- We have over the course of this semester
and last semester, put on a series
of speakers who have been talking about
various groups in society who,
from the point of view of
a large number of people,
who are not necessarily correct,
but look at these people
as being different,
and because they look at
them as being different,
they were treated differently.
The speaker we have today
is someone exceptional.
I never met him until
about 20 minutes ago,
but when Susan said, you
know, let me give you
some notes about who he is, I said:
I wish I was a student at his college,
because so many of the
courses that he teaches,
I say I'd really like to take.
So let me tell you a little
bit about our speaker today.
Dr. Christian Perring is a
professor at Dowling College.
He has been there since
1998, and has been chair
of the department of
philosophy and religious study
for all but three of
his years at the school.
Now, listen to this: he
teaches a wide variety
of courses covering philosophy,
(unintelligible) ethics,
criminal justice, the culture of madness,
sometimes I think we live
in a culture of madness,
ethics and values in
science, marvel theory,
the philosophy of sex and love,
law education, psychiatry and psychology.
Wow, he is committed to
making philosophy accessible
to a wider group of people,
spelling out how philosophical
ideas are part of the
fabric of everyday life.
Dr. Perring runs a metapsychology
online review website,
and is on the editorial board
of Philosophers' Magazine.
We're delighted to have
you here, professor.
- Thank you very much.
It's an honor to be here.
And I'm very grateful for the invitation.
Thanks to Susan and The
Holocaust Center for that.
So my topic is the Mentall Ill
People as Unfit for Society.
Really, my area of discussion
is gonna be broader
than just the mentally ill.
I'm gonna be talking generally
about the history of eugenics
so I'll be focusing on the mentally ill,
but what I'm gonna be
talking about will apply
to quite a lot of other areas, too.
Generally to areas in disability.
So I'm gonna be talking
about, this is my outline,
I'm gonna be talking about
the history of eugenics.
And then kind of current
and future problems
in our society regarding
mental illness and disability,
and how, the relationship
between how things are now
and the issues that were
faced around the beginning
of the 20th century, up
until the Second World War.
I'm going to, to give,
ah, I don't like to just
kind of leave the, my take
home message until the end.
So my take home message
is going to be, basically,
that the issues facing,
kind of describing people
as unfit or describing
some lives as more worthy
or less worthy than others are issues
that are persisting today.
So that, ah,
while the history of
eugenics and the history
of the Holocaust was truly horrible,
and something we want to avoid,
it's not as if we can simply do away
with making those sorts
of value judgments,
and that's something we
have to do very carefully
and keeping in mind the history
that we're faced with in the 20th century.
So, I want to give you
some sort of background.
Let me ask you this: how
many of you are familiar
with the term "eugenics"?
Alright, so it's a new
term for most of you.
Eugenics is the science,
the supposed science,
of improving a race or improving a people.
And this was very much
based on the theories
of Charles Darwin.
So, Charles Darwin gave
a descriptive theory
where he was describing how, ah,
species and mankind
evolved over the hundreds
of thousands and even millions of years,
from the dawn of our planet.
So that was a descriptive theory,
and it didn't have, in itself,
any particular implications
for how we should live now.
So, again, that scientific theory
is meant to be value neutral.
But it had a profound
influence on thinking
in the late 19th century
and early 20th century.
And in particular, one
of Darwin's followers,
Francis Galton, took up his views
and applied it to how society should be.
Galton, he was mainly in the 19th century.
He was born in 1822.
And he was a scientist, a mathematician,
a very kind of learned
and scholarly person,
but he's mainly remembered
these days for his creation
of the science of eugenics.
He was English, as was
Darwin, and so he created
the term eugenics in 1883.
Now, he was in favor of positive eugenics.
So the basic idea of eugenics is that,
if you have in a society a
variety of different kinds
of people, some of them
are going to be better
for society than others.
And the idea of eugenics
is that you want to promote
those people in society
who are kind of valuable,
and you want to have less of
those who are not valuable.
