Race & Health: Eugenics in science

Eugenics is a concept closely tied to what makes us unwell, and its roots in race medicine amplifies the drivers of racial health inequities, ableism, and white supremacy. Though scientifically flawed, eugenic thinking is present throughout modern-day society and politics. We can see eugenic thinking in policies and protocols throughout the pandemic, through mental health, and much more. In the third episode of our collaboration with the Race & Health podcast, we learn about how eugenics was created, how it has been employed, and how today’s public health world is still riddled with this divisive concept.
 
Guests include Dr Ayah Nuriddin, who is the Cotsen postdoctoral fellow in the Society Fellows, a lecturer, and in the Council of the Humanities in African American Studies at Princeton University, Angela Saini, an award-winning journalist and author of books, including Superior, the Return of Race Science, and Professor Marius Turda, professor of biomedicine and director of the Centre for Medical Humanities at Oxford Brookes University.

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Transcript

This transcript was automatically generated using speech recognition technology and may differ from the original audio. In citing or otherwise referring to the contents of this podcast, please ensure that you are quoting the recorded audio rather than this transcript.

Delan: Hi everyone, welcome to the third series of the Race and Health podcast, in which we're partnering with the Lancet Voice podcast to talk about topics raised in the recent Lancet series on Racism, Xenophobic Discrimination and Health, which was published in December 2022. My name's Dela Devakumar, I'm a professor of Global Child Health in University College London, and the lead on the academic series.

In our first paper, we briefly discussed the topic of eugenics and I really felt that we should go into more detail on this the history of eugenics and also how it's relevant today. And I'm very happy to have a podcast to talk about this with three experts on the topic. First, we have Dr. Aya Nooruddin, who's the Cotsen Postdoctoral Fellow in the Society of Fellows.

And in the Council of the Humanities and African American Studies at Princeton University. Ayers working on her book manuscript tentatively entitled, Seed and Soil, Black Eugenic Thought in the 19th and 20th Centuries. Next we have Miss Angela Saini, who is an award winning journalist and author of books including, Superior at the Return of Race Science, which was a finalist in the LA Times Book Prize, and the Patriarchs, a finalist in the Orwell Prize.

She has a master's in engineering from Oxford University and is an honorary fellow of Keble College. And finally, Professor Marius Tirdo, who's a professor of biomedicine and director of the Centre for Medical Humanities at Oxford Brookes University. Maris is also the curator of the public history project, Confront Eugenics.

According to Francis Galton, Eugenics deals with what is more valuable than money or lands, namely the heritage of high character, capable brains, fine physique and vigour. It aims at the evolution and preservation of high races of men. Galton was a statistician and professor at my own university, University College London, and he coined the term eugenics at the idea of being well born.

And closely linked to eugenics is this idea of racial hierarchies, which was prevalent at the time and persists today. There's a division of people, with some people being above others. And in this case, creating a hierarchy which placed white Europeans at the top. And this was linked to the idea of race hygiene programs under the Nazi regime, for example, that led to some of the worst atrocities we've seen.

And the scientific community was complicit in this. The idea of scientific racism, the misappropriation of scientific methods, adding scientific legitimacy to ideas. But eugenics isn't just something to learn about from the past this ideology lies behind forced sterilization, segregation, and immigration policies that still persist today.

Can we start with some of the historical roots of this? And Aya, can you tell us a little bit about the idea of eugenics and how it came about? 

Ayah: Sure. So there's lots of different origin stories for thinking about a sort of beginning of eugenics. a range of opinions and debates around this kind of central question of nature versus nurture, in which one sort of defines what it means to be human and has a bigger impact on human reproduction and human heredity.

Some eugenicists were very fixated on thinking about nature as the source of different characteristics, traits, behaviors, et cetera, and argued that those things were the result of innate hereditary differences that could only be addressed through interventions. Like reproductive control, one of the sort of key definitions of eugenics is the science of human improvement through better breeding, which was Charles Davenport.

of the eugenics record office's definition. People of Davenport's ilk were really invested in how do we weed these characteristics out. Other eugenicists emphasize that there is a relationship between nature and nurture, and that you need to get your arms around both in order to address this broader question of human improvement or human betterment.

