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).

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.

"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.

THE JEREMIAH METZGER LECTURE: A BRIEF HISTORY OF EUGENICS IN AMERICA: IMPLICATIONS FOR MEDICINE IN THE 21ST CENTURY.

In the first half of the 20th century, the US was swept up in a multifaceted movement to enhance the genetic makeup of the country's population. This eugenics movement, based on flawed scientific principles promulgated by Galton in the UK and Davenport in the US included legally mandated compulsory sterilization in 27 states in the US and sharply restricted immigration from many parts of the world. Compulsory sterilization legislation was upheld by the Supreme Court in 1927. The American eugenics movement was a model for the compulsory sterilization implemented by the Nazis after they took power in Germany in 1933. The movement waned in America only following World War II when the US public became aware of the full extent of the Nazi Aryan racial superiority program. With the advent of major advances in molecular and cellular biology that are already being applied to clinical medicine in the 21st century, we have entered a new eugenics era. It is critical that we learn the lessons of our earlier eugenics movement if we are to avoid making the same flawed decisions now.

Legalised non-consensual sterilisation - eugenics put into practice before 1945, and the aftermath. Part 2: Europe.

This article deals with the nine European nations which legalised non-consensual sterilisation during the interwar years, thus completing the review, the first part of which was published in an earlier issue of this Journal. Like we did for North America, Japan and Mexico, countries concerned are addressed in chronological order, as practices in one of these influenced policies in others, involved later. For each, we assess the continuum of events up to the present time. The Swiss canton of Vaud was the first political entity in Europe to introduce a law on compulsory sterilisation of people with intellectual disability, in 1928. Vaud's sterilisation Act aimed at safeguarding against the abusive performance of these procedures. The purpose of the laws enforced later in eight other European countries (all five Nordic countries; Germany and, after its annexation by the latter, Austria; Estonia) was, on the contrary, to effect the sterilisation of large numbers of people considered a burden to society. Between 1933 and 1939, from 360,000 [corrected] to 400,000 residents (two-thirds of whom were women) were compulsorily sterilised in Nazi Germany. In Sweden, some 32,000 sterilisations carried out between 1935 and 1975 were involuntary. It might have been expected that after the Second World War ended and Nazi legislation was suspended in Germany and Austria, including that regulating coerced sterilisation, these inhuman practices would have been discontinued in all nations concerned; but this happened only decades later. More time still went by before the authorities in certain countries officially acknowledged the human rights violations committed, issued apologies and developed reparation schemes for the victims' benefit.

Legalised non-consensual sterilisation - eugenics put into practice before 1945, and the aftermath. Part 1: USA, Japan, Canada and Mexico.

In the late 19th century, eugenics, a pseudo-scientific doctrine based on an erroneous interpretation of the laws of heredity, swept across the industrialised world. Academics and other influential figures who promoted it convinced political stakeholders to enact laws authorising the sterilisation of people seen as 'social misfits'. The earliest sterilisation Act was enforced in Indiana, in 1907; most states in the USA followed suit and so did several countries, with dissimilar political regimes. The end of the Second World War saw the suspension of Nazi legislation in Germany, including that regulating coerced sterilisation. The year 1945 should have been the endpoint of these inhuman practices but, in the early post-war period, the existing sterilisation Acts were suspended solely in Germany and Austria. Only much later did certain countries concerned - not Japan so far - officially acknowledge the human rights violations committed, issue apologies and develop reparation schemes for the victims' benefit.

Disproportionate Sterilization of Latinos Under California's Eugenic Sterilization Program, 1920-1945.

OBJECTIVES: To compare population-based sterilization rates between Latinas/os and non-Latinas/os sterilized under California's eugenics law. METHODS: We used data from 17 362 forms recommending institutionalized patients for sterilization between 1920 and 1945. We abstracted patient gender, age, and institution of residence into a data set. We extracted data on institution populations from US Census microdata from 1920, 1930, and 1940 and interpolated between census years. We used Spanish surnames to identify Latinas/os in the absence of data on race/ethnicity. We used Poisson regression with a random effect for each patient's institution of residence to estimate incidence rate ratios (IRRs) and compare sterilization rates between Latinas/os and non-Latinas/os, stratifying on gender and adjusting for differences in age and year of sterilization. RESULTS: Latino men were more likely to be sterilized than were non-Latino men (IRR = 1.23; 95% confidence interval [CI] = 1.15, 1.31), and Latina women experienced an even more disproportionate risk of sterilization relative to non-Latinas (IRR = 1.59; 95% CI = 1.48, 1.70). CONCLUSIONS: Eugenic sterilization laws were disproportionately applied to Latina/o patients, particularly Latina women and girls. Understanding historical injustices in public health can inform contemporary public health practice.

Global maternal health and newborn health: Looking backwards to learn from history.

The late appearance of the 'M' on the international health agenda - in its own right and not just as a carrier of the intrauterine passenger - is thought-provoking. The 'M' was absent for decades in textbooks of 'tropical medicine' until the rhetoric question was formulated: 'Where is the "M" in MCH?' The selective antenatal 'high-risk approach' gained momentum but had to give way to the fact that all pregnant women are at risk due to unforeseeable complications. In order to provide trained staff to master such complications in impoverished rural areas (with no doctors), some countries have embarked on training of non-physician clinicians/associate clinicians for major surgery with excellent results in 'task-shifting' practice. The alleged but non-existent 'human right' to survive birth demonstrates that there have been no concrete accountability and no 'legal teeth' to make a failing accountability legally actionable to guarantee such a right.

