Abstract

PIP: Eugenic sterilization is defined as sterilization of a person who is either mentally ill or mentally defective and will either severely handicap any future offspring through heredity or is unable to properly care for a child. When an institutionalized mentally disordered person of reproductive age reaches a stage when he is able to return to the community, 3 possibilities arise: 1) eugenic surgical sterilization; 2) eugenic institutional sterilization, where the patient is effectively sterilized by being kept in the institution; and 3) discharge without eugenic sterilization. 3 cases of patients discharged without sterilization are presented. A review of the law of eugenic surgical sterilization reveals that 22 states have laws that permit compulsory eugenic sterilization without patient consent. Even though a state does not specifically authorize eugenic sterilization, it does not mean that such a procedure cannot be done legally. However, fewer and fewer eugenic sterilizations are being performed. Decisions relating to sterilization more often are made by medical men than by judges. Medically, the Committee of the American Neurological Association for the Investigation of Eugenical Sterilization, in a report made 25 years ago, condemned on both medical and philosophical grounds widespread eugenic surgical sterilizations except in certain cases. Morally, the author believes that patients and physicians are incapable of acting as moral beings in dealing with the question of eugenic sterilization because of 1) lack of proper facilities to allow freedom of choice, and 2) lack of knowledge of available relevant facts. With respect to the 3 alternatives for dealing with mental patients who are capable of reproducing, the author asks: Is it morally just to sterilize a person without first offering adequate treatment, rehabilitation, and follow-up that a well-equipped institution could offer? Is it just to incarcerate a patient without offering the personnel and facilities for proper custodial and therapeutic care? Is it proper to discharge a person without sterilization without offering rehabilitation and follow-up that might lead to a better life? A study comparing the way the problem of sterilization is being handled in states with different approaches to the subject is proposed.