were medically diagnosed as “feeble-minded,” “schizophrenic,” “epileptic,” or afflicted with other “incurable diseases.” These medical categorizations followed the theories of Freiburg psychiatrist Alfred Erich Hoche (1865–1943), as he had conceptualized them in 1920, shortly after the First World War.⁸⁹ The situation was exacerbated by the enactment in 1935 of the Nuremberg Race Laws, which detailed strict racial classifications—on the basis of previously accepted agricultural breeding protocols—and forbade both sexual and marital relations between Jewish and Aryan German citizens.⁹⁰

On many levels, Nazi Germany attempted to surpass the amount and breadth of American eugenics programs, by instituting the Division for Inheritance Statistics at the German Research Institute for Psychiatry (which assembled data on all Germans diagnosed with eugenically relevant psychiatric and neurological conditions), as well as multiple large-scale research programs at the Berlin Kaiser Wilhelm Institute for Anthropology and Human Genetics and the Kaiser Wilhelm Institute for Brain Research.⁹¹ Following a visit by eugenic scientists and legislators in Germany in 1934, the head of the American Eugenics Society, Leon Fradley Whitney (1894–1973), even described the eugenics initiatives in the United States as “something very like what Hitler has now made compulsory” and brought to widespread application.⁹²

The intensity of the transnational exchanges and collaboration was also visible within the community of contemporary psychiatrists and neurologists, as addressed by, for example, clinical psychiatrist Oswald Bumke (1877–1950). Bumke, trained at the Leipzig school of brain psychiatry, succeeded Kraepelin in the chair of psychiatry at the University of Munich in 1924. Bumke regarded it as the duty of any patient groups to guarantee their further existence through their own means, not to rely continuously on the support of nurses, wardens, or physicians. This claim had already been made before the First World War—as promoted by Bumke’s influential treatise Ueber Nervoese Entartung (On nervous degeneration)⁹³—but with the political conditions of the interwar period, it became much more widespread and accepted.⁹⁴ Right-wing and left-wing psychiatrists similarly focused on “nervous degeneration” as a rhetorical means to strengthen their individual claims as under-labourers of an increasingly politicized health-care field and emphasized the cost effectiveness of state-run mental health programs (see chapter 7).⁹⁵

These conceptual changes and discipline-building developments occurred in a period of increasing academic exchanges and international relations, especially between young North American medical doctors and European psychiatrists.⁹⁶ These exchanges significantly modified research and health-care landscapes on either side of the Atlantic.⁹⁷ Between the establishment of the German Research Institute for Psychiatry in 1917 and the declaration of war with the United States in 1941, nearly two hundred junior researchers and visiting professors from North America travelled to Munich to work in the institute’s laboratories and clinical wards.⁹⁸

A noteworthy protagonist deeply enmeshed in transatlantic relations was the Swiss-born psychiatrist Adolph Meyer, who already possessed well-established contacts with North American colleagues from an earlier research visit in 1891 and later became a full professor of psychiatry at Johns Hopkins University in Baltimore as well as a leading figure in US psychiatry.⁹⁹ Meyer represented a “central node” of the North American neuroscientific network and was an important mediator and referee to the Rockefeller Foundation as the major funding institution of biomedical research and public health before the Second World War.¹⁰⁰ His engagement and the Rockefeller Foundation’s subsequent decision-making processes essentially fostered a pre-existing and now tightening network of well-respected medical scientists between basic researchers, public health workers, and clinically active psychiatrists.¹⁰¹ Financial support from North America was considerable: from the 1920s onward, the Rockefeller Foundation was one of the first foreign institutions to react to the devastating effects of the war on German medical research and higher learning institutions.¹⁰² In fact, the advent and recovery of many major scientific endeavours in interwar Germany would be inconceivable without taking the American financial contributions into account.¹⁰³ Specifically, this support resulted in increased and sustained funding of the eugenics-related Kaiser Wilhelm Institute for Brain Research in Berlin-Buch, Kaiser Wilhelm Institute for Anthropology in Berlin-Dahlem, and the German Research Institute for Psychiatry in Munich.¹⁰⁴

