Physician complicity in human rights violations: Involuntary sterilization among women from Mexico and Central America seeking asylum in the United States.

Involuntary sterilization is a violation of human rights and grounds for asylum in the United States. Forensic medical evaluations can be useful in documenting this form of persecution and supporting asylees' claims for immigration relief. We conducted a retrospective case analysis of the personal and medical affidavits of 14 asylum-seeking women from four Latin America countries who all reported they had been involuntarily sterilized. Sixty-four percent said that "consent" was coerced; the remainder were unaware of having been sterilized at the time of the procedure. In all cases, findings on hysterosalpingogram were consistent with sterilization, revealing that all 14 had undergone a tubal ligation. Eighty-six percent of the women had been sterilized at the time of childbirth. The healthcare providers involved in the 14 cases failed to obtain informed consent, misled patients about sterilization, engaged in discriminatory behavior, and/or breached patient confidentiality regarding their HIV-status. All 14 asylum cases were defensive; of the 7 cases (50%) that have been decided to date, 100% have been granted asylum.

Debilitated Lifeworlds: Women's Narratives of Forced Sterilization as Delinking from Reproductive Rights.

Peasant women in Cajamarca, Peru, who were sterilized by the Peruvian government in the 1990s, narrate their experiences of reproductive abuse using Andean medical principles of debilidad and fuerza (debility and strength) (Tapias 2006). In their narratives, many describe a generalized sense of loss of strength resulting from the procedure. This contrasts with the reproductive rights framework's emphasis on infertility as the main harm. In this article, I ponder the dissonance between these two frameworks and propose the concept of debilitated lifeworlds as decolonial feminist delinking (Mignolo 2007) from human fertility-centric narratives. This concept is methodologically significant as a decolonial attunement to local motifs to talk about abuse and for weaving a constellation of embodied, emotional, social, and family harms. This article contributes to the emerging field of "decolonial reproductive studies" (Smietana et al. 2018: 117).

The Dangers of White Supremacy: Nazi Sterilization and Its Mixed-Race Adolescent Victims.

Mixed-race African German and Vietnamese German children were born around 1921, when troops drawn from the French colonial empire occupied the Rhineland. These children were forcibly sterilized in 1937. Racial anthropologists had denounced them as "Rhineland Bastards," collected details on them, and persuaded the Nazi public health authorities to sterilize 385 of them. One of the adolescents later gave public interviews about his experiences. Apart from Hans Hauck, very few are known by name, and little is known about how their sterilization affected their lives. None of the 385 received compensation from the German state, either as victims of coerced sterilization or as victims of Nazi medical research. The concerned human geneticists went unprosecuted. (Am J Public Health. 2022;112(2):248-254. https://doi.org/10.2105/AJPH.2021.306593).

Precarious Lives: Forced sterilisation and the struggle for reproductive justice in Peru.

It is estimated that more than 200,000 women were sterilised without giving free, prior and informed consent in Peru between 1996 and 2000 during the Fujimori regime. This paper places forced sterilisation within the frameworks of precarity and reproductive justice to understand policies that legitimised the violation of women's rights irrespective of the type of political regime: forced sterilisations during a dictatorial regime and denial of access to sexual and reproductive rights during a period of democracy. Through document analysis, this paper examines narratives around sterilisation and reproduction produced by policymakers, political and religious leaders and health care practitioners during these two political periods. This paper shows the continuity of the struggle that marginalised populations face in exercising their reproductive rights in the context of symbolic and structural inequalities.

How Should a Physician Respond to Discovering Her Patient Has Been Forcibly Sterilized?

Forced sterilization has a long history in the United States. Because sterilization requires surgical skill, physicians have been the lone professionals engaging in this practice, although they were not the only experts or Americans to hold eugenic and neo-eugenic views. But physicians have also been whistleblowers who exposed sterilization abuse and led efforts to end it. The commentary on this case suggests that physicians should respond along those lines.

