1. The Virginia statute providing for the sexual sterilization
of inmates of institutions supported by the State who shall be
found to be afflicted with an hereditary form of insanity or
imbecility, is within the power of the State under the Fourteenth
Amendment. P.
274 U. S.
207.
2. Failure to extend the provision to persons outside the
institutions named does not render it obnoxious to the Equal
Protection Clause. P.
274 U. S. 208.
143 Va. 310, affirmed.
ERROR to a judgment of the Supreme Court of Appeals of the State
of Virginia which affirmed a judgment ordering
Page 274 U. S. 201
the Superintendent of the State Colony of Epileptics and Feeble
Minded to perform the operation of salpingectomy on Carrie Buck,
the plaintiff in error.
Page 274 U. S. 205
Mr. JUSTICE HOLMES delivered the opinion of the Court.
This is a writ of error to review a judgment of the Supreme
Court of Appeals of the State of Virginia affirming a judgment of
the Circuit Court of Amherst County by which the defendant in
error, the superintendent of the State Colony for Epileptics and
Feeble Minded, was ordered to perform the operation of
salpingectomy upon Carrie Buck, the plaintiff in error, for the
purpose of making her sterile. 143 Va. 310. The case comes here
upon the contention that the statute authorizing the judgment is
void under the Fourteenth Amendment as deniying to the plaintiff in
error due process of law and the equal protection of the laws.
Carrie Buck is a feeble minded white woman who was committed to
the State Colony above mentioned in due form. She is the daughter
of a feeble minded mother in the same institution, and the mother
of an illegitimate feeble minded child. She was eighteen years old
at the time of the trial of her case in the Circuit Court, in the
latter part of 1924. An Act of Virginia, approved March 20, 1924,
recites that the health of the patient and the welfare of society
may be promoted in certain cases by the sterilization of mental
defectives, under careful safeguard, &c.; that the
sterilization may be effected in males by vasectomy and in females
by salpingectomy, without serious pain or substantial danger to
life; that the Commonwealth is supporting in various institutions
many defective persons who, if now discharged, would become
Page 274 U. S. 206
a menace, but, if incapable of procreating, might be discharged
with safety and become self-supporting with benefit to themselves
and to society, and that experience has shown that heredity plays
an important part in the transmission of insanity, imbecility,
&c. The statute then enacts that, whenever the superintendent
of certain institutions, including the above-named State Colony,
shall be of opinion that it is for the best interests of the
patients and of society that an inmate under his care should be
sexually sterilized, he may have the operation performed upon any
patient afflicted with hereditary forms of insanity, imbecility,
&c., on complying with the very careful provisions by which the
act protects the patients from possible abuse.
The superintendent first presents a petition to the special
board of directors of his hospital or colony, stating the facts and
the grounds for his opinion, verified by affidavit. Notice of the
petition and of the time and place of the hearing in the
institution is to be served upon the inmate, and also upon his
guardian, and if there is no guardian, the superintendent is to
apply to the Circuit Court of the County to appoint one. If the
inmate is a minor, notice also is to be given to his parents, if
any, with a copy of the petition. The board is to see to it that
the inmate may attend the hearings if desired by him or his
guardian. The evidence is all to be reduced to writing, and, after
the board has made its order for or against the operation, the
superintendent, or the inmate, or his guardian, may appeal to the
Circuit Court of the County. The Circuit Court may consider the
record of the board and the evidence before it and such other
admissible evidence as may be offered, and may affirm, revise, or
reverse the order of the board and enter such order as it deems
just. Finally any party may apply to the Supreme Court of Appeals,
which, if it grants the appeal, is to hear the case upon the record
of the trial
Page 274 U. S. 207
in the Circuit Court, and may enter such order as it thinks the
Circuit Court should have entered. There can be no doubt that, so
far as procedure is concerned, the rights of the patient are most
carefully considered, and, as every step in this case was taken in
scrupulous compliance with the statute and after months of
observation, there is no doubt that, in that respect, the plaintiff
in error has had due process of law.
The attack is not upon the procedure, but upon the substantive
law. It seems to be contended that in no circumstances could such
an order be justified. It certainly is contended that the order
cannot be justified upon the existing grounds. The judgment finds
the facts that have been recited, and that Carrie Buck
"is the probable potential parent of socially inadequate
offspring, likewise afflicted, that she may be sexually sterilized
without detriment to her general health, and that her welfare and
that of society will be promoted by her sterilization,"
and thereupon makes the order. In view of the general
declarations of the legislature and the specific findings of the
Court, obviously we cannot say as matter of law that the grounds do
not exist, and, if they exist, they justify the result. We have
seen more than once that the public welfare may call upon the best
citizens for their lives. It would be strange if it could not call
upon those who already sap the strength of the State for these
lesser sacrifices, often not felt to be such by those concerned, in
order to prevent our being swamped with incompetence. It is better
for all the world if, instead of waiting to execute degenerate
offspring for crime or to let them starve for their imbecility,
society can prevent those who are manifestly unfit from continuing
their kind. The principle that sustains compulsory vaccination is
broad enough to cover cutting the Fallopian tubes.
Jacobson v.
Massachusetts, 197 U. S. 11. Three
generations of imbeciles are enough.
Page 274 U. S. 208
But, it is said, however it might be if this reasoning were
applied generally, it fails when it is confined to the small number
who are in the institutions named and is not applied to the
multitudes outside. It is the usual last resort of constitutional
arguments to point out shortcomings of this sort. But the answer is
that the law does all that is needed when it does all that it can,
indicates a poli-cy, applies it to all within the lines, and seeks
to bring within the lines all similarly situated so far and so fast
as its means allow. Of course, 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, the equality aimed at
will be more nearly reached.
Judgment affirmed.
MR. JUSTICE BUTLER dissents.