BACK TO CANADA

McLaren argues that “mentally deficient” patients institutionalized in hospitals and psychiatric wards were often seen as an economic burden in Canada and North America as well—a sentiment that increased during the hardships of the Great Depression in the early 1930s.¹⁰⁵ Grekul shows that the future aims of the CNCMH included a campaign against “crime, prostitution, and unemployment,” conditions that the committee related to the social circumstances of the “feeble-minded” in Canadian society.¹⁰⁶ In fact, eugenic tendencies similar to those in Alberta, with its “top-down” legalistic approach, can also be seen in the neighbouring province of Saskatchewan and its psychiatric and mental health past. Individual chapters in this book refer to the localized and regional “bottom-up” approaches to eugenics in Saskatchewan in passing, yet the historical situation there was very different from those in Alberta, many American states, and European countries. No full-fledged “program of eugenics” existed in Saskatchewan after the withdrawal in 1930 of its proposed Mental Defectives Act.¹⁰⁷

While the ideas of the CNCMH influenced many Canadians, a watershed moment in the history of Canada’s eugenics movement occurred when Tommy Douglas, the future premier of Saskatchewan, admitted to the press that he had been “turned away from eugenics” following a trip to Germany in 1936.¹⁰⁸ Increasingly informed through newspaper reports and radio programs about the Nazi race laws and the resulting forced emigration to North America of tens of thousands of non-Aryan or politically oppositional individuals, Canadians became more and more suspicious about the racially grounded social and health programs in Nazi Germany.¹⁰⁹ Following the end of the Second World War, when the realities of patient euthanasia in asylums and hospitals and the atrocities in concentration camps became widely known, eugenics policies were increasingly discredited.¹¹⁰

However, despite the growing public knowledge in both the United States and Canada, which also challenged the scientific underpinnings of existent North American eugenics programs, Alberta’s sterilization program saw a second peak in numbers at the end of the 1940s.¹¹¹ One explanation for the anomaly of the Alberta eugenics program has been the observation that, immediately following the Second World War, a baby boom ensued and the overall population in western Canada began to surge.¹¹² The influx of patients into institutions such as the Provincial Training School in Red Deer—which became the primary “feeder institution” for the eugenics program from the 1950s onward—may have motivated the Alberta Eugenics Board (AEB) to increase the number of patients considered for sterilization.¹¹³ In fact, many similar complexities, local histories, and international exchanges of the Canadian and North American eugenics landscape have only begun to emerge and to be tackled in the scholarship.

INDIVIDUAL CONTRIBUTIONS TO THIS VOLUME

Reflecting several recent trends in the history of eugenics, psychiatry, and mental health as a whole, the chapters included in this volume reveal a continuing interest in the interrelationship of public health and psychiatric perspectives in the scholarship on Canadian and international eugenic developments. For example, these contributions show both the social and political appeal that the eugenics movement has had for psychiatrists, alienists, and neurologists, as well as other medical experts, in the first half of the twentieth century—in particular, when relating ready biological answers to complex and pressing social issues since the First World War, the Great Depression, and the emergence of Fascism and Nazism in central Europe. Of course, this can hardly be achieved without considering the philosophical and theoretical trends of the time—trends that extended between North America and Europe and gave rise to active and robust transatlantic eugenics networks—when comparing the scientific assumptions in contemporary genetics, anthropology, and psychology with the sociopolitical theories and aspirations. Most of the chapters in the first part of the book thereby deal with individual case examples of Canadian history, particularly in the western Prairie provinces.¹¹⁴ As a collection of international case studies on eugenics, this volume examines eugenics in western Canada through an international lens that considers the discourses, policies, and consequences of eugenics along with its legacies. The points drawn out in chapters 9 and 10, by the two commentators, relate these historical contributions largely to contemporary policy and human rights debates by drawing on more recent developments such as gene editing, experiments with the artificial womb, parenting by people with disabilities, and immigration legislation related to people with disabilities.