And so the idea was that
this was a scientific theory,
and that you could do away
with old forms of prejudice
and you could base your
value judgments on science.
Now, there's a distinction
between positive eugenics
and negative eugenics.
Positive eugenics is
basically trying to encourage
those who are valuable to
society to have as many offspring
as possible, and to try
and increase their portion
of the population.
And while negative eugenics
is trying to stop people
who are considered bad for
society from reproducing.
And in fact, to a, in extreme forms,
you wouldn't just stop
them from reproducing,
you would kill them, right?
That's the most extreme
form of negative eugenics.
So Galton himself was not very much
in favor of negative
eugenics, but he was in favor
of trying to encourage
those in society who were
most valuable to have as
many offspring as possible.
So this, Galton's ideas
were very influential.
And eugenics soon became
an international movement.
It was popular both in the
United States and Canada,
and all over western and northern Europe.
And it also spread to
other parts of the world.
You can find eugenics movements in Russia,
in South America, and it was also used
by a lot of colonial countries,
the UK, England had
colonies all over the world,
and it exported its eugenic ideas
to a lot of the rest of the world.
The eugenics movement as a
scientific idea was very, ah,
it fit very well with other worries
that people had around that time.
And certainly in the USA and
in some other countries too,
there was extreme worries
about immigration.
If you know about the history of the USA,
there were very severe, ah,
holds in the, the demands
put on immigrants,
and there was a lot of
worry about who was coming
into the USA, and so that fit in
with ideas about racial purity.
So, eugenics grew from its
birth in the late 19th century,
and grew stronger and stronger,
up until World War Two.
And it's important to
know that it was embraced
not only by people who we
would see on the right wing,
but also it was embraced in countries
we also see as socialist,
so it was quite strong
in Sweden, for instance.
We think of Sweden as a socialist country,
kind of very committed
to equality in some ways,
but it was the idea of
having unity and, ah,
kind of the purity was very,
was very appealing to them.
One of the, I'm going to
give you some of the main
people who were involved
in eugenics in the USA,
and then I'll be moving
to eugenics in Europe.
So, this is not gonna be a
complete history, by any means,
but it gives you at least
some flavor of how important
eugenics was in the USA,
about 100 years ago.
So David Starr Jordan,
he lived up until 1931.
He was an influential man.
He was President of Stanford University
for over 20 years, and he
was also chancellor there.
And I mentioned the idea that eugenics
went across the political spectrum.
David Starr Jackson was a pacifist.
So he was by no means a war-monger,
but he believed very strongly
in the idea of eugenics.
He was the president of the
National Education Association.
So one of his quotes was:
no community was ever built
up of thieves and imbeciles.
And he also, he published
a great many books.
One of his most notable is
The Blood of the Nation,
a Study in the Decay of Races
by the Survival of the Unfit.
Now, Jordan was very
influential in creating
one of the important parts
of eugenics in the USA,
which was the Committee on
Eugenics, formed in 1909.
It was created by the American
Breeders' Association.
And you think: well,
that's to do with farming.
But this is very much to do
with the human population.
And this Committee on Eugenics
had some of the, kind of,
most important people in
America on that committee.
The secretary was Charles
Benedict Davenport.
He was from Harvard.
And other members of the
committee were Alexander
Graham Bell, so that, that
name should be familiar to you.
Can anybody tell me who
Alexander Graham Bell was?
(muttering)
He invented the telephone,
right; a very important man.
Vernon Kellogg was
associated with Kelloggs,
a very successful food company.
And other people on the
committee were Adolf Meyer,
who was one of the main
psychiatrists in the USA,
associated with, he was at Johns Hopkins.
So, this Committee on
Eugenics had some of the most
kind of powerful and
important people in America.
They created the Eugenics Record Office,
which is here on Long Island.
It's at Cold Spring
Harbor, and the creation
of the Eugenics Record Office was funded
by the Harriman family.
I think they made their
money from the railroad,
and one of the richest
families in New York.