This leads to an interest and an investment in different kinds of environmental and social interventions, so this is where we get Eugenically inflected public health programs is also where we get the concept of hygiene as this sort of link between Nature and nurture. And so what we see across as early as the mid 19th century, but and also well into the 20th century, people wrestling with where they fall on that line between nature and nurture and what interventions are necessary to weed out the characteristics or traits or behaviors that are deemed problematic to society.

In the American context, which is what I'm the most familiar with it's also wrapped up in these progressive era ideas of reform and improvement that rely on the cultural authority of science and envisioning eugenics as a way to use science to address social problems. This leads to an incredible breadth of eugenic thinking, but also a wide embrace of eugenics.

One of the ways that I teach it to students is to think about if you were to walk down the street in 1925 and ask someone should we use the knowledge of heredity to address social problems, almost everyone would say yes. For some folks, they even imagine it as humanitarian. Of course, we, with the benefit of hindsight, we know that this is, It's not actually how it goes and becomes this weapon to be used against those that are marginalized because they become marked as the members of society with defective heredity.

So this is wielded against racial minorities. This is wielded against immigrants. This is wielded against people with disabilities. This is wielded against women. People imagine that they can take this tool of eugenics and weed out the people that they think are a problem. 

Delan: And was that idea present right from the start, this sort of targeting of marginalized groups?

Ayah: Yes, I would argue for sure. I think others might disagree with me, but I think right from the start the people that they are, that are being imagined as a problem. are people that are already marginalized by society. Even when people imagine that they're doing some sort of humanitarian project for society, that the people that are the problem to society are already those who have been pushed to its periphery.

Thank you. Mara Sanjua. 

Angela: You're absolutely right, that this isn't, belief system. I, we call it an ideology now, but it was considered perfectly mainstream to think about people in this way at the time. And it was seen as a truly progressive, scientific, rational way of thinking about how we might fix social problems.

And that idea that we can use science to fix social problems is one that we haven't really left behind. That eugenic style of thinking still persists in modern day. government policy in everyday thinking about self improvement even, this idea of self improvement, that we should be using medicine in order to improve ourselves, that we are improvable at all.

I think all is a product of that period of time in which scientists, anthropologists and philosophers all believed, within Europe at least, or in the Western world, that we were, as humans, on some kind of trajectory towards perfection, that we were improving a human race and that with intervention, we could speed up that rate of improvement.

Marius: Yeah, no I completely agree. And I think it might be important to highlight that my colleagues pointed out that's how seriously this was taken from the very beginning. And of course, if we go back to the 80s, and we look at Gorton's version of model eugenics. We can see how he married various scientific theories and the three are very important for that.

Thomas Malthus theory of overpopulation, Charles Darwin theory of evolution of natural selection. And there was this Belgian statistician he was very impressed by which is Adolphe Cotelet and his concept of the average man. So that's a very important thing, Legault envisioned eugenics as a synthesis.

Basically, it was wedded to the emergent disciplines of, you have statistics, sociology, demography. Whilst, of course, at the same time, it draws a lot of his sustenance from anthropology, what Angela defines in the book, Race Science. If you look at the 18th and 20th centuries, you have all these Western European anthropologists who measure and dissect human bodies to demonstrate how brain size and weight and the shape of the skull and cerebral circumvolutions, differ between men and women.

And, of course, the addition between people belonging to different races. But ultimately, the central argument for them, as it was for Goulton, is that you could actually observe, you could count, you could measure up variations in the bodies and the brains of human beings. And these variations are relevant because they indicate differences in their intelligence.

And for Galton and the eugenicists, it's also differences that inform culture dominance, particularly of white people. Eugenics was actually very rarely based on proven scientific arguments. So they were presenting a very sophisticated scientific edifice, but ultimately very little of that scientific argumentation defies scrutiny and survived what was called the examination.

But that's very important. Lots of the eugenics argument actually relied on speculation. Speculation about social norms, speculation about cultural ethnic agenda differences and importantly speculation about racial wealth. And in the context of how you connect these to the present. A lot of the eugenic ideas actually one drawing of inspiration from economic and social productivity.