International networks and relationships within psychiatry and mental health in relation to eugenics movements are taken into account in the second part of the book (chapters 6 to 8), which places them in a wider cultural, political, and public health context. This volume thereby offers an authentic overview of the existing breadth and depth of current eugenics scholarship in Canada, the United States, and Europe, while adding to the closure of a research lacuna pertaining to the specific psychiatric and mental health implications of eugenics approaches in their legal, sociopolitical, and health-care settings between 1905 and 1972. Although focused specifically on the western Canadian context, it places the analysis in a wider international context, providing more general appeal to any reader with interests in eugenics, disability, scientific expertise, public authority, and the historical and current relationships between them.

In her foreword, Guel A. Russell focuses on the International Summit on Human Gene Editing held in Washington, DC, in 2015, which saw a scientific debate about the opportunities and ethical concerns around the clinical implementation of gene editing in human populations. As Russell importantly emphasizes, new methodological precision technologies in gene editing, such as CRISPR-Cas9 (Clustered Regularly Interspaced Short Palindromic Repeats), also offer essential “newgenics” opportunities for physical and mental trait selection, genetic repair, and enhancement choices on the horizon of human bioengineering. She places the research directions, historical case studies, and contemporary disability studies commentaries in this volume in a wider context of the critical analysis of “eugenics futures” and “newgenics tendencies,” in which similar social and progressivist tendencies of today meet with stunningly augmented biotechnological opportunities and prospects, thus causing prevalent bioethics concerns.

In his prologue, Robert A. Wilson—the former principal investigator of the multi-centre research group Living Archives on Eugenics in Western Canada—highlights a recent interest among philosophers, historians, disability activists, and other scholars in exploring the historical, political, and economic conditions of the Sexual Sterilization Act of Alberta (1928–72) and its implementation. Four themes have emerged as being of particular interest in this research endeavour: first, the analysis of recently accessible historical source material in Canada and elsewhere; second, the exploration of collective memories of eugenics that have entered into the collective consciousness of almost three generations of Canadians, Americans, and Europeans; third, the often neglected perspective of mental and physical disability in the self-acclaimed or externally designated eugenics experts of the prewar and postwar periods; and fourth, the implications that historical and philosophical developments still have today on matters of the social inclusion of different “sorts of people” in education, health, and general social participation in Western industrialized societies such as Canada. Such historical and philosophical developments still influence the so-called post-eugenics period, in which modern genetic diagnostic technologies, reproductive methodologies, and medically therapeutic approaches emerge and often perpetuate social clichés and pejorative views about mental illness and physical disability as socially “unwanted” or in need for medicalization. Related assumptions too often circulate around the idea that key eugenic practices are continuously conceptualized as forms of wrongful accusations, which helps to make sense of the functioning of those practices and their distinctive features. This may seem like a peculiar and indirect acceptance of eugenic practices, such as through the classification of people as “feeble-minded” or “morons” who were thereby rendered vulnerable to sterilization or criminalization.¹¹⁵ However, it could also appear as a very direct expression of what Anglo-Irish essayist Jonathan Swift (1667–1745) had in mind with “A Modest Proposal,” namely, an intellectual blueprint for eugenics to be taken seriously in its own right. According to Wilson, the scientific plausibility of eugenics was further enhanced by newspaper coverage in editorials and articles as well as contemporary radio programs. He further provides insights into the mechanisms through which both historical eugenic and recent “newgenic” practices have operated, both inside the minds of the individuals involved in those practices and through their group interactions.

In the introduction, Frank W. Stahnisch and Erna Kurbegović map and contextualize the relationship of eugenics to the field of psychiatry and mental health (see Appendix, table A2), while highlighting the specific Canadian and transatlantic perspectives under scrutiny. Western Canada is of special interest to the scholars assembled herein. The experience of two world wars and the Great Depression during the first half of the twentieth century exacerbated existing societal problems in Canada that related to minority populations, including the mentally ill and new immigrants. At the same time, this period also witnessed influential social reform movements related to medically oriented areas such as public health and psychiatry, one of which—eugenics—categorized abnormal populations from the normal ones and led to controversial public mental health measures (see Appendix). The book’s historiographical focus concerns eugenics in Canada and beyond from the late 1920s to the 1970s.