There was the Rockefeller family
and the Carnegie Foundation.
So these are some of the most powerful
and well-known names in the USA,
and they created the
Eugenics Record Office.
And the basic premise of
the Eugenics Record Office
was from this quotation here:
society must protect itself
as it claims the right
to deprive the murderer of his life,
so also it may annihilate
the hideous serpent
of hopelessly vicious protoplasm.
So the basic idea of eugenics
is that there are some
people in society who are not
welcome, who we don't like,
and we want to try and get rid of them.
And this was, there's a close association
between this and the Long
Island Biological Society.
These are some pictures of
the Eugenics Record Office.
One of the main names from
the Eugenics Record Office
was HH Laughlin, a well-known person.
He had a PhD in biology from Princeton.
And under his, ah,
leadership, the office
conveyed an estimate
that about 10 percent of the
USA population were unfit.
And Laughlin himself advocated
for compulsory sterilization.
Now, his ideas weren't widely,
well, weren't completely
accepted and prominent
organizations disagreed with him.
So there was the American Bar
Association, for instance,
was against it.
But certainly there was
a very active movement
for sterilization in the United States.
So in the late 19th
century, there was, ah,
sterilization was used as a cure.
I think some of their ideas
seem very curious to us now.
So some people thought
that women's mental illness
could be cured by removing the ovaries.
It's hard to see how
removing someone's ovaries
would help their mental
health, but that was,
I think it was associated
with the idea of hysteria
and a kind of wandering uterus.
And it was, I mean, some of their ideas,
although it was the scientific age,
they seem very bizarre to us.
There was also a great deal
of worry about masturbation
in the late 19th century
and early 20th century,
and they thought the idea
was that masturbation
led to insanity.
And there was kind of, there
was also castration of men
was used as a cure for insanity.
One of the kind of central
ideas and why this was related
to eugenics was the belief
that mental illness,
and especially severe mental
illness, was hereditary.
One prominent psychiatrist
argued that drunkenness,
insanity and criminal traits were passed
from parent to child.
And there was, so that
was one of the reasons why
it was thought that sexual
criminals should be castrated.
So it wasn't necessarily
just as a punishment,
but also the idea that
sexual criminals should
not have children, because
their offspring would be
more likely to be sexual
criminals themselves.
So, sterilization became
a popular movement in the United States.
To give you one example of Kansas,
in the, ah, way back in
1898, one psychiatrist,
Dr. Hoyt Pitcher, who
worked at the Institution
for Feeble-Minded Children,
got permission to castrate 58 boys.
And by the 1910s, sterilization
had become common.
Strangely, it wasn't actually
legalized until 1913.
So they did a lot of castration and, ah,
sterilization before it was even legal.
The estimate, there is an
estimate that, up until,
and this went on until the 1950s,
it's estimated that Kansas
sterilized about 2,800 patients.
Now, including nearly 800
who were classified as feeble-minded.
So, that's a dramatic number of people.
In Indiana, Indiana was
well-known as leading the, ah,
charge for having
compulsory sterilization.
It was advocated by Harry Clay Sharpe,
who argued that: no confirmed criminal
or other degenerate ever
begot a normal child.
Right, so there was the thought
that if you were a criminal
then you were likely to
have criminal children.
Or at least abnormal children.
So in 1907, Indiana passed
compulsory sterilization laws.
And many other states followed.
By the mid 1930s, 30
states in the United States
had compulsory sterilization laws,
including New York in 1912,
and New Jersey in 1911.
And by 1942, there'd been
roughly 38,000 sterilizations
performed in the United States.
Which is a dramatic number.
They were, and certainly
this was not uncontroversial.
Many people had opposition to this,
and this was fought in the courts.
There was a test case with
the state of Virginia.
Some states disapproved of sterilization,
and they struck it down.
Virginia approved it in 1925,
and there was a test case
of Carrie Buck.
She was classified as being
epileptic and feeble-minded.
She, I think she'd had one child,
and Virginia wanted to sterilize her.