Prácticas de salud de dominación y exclusión: visiones de activistas, profesionales e investigadoras sobre situación de esterilizaciones forzadas en mujeres y niñas con discapacidad en España / Health practices of domination and exclusion: views of activists, professionals and researchers on the situation of forced sterilization of women and girls with disabilities in Spain

Resumen En 2017, las Naciones Unidas declaran que 38 países, entre ellos España, continuaban realizando esterilizaciones forzadas en mujeres y niñas con discapacidad, a pesar de tratarse de una práctica ampliamente condenada por diversos organismos internacionales de derechos humanos. Este estudio analizó la situación de esta práctica en España, desde la perspectiva de activistas, profesionales e investigadoras con experiencias vinculadas a este colectivo. La metodología empleada fue de tipo cualitativa basada en la Teoría Fundamentada Constructivista. Se aplicaron entrevistas semiestructuradas en profundidad a 22 informantes, que representaron a 6 comunidades autónomas del país. Las participantes identificaron un modelo de prácticas de salud de dominación y exclusión, donde la sexualidad y reproducción de mujeres con discapacidad ha sido objeto de expropiación, alienación y desprecio por parte de sistemas, estructuras y políticas diferenciadas, con escasa transferencia del marco global de derechos humanos a su realidad. La violencia sexual ha pasado inadvertida, naturalizándose por el entorno, han promovido mecanismos de exclusión social e inequidades en salud, al privarles de sus derechos humanos fundamentales. Al tratarse de una situación que se replica en diversos lugares del mundo, debiese considerarse un tema de relevancia para la salud pública internacional.

Abstract In 2017, the United Nations declared that 38 countries, including Spain, continued to practice forced sterilizations on women and girls with disabilities, despite it being a practice widely condemned by various international human rights organizations. This study analyzed the situation of this practice in Spain, from the perspective of activists, professionals and researchers with experiences related to this group. The methodology used was qualitative, based on Constructivist Grounded Theory. Semi-structured in-depth interviews were applied to 22 informants, representing 6 autonomous communities of the country. The participants identified a model of health practices of domination and exclusion, where the sexuality and reproduction of women with disabilities has been the object of expropriation, alienation and contempt by systems, structures and differentiated policies, with little transfer of the global framework of human rights to their reality. Sexual violence has gone unnoticed, becoming naturalized by the environment, and has promoted mechanisms of social exclusion and health inequities, depriving them of their fundamental human rights. As it is a situation that is replicated in various parts of the world, it should be considered an issue of relevance for international public health.

Prácticas de salud de dominación y exclusión: visiones de activistas, profesionales e investigadoras sobre situación de esterilizaciones forzadas en mujeres y niñas con discapacidad en España / Health practices of domination and exclusion: views of activists, professionals and researchers on the situation of forced sterilization of women and girls with disabilities in Spain

Resumen En 2017, las Naciones Unidas declaran que 38 países, entre ellos España, continuaban realizando esterilizaciones forzadas en mujeres y niñas con discapacidad, a pesar de tratarse de una práctica ampliamente condenada por diversos organismos internacionales de derechos humanos. Este estudio analizó la situación de esta práctica en España, desde la perspectiva de activistas, profesionales e investigadoras con experiencias vinculadas a este colectivo. La metodología empleada fue de tipo cualitativa basada en la Teoría Fundamentada Constructivista. Se aplicaron entrevistas semiestructuradas en profundidad a 22 informantes, que representaron a 6 comunidades autónomas del país. Las participantes identificaron un modelo de prácticas de salud de dominación y exclusión, donde la sexualidad y reproducción de mujeres con discapacidad ha sido objeto de expropiación, alienación y desprecio por parte de sistemas, estructuras y políticas diferenciadas, con escasa transferencia del marco global de derechos humanos a su realidad. La violencia sexual ha pasado inadvertida, naturalizándose por el entorno, han promovido mecanismos de exclusión social e inequidades en salud, al privarles de sus derechos humanos fundamentales. Al tratarse de una situación que se replica en diversos lugares del mundo, debiese considerarse un tema de relevancia para la salud pública internacional.

Abstract In 2017, the United Nations declared that 38 countries, including Spain, continued to practice forced sterilizations on women and girls with disabilities, despite it being a practice widely condemned by various international human rights organizations. This study analyzed the situation of this practice in Spain, from the perspective of activists, professionals and researchers with experiences related to this group. The methodology used was qualitative, based on Constructivist Grounded Theory. Semi-structured in-depth interviews were applied to 22 informants, representing 6 autonomous communities of the country. The participants identified a model of health practices of domination and exclusion, where the sexuality and reproduction of women with disabilities has been the object of expropriation, alienation and contempt by systems, structures and differentiated policies, with little transfer of the global framework of human rights to their reality. Sexual violence has gone unnoticed, becoming naturalized by the environment, and has promoted mechanisms of social exclusion and health inequities, depriving them of their fundamental human rights. As it is a situation that is replicated in various parts of the world, it should be considered an issue of relevance for international public health.