Henderikus J. Stam and Ashley Barlow in their chapter, “John M. MacEachran and Eugenics in Alberta: Victorian Sensibilities, Idealist Philosophy, and Detached Efficiency,” scrutinize the intentions and motives of the former head of the Department of Philosophy and Psychology at the University of Alberta. MacEachran was in fact the only Canadian academic psychologist who trained with the German doyen of experimental psychology, Wilhelm Wundt (1832–1920), in 1907 at the University of Leipzig. With the joint aim of improving society, as Stam and Barlow argue, it was not entirely surprising that both the new science of experimental psychology and the application of the latest findings in human genetics and inheritance became inextricably linked during their inceptions. The scientific and social eugenics movement frequently intersected, while contemporary psychologists became deeply involved in the eugenics movement at the beginning of the twentieth century.¹¹⁶ While focusing on the ideals of the so-called exact sciences, and their application to the new humanistic knowledge fields, the pioneers of experimental psychology and mental hygiene applied what they saw as a progressivist impulse to answer to the latest social problems, such as “social deprivation,” “alcoholism,” and “feeblemindedness.” Chapter 1 shows how, in their attempt to reform the social and health-care conditions in the province of Alberta, MacEachran and other members of the provincial eugenics board came to patronize the autonomy and self-interest of the forced-sterilized, violate their physical and mental integrity, and disregard their humanity. Stam and Barlow identify MacEachran’s psychology-psychiatry background as well as the academic and social world he inhabited, concluding that his training left him entirely ill-suited to the sort of work he infamously became known for.

As Stam and Barlow demonstrate, understanding the role that experimental psychology played with respect to eugenic thinking, legislation, and medical application requires in-depth consideration and analysis of the significance of the ideology of scientific progressivism, along with the connections between this ideology and mental health concerns. Indeed, sterilization was part of a general set of practices intended to alleviate mental and physical disease, social ills, and poverty in the early twentieth century. As other historians of eugenics have also noted in recent years, it is important that the history of sterilization practices be carefully delineated at the local level to prevent the erroneous assumption that there was a single historical event.¹¹⁷ Stam and Barlow’s contribution explores particularly problematic details of eugenics history in western Canada and factors that influenced the fusion between scientific psychology and applications of forced sterilization programs.

In chapter 2, entitled “The Consequences of Eugenic Sterilization in Alberta,” Douglas Wahlsten describes in detail how the genetic science of eugenics—even at the time of its emergence, in the late nineteenth century—was known to be inaccurate and did not support the bold biological and social claims of eugenicists around Charles Davenport in the United States and elsewhere. Historically, various international eugenic programs since the 1910s set out to reduce the frequency of some well-defined disorders of the nervous system, as caused by an assumed defect in their germ plasm inherited from the parents; these eugenicists claimed to have found good scientific principles in the 1920s and 1930s that could explain such defects in the general population. Yet even at the beginning of the twentieth century it was clear to physicians and biologists that the more severe defects are generally very rare. Whether such a program should be voluntary and implemented through education and counselling or forcible by edict of the government was a question of ethics and politics at the time, however, and not one of biological science.¹¹⁸ Many other important human traits such as intelligence, personality, and emotions were known scientifically to be highly complex and could not be traced to simple pathways of inheritance. Chapter 2 concludes that the AEB had no understanding of the science of genetics and, further, that most real geneticists had long abandoned eugenics as a legitimate field by the 1930s at the latest. On the other hand, there appeared to be plenty of evidence supporting environmental factors in the development of traits like intelligence, which makes for an intriguing and interesting scholarly contrast.

