North Carolina made headlines this year with its commitment, after ten years of discussion and deliberation, to compensate the victims of forced sterilization in the 20th century. The state’s decision could have major repercussions, as contrary to what one might expect from the parity of coverage in the news, North Carolina wasn’t the biggest offender in the era of widespread forced sterilizations: that honor goes to California, which performed 1/3 (20,000) of the estimated 60,000 forced sterilizations between the early 1900s and the 1960s. (Virginia came in second, with a little over 8,000 sterilizations.) Those states could be held equally accountable in coming years, requiring a substantial cash payout.
But is a cash settlement enough?
The state has identified 3,000 living victims as of this year, and intends to divide $10 million amongst them as compensation for pain and suffering. However, this is not a situation like a classical tort case: if your tree falls on a neighbor’s house, you can pay to replace the house, but how do you put a cash value on a deed committed by the state that forever changed someone’s life?
Most victims of forced sterilizations were low-income members of the community, and many lived in residential institutions. North Carolina invested considerable energy in sterilizing poor people of color, although numerous low-income white youth (forced sterilization was especially common for people in their teens and early twenties) were victims as well.
Of course, North Carolina, like other states, heavily sterilized disabled wards of the state in the belief that they shouldn’t be allowed to reproduce. All of these sterilizations were performed with the approval of a board of people who supposedly reviewed applications for sterilization put forward by doctors, parents, guardians and officials, but the board didn’t apply anything resembling modern bioethics to these decisions.
Many patients weren’t told what the surgery they were ordered to undergo was for, let alone asked for consent. Many women were sterilized during labor and delivery without their knowledge. Men and women only found out about their sterilization later, when they went to have children and began struggling with infertility. Years later, the legacies of sterilization still echo: the devaluation of low-income communities, the sense of loss among survivors, and the anger among their communities at the way they were treated.
In the face of the tremendous social and personal impact of sterilization, is money enough? Some advocates argue that it’s not, and look for a more complete and reparative system of justice, acknowledging at the same time that there’s no way to undo the harm that has been done. The focus may need to include concrete evidence that the state will not participate in forcible sterilization again (mass or otherwise) and that it understands this critical part of its history.
One element of such a program should include an extensive historical archive, one that carefully preserves documents relating to sterilization along with the personal stories of its victims. This can ensure that their voices will continue to be heard and their stories will be told even after they’re gone, creating a living history lesson for the state to keep in mind. The existence of a library of resources on eugenics would be quite valuable to scholars, bioethics committees, and others interested in the history of eugenics and the state’s role in it.
Criminal prosecution is also an option. As officials, medical practitioners and other key players from the era gradually die off, now more than ever is the time to evaluate opportunities for criminal and civil prosecutions of parties who forced sterilization on the residents of North Carolina. Holding them accountable for their crimes is critical, as is sending a clear message to the state as a whole that the government is ready to take responsibility for its role in mass sterilization, and it wants to prevent this crime from occurring again. Truth commissions could become another component of the plan, providing an opportunity to hear evidence in a public forum and issue rulings.
Like other states, North Carolina also desperately needs institutional reform. Forcible sterilization is not a thing of the past, as recently illustrated in California, and states need better controls and preventions to ensure that reproductive freedom is protected for all residents.