Buck v. Bell

Summary

This record concerns compulsory sterilization and is best read with a teacher's guidance. In March 1924 Virginia enacted a statute permitting the superintendents of certain state institutions to have inmates sterilized if, after a hearing, they were found to be afflicted with hereditary forms of insanity or what the law called imbecility. The statute's preamble declared that heredity played an important part in transmitting such conditions and that sterilized patients could be discharged to support themselves. Its sponsors, including the Colony's attorney Aubrey Strode and its superintendent Dr. Albert Priddy, sought a test case to establish its validity. They chose Carrie Buck, an eighteen-year-old committed to the State Colony for Epileptics and Feeble Minded near Lynchburg after giving birth to a daughter. Her mother was also an inmate of the Colony. The Colony's board ordered the operation, and the Amherst County Circuit Court and the Supreme Court of Appeals of Virginia affirmed. Priddy died in 1925, and his successor, Dr. John H. Bell, became the named party. Buck's lawyer argued that the statute denied her due process, because the state had no power to take away a person's capacity to have children, and equal protection, because it applied only to the few people in institutions and not to the many outside them. The state answered that the procedure contained careful safeguards, that the legislature had made findings about heredity, and that the measure served both the patients and the public. On 2 May 1927 the Court affirmed, eight to one. Justice Holmes found that the procedure, with notice, a guardian, a hearing and two levels of appeal, gave Buck due process. On the substance he accepted the legislative and judicial findings, reasoned that the public welfare could call on citizens for lesser sacrifices than the lives it asks in war, and cited Jacobson v. Massachusetts (1905), which upheld compulsory vaccination. He closed that paragraph with the sentence, in the period's language, "Three generations of imbeciles are enough." He rejected the equal protection claim on the ground that a law does enough when it applies a policy as far as its means allow. Justice Butler dissented without opinion. The library text is Holmes's entire opinion, followed by the note of Butler's dissent; nothing else from the report is included. Carrie Buck was sterilized in October 1927. Virginia sterilized several thousand more people before repealing the law in 1974, and many other states passed or used similar statutes. In Skinner v. Oklahoma (1942) the Court struck down a sterilization law for certain criminals without overruling Buck, and the opinion has never been formally overruled. In 2002 Governor Mark Warner apologized on behalf of Virginia. Paul Lombardo's Three Generations, No Imbeciles (2008) documented that Carrie Buck was of normal intelligence, that her daughter Vivian did well in school before her early death, and that Buck's own counsel, Irving Whitehead, was closely tied to the Colony and its lawyer and did little to defend her.

Top Lessons

• Procedure is not the whole of justice

  Holmes devotes much of the opinion to the statute's careful procedure and concludes that Buck received due process. Yet the facts later uncovered show that hearings and appeals did not prevent a mistaken result, since her own lawyer did not seriously contest the evidence. The case invites students to ask what procedure can and cannot guarantee.

• Deference to findings of fact

  Holmes says the Court cannot declare, as a matter of law, that the grounds found by the legislature and the trial court do not exist. Because the record was built by parties seeking the same outcome, the Court's deference rested on facts no one had truly tested. The case shows how an appellate court depends on the record that comes before it.

• The reach of an analogy

  Holmes rests his reasoning on Jacobson v. Massachusetts, treating the principle behind compulsory vaccination as broad enough to cover sterilization. Students can examine how far an analogy between a temporary public-health measure in an epidemic and a permanent operation on one person can fairly be carried.

• Science, law and human dignity

  The statute's preamble presented the hereditary transmission of mental conditions as settled experience, reflecting the eugenics movement then supported by many scientists, physicians and reformers. Later genetics and the historical record overturned those claims in Carrie Buck's case. The decision raises lasting questions about how courts and legislatures should treat confident scientific claims when bodily integrity is at stake.

Verified Quotes

Medical Lens

Buck v. Bell is a central document in the history of eugenics, hereditarian theories of mental illness and intellectual disability, and the ethics of institutional medicine. It shows physicians and institution superintendents acting as advocates for a statute, the use of hereditary-degeneration theory as legislative fact, and the absence of informed consent; it is now taught in medical ethics as a case of professional and legal failure. Holmes's opinion uses the diagnostic vocabulary of 1927, which should be read as historical terminology.

• Opinion of the Court, the statute's preamble: that experience has shown that heredity plays an important part in the transmission of insanity, imbecility, etc.

  Holmes summarizes the legislative findings on heredity and the discharge of institutionalized patients, the hereditarian premises on which the statute rested.

• Opinion of the Court, review of procedure: The superintendent first presents a petition to the special board of directors of his hospital or colony

  The procedure by which an institution's superintendent initiated the operation and the board, courts and guardian reviewed it, a window on the authority of asylum administrators in the 1920s.

• Opinion of the Court, closing paragraph: so far as the operations enable those who otherwise must be kept confined to be returned to the world, and thus open the asylum to others

  Holmes links sterilization to the discharge of patients and the freeing of institutional beds, reflecting the period's view of the asylum's custodial role.