Early in the twentieth century, eugenic programs emerged internationally that were intended to alter physical and mental defects in the population, their scientific and genetic principles based on selective breeding that improved strains of farm animals. These principles were well known and publicly accepted by the 1930s and 1940s and were widely taught in agricultural colleges until the 1950s. However, even though critical scientific discussions about the fundamentals and the (limited) breadth of genetic understanding in agricultural science were prevalent at the time, there is no evidence that the AEB was ever aware of these discussions or even cared about such scientific principles. Rather, the practices of the AEB appear to have been based only on social prejudice, not on genuine genetic knowledge. The board members’ scientific or medical “expertise” was evidently determined by allegiance to a pseudo-scientific creed—one that allowed the government of the time and the eugenics movement at large to deny the fundamental humanity of their victims, who suffered not only from loss of their sexual reproductive rights and violation of their self-identity and private sphere, but also from inflicted physical and mental harm (see Appendix, table A3). Human rights were disregarded and the forced sterilization methods often had severe health consequences—such as major hemorrhaging, infections, and scarring—beyond the annihilation of the reproductive rights and choices among the victims. As such, without doubt, the eugenics activities turned out to also be crimes under contemporary Canadian law.

The participation of the nursing community in Canadian eugenics initiatives is one example of the strong role played by a specific professional group in the pursuit and application of both positive and negative eugenics measures among the mentally ill and physically handicapped at the time. In chapter 3, “The Involvement of Nurses in the Eugenics Program in Alberta, 1920–1940,” Diana Mansell investigates the first decades of the twentieth century as years in which the Canadian government actively recruited immigrants from Britain, Europe, and the United States in order to support the settlements in the newly founded provinces of western Canada.¹¹⁹ As McLaren and other scholars have shown, the resulting immigration movement included fairly large numbers of non-English-speaking individuals arriving from eastern European countries. With increasing numbers of eastern European immigrants arriving (from the Ukraine, Russia, and Poland), the white Anglo-Saxon classes in Canada became increasingly concerned about what they saw as a process of the “multiplication of inferior populations.”¹²⁰

As is well known from the literature and further expanded upon by Mansell, the newly founded province of Alberta saw a ready solution in the enactment of its Sexual Sterilization Act, which remained in existence until 1972. The act was supported by many prominent first-wave feminists, such as Nellie McClung (1873–1951) and Emily Murphy (1868–1933), who argued that it would be harmful to those targeted by this act to be subjected to the rigours of parenthood, as well as harmful to their offspring, and that these “idiots” were a burden to society at large.¹²¹ Nurses too supported Alberta’s new eugenics program and the philosophical ideology behind sterilization, yet their role in promoting eugenics in the western Canadian provinces has not been studied very extensively. Chapter 3 explores their contribution to mental health nursing and the promotion of birth control measures in an overtly eugenics context. The involvement of public health nurses is taken into account here, since much of their work was directed at the health and psychiatric surveillance in the integration process of new immigrants to Canada. The period between the 1920s and the 1940s represents a time in nursing history when nurses’ duty to care was increasingly influenced by the attitudes and values of those societies in which they worked, so that these cannot be artificially separated from the health-care and research perspectives undertaken in the medical and health-care fields.

Chapter 4, titled “The Alberta Eugenics Movement and the 1937 Amendment to the Sexual Sterilization Act,” by Mikkel Dack, introduces another important Alberta development that attracted national and international attention. The scholarly study of eugenics legislation in Alberta has appeared rather over-focused on matters regarding the province’s original Sexual Sterilization Act, passed in March 1928, along with the political, social, and economic conditions of the 1920s. Although the 1928 act was of great significance, being the first sterilization law passed in Canada, it was its 1937 amendment and the allowance of involuntary sterilization measures that made Alberta’s eugenics movement truly distinct both in Canada and in comparison to many American state laws. His chapter intriguingly shows that at a time when many other regional governments were revising their sterilization laws and regulations, Alberta still expanded its own legislation. Although similar laws were met with fierce opposition in other provinces and states, this new amendment of 1937 remained virtually unopposed in Alberta. As a result of such limitations in research, historical explanations have often proved to be exaggerated, inaccurate, and misleading. By dismissing the preconceived notions and arguments of the past, as Dack argues, we lose and important intellectual residue from which to derive important insights, critical depths, and bases for comparisons when dealing with more recent forms of eugenics in social and criminal law, reproductive medicine, and biomedical experimentation in Canada and beyond.