And so it went to the Supreme Court.
Laughlin, who you saw before, was a leader
of the Eugenics Office, and said:
these people belong to
the shiftless, ignorant,
and worthless class of
anti-social whites of the south.
And the United States Supreme Court
approved of sterilization in 1927.
Justice Oliver Wendell Holmes Junior, ah,
wrote the decision, and
he compared the sacrifice
of women's fertility
to the sacrifice of men
who gave their lives in
the Second World War.
And he thought this is
certainly justified.
He said: it's better for
all the world if instead
of waiting to execute
degenerate offspring for crime,
or to let them starve
for their imbecility,
society can prevent those
who are manifestly unfit
from continuing their kind.
The principle that sustains
compulsory vaccination,
broad enough to cover
cutting the fallopian tubes.
Three generations of imbeciles,
the claim was Carrie Buck
was the third generation
of imbeciles, he says:
three generations of imbeciles are enough.
So that's the history of
eugenics in the United States.
And eugenics, certainly the
United States was, in some ways,
the country which led the
compulsory sterilization,
and the United States was
actually very influential
on policy in Germany.
But certainly, once, ah,
the Nazis took power in Germany,
things kind of accelerated rapidly.
And eugenics was spread
with anti-Semitism,
and combined with anti-Semitism
to ultimately lead
to the Holocaust.
But it's important to note
then that Germany was not
alone in its views, that
eugenics was a popular movement,
both in the United
States and across Europe.
So some of the history of
the, kind of, what led to
the Final Solution will be
somewhat familiar to you.
I wanted to give you at least
just some of the history here
for completeness, so
some of the markers were
the creation of the
Nuremberg Laws in 1935.
Notice 1935 is a long time
after a lot of these changes
were happening in the United States.
There you see the United States
Supreme Court case was 1927
so this is, ah, eight years after that.
And then they passed the
Law for the Protection
of German Blood and Honor,
and the Citizenship Law,
both of which were limits on marriage.
And there was a Marital Health Law,
the Law for the Protection
of the Genetic Heath
of the German People,
which required a marriage
certificate for people so they
could prevent racial damage.
And they were looking for a
history of feeble-mindedness,
epilepsy, venereal disease,
or other what they called:
racially contagious diseases.
And it was around this
time that the Romas, ah,
the German people began to
also focus on the Romas,
who they would sometimes call the Gypsies.
So there was this focus on
the idea of Aryan blood.
So, sterilization in Germany
became, started around 1933.
And there was forced
sterilization of disabled people,
blacks or Afro-Germans, and the Roma.
And it was done under the
Law for the Prevention
of Genetically Diseased Offspring.
Under the idea that you
wanted to keep the race good
and pure, and so they
wanted to avoid diseases
like schizophrenia, manic
depression, epilepsy,
and then but also blindness, deafness,
when these were hereditary,
and even extreme alcoholism.
They also believed that
criminality, as in the USA,
they believed that
criminality was hereditary.
And so there was a move to
sterilize habitual criminals.
So there was a Law on Measures
of Security and Reform,
which wanted to place people
who were called "asocial",
we might call them anti-social
now, in mental hospitals.
And as in the USA,
there was a move to
castrate sexual deviants.
So these policies were
put in place in Germany
from 1933 up to 1945,
and the estimates are
that something like 400,000
Germans were sterilized.
And the peak of that
was from 1934 to 1937.
The bulk of people who
were sterilized were people
who were classified as having a low IQ,
or what was known as being feeble-minded.
But the other groups of
people who were sterilized
were people with schizophrenia, epilepsy,
or severe alcoholism.
There was an appeals process,
but the appeals process
was very unlikely to be successful.
So if you were, if it was decided you were
going to be sterilized, you could appeal.
But you didn't have
much chance of success.
Now, in Germany, the move
went from being sterilization,
moving to euthanasia.
And so, ah, whenever we talk
about euthanasia in Germany,
around this time, we used to
think about it in scare quotes.
