She was 17, just a girl, and she was in the State Home and Industrial School for Girls in Moore County. The state was considering releasing "Peggy," but there was a condition. She would have to be sterilized first.

At a hearing before the Eugenics Board of North Carolina in 1938, Peggy's mother pleaded for her daughter's future.

"If she is not operated on, won't she ever come home?" her mother asked.

"I don't know," replied Paul Mickey, a member of the eugenics board.

"I object on grounds of 'feeblemindedness,'" Peggy's grandfather said. "She was not feebleminded when she left home. I can get plenty of witnesses to say that she was not."

"The main thing is to keep feeblemindedness from becoming a great problem," said Dr. J.C. Knox.

Mickey added that "the state has placed (the) decision in the hands of government agents, and we can't go beyond that."

"I object and if you go ahead and do it and she doesn't get along all right, I am going to sue the state," Peggy's mother said.

The eugenics board approved the sterilization.

Institutions in North Carolina made extensive use of the state's eugenic sterilization law in its early years, and they frequently made sterilization a condition of release. The 1935-36 biennial report of the eugenics board notes that "none of the inmates of Caswell Training School should be released before being sterilized, except in the few instances where normal children have been committed through error."

All the cases that came before the eugenics board were supposed to include some sort of "consent" by parents, patients or guardians, but there was a catch. In the 1930s and 1940s, the eugenics board often refused to release patients from institutions before sterilization.

Institutional sterilizations peaked at 152 during the 1938 reporting year and then started to decrease. In 1947, there were just 65. About a third of the 7,600 sterilizations authorized by the state were for patients in mental institutions and training schools.

In the late 1940s, the Human Betterment League of North Carolina had started a statewide publicity campaign to promote an expanded sterilization program.

But the psychiatrists and mental-health professionals who knew most about the issue proved to be the toughest audience, and this skirmishing continued for years.

In 1954, the Human Betterment League met with Dr. Ellen Winston, the head of the N.C. Department of Public Welfare and a eugenics board member.

The minutes of the meeting note that "the large decrease in the number of institutional sterilizations for the calendar year 1953. Winston cited the fact that some superintendents and staff members of state hospitals are unsympathetic toward sterilization."

That was because most people in the mental-health field were aware that IQ tests were flawed and that the entire concept that genes always passed on intelligence was wrong, too, said Gilbert Gottlieb, a research professor of psychology at the University of North Carolina at Chapel Hill who worked at Dorothea Dix Hospital in the late 1950s.

Gottlieb recalls discussing the sterilization program with other professionals in the late 1950s. Dr. Eugene Hargrove was the state mental-health director and a member of the eugenics board in the early 1960s, and he was "unhappy" about the sterilization program, Gottlieb said.

Eugenics board records reviewed by the Winston-Salem Journal show that Hargrove cast an increasing number of "no" votes on sterilization cases as the 1960s progressed.

But if mental-health professionals had become wary of sterilization, the Journal's review of eugenics board records shows that social workers continued to push the program.

Because she has gotten along so well at Caswell, the staff now feels that she is able to return to the community. However, before she is returned to the community due to her sexual promiscuity the Department of Social Services feels that she needs sterilization.
¯ Eugenics board minutes, 1969

It's unknown whether that petition was approved.

In all, there were 597 sterilization operations performed at Caswell from 1929 to 1968. At Broughton Hospital there were 829; Cherry Hospital, 487; Dorothea Dix Hospital, 632; and John Umstead Hospital, 34. Over the life of the program, at least 2,900 institutional sterilizations took place.

The eugenic sterilization program is gone, but mental-health professionals say that some of the ethical issues about how to treat people with disabilities remain.

"We serve about 400,000 people in (public) mental-health centers every year, and I do think we have come light years in terms of civil and legal rights," said John Tote, the executive director of the Mental Health Association of North Carolina.

"But who does have access to the best, the newest, the most effective treatments? As you have (mental health) decisions made more and more on cost, you bring up the whole (ethical) issue," he said.

Tote said that a core flaw of the eugenics movement was the idea that society, or people, could be made flawless.

"Quite frankly, none of us are (perfect)," he said. "We will never have a perfect society in terms of physical issues. Just because somebody is in a wheelchair or on crutches or has schizophrenia, doesn't make them any less of a person."

Treating those who are different from some mythic ideal isn't just a question of compassion, he said.

"Part of it is, we will be judged on how we treat those folks," Tote said. "Society can also be enriched by how it responds to the needs to others."

• Kevin Begos can be reached in Washington at (202) 662-7672 or at kbegos@mediageneral.com