Canada has made a lot of progress in LGBT rights, with full marriage rights, and it made that progress a lot faster than the USA did. We’re still behind the curve compared to our friendly neighbors up north. Indeed, Canada has made many contributions, along with other western nations, to the field of psychology. Psychology is an important field of study when considering sexuality and what is “normal” or “abnormal.” Unfortunately, a psychological contribution may not always be made in the best interests of the patients that psychologists have dedicated themselves to helping, and Canada was not spared from such abuses. Although Canada was hardly unique among the world’s nations for doing so (I should point out that many countries, not just Canada or the USA, were guilty), in 1928 the province of Alberta enacted legislation to provide for the sterilization of thousands of mentally disabled Canadians. This had profound consequences for the field of genetics but more importantly also contributed to psychology’s continuing questions of where the line between ethical and unethical treatment is drawn, and how it is crossed.
Throughout recorded history, humanity has attempted to alter the gene pool to root out “undesirable” characteristics including psychological disorders. Although psychology has evolved relatively recently in human history, the practice of eugenics has gone back to ancient times. The ancient Spartans for example checked newborn infants for physical defects and killed those that were defective in any way to ensure that only the best children lived. It was perhaps inevitable that once genetics was found to play a role in psychological disturbances that attempts to eliminate such disturbances via sterilization of the mentally ill would emerge. The most heinous example of this took place during the same time period that Alberta was enforcing its policies of sterilization, namely in Nazi Germany. Adolf Hitler’s desire to keep German bloodlines “pure” went much further than simply exterminating Jews who would “contaminate” German bloodlines. The physically and mentally handicapped were also sterilized and/or exterminated in the concentration camps. Although homosexuality is no longer considered a psychological disorder by the major psychological organizations, homosexuals were considered mentally ill and also viciously persecuted under the Nazi regime for similar official reasons. The USA and Canada would adopt a relatively humane approach, at least compared to the Nazi approach, by sterilizing mentally defective individuals under anesthesia in hospitals. The Nazis felt no such ethical obligation to provide anesthesia or pain killers. Thus the Canadian sterilization program was not inherently unique, although it would highlight several problems that psychologists would have to confront, including what constituted a “mental disturbance” and the ethics of such a program.
There was fairly widespread support in the Canadian psychiatric and medical communities for mandatory sterilizations. Despite some opposition by psychologists and medical doctors, the Sexual Sterilization Act of Alberta was passed on March 21st, 1928. An Alberta Eugenics Board was established to regulate sterilization. Psychiatric institutions and hospitals had to first receive permission from this board before sterilizing patients. The inherent problem was the definition of who was eligible for sterilization. In 1937, the original act was changed so that “mentally defective” patients that the Eugenics Board wanted to sterilize could no longer object. In 1942 it was again changed to allow for those with epilepsy, Huntington’s disease and other similar conditions to be sterilized.
The criterion for someone who was “mentally defective” was problematic by today’s standards. The case of Leilani Muir, who awarded almost a million dollars in 1996 in a successful lawsuit against the Alberta provincial government, illustrates the gross abuses that such a program invited. Ms. Muir was classified as insane for only one apparent reason. She flunked an intelligence test given to her when she was a young child after being abandoned by her mother. She passed the same test again once she was older, but one failure was all it took for her to be marked for sterilization. She was sterilized without being asked or told when she was 14, with her doctors claiming it was an appendectomy. This was only one of many abuses. Despite the fact that doctors knew that boys with Down’s syndrome were sterile by 1940, the Eugenics Board still had at least 15 such boys sterilized between 1953 and 1971 (Cairney 1996). By 1946 over 2000 Albertans had been sterilized. The psychological criteria for a mental illness have been an ongoing issue in the field of psychology, and Canada’s sterilization program brought about more questions as to what constitutes a “disorder.” A journal article written by American doctors at the time noted that the program in Alberta based some of its decisions for who would be sterilized on psychological profiles that included “bad family history…immorality, illegitimacy, delinquency, dependence…” (Baragar 1935). The same article noted one sterilized patient who had an extremely bad family history but otherwise