I mean, generally the idea of
euthanasia is mercy killing.
And in some ways, I think
many of us will approve
of some kinds of mercy killing.
I think certainly any
of us who've had pets
who've been suffering, we
believe in mercy killing of pets.
And they, you know, there
are controversial cases
in medical ethics these
days with people who, ah,
whose lives look very
grim, and they want to die,
and we can, there's an active debate about
whether euthanasia is permissible
in those sorts of cases.
But the kind of euthanasia
that was being considered
in Germany was maybe
better called: murder.
Right, but the idea was
that it was killing,
the justification was
that it was killing people
for their own good.
And the idea for euthanasia
was, at least one
of the main architects of
it was Dr. Alfred Ploetz,
who was a major scientist in Germany,
and an international scientist.
He met, at various international meetings,
with the leading US scientists.
He argued that you needed
euthanasia to strengthen
the degenerative racial stock.
You needed to go get the bad
stock out of the German race.
He formed the Journal for
Racial and Social Biology,
and he created the Society
for Racial Hygiene.
And so, there was, ah,
back then, back in 1904,
there wasn't active murder,
but there was a willingness
to let people who were
considered unfit die.
So during World War One,
which is a very kind of, oh,
there was great poverty in
Germany around that time,
one of their decisions in
Germany was to let the inmates
of their mental institutions
die of malnutrition.
So it was thought that it
was better to send the food
to the soldiers, rather than
give it to the mental patients.
So you might see that
as a kind of euthanasia.
And there was, the basic
idea coming from around 1920
was some people had unnecessary lives.
The leading members of
the legal profession
and the psychiatric
profession, Karl Binding
and Alfred Hoche,
advocated for euthanasia.
And they argued that some
people were incurable idiots
and brain-damaged human vegetables.
And so these, they thought
that they'd be better off dead.
And combined with this
was, both in the USA
and in the rest of Europe,
there was a massive growth
in the population of mental institutions.
And so there was a sense of crisis,
that they needed to do
something to reduce the numbers.
In 1932, Berthold Kihn
argued that there was a, ah,
you needed to have an eugenic solution
to these sorts of problems,
and here you have pictured,
pictured is Gerhard
Wagner, who was the head
of the German Physician's League.
And he said that: a
society who put the sick,
the dying and the unfit
on a par with the healthy
and the strong was dangerous.
So there was this move to, a
kind of move to euthanasia.
What's gonna really, you
know, I think the point
I wanna drive home is
that it wasn't just people
who were at the kind
of political extremes.
These were the scientific
leaders of Germany,
and a lot of people in the
rest of the international
community were very much
onboard with these ideas.
The first active, kind of,
major move in euthanasia
was the euthanizing children.
So it started off with
children who were three years
and younger, and who had Down
Syndrome or were diagnosed
as being idiots, as a
technical term; so-called.
Or who were diagnosed with microcephaly,
hydrocephalus, and had
deformities, missing arms or legs,
or who were paralyzed.
So the move to kind of
achieve racial purity
started with those children,
and it was rapidly,
it rapidly expanded.
So it started off with
children who were three years
or younger, but by 1941,
it included all children
with any disability; they were
candidates for euthanasia.
And this program led to probably around
more than 5,000 children being killed.
And this is expanded to adult euthanasia.
Hitler approved for doctors
to conduct euthanasia
on people with incurable
sickness in a letter in 1939,
and he, there was a general
requirement for all doctors
to report adults who had
serious mental problems,
who had epilepsy, or who had a low IQ.
Also, people with incurable
physical illnesses.
This was known as the T-4 Program.
And it led to the murder or
the "euthanasia", so-called,
of at least 70,000 disabled
adults, between 1939 and 1941.
And the developing of this
technology for killing
was one of the things that was then used,
that technology was then
used in concentration camps.
For the mass murder of Jews.
So, I think it's not often understood
that kind of the Final
Solution was very much led
with the idea of killing
people or getting rid of people
who were considered unfit in
terms of their mental health,
and their disabilities.