An Evil Hitherto Unchecked: Eugenics and the 1917 Ontario Royal Commission on the Care and Control of the Mentally Defective and Feeble-Minded.

In 1917, the Ontario government appointed the Royal Commission on the Care and Control of the Mentally Defective and Feeble-Minded, headed by Justice Frank Hodgins. Its final report made wide-ranging recommendations regarding the segregation of feeble-minded individuals, restrictions on marriage, the improvement of psychiatric facilities, and the reform of the court system, all matters of great concern to the eugenics movement. At the same time, however, it refrained from using explicitly eugenic vocabulary and ignored the question of sterilization. This article explores the role the commission played in the trajectory of eugenics in Ontario (including the province's failure to pass sterilization legislation) and considers why its recommendations were disregarded.

The Central Role of Neuroscientists under National Socialism.

Neuroscientists played central roles in the victimization of colleagues and their patients during the era of National Socialism from 1933 to 1945. After helping dismiss Jewish and nonideologically aligned colleagues, German neuroscientists were among the physicians and researchers who joined the Nazi Party and affiliated groups in record numbers. Forced sterilization and then so-called 'euthanasia' of neurological and psychiatric patients were planned and executed by prominent German and Austrian neuroscientists. Other neuroscientists collaborated indirectly by using patients for unethical experimentation to discover the cause of multiple sclerosis or to try to induce epileptic convulsions in a hypoxic state. Some merely used neuropathological material from murdered patients for publications in scientific journals. In the totalitarian state, research funding and academic advancement were awarded to physicians engaged in eugenics research. Opportunism and ideologically tainted science without regard to medical ethics were the motivating factors for collaborating neuroscientists. Some German and Austrian neuroscientists tried to resist Nazi policies, although much more passively than their colleagues in German-occupied countries. French, Dutch, Norwegian, and Danish neuroscientists actively resisted the Nazification of their profession from the beginning and helped to save some patients and colleagues, at great personal risk. Many German, Austrian, Czech, and Polish neurologists were murdered in the Holocaust, and hundreds of thousands of neurological and psychiatric patients were sterilized or murdered in just 12 years. The Nazis used the 'successful' techniques developed in the 'euthanasia' programs to carry out the mass murder of millions in the Holocaust. Today's neuroscientists are obligated to learn of the ethical violations of their predecessors 70-80 years ago. No law will prevent abandonment of the basic principles of ethical patient care and professionalism that can occur in any totalitarian state, but neuroscientists can possibly prevent it.

[The Homburg clinic for nervous diseases in the National Socialist Era. Special features in the Saarland border region]. / Die Homburger Nervenklinik im Nationalsozialismus. Besonderheiten in der saarländischen Grenzregion.

BACKGROUND AND OBJECTIVES: When the National Socialists (NS) came to power in 1933, the German health care system was reorganized according to the principles of eugenics. Neuropsychiatric patients were victims of compulsory sterilisation and "euthanasia". As the Saar territory did not become part of the German Reich until the 1 March 1935, it is of special interest how quickly and completely NS health care policies were implemented. METHODS: The analysis is based on medical records of the Homburg State Hospital's (HSH) clinic for nervous diseases from 1929 to 1945 (n =7,816) found in the Saarland University Medical Centre. RESULTS: 1,452 patients were sterilised by force between 1935 and 1939 in the HSH. The most frequent diagnoses were congenital debility, schizophrenia, and epilepsy. Some of the 441 Homburg patients who were transferred to other mental hospitals from 1939 to 1940 were killed in the context of "Aktion T4" and presumably in a nonsystematic manner. CONCLUSIONS: NS health care policies were implemented immediately after incorporation of the Saar territory in 1935. Physicians of the HSH were involved directly in compulsory sterilisation of neuropsychiatric patients. An initial intention to kill by the time of patient transfers from Homburg cannot be proven. Further research concerning the killing centres is necessary.

Eugenics and Involuntary Sterilization: 1907-2015.

In England during the late nineteenth century, intellectuals, especially Francis Galton, called for a variety of eugenic policies aimed at ensuring the health of the human species. In the United States, members of the Progressive movement embraced eugenic ideas, especially immigration restriction and sterilization. Indiana enacted the first eugenic sterilization law in 1907, and the US Supreme Court upheld such laws in 1927. State programs targeted institutionalized, mentally disabled women. Beginning in the late 1930s, proponents rationalized involuntary sterilization as protecting vulnerable women from unwanted pregnancy. By World War II, programs in the United States had sterilized approximately 60,000 persons. After the horrific revelations concerning Nazi eugenics (German Hereditary Health Courts approved at least 400,000 sterilization operations in less than a decade), eugenic sterilization programs in the United States declined rapidly. Simplistic eugenic thinking has faded, but coerced sterilization remains widespread, especially in China and India. In many parts of the world, involuntary sterilization is still intermittently used against minority groups.