Erna Kurbegović, in chapter 5, “Eugenics in Manitoba and the Sterilization Controversy of 1933,” provides an insightful counterpoint to the scholarly discussion of the existent eugenics programs in Alberta and British Columbia. The debate in Manitoba focused on the sterilization clause within the Mental Deficiency Act of 1933. The clause called for sterilization of those deemed to be “mentally defective,” if the provincial psychiatrists deemed it necessary and the patient provided consent (see Appendix). Based on the often superficial understanding of human genetics at the time, many in the medical profession presumed that “mental deficiency” was hereditary and thus would be passed on to future generations if the respective individuals were allowed to reproduce. A profound debate occurred not only within the Manitoba legislature between designated career politicians but also within communities across the province. Clearly, as Kurbegović shows, there was much opposition to the bill in this province, primarily from Roman Catholics. However, a significant amount of support also emanated from within the province’s medical profession. In mid-1933 the Mental Deficiency Act passed but without the controversial sterilization section, which was defeated by one vote. Chapter 5 provides an analysis of the debate in Manitoba by investigating both sides of the political controversy in order to understand how different segments of society viewed eugenics and sexual sterilization during the interwar period. Kurbegović’s findings pertaining to Manitoba can be seen as a fruitful countering foil that allows the political eugenics developments in other western Canadian provinces, particularly Alberta and British Columbia, to be placed in a more adequate historical perspective.

Chapter 6, by Celeste Tường Vy Sharpe, entitled “ ‘New Fashioned with Respect to the Human Race’: American Eugenics in the Media at the Turn of the Twentieth Century,” analyzes the public and media construction of the notion of a better race for human beings in early twentieth-century North America. Ever since the term “eugenics” entered the realm of public discourse in 1883 with Francis Galton’s publication—defined as “the science which deals with all influences that improve the inborn qualities of a race; also with those that develop them to the utmost advantage”—it had intrigued not only medical doctors, psychiatrists, and scientific experts but also politicians, social reformers, and activists, as well as Western societies at large.¹²² At the turn of the twentieth century, the United States grappled with social pressures resulting from two decades of intense industrialization and urbanization.¹²³ Subsequently, eugenics achieved its greatest level of success and support in the 1920s and 1930s, following the establishment of the ERO in 1910 and the 1927 Supreme Court decision in Buck v. Bell, which upheld the constitutionality of forced sterilization vis-à-vis patients’ claims against physicians and their institutions. Also, increased fear of the fecundity of immigrants created a panic about “race suicide.” In the convergence of competing ideologies and global pressures, eugenics emerged in the United States as a proposed solution to the perceived ills of society. Chapter 6 analyzes how eugenics was discussed in US print media between 1900 and 1909 and how this discourse thereby reflected social values and perceptions. Newspaper articles consistently blended established nineteenth-century conceptions of scientists as vessels of progress, racial hierarchies, and marriage with messages that emphasized the collective over the individual and, more significantly, the need to reform society through scientific means. These frameworks sought to present eugenics in an ideologically familiar manner to gain public support for sterilization programs and legislation.

In chapter 7, Frank W. Stahnisch addresses the issue of social progressivism as a philosophical and democratic ideal among many eugenics experts in the interwar period and the stark contrast with the denigrating theoretical and anthropological assumptions as well as demeaning medical actions that contemporary nerve doctors and psychiatrists took with their involvement in the eugenics programs of the time. His example is the German-American neurologist Kurt Goldstein (1878–1965), regarded by many as an impressive interdisciplinary scholar who made numerous and lasting contributions to the fields of clinical neurology, brain psychiatry, experimental psychology, medical rehabilitation, and philosophical anthropology. Goldstein tried to combine the analytical approach of classical neurology with a holistic theory of brain function while likewise integrating the insights of contemporary “Gestalt theory” into psychology. In the clinical departments that he chaired at the Universities of Frankfurt am Main and Berlin in Germany, Goldstein not only educated medical students and residents in basic brain research and neuropathology but also trained them in broader psychoanalytic and clinicopathological approaches that emphasized the distinct need for a more humanistic attitude among future medical doctors.¹²⁴