And that was like the
scientific rationale for, ah,
the Final Solution.
And it was popular with a
lot of different scientists.
Okay.
Alright, so now I wanna move
to kind of the current, ah,
situation, as I promised
to do, because as I said
at the start, one of my
main arguments is that,
the reaction, we might
wanna say: well now,
we've passed the Second
World War and we no longer
make those sorts of judgments,
we don't judge people to be unfit.
And what I want to say
is we are still trying
to make those judgments and working out
how to decide who should
live and who should die.
Now, psychiatry has existed in
some ways since ancient times
and has been considered a
science since about 1879.
Psychiatry has always been
kind of a contested area,
with many different sorts of theories,
many different approaches,
and the problems of psychiatry
have in the 20th century
been the increasing number
of people diagnosed with
severe mental illnesses
and working out how to deal with them.
And the major mental illnesses
that psychiatry deals with
are conditions, not necessarily
given those names then,
but now we call schizophrenia,
bipolar disorder,
and major depression.
Now one of the major theorists
of psychiatry was German.
He was born in 1856, Emil Kraepelin.
And died in 1926.
Kraepelin is still
considered a very important
psychiatric theorist, and as a theorist,
he's not simplistic; he has
quite a sophisticated view.
But certainly what he's best known for
is his emphasis on the
idea that mental illness
is an organic brain
disease, and that it needs
to be seen as such and treated as such.
And certainly that idea
has been a major part
of contemporary thought, and these days
mental illnesses are often described,
many mental illnesses are
described as brain diseases
or brain disorders, and
certainly Kraepelin's influence
was very important in
starting that line of thought.
As I've said, the care of
the mentally ill in the USA
has been a major issue.
So, asylums grew and the number of asylums
and the number of people
in asylums grew rapidly.
So for example, in 1865,
the New York legislature
authorized a building
in Willard, near Utica,
1,500 bed hospital.
And in 1890, the State Care
Act led to state responsibility
for the mentally ill, so
that was one of the reasons
why the worries about
mental illness transferred
from families to the state.
And this, one of the best-known
and one of the biggest
state hospitals, state mental
hospitals, is on Long Island.
You may have driven past it at some point
if you've ever been out in Long Island.
It's Pilgrim State Hospital,
which started in 1929.
It had 100 patients,
within a year it had over 2,000 patients.
By 1954, its population
grew to 13,000 patients.
So, it was by no means
the only mental hospital
on Long Island; there were several others.
King's Park is another, a
well-known mental hospital.
So the population of people diagnosed
with severe mental illnesses
was growing rapidly,
up to the 1950s.
And certainly psychiatry
has, and I haven't got time
to rehearse all of the
kind of issues to do with
psychiatry now, but
there's been a long history
of mistreatment of patients in asylums.
There's been lots of worries
about the cost of patients,
and there have been various
scandals to do with, ah,
how mentally ill people have been treated.
One of the other issues
is: how do you actually get
good doctors to practice psychiatry?
Psychiatry has long been one
of the low-prestige routes
for doctors to go in.
It's generally gonna be
much more profitable,
and people are gonna get paid better
and they're gonna have more prestige
if they go into other areas of medicine,
as opposed to psychiatry.
Alright.
So how have things changed, ah,
in the modern world from
the time of eugenics?
Well, we don't use the
word eugenics anymore.
Certainly it's very,
kind of, nobody is gonna
call themselves a eugenicist.
We don't use the phrase: the unfit.
And in fact, psychiatry, if you look
at the diagnostic manual in psychiatry,
called the DSM, The Diagnostic
and Statistical Manual,
there is no category for insanity.
People don't use madness or
insanity or words like that.
And we also don't use words
like idiot or feeble-minded.
Now we are, so there's
been a change in language.
So it's slightly ironic, one
of the changes in language
that was proposed
through the 20th century,
to cover people who
were regarded as idiots
or the feeble-minded was: moron.
Now, moron was not very
successful as a new term.