In other words, genic said one individual is found to be mentally and socially unfit. It was appropriate for them to be worded out. You have all these labels, which actually become a sort of metonymy for the identity of the person. So unfit is one of them. It's a metonymy for pathological, criminal, subnormal, asocial, foreign, undesirable.

But you have to remind ourselves, and this is what Angela does very well in her book, These are socially constructed terms. Undesired is not a scientific term. For example, an undesired individual. And all of this terminology in a way, we know it very well now, basically reliant upon stereotypes, biases, and prejudice for an understanding and ordering of the world.

Which ultimately distinguish between normal and unknowable people able born from disabled individuals and so on. We have also to remind ourselves, to remind our listeners that Eugenics was more than just a science from the very beginning. Golden is very clear about that. He talks about eugenics as a future or as a secular religion of the future.

Golden understood eugenics as a subject or very complex subject, which comprising comprises fields outside science. For Galton, eugenics was a system of thought, of feeling, and of behavior. Of course, there were scientists who looked at eugenics as a science, but there are also politicians who look at eugenics as a form of policy, and the population at large looks at eugenics as a form of sentiment.

Delan: And that was closely twinned in terms of the politicians being involved in these movements as well. 

Marius: Yeah, because ultimately we spend a lot of time, and rightly looking at the scientific arguments behind eugenics, the discussion about heredity and social heredity, but at the same time I think we need to look at the cultures within which this argument circulated to understand the intricacies of those political cultures or social contexts.

or cultural communities within which ideas about social net selection or ideas about heredity circulated. Because this is how eugenics became so popular and really captivated so many people. And eugenicists were avid communicators. Before we had social media, they knew exactly how to use affairs, literature, films, photography, to really break into and crack open all these, the insecurities people had about themselves and about their neighbors and about society.

Ayah: This is such an important point that I think a lot of folks I think miss about the history of eugenics is just how capacious it really is. The folks that I write about in my work, for example, are African Americans who think they can mobilize eugenics in a way that is productive for racial equality.

And it doesn't quite work out the way that they think it will, right? That's the spoiler for the book. But what's so important is that you have all of these different groups of people who imagine that eugenics can do something for what their belief system is. But I think one of the most evocative ways that I use to, to teach with and think about this is there's this image from the Second International Eugenics Congress.

It's the sort of logo for the Congress in 1921. And it's a massive tree, and the tree has the word eugenics written on the trunk, and the roots are of the tree are all these different disciplines, so you have biology, you have medicine, you have anthropology, you have sociology, you have history, you have psychology, as all of these roots that grow into eugenics.

This sort of adds to this perceived authority people are inundated with this material that all of these things play on the anxieties that people already have and we get an in a sort of intellectual infrastructure in which those.

Delan: for describing how this has played out over the last couple of centuries. I want to just ask a little more about health and health outcomes and how these ideologies have related to people becoming unwell and Marius. 

Marius: Yes that's one of the major issues in, in the eugenic literature.

Eugenicists were constantly alarmed, really by the growing number of people with mental health problems. People they called feeble minded. Once you were labeled and diagnosed by a physician, your body was marked as eugenically unfit. For these people, feeble mindedness or any mental health problems was believed to be hereditary.

And then, a threat to the future of the race or the future of the nation. So I think we have to be very outspoken about the relationship between eugenics and psychiatry and psychology, then education behavioral genetics, psychometrics, and all of those, other disciplines which derives from the big chunk of psychiatry and psychology.

Because I think they bear a great deal of responsibility for the widespread influence of eugenics all the way until the 1960s and 70s. Also, I think very importantly, these people major psychiatrists across the world, they added credibility. We spoke about credibility before, they added medical credibility to the popular view that society needs to be protected from these people.

And of course we know how Terribly offensive were these terms, and are mentally deficient idiots imbecile, moron. All of these terms are created by eugenicists to really create this absolutely perfect dichotomy between us and them. And then we're not, obviously for white races would be a person of color, for classes would be someone belonging to an inferior class, but for most, for the majority of the population, the eugenicists understood it, were people with disabilities, people with learning difficulties.

The very important British psychiatrist, James Crichton Brown, prominent towering figure in British psychiatry, he uses the expression our social rubbish. This is how he talks about his patients, the people learning, they are our social rubbish. Clearly, you could see how the life of an individual deemed very valuable was prioritized to a person who didn't have a mental problem, to use the old language then.