Rarely, however, has the fact been explored that Goldstein also ardently embraced eugenicist and racial-anthropological ideals—ideals that may be found in his concise 1913 book On Eugenics (Ueber Rassenhygiene). In this early work, Goldstein discusses, for example, the interdependencies of structural brain anomalies that have clinical neurological symptoms. With respect to this publication, the argumentation becomes somewhat interwoven with elements from the “degeneration” and “exhaustion” discourse that display major cultural characters of Weimar medicine and science. Among some of his other claims, Goldstein stated that “the relationship of hereditary conditions” does not point at specific characteristics but aspires to ameliorate the human race by eliminating unfit individuals. With similar biologistic formal rhetoric, Goldstein sided with many ardent contemporary racial anthropologists. In particular, his language invokes that of the psychiatrist Alfred Erich Hoche (1865–1943), who later—and along with Heidelberg law professor Karl Binding (1841–1920)—coined the disturbing term “life not worth living.” In fact, On Eugenics was published out of Hoche’s psychiatric department in the medical faculty of the University of Freiburg, where Goldstein had served as a clinical research associate. Though Stahnisch does not intend to exempt Goldstein from his early views on eugenics, he emphasizes the latter’s social progressivist inclinations that motivated his eugenic theorizing in the 1910s, by combining these assumptions with relics of traditionalism in medicine. This “paradox of eugenics” has haunted many social progressivists of that period. Many of these individualists shared eugenics ideals; however, individuals such as Goldstein—after his emigration to America—and Tommy Douglas, the respected Canadian health-care politician, eventually discarded them. Nevertheless, several psychiatrists and biomedical researchers carried the promotion of eugenics forward in time, such as the Swiss-German psychiatrist Ruedin, while thus laying the basis for the inhumane health care system in the National Socialist period in Germany. In considering Goldstein’s On Eugenics in its wider social and cultural contexts, chapter 7 untangles some philosophical trends and eugenics convictions that emerged from the context of modernity and its many antagonisms.¹²⁵

In chapter 8, “Too Little, Too Late: Compensation for Victims of Coerced Sterilization,” Paul Weindling—a long-standing international specialist on eugenics and medical interventions in human subjects—takes the important transatlantic dimension of knowledge exchanges in the eugenics and medico-psychiatric fields masterfully into account. Whereas European sterilization has been seen as a direct transfer of North American (notably Californian) sterilization programs in the later 1920s, this chapter outlines a far more complex and diverse forms of sterilization policies. Weindling emphasizes the dynamic interplay of state welfare and mental health policies, politics, religion, and public attitudes, which determined both the forms that sterilization took and (a matter of further complexity) its incidence. The chapter accordingly examines the following forms of sterilization: segregation of mental defectives in the United Kingdom; legislation at a provincial level, notably in Vaud, Switzerland; “voluntary” legislation at a national level from Denmark (1929) onward, notably in Scandinavia; professional sterilization, with the examples of Finland and German-speaking Swiss cantons; coercive sterilization in Nazi Germany on a legislative basis; X-ray sterilization, notably in the Nazi concentration camp of Auschwitz; sterilization on the recommendation of professionals and guardians, such as in Canada and in the United States; and vasectomy for personal contraception later in the postwar period.

These various types of sterilization policies had a complex take-up, with an uneven incidence over time and place and a changing pattern of rationales and target groups in such contexts as Nazi Germany and Scandinavia. After the Second World War, sterilization presented complex problems of legality, particularly in Germany under its Allied occupation and in Austria. Moreover, a range of issues surrounds the demand for, practice of, and denial of re-fertilization, as well as the compensation procedures for sterilization victims. This dense and exhaustive contribution highlights the immense diversity of the incidence of sterilization within Europe, particularly when neglected contexts such as Switzerland and eastern Europe are figured in. It also points to possible North American as well as specifically Canadian comparisons and links as relevant to the early twentieth-century discourse of eugenics and psychiatry. Finally, this chapter on compensation, along with the first of the two commentaries, connects the historical studies herein with more recent discussions regarding disability and human rights.