It soon became associated,
had the same negative
connotations as idiot or retarded.
And in more recently,
there's the idea of people
who are special, or special education.
And my sense is that some of the problems
that occurred with the term moron,
are now occurring with the term: special.
To call somebody special
is not necessarily
to give the a compliment now,
in a context of saying they
have cognitive deficits.
So it tends to be that our
language to describe people
who are regarded as having a low IQ
or having cognitive deficits
is constantly changing,
so we can try and avoid the stigma
that's associated with that.
Certainly euthanasia
and letting people die
has become a major
issue in medical ethics,
as I was discussing before.
So one of the big debates
in modern medicine
is the use of physician-assisted suicide.
And physician-assisted suicide
is not legal in New York,
and it's not legal in most
states in the United States,
but it is legal in Oregon
and Washington State.
And you know, there are
fairly strict controls
about who can request suicide.
Certainly in the United States,
you have to be diagnosed
with a terminal illness to
be able to request suicide.
And it has to be your choice.
It's not a matter of
somebody else deciding
that you should not
live; it's your choice.
But still, the ultimate
decision that somebody is making
is that their life is
no longer worth living.
And so they, so it goes back to the issues
that were kind of discussed
around the beginning
of the century, like: which
lives are not worth living?
There's also been cases
of when we can withdraw
life-saving treatment from people.
And one very famous case, ah, what was it?
From the 1990s, was Terri Schiavo,
who's pictured at the top there.
And there was a disagreement
between family members about
whether she should continue
to receive treatment or not,
and there was evidence, some evidence,
that she would have preferred
not to have treatment.
But that was disputed.
You know, she was from a fairly
strong Roman Catholic family
and her family said that she
would have wanted treatment.
Very recently there's
the case of Jahi McMath.
You may have seen it in the news.
She's a 13 year old girl who
doctors say is brain dead.
And her mother says she's simply sleeping.
And so her mother wants to
have the treatment continued.
The doctors in the
hospital said they did not
want to continue treating
her, because they felt like
it was waste of resources.
Jahi is still being treated,
but at least according
to some medical ethicists,
she's no longer,
although her heart is
beating through the use
of machines and she's receiving, ah,
sustenance through tubes,
she could be declared dead
if her parents would allow it.
So those are kind of, they're
very controversial cases
going on right now about, you
know, who should be allowed
to live and who should be allowed to die.
Certainly there's the
issues of genetics are, ah,
very powerful and very important,
and modern technology
is growing all the time.
One of the main treatments
that's used these days
is in-vitro fertilization.
And it's quite a common thing these days
for couples who have a
difficult time getting pregnant
to use in-vitro fertilization.
One of the things that
in-vitro fertilization allows
is the genetic testing of fertilized eggs,
before implantation in the woman.
So the eggs are fertilized in the lab,
and then they're tested,
and then it's decided
which ones to implant into the woman.
And that means that
parents, or other people,
can decide which sorts
of traits should continue
to exist, and which should not.
Generally the idea, this
is based on the idea
that you, we don't want
to continue what we see
as serious genetic diseases.
Things, conditions such as Down Syndrome.
But it seems like the
future holds the possibility
that we will have
predictions for other traits,
such as height and at
least some people believe
that we will be able to
predict sexual preference.
And so it'll be the option
for parents to decide
whether they want to have a
straight child or a gay child.
And so there will be a question then:
what will that mean for the
random diversity of people
that we have now, if
parents start being able
to control what kind
of children they have?
Another technology
which is growing greatly
is germline gene therapy.
And germline gene therapy
means that any changes
you make to genes of one
person would also get passed
to their children.
So although we don't use the
word eugenics these days,
in some ways similar
decisions are being made.
We're still looking at questions about:
which lives do we want to continue,
what kinds of conditions
do we want to continue,
which ones do we say should not exist?
So most prospective parents would say
they don't want to have a
child with Down Syndrome,
with spina bifida, or
with fetal lung maturity.