appeared quite normal. It noted that about 60% of sterilized patients had a symptom “indicating a hereditary trait.” They never defined what these symptoms were or how they came to the conclusion that these traits were hereditary. What about the other 40% who did not have such symptoms? Unfortunately, these American doctors also concluded that the program was necessary and proper. Their conclusion was symptomatic of a larger problem in the medical and psychological community at the time, which was a lack of precise definitions for mental illnesses. It was never exactly defined what constituted “immorality,” “bad family history” or “delinquency” in the eyes of the Alberta Eugenics Board. Today most mainstream psychologists would understand that none of these three “symptoms” are necessarily indicative of mental illness, and are highly subjective words when used to describe a patient. Psychology has continued to wrestle with the question of what is “normal” or “abnormal” thinking or behavior, and this program demonstrated the ethical consequences of failing to adequately define various behaviors appropriately and in an unbiased manner. For example, although western society tends to frown upon prostitution, being a prostitute does not mean that one is mentally ill or inherently “abnormal.” It may not be morally right, but that doesn’t make it a disease. The assumption was that the mentally ill would usually be more likely to engage in such behaviors. The same principle was applied to Albertan children in Canada. IQ tests and “interviews” were given to schoolchildren to test their intelligence and their “moral values.” The result found by psychologists was that a lower intelligence score was linked to lower “moral values.” Today we would question the definition of “moral values” and indeed Canada later modified IQ and other psychiatric tests due to its recognition of the inherent bias in previous ones. The issue of informed consent was also problematic, since mental patients without anyone to defend them, such as a relative or a sympathetic psychologist, had no choice if marked for sterilization. And as seen in the case of Muir, patients were not always even told that they were going to be sterilized.
Bias was a particular problem with the Eugenics Board. Disproportionate numbers of candidates for sterilization were unmarried women, Eastern European immigrants and other minorities. This also raises the question of whether or not sterilization was conducted to benefit society or as an expression of society’s prejudices, or perhaps both.
Canada finally repealed the Sexual Sterilization Act in 1972 and dismantled the Alberta Eugenics Board in response to a push for greater civil liberties by a new Canadian government. The Eugenics Board had ultimately been responsible for over 2800 sterilizations. Canada’s failed experiment with the sterilization of psychologically disordered people showed the failure of psychologists at the time to confront mental problems by treating the problem, rather than by trying to prevent it from happening to a future generation. It also showed societal biases at the time regarding what constituted a mental disorder by linking illicit and/or socially unacceptable activities or conditions (i.e. prostitution, learning disabilities, etc.) exclusively to mental disease, providing a convenient rationale that as sterilization increased, such unacceptable behaviors/conditions would decrease. The “evidence” for such assertions was deeply flawed by today’s scientific standards, not to mention current-day understandings of what constitutes “deviant” behavior.
We should remember that a lot of the controversey over what is “normal” or “abnormal” spilled over into the debate regarding homosexuality in the 1970s, when the American Psychiatric Association removed it from its list of mental disorders (the Diagnostic and Statistical Manual, or DSM). To a certain extent, this is still a cause of controversey, since the American religious right typically claims that the decision was pure politics (more on that in another post), but that’s beside the point right now. Hopefully, we’re a little more enlightened now and recognize the need to not only be clear about how we define what is mentally healthy and what is not, but also the need to be humane in finding ways to help those who suffer from true mental disorders. We must also remember the potential consequences of failing to resolve these issues appropriately.
BIBLIOGRAPHY
Baragar, C. A., et. al. (1935, January). Sexual sterilization: Four years experience in Alberta. American Journal of Psychiatry, 91, 897-923.
Cairney, R. (1996). Democracy was never intended for degenerates: Alberta’s flirtation with eugenics comes back to haunt it. Canadian Medical Association Journal, 155(6), 789-792.
Christian, T. J., (1973). The Mentally Ill and Human Rights in Alberta: A Study of the Alberta Sexual Sterilization Act. University of Alberta.
Dowbiggin, I., (1997). Keeping America Sane. Ithaca: Cornell University Press.
Grekul, J. M., (2002). The Social Construction of the Feebleminded Threat: Implementation of the Sexual Sterilization Act in Alberta 1929-1972. University of Alberta.
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