Whilst a host of measurements and tests were introduced by these people and applied to demonstrate the intellectual inferiority and accordingly does to the reproductive worthlessness. 

Delan: And what happened to those people who were deemed to be inferior? 

Marius: If we only talk about people with mental or learning disabilities, they were stigmatized, marginalized, and ultimately dehumanized.

Their life was not only controlled and supervised. It continues throughout the 20th century to this day in some parts of the world. They were institutionalized in special schools, colonies. But ultimately the temptation was that you could solve a social problem by declaring these people less fit, biologically predisposed.

to criminal behavior. Women are predisposed to being of low morals. They can't control their urges. They can't think straightforwardly. Or they are, some people are innately suited for poverty and promiscuity. So they were immediately categorized as feeble minded, as it happened with a lot of women.

And then it became very easy for for the judge and the physician and the judge to argue for her. And for the British history, of course, self eugenics is very important because it becomes legal to use this term. So you have idiots, imbeciles, feeble minded, and moral imbeciles. So there are four categories of people that are qualified in this Act of Parliament.

So it's very important to see how this was created as a direct engagement with mental health. But it all starts, as we already pointed out, by really bringing that concern from the medical so called into the social debate and highlighting a problem that people believe they could solve, maybe a social problem, and people believe that by offering this eugenic solution they could solve this problem.

Delan: Thank you. And Angela, to you, because it struck me that this covers all your books, this sort of ideology. 

Angela: I think as Marius says, a lot of what he is describing in terms of The social problems that affect people are a product of poverty. And we have to remember that the early days of the British eugenics movement, and in fact, for most of the British eugenics movement, the big emphasis was on those at the bottoms of society who were poor.

So the social problems you inevitably get. as a result of poverty, like higher rates of criminality because it becomes a product of desperation, of course, bad health. And I sometimes wonder whether we forget that class aspect. In Britain, at least, the geneticization of class, the biologization of class, was so overwhelming.

And we still retain that as well. We just don't think about it in exactly the same way. So for example, it's very rare that These days to see genetics papers or GWAS studies looking at higher rates of poor health or lower life expectancy amongst lower socioeconomic groups and then looking for genes to explain that.

Although that does happen, there are sometimes papers that attempt to do that. But there was this real sense that people's problems in life and problems within families were not a product of how society was treating them. But was a product of, something innate that they were passing down over generations.

And this is how race gets invoked then. Because of course, race overlaps with poverty. It does that in quite a profound way in the UK, which is why during the COVID 19 pandemic, we saw much higher rates of critical illness and death among ethnic minority communities was because of race. These tended to be, in London at least, where the virus hit first, tended to be poorer, tended to work in front line jobs, tended to live in more overcrowded conditions, in multi generational households.

All the symptoms of poverty were affecting people because of their race. 

Delan: Thank you. I you talked earlier about this interplay between nature and nurture. And it seems that a lot of the people, proponents of eugenics, weren't really thinking about, as we say today, social determinants of health, but rather saying that this is due to someone's biology and that's where eugenics can be brought in.

But what was that the case? Were people disregarding? Someone has ill health, maybe due to their social position or classes, as Angela was just saying. 

Ayah: Yeah there's definitely that. And I think this sort of geneticization or biologization of class is a really great way to think about it.

The ways that people frame poverty, not as an environmental or a social problem, but as a biological one. It's something that definitely runs through the history of American eugenics. You have eugenicists who will come up with these sort of what they describe as like hereditary characteristics that are really just poverty.

They'll be like see, pauperism runs and in this family, see how they've all been poor all of these years. It must be heredity instead of all of these people have worked in the same coal mine. It's the ways that class or social inequality becomes biologized to make certain kinds of claims.

And so some of the folks that I write about are talking about what we would now call social determinants of health. They're talking about health inequality, and they're even talking about structure and racism, but are using different terms for that, and are making claims that no, black people don't have these, high rates of disease, morbidity, mortality, et cetera, because of some biological difference.

