“Three generations of imbeciles are enough.” With these words, United States Supreme Court Justice Oliver Wendell Holmes cleared the way in 1927 for the forcible sterilization of a 21-year-old girl, Carrie Buck and, subsequently, some sixty thousand or more other Americans as part of a eugenics project that would last in some states well into the 1980s.
There was perhaps an unsettling echo of Wendell Holmes’s pithy formulation of contempt in the reports last month of an Oxford woman of much the same age as Carrie Buck being ordered by the Court of Protection to be fitted with a contraceptive device against her will.
The case of Oxford University Hospitals NHS Foundation Trust v. Z concerned a woman described as having “a mild learning disability”. She also suffered from diabetes, anaemia and a Vitamin D deficiency. At the time of the judgment the woman, who remains anonymous for legal reasons, was in the late stages of pregnancy and booked-in for an imminent caesarean section.
Whereas Justice Wendell Holmes had been chiefly concerned with the supposed benefits to the wider society of curtailing procreation among the feckless, both the clinical and the legal focus in Z’s case were on her safety and wellbeing and those of any child she might carry. Her doctors and the court decided not only that for Z to have any more children after this one would be unwise, but that measures should be taken to ensure that could not happen.
You might think that the threshold for the state to intervene in something so essentially private as future fertility would be higher than is described in Mrs Justice Knowles’s judgment. Gestational diabetes is quite common among some ethnic groups and hospitals are used to managing it. And iron and vitamin deficiencies – even quite serious ones – are hardly unknown in pregnancy. Although Z’s mild cognitive impairment would probably have placed her in the special educational needs group at school, it would be shocking if being in the bottom set were enough to cast doubt on someone’s fitness to make decisions about having children.
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