And of parents who, of women
who have an amniocentesis,
and they find that the fetus
is carrying Down Syndrome,
90 percent of those decide
to have an abortion.
So, no, suddenly people
are making decisions about
what lives they consider to be valuable,
and what lives they don't want
to continue into the world.
And it's, so it means that we are making,
we are still making
decisions about which lives
are good and which lives are not good.
Now there has been a considerable
disagreement about this,
and there's a portion of the
disability rights movement
who have strongly argued
that this sort of,
these sorts of decisions
are deeply troubling.
And the particular group
of people who have been
arguing this are the people
who say that society,
that disability is not
something that's intrinsic,
but rather that it's imposed
in the way society treats people.
And it's been particularly
powerful for advocates
of deafness and some advocates for people
on the autistic spectrum,
especially people
who are known as having Asperger's.
And they are, they've argued
that those are not diseases,
or disabilities, intrinsically.
Rather, they're simply
differences between people,
and that we shouldn't
make judgements about
what kinds of people,
whether those kinds of people
should live or die.
We should be much more
inclusive as a society.
So the, this disability rights movement
is not a completely theoretical, unified,
but it certainly has argued to some extent
that we should be much more welcoming
of people with disabilities,
and we shouldn't decide
that those lives are not worth living.
Okay.
Now, I think this social
model of disability
is certainly a very important idea,
and certainly puts, gives a lot of insight
into the way that society
does make the lives
of people with disabilities
more difficult.
But I think we don't necessarily
have to accept the whole
social model in order to
take some insights from it.
It is certainly true that
people with mental illnesses
and other disorders can
have very, very good lives.
And so to simply to say that
people with Down Syndrome
shouldn't exist or their
lives aren't worth living
is a problematic judgment.
But it is true that it
takes a great many resources
to make their lives good,
and in a neglectful society,
their lives can be terrible.
And certainly in the
history of Western Society
in the last few hundred years
there have been many cases
of disabled people and mentally ill people
whose lives have been miserable because
of the way that society treats them.
Now, our society is
definitely far from perfect,
and we don't live in a
completely inclusive society.
So, it may well be that
ultimately our goal
should be to have the most
inclusive society possible,
but that's not society as it is now.
So given that's the
situation as it is now,
it may be quite a reasonable decision
for parents to decide they don't want
to have a child with Down Syndrome.
Or with other severe mental illness.
I think the point is, though,
that we are still making
these value judgments, and
I think given the history
of eugenics in the 20th century,
we need to be very careful
about those value judgments.
The idea, I mean, we might
wanna condemn the scientists
of the past as simply being ignorant.
We might wanna say:
well now we are much wiser than they were.
But I think that's to
take a position of, ah,
an unjustified position, really.
I mean, constantly we
look back on the past
and decide everybody else
before us was stupid,
and we're not stupid.
But then it's quite likely
that people in 100 years time
are gonna look back on us and think:
those people were so ignorant.
And they're gonna think that
they were much wiser than us.
So I think it's really
important for us to have
a position of humility
and to realize that our,
the judgments we make right now,
may well be judged to
be wrong in the future.
So we need to be very cautious
in making our decisions
about which lives are valuable
and which ones are not.
And so the disability rights movement
and the social model of
disability is very important
in indicating that the lives
of people with mental illnesses
and with disabilities can be very rich.
So my kind of conclusion
then is that we need to
kind of be very cautious when we're
making these sorts of judgments.
Certainly, there was a lot
of hatred in Nazi Germany,
and a lot of irrational emotion,
but the history of eugenics
as an international movement
had a lot of scientists
and leaders of society
who considered themselves
to be very well-meaning
and wanted the best for society.
And so now we look back on
their views as deeply mistaken,
but it was, a lot of those
people were very sincere
in their beliefs.
So, inheriting the past and
the history of eugenics,
we need to kind of be
very mindful of that past,
and in making judgments,
we need to work very hard
not to kind of repeat the mistakes
that have been made before.
That's my message.
(applauding)