These are because of economic and social conditions. But we should still sterilize certain groups of people because they're still a drag on the rest of the race, right? Or they'll say we need to have these kinds of interventions because if we have this public health program and we have this kind of, environmental intervention, that will then have a eugenic effect on the rest of the race.

Even though they're talking about things that are caused by social and environmental conditions, they're still imagining that addressing those things. Has this eugenic benefit that can then be passed on. 

Delan: Can we move on to the present day? So we've talked about the history of this idea of eugenics and how it's played out, but how is it still relevant today?

What, if you can talk a little bit about the policies and actions and outcomes today. Angela, 

Angela: it's obviously more subtle. I'm so grateful that we live in a world in which, because of what happened in the 1950s, this attempt to come together. We have this language around universal human rights.

It's understanding that every person is valuable regardless of their intellectual capacity or whether they are disabled or whatever and regardless of race and gender. So legally, and in terms of the lexicon of human rights, I think we've made such enormous progress, but there are certain tensions that remain, and I'm not sure will ever be resolved.

Number one of these is that imagined belief that humans are progressing towards something better, that we are improvable. That is a very difficult thing to lift. I know as a science journalist, so much of science itself, so much of research is geared towards this idea of human improvement. You only have to look at, for example, the fact that the Nobel Prize was given to CRISPR, a gene editing technology, which is a, is an incredible thing.

But the question is, why is that deemed as so valuable? Why do we see that as so important to be able to tinker with our genomes and change them? Because of this perceived idea that then we can improve ourselves. How different is that really from this eugenic idea that you can breed away certain traits.

Now you can just tinker away certain traits using CRISPR. So theoretically, even though it's never framed this way, the conceptual link is still there. The ideal, ideological framework of that improvability of the human race I think is still there. You can be more productive as a human being, that you should be working towards your productivity, which again was a big part of the eugenics movement.

What is a better society? It's a more productive one. It's one in which every single person It's the most useful, and we haven't really let go of that either. Is that really the society that we want, in which everybody is the most productive that they can be? Or do we want a society in which everyone is valued regardless of how productive they are?

We haven't asked ourselves fundamentally, what is science for? What are the kind of societies we want to create? And in that sense, I think we're still living under the yoke of the philosophical ideas that created eugenics in the first 

Ayah: place. I would just really want to echo that word that in a lot of ways, even though we don't have the same state sponsored infrastructure that you see at the beginning of the 20th century, in some ways we have internalized.

This eugenic thinking and then deploy it outwards in a whole host of different ways, which is exactly Davenport's dream, right? That everybody would just absorb this eugenics and enact it without having the need for government intervention. But I think one of the most powerful and most, I think honestly dangerous manifestations that I've seen in eugenic thinking and the sort of present moment is the ways we talk about dis disability in the wake of the pandemic.

One of the things we see a lot in the US context is part of the justification for. Lifting of mask mandates or removal of vaccine mandates is this is okay because only these vulnerable populations are at risk the regular people will be fine. So if you're high risk, you just need to do X, or if you're vulnerable, you need to do Y, or if you're immunocompromised you have to just figure this out, that society imagines and frames these populations as expendable for this imagined greater good, so that certain people, and often, and these are often people with disabilities, can be sacrificed for this other perceived benefit, which is straight out of the eugenics playbook, the way that certain populations continue to be vulnerable due to age or disability or race or whatever, what have you, that because they are vulnerable or high risk, they are less deserving of protection by society.

And I think I've seen a lot of the same rhetoric also being employed around the scarcity of resources and resource allocation in medical settings. Where I remember seeing things like during the height of COVID in the U. S. that. If we run out of ventilators and we have to decide who gets a ventilator we should evaluate this person is a more productive member of society, so they should get the ventilator.

Or people with X, Y, Z disabilities will not be eligible because these other people will outrank them. That imagining even the ways that people use terms like quality of life. Have this kind of eugenic tinge to them in these conversations about resource allocation. The other thing, especially in, in, in the American context with our, recent assault on reproductive rights is that part of the arguments that people will make about why there should be access to abortion is predicated on the need to terminate fetuses with disabilities, rather than emphasizing the importance of the autonomy.

of the pregnant person and their ability to make decisions over their own body. And this anxiety and this fear of disability becomes the linchpin and becomes the justification rather than thinking about the well being of the pregnant person. 

