19

H.—,3la

The question naturally arises as to the Department of State to which the proposed sub-department for the care of the feeble-minded might best be attached. In the judgment of the Committee the education of feeble-minded children should be continued by the Education Department, which has evolved a very successful system and is administering it well. After everything possible has been done in the matter of education a large proportion, as they grow up, will be quite unable to hold their own in the world, and for their own protection and safety, and in the interests of society, must be cared for in some institution, where they may be kept usefully occupied in gardening or farming, or in some handicraft which will serve to keep them in health and help to recoup the State some part of the cost of their maintenance. It is, of course, most essential that they should not be allowed to reproduce their kind, thus further enfeebling and deteriorating the national stock, adding to the burden of the community and to the sum of human misery and degradation. '• To produce but not to reproduce " sums up the best scheme of life for these unfortunates. Looking at all the circumstances of the case, it appears to the Committee that it would be better if the compilation of the register, the provision of the farm and industrial colonies, and the after-care of adult feeble-minded patients coming under Classes Y and VI and " moral imbeciles " were entrusted to a special branch of the Mental Hospitals Department. It is essential that the feeble-minded shall be kept separate from the insane, while the feeble-minded themselves, of course, require careful classification. It is very important that marriages with registered persons should be made illegal, and, as a corollary to this, that it should be made an indictable offence for any person knowingly to have carnal knowledge of a registered person. It should also be provided that any parent or guardian who facilitates or negligently allows any registered person to have carnal intercourse with another person shall be guilty of an indictable offence. Section 10.—The Question of Sterilization. A question which has given the Committee much anxious thought is as to whether sterilization should be adopted as a method of preventing the propagation of the feeble-minded. That it would be an effective method as regards the persons operated on goes without saying. The operation of vasectomy in the case of males is a very simple one, which may be performed with the aid of a local anaesthetic, and may be said for all practical purposes to be unattended by any risk to the patient. In the case of women a similar operation on the Fallopian tubes, which is known as salpingectomy, is an abdominal operation and cannot be said to be entirely free from danger, although it is not regarded as very serious. Except for the prevention of fertility, the operation does not interfere with the sexual powers of the patient and has little or no effect on sexual desires. It has been stated that a process of sterilization by means of X-rays can be applied to either sex. The only evidence available, however, shows that this method is still in the experimental stage, and the Committee, for this reason, cannot recommend it, especially as there is a danger that it might damage the cells producing the internal secretions which influence the secondary sexual characteristics and so injuriously affect the general health and mentality. Several States in America have passed laws providing for the sterilization of persons in State institutions who are —(1) Insane, (2) feeble-minded, (3) criminalistic. In some of the States an appeal was made to the Supreme Court, and, the law being pronounced unconstitutional, no attempt was made to enforce it. In other States the law has been allowed to become a dead-letter. Up to the Ist January, 1921, the latest date dealt with by the most recently published work on the subject, there have been 124 State institutions legally authorized to perform operations for sterilization, of which thirty-one have made more or less use of their authority, while ninety-three have not. The total number of operations performed up to the date mentioned was 3,233, divided into classes as follows : Feeble-minded, 403 ; insane, 2,700 ; criminalistic, 130. Of this total of 3,233 operations the State of California contributed no less than 2,538, and in this State a single institution (the State Hospital for the Insane at Patton) is responsible for no fewer than 1,009 cases. A Bill introduced in 1924 into the Senate to legalize sterilization of mental defectives, &c., was rejected. Dr. H. H. Laughlin, of the Psychological Laboratory of the Municipal Court of Chicago, has devoted several years to the study of this question, and has recently published the result of his researches in a book entitled " Eugenical Sterilization in the United States." He publishes the texts of all the laws past and present, gives his idea of a model sterilization law, together with the necessary forms for putting it into effect. He also deals with the physiological and mental effects of sexual sterilization. A reviewer of his book, writing in the Journal of Heredity of October, 1923, states forcibly the case for the opponents of sterilization. He expresses the opinion that " The release of sterilized individuals with feeble inhibitions or anti-social tendencies is the equivalent to the creation of so-many new and virulent foci of venereal diseases and promiscuity." Furthermore, the Central Association for Mental Welfare of Great Britain, which was formed in 1913 to act as a co-ordinating and representative body on all questions affecting mental defectives and their relations to the community, not long ago referred the question to their standing Medical Committee, who gave the considered opinion that " sterilization at the present time is not a practical proposition." The Committee of the Central Association being in complete agreement with this view, the Association decided not to advocate the policy of sterilization, because they consider that it would have only a limited influence in preventing the increase of mental deficiency, that it would be attended with certain harmful results in other directions, and because its adoption is impracticable. The Association's statement on this subject goes on to say : "It is very important to remember that

4—H. 31a.