From the Epilogue of: The current Journal series on eugenics and North Carolina's sterilization program opens some old wounds that many might prefer to keep closed. It was not a proud period of state history, and it is frightening to think that it lasted into the 1970s, after many other similar programs had been abandoned for many years.
It is past, and cannot be undone. It would be comforting, perhaps, to ignore this piece of our history and look forward to what a consensus of experts believes is a bright future. But this is the sort of cautionary tale that needs close study because it could all too easily be repeated as science races ahead of our capacity to understand its moral and ethical consequences. Someone said as early as 1670 that "the road to hell is paved with good intentions." The warning still rings true.
There is no doubt that many of the people involved with these programs believed they were working to make the world a better place. The idea was that many human defects were hereditary, and if you could prevent defect carriers from reproducing, you might eventually eliminate the defects.
Since World War II and Hitler, the consequences of such thinking should have given pause to advocates of these programs. They had a very dark side to them. In North Carolina, where before the program was finally ended, some 7,600 individuals had been sterilized, there was too little caution, too little thought of unintended consequences.
In theory, sterilizations were generally consensual, and circumstances of each case were carefully reviewed. In practice, that didn't happen, and in some cases, it was clear that racial bias, a belief that blacks were inferior, motivated and justified the program.We have, one must hope, come a long way from those days. But the journey is not ended. And that is why scrutiny of the past is not voyeuristic or sensational; it is a wake-up call.
It is amazing what medical science can do today that it couldn't 40 years ago. But 40 years from now, what medicine will be able to do is virtually unimaginable. Perhaps the most important question we face is: If we can do it, should we? Put another way, at what point does genetic tinkering jeopardize our basic understanding of what it means to be human?
This is not a matter for scientists to decide. They will provide us with the information that we as a society need to make these decisions. What would it mean for our grandchildren if their parents could decide, with no input from them, what sort of genes would influence their development? Are we tempting God, flying, like Icarus, too close to the sun?
The three big lessons to be learned from this series are:
First, we don't know as much as we think we do about cause and effect. Second, unintended consequences are virtually inevitable. Third, the best-intentioned ideas frequently fail in their implementation, often because their original purpose is distorted by people pursuing other agendas.
It is good that the Wake Forest School of Medicine is not attempting to dismiss or excuse its role in eugenics and sterilization efforts. The dean of the school, William Applegate, has promised to set up a review committee of faculty and administrators to examine the school's role in these programs.
We look at history with the 20/20 vision of hindsight. We think that if we knew then what we know now, things would have been different. We need to remember that this could be said of every generation throughout history. A little humility seems appropriate.