Delan: So this idea of progression is progression towards this kind of ableist ideal of what society should be.

Angela, do you want to come back on that? 

Angela: I was just going to say that the abortion debate I think raises an interesting quandary because If you, just for a second and I am of course pro choice, but if you just for a second park the woman's autonomy. Aspect of that debate and look at the child's right to live aspect of it.

It does raise a problem because there was for most of history, people have seen some of their children as expendable if they aren't able to look after them. So in many cultures, that's the case, abortion and fetus side has been practiced in many cultures. We're now, we've now entered an age in which the rights of the child have become equal to the rights of the adult.

It's actually quite a revolution. That wasn't really the case before. Children were not seen on a par with adults in terms of rights or even being fully human sometimes. What right then do we have over the life and death of this unborn person or this person who now, because of technology we know, can be kept alive even after a premature birth for a much longer time than we imagined before was possible.

So that creates an ethical debate which is a genuine one for all of us, whether we are pro choice or anti abortion. 

Delan: Thank you. Marius if I can come to you next, and can you talk a little bit about some of the segregationist policies that we see today as well? 

Marius: Firstly I think that connects very interestingly with what Angela was saying about living in a 21st century anti eugenic society.

Obviously, I, there's more of a aspiration than a reality, sadly. As where we could see that in 2023, eugenics still remains attached to various policies. Obviously, as a historian, I want to emphasize one point. There is a remarkable continuity in conceptions of what I call eugenic stigma attached to certain categories of people.

And we discussed some here, what is the issue of abortion? Or whether it's people with disability, or whether it's people born in poverty, or whether it's various ethnic and sexual minorities. We shouldn't forget about that. In this country, in the United States, it's what they call the decline in fertility of white families.

So white families are not producing enough children. Or you have this conversation about nationalist, pro natalist. Which is very typical of certain countries in Europe, we are a small nation. We don't have enough people So we need to close ourselves in and reproduce either we have here this in Poland or Hungary Czech Republic, this kind of country.

I think it, it certainly helps in a negative way, obviously that eugenics continues to be, endorsed or sustained by what they call expert knowledge. After the murder of George Floyd, and of course the pandemic is, we see this what I call eugenic dehumanization, whether it's people of color, whether it's women or people with disabilities, and that continues.

It's eugenic rationalization of their supposed inferiority. And the inability to become parents or what have you it's deeply embedded in society. It's not just policy makers, medical professionals, but actually, as you pointed out, people on the street, if you go around and you ask people, they will be shocked by the kind of eugenic ethos that some of the answers possess.

It makes you on the one hand comfortable because you realize, you're not perfect. You are not very healthy, very tall, very bright. What have you. But at the same time, it creates this sense of discomfort because you're not only unhappy with yourself, but also you're not happy with your neighbors.

You're not happy with people who live with you, whether it's about your neighborhood or it's about your city or it's about your country. And that kind of pressure always. comes from this eugenic worldview that, started in the 19th century but which continues to really echoes widely in our lives.

Delan: Can I try to look forward, Aya, you mentioned the tree and this sort of symbol of the tree and what I liked in your exhibition, Marius, you re imagined that tree in terms of how we might, go forward in, in terms of trying to reduce the impact of eugenics. What can we do to reduce the impact of eugenics in modern medicine and in healthcare?

Marius, maybe to you first. 

Marius: I think we need to accept and understand the entire discussion in terms of its global impact. Eugenics was global, it was a global phenomenon although of course it had natural variation. As someone who's worked in the history of eugenics for 30 years now I, I'm absolutely convinced now that I will never, I'll never grasp or know the full impact of eugenics.

So what we could say, I think, with certainty, and we could say it out loud, is that it cut very deep and wide in the texture of our modern world. But to heal these deep wounds caused by more than a century of eugenics, I think, first of all, requires public recognition of those who were wronged in the past, and those who continue to be mistreated in eugenics.

This is a slow process, but it has begun, progress is being made to the victims of sterilization in Japan, of course, the United States. The Czech Republic, now Peru, they receive final apologies and are provided with financial compensation. So something is done in this direction. To give you one small example someone, a Japanese man who was sterilized when he was 16.