This collection involves several intriguing themes about the wider relationship of eugenics, psychiatry, and mental health, which are connected by distinctly Canadian and transatlantic perspectives. The consequences and legacy of the eugenics movement are taken up in a commentary section at the end of the book, which links the historical insights with current issues such as “ableism” and “dis-ableism” and “newgenics,” thus demonstrating the value of a deeper historical understanding in present-day debates. Furthermore, the two commentaries emphasize the interdisciplinary and transnational ambitions of this volume. In Commentary One (chapter 9), Marc Workman looks at the disability rights movement in Canada and considers the ways in which the beliefs that motivated eugenicists continue to influence the treatment of people with disabilities. In particular, he explores the issues of immigration and disability and parenting with disability from a disability rights perspective. Workman’s interpretation is that the disability rights movement in Canada has brought about significant legal protections for people with disabilities. However, despite these major legislative victories, Canadians with disabilities still face greater challenges from a socioeconomic perspective than do their non-disabled counterparts. The chapters in this book describe a number of violations of the rights of people with disabilities: compulsory sterilization, scientific experimentation, institutionalization, and euthanasia. Based on these insights, Workman points out that in Canada the most deplorable of these actions took place primarily before the emergence of the disability rights movement in the 1970s. His commentary not only highlights the importance of collective action for those living with disabilities; it also illuminates some of the attitudes about disability that were behind past eugenic initiatives and that persist today.

In Commentary Two (chapter 10), Gregor Wolbring goes one step further in unearthing the philosophical constructions that lay at the centre of the eugenics discourse since its beginnings. In particular, he analyzes the language used, pointing out that the categories of “mentally/physically unfit,” “feeble-minded,” “morons,” and so on were always construed from an angle of binary opposition that contrasted the “unable” with the “able” and the “abnormal” with the “normal,” similar to the analysis of French philosopher and historian of medicine George Canguilhelm (1904–95) in his well-known book On the Normal and the Pathological.¹²⁶ Wolbring interprets the recent concept of “ableism” in contrast to the socially pejorative and medicalizing concepts of the eugenics discourse in psychiatry and mental hygiene since the beginning of the last century. By commenting on the historical examples presented in this volume, he reveals that the uses of “ableism” and “dis-ableism” are and have been limited in both content and scope. Ableism values certain abilities, which leads to dis-ableism, or discrimination against the “less able.” Ableism often confuses the valuing of or obsession with ability with the term “dis-ableism.” However, besides confusing ableism with dis-ableism, speaking about ableism only in connection with the so-called “disabled people” or the “handicapped” is also problematic, as these chapters show from psychiatric, mental health and nursing care, scientific and legal, and public media and policy perspectives.

In their concluding chapter, Stahnisch and Kurbegović emphasize the ways in which the history of eugenics can help us to understand ongoing debates over control of social participation and reproductive rights in modern industrialized societies. The historical eugenics perspective can lead us to question new technological practices, especially those that screen for the “abnormal” development of a fetus, thus giving parents the technical option of abortion rather than fostering a societal debate about support of the “dis-abled” or differently “en-abled” in our modern societies, as Wilson and Wolbring argue.¹²⁷ Lastly, technological advances allow individuals in modern societies to be selective; for example, in vitro fertilization provides the option to choose the “best” embryos and discard the “unfit.” Therefore, the history of eugenics remains important because it offers insights into current scientific research and medical ethics as well as recent reproductive policies and practices. This volume provides an excellent perspective on bridging historical analysis in the first section, in which chapters 1 to 5 focus mainly on issues in western Canada, while chapters 6 through 8 provide valuable case studies from Europe and the United States, thus introducing transatlantic and transnational perspectives into considerations of contemporary policy and human rights issues. Individually, the chapters are significant in several fields and can be seen as important contributions in various different areas. The editors, Stahnisch and Kurbegović, anticipate that the book will be of particular interest to researchers and teachers in the fields of the histories of eugenics, public mental health, medicine, nursing, and psychiatry. Yet it can also be a productive read for scholars and workers in disability studies, human rights, medical ethics, legal and compensation studies, and public affairs, particularly in Canada. The two commentaries, together with the introduction and conclusion, build a bridge toward open and urgent issues of our time when dealing with disability, the future prospects of the new genetics field, and their wider social and public interest and response.