Hans Gerhard Creutzfeldt (1885-1964) in the Third Reich: A reevaluation.

Hans Gerhard Creutzfeldt (1885-1964) is an internationally known Professor of Psychiatry and Neurology. During the time of National Socialism (1933-1945), he worked in the Charite University Hospital Berlin and moved to Kiel University as Head of the Department for Psychiatry and Neurology in 1938. Until the turn of the millennium, Creutzfeldt was considered to be of moral integrity and an opponent of the Nazi regime and its eugenics measures. Publications of the last years came to the conclusion that this depiction does not hold up. They questioned his relations to the ideas and structures of the National Socialist system, his role as a consultant in the National Socialist's forced sterilization program, a possible involvement in the Nazi euthanasia measures, and his position as a psychiatric consultant for the German navy. The article considers 2 aspects concerning the National Socialist racial hygiene in greater detail by using newly found source material. It is shown that Creutzfeldt, although he did not actively resist, was not acting in the interest of the Nazi regime, but rather was trying to save as much patients as possible by changing their diagnoses and prevent them from being killed in the euthanasia program.

Involuntary Sterilisation, Eugenics, and Physician-assisted Dying: Lessons for New Zealand.

Opponents of physician-assisted dying (PAD) view it as modern eugenics and a significant risk to people with disabilities. The involuntary surgical sterilisation (ISS) of girls and young women with intellectual disabilities is an example of eugenics in practice. This article reviews the social and political attitudes toward ISS and PAD in New Zealand, England, and the United States. The attitudes were compared to determine if they demonstrated any indicators of potential PAD-related harm for people with intellectual disabilities. The research identified several issues, which need to be considered to ensure the safety of people with intellectual disabilities if New Zealand was to legalise PAD.

Experiences of forced sterilisation and coercion to sterilise among women living with HIV (WLHIV) in Namibia: an analysis of the psychological and socio-cultural effects.

The forced and coerced sterilisation of women living with HIV (WLHIV) is a phenomenon reported in several countries. In Namibia, litigation efforts for cases of forced and coerced sterilisation were successful, yet the psychological and socio-cultural well-being of those affected has not been adequately investigated and addressed. To determine the psychological and socio-cultural effects of involuntary sterilisation on WLHIV in Namibia, qualitative data from seven WLHIV were collected through face-to-face interviews. Our analysis showed that, firstly, there are negative psychological effects manifesting in psychological symptoms associated with anxiety and depression. Secondly, there are negative socio-cultural effects including discrimination, victimisation and gender-based violence. Patriarchal cultural values regarding reproduction, marriage and decision-making contribute to negative psychological and socio-cultural effects. Finally, negative psychological and socio-cultural effects of involuntary sterilisation are long-lasting. For participants, coping remains difficult, even over a decade after the sterilisations. Given the considerable long-lasting negative psychological and socio-cultural effects, psychological interventions to expedite positive coping and well-being must be prioritised.

[Oswald Bumke (1877-1950)-silence as resistance?] / Oswald Bumke (1877­1950) ­ Schweigen als Widerstand?

In 1924 Oswald Bumke was appointed as Emil Kraepelins successor to the Chair of Psychiatry at the University of Munich. After 1933 he was a promoting member of the SS and the National Socialist Teachers Federation but he was never a member of the National Socialist German Workers' Party (NSDAP). In 1933 he assumed the presidency of the Society of German Neurologists but only 2 years later he withdrew from the executive board because of scientific and personal differences with Ernst Rüdin, the new "strong man" of the merged Society of German Neurologists and Psychiatrists. After the end of WWII, Bumke affirmed that despite his exposed position as professor of psychiatry during the NS era, he had lacked any influence and that he had sabotaged the "Law for the Prevention of Genetically Diseased Offspring" (GzVeN). He declared that for scientific reasons he had been extremely critical of the GzVeN and even had expressed his views in various publications. Nevertheless, he supported forced sterilization in his treatise "The State and Mental Diseases" published in 1939. His statement that the clinic in Munich had manipulated diagnoses in order to protect patients from eugenic measures and "euthanasia" refers to a potential interference, but as documents are lacking this cannot be substantiated. After 1940 Bumke functioned as a consulting military psychiatrist in expert reports. Political assessments from this period presented him as politically reliable. His biography exemplarily shows that a meticulous juxtaposition of post-war documents with correspondent records stemming from the Nazi period is imperative in order to arrive at a source-critical well-founded and differentiated evaluation.