So he spoke completely about his own experience and he told me the following, we need to stick together because if we are separate, they will break us like chopsticks. We need to plant a new tree, a tree of togetherness. Speaking about Ho, of course, he's suing the Japanese government and he wants to be, he wants to be recognized and the Japanese government needs to apologize to him.

He wants that kind of reckoning, but he also spoke that, he together with us should be in a collective reckoning and that would be one way to deal with it collectively from all the individual work so many great people do in all various fields. But obviously we need to come together.

Ayah: I really want to second a lot of what Marius was saying, that I think the public recognition does a lot of work for trying to alleviate some of the harm, right? And it also is so important that people understand what eugenics actually was, is, and did. And I think there's this sort of more, a more popular conception of eugenics that mostly people, think of Nazis and they think of the Holocaust and they think of very specific things and they're not recognizing like how broad this thinking was and how much it permeates so many, areas of our thinking the work of.

public recognition the work of getting the stories of survivors. I think all of that does a lot to help make this visible to people. Because I think for, at least from some of my experience, that when I've been able to say actually this way of thinking is because of eugenics, because such and such person, and I lay it out, then people have this kind of, this moment of like revelation where they're, wait, I didn't realize that was eugenics too.

Let me, I need to reevaluate, how I'm approaching X, Y, Z issue. And I think this is particularly important for physicians and folks in clinical settings to see how deep eugenics is baked into medicine. Some of the most canonical and important figures in the history of American medicine are deeply implicated in the history of American eugenics and a lot of, those dots need to be connected, right?

Having this very visible public reckoning with what the impact of things like compulsory sterilization laws in the United States were, right? The fact that Bob vs. Bell, which was the landmark case that upheld compulsory sterilization in the United States, has actually not been overturned yet. We just It's terrifying in the wake of the assault on our reproductive rights in, in, in the United States wrecking, like having those conversations about this stuff is still here, right?

That it's still legal in a lot of states to sterilize folks with disabilities without their consent, right? That it's still legal at a lot of these settings, not even just legal, that there are all these workarounds for taking away people's reproductive rights because, They were somehow deemed unfit for folks who were receiving welfare.

If you were on certain kinds of government assistance in the United States, you could get Norplant, which is a contraceptive implant that Medicaid would pay for the implant to go in, but wouldn't pay for it to come out, right? These kinds of things that are done to ensure that certain people's reproduction remains restricted are part of this legacy of eugenics that we're still in.

Needing to fully reckon with that. We're not just reckoning with, the sort of impact of the eugenics of the 1930s. That we have to eugen reckon with the eugenics of 2023 as part of the conversation too, that it's not only about a historical reckoning, but a current reckoning at the same time.

Angela: Yeah, I would agree with all of that. We're in constant conflict, I think, between knowing deep down that the ideal society for each of us would be one in which every person was valued as they are, without having to improve, without having to change, without having to eradicate them. And yet at the same time, we live in societies that are driven by certain imperatives in capitalist democracies for productivity, for keeping birth rates up to a certain level, anti immigration, so many things about nation states which mitigate against our wish to live in a society in which we're free and we're able to be who we are.

So I do wonder how do we actually get beyond the fact that we've created societies that push us towards. social improvement, which is what led to eugenics in the first place, this idea of there are some people who are better than others, who are more valuable or more productive than others. I don't know if we can, if we'll ever fully get beyond that or whether we can build societies that don't care about that anymore.

For me, just as a thought exercise what would that anti eugenics society really look like? I can't imagine it right now because I can't see a world in which we would fully ever be able to extricate ourselves from those ideas. 

Delan: Wonderful, but also quite a troubling conversation. So thank you to all my guests and to Aya, Angela, Marius, understanding the historical roots of the practices that we see today, and also the scientific basis for them is essential.

Eugenic ideas persist to today, and at the very least need to be called out, and thank you very much, all of you. Thank you to my guests, Aya Nooruddin, Angela Tirda. This episode was produced by Mita Hawke, Sofia Lobanov Rostovsky, and myself, editing by Gavin Cleaver, and by Mita Hawke. To visit the recent and health website on www.raceandhealth.org for more information about our academic work and to sign up to our newsletter.