[Austrian neurologists under the swastika: Julius Wagner-Jauregg-Walther Birkmayer-Franz Seitelberger]. / Österreichische Neurologen unter dem Hakenkreuz: Julius Wagner-Jauregg ­ Walther Birkmayer ­ Franz Seitelberger.

There were three Austrian neurologists with connections to neurology in National Socialism who have been honored by the German Neurological Society (DGN) or its predecessor organizations with honorary membership. From 1928 to 1934 Julius Wagner-Jauregg (1857-1940) was head of the Austrian Alliance for National Regeneration and the Study of Heredity; in at least two publications he advocated eugenic measures and racial hygienic positions as defined by Nazi ideology. As a former member of the Greater German People's Party (Großdeutsche Volkspartei), he applied for membership of the National Socialist German Workers' Party (NSDAP) a few months before his death. Walther Birkmayer (1910-1996) was an early member of the NSDAP, SA, SS and other Nazi organizations. As a staunch supporter of the "movement" he worked from 1938 in the Office of Racial Policy of the Gauleitung of Vienna. In lectures and publications he demanded or recommended forced sterilization for a number of neurological diseases. Due to the classification of his grandmother as "non-Aryan", he had to give up his party and university posts and served as a Wehrmacht physician. After some hard years immediately after the war, he was allowed to continue his career. As a co-discoverer of the effect of L­DOPA on parkinsonism, he was awarded numerous honorary doctorates and honorary memberships. Franz Seitelberger (1916-2007), a member of an SS unit during the Nazi era, benefited in his research work from the 1950s onwards from specimens obtained in the course of neuropathological "concomitant research" to Nazi "euthanasia". It is to be welcomed that the Austrian Society of Neurology (ÖGN) will soon start a historical project investigating open questions related to the Nazi era.

"A Revolution in Favor of Reproduction"? Gynecology and Obstetrics in the "Third Reich".

During the "Third Reich," the majority of German gynecologists and obstetricians did not hesitate to put themselves at the service of those in power. In 1933, many gynecologists initially only focused on the fact that the biopolitical objectives of the National Socialists matched their own long-standing demands for population policy measures and the early detection and prevention of cancer. In addition, cooperating with the Nazis promised the political advancement of the profession, personal advantages, and the honorary title of Volksgesundheitsführer (national health leaders). As a result, gynecologists exchanged resources with the regime and thus contributed significantly to the implementation of the criminal racial policies of the Nazis. At the congresses of the Deutsche Gesellschaft für Gynäkologie (German Society of Gynecology) "non-Aryan" members, mostly of Jewish descent, were excluded, the law on forced sterilization of 1933 (Gesetz zur Verhütung erbkranken Nachwuchses/Law for the Prevention of Offspring with Hereditary Diseases) was scientifically legitimized, its implementation was propagated, and relevant surgical techniques were discussed with regard to their "certainty of success." In the course of these forced sterilizations, existing pregnancies were also terminated and the victims were misused for illegal scientific examinations or experiments. Drawing upon racial and utilitarian considerations, gynecologists did not even shy away from carrying out late abortions on forced laborers from the East during the Second World War, which were strictly prohibited even under the laws of the time. Some gynecologists carried out cruel experiments on humans in concentration camps, which primarily served their own careers and the biopolitical goals of those in power. The few times gynecologists did protest or resist was when the very interests of their profession seemed threatened, as in the dispute over home births and the rights of midwives. Social gynecological initiatives from the Weimar Republic, which were mainly supported and carried out by gynecologists persecuted for their Jewish descent since 1933, were either converted into National Socialist "education programs" or simply came to an end due to the exclusion of their initiators. German gynecologists had hoped for a large-scale promotion of the early detection of malignant diseases of the uterus and breasts, to which they had already made important contributions since the beginning of the 20th century. But even though the fight against cancer was allegedly one of the priorities of the Nazis, no comprehensive measures were taken. Still, a few locally limited initiatives to this end proved to be successful until well into the Second World War. In addition, German gynecologists established the modern concept of prenatal care and continued to advance endocrinological research and sterility therapy. After the end of the Nazi dictatorship, the historical guilt piled up during this period was suppressed and denied for decades. Its revision and processing only began in the 1990s.