The Duty of the State in the Treatment of the Deformed: R. Z. Mason, Appleton WI, 1879

R.Z. Mason, mayor of Appleton, WI, “The Duty of the State in its Treatment of the Deaf and Dumb, the Blind, the Idiotic, the Crippled and Deformed, and the Insane.” [Source / Italics added, bold text added]

In the progress of modern civilization, the state has come slowly to a recognition of certain duties and obligations to these unfortunate classes.  At present we take up the subject in the interests not only of humanity and of sound political philosophy, but also in the interests and light of modern science.  Perhaps we shall commit a grave mistake in venturing to draw our conclusions solely from the cold suggestions which the teachings of the most advanced investigators in science might supply.  Humanity certainly has claims upon us which the dictates of our spiritual natures must respect.  Shall we adopt the language of Herbert Spencer, “the fittest shall survive,” and be induced thereby to turn out the unfortunate idiot, the insane or the deformed cripple, with nothing but his own resources to depend upon, to compel him to struggle for a precarious existence by battling with the relentless forces of nature, and sharp competition with the fierce selfishness of individual life?  Would this course be in accordance with the instincts of man’s better and higher nature?  Whatever theories we may adopt as to our origin, we cannot ignore the fact that we belong now to a cultured race, to those whose gentle humanities are to be as much regarded as the mere elements of physical strength or intellectual acumen.  If we did spring from the brute, we cannot afford to act quite like him.  But the subject has another phase which it is proper we should carefully examine. The question arises, whether the state shall expend its hundreds of thousands of dollars per annum in the almost hopeless effort to correct congenital malformations, to subdue the frantic manifestations of insanity, to counteract the subtle forms of organic disease, and to educate the feeble minded and still allow these pre-natal and constitutional disorders to flow on through countless generations of the unborn.  Of course we assume in our argument, that it is the province of the state, acting from considerations of the highest political economy, to care by systematized and organized effort, for such of the unfortunate as cannot care for themselves, or whose wants friends cannot supply.  The insane can, not unfrequently be rendered happy and useful, but even sane.  The idiotic can, by skillful treatment of the educator be developed into the self-reliant, self-sustaining human being.  The orthopedic surgeon can bring beauty out of deformity, and can so change those flexures that deform and weaken the physical anatomy, as to bring nature to her true and original lines, and impart a new strength and vitality.

But the prosecution of all these lines of experiment and modes of rendering the combined skill of the civilized world available, require large outlays of time and money.  And is it not vastly better that the state, acting in her organic capacity as the agent of human society, should encourage and aid by her own means, the foundation of institutions for such purposes, rather than to leave the large numbers of these unfortunate people to the ill-directed and uncertain efforts of poor, and often unintelligent families, to get along with their herculean difficulties as best they may?  Is it not better, therefore, that the state should tax herself a little to help the blind to become an intelligent, self-sustaining member of society, or to cure a child of some dwarfing deformity or some smiting paralytic stroke, rather than tax herself much by and by in maintaining these victims of relentless misfortune in poor-houses in the long years of their future.  Such a question can, I apprehend, have but one answer.

But above and beyond all this, the state has another and more important duty to perform to society, than that of merely taking care of such as have come into the world under the blight of some terrible misfortune.  This other and higher duty is to modify its legislation as to prevent the propagation of congenital idiocy, deforming insanity and organic disease. I know that in venturing to discuss this subject by treating it as a function properly belonging to the state, I may be assuming what will not be readily conceded.  To prevent, if possible, these serious misfortunes, is unquestionably the duty of somebody.  Or must we admit that man, intelligent and immortal, is such a creature of blind and reckless passion, that he must be permitted to go on through the vast eons of the future as he has done in the past, reproducing himself, depraved and demoralized as he is, transmitting his anatomical defects, his physiological idiosyncrasies, his organic imperfections, in the most marked manner, in order that posterity may have the opportunity to cultivate the moral virtues by taking humane care of the insane, the blind, the deformed and the idiotic.  It is not too early in the history of man, I more fear it is too late, to ask the question, should a radically defective organization be allowed to perpetuate itself by reproduction?  To this I would answer, that for the good of the race it should not.  This must be our conclusion unless we are prepared to adopt the modern school of Euthanasists, who take the ground, that when a human being cannot live and be happy, he has the right to claim of society the boon of death, legally administered.  I would modify the position by saying rather, that such an unfortunate had a right not to be born; yet, having been born, perhaps the Euthanasist may say that he has the right to ask the privilege of an early, painless death.  Yet the original question still recurs, What is the duty of the state towards this large and constantly increasing class of incurables and unfortunates?

First, I answer as to those in existence.  Let them be taken care of in the most economical and best systematized way which science, art and experience can devise.  Let alms-houses, the insane hospital, the deaf and the dumb, and blind asylums, still stand as monuments of the generous and humane spirit of the age.  Let the crippled and deformed have ready access, if need be, by public charity, to all sources of relief which the world’s best wisdom can supply.  It is better that the state pay the expense of putting a man in a condition so that he can take care of himself, than to tax the public through an entire generation for the support of a cripple in the poor house.  But secondly, I propose to show a rational answer, it may be imperfectly and impractically, to the second branch of this question, to wit:  the duty of the state to the unborn generations, with which our successors will have to deal.  The state establishes a state board of health, to whom it commits the various questions concerning the public health.  It requires the individual to conform to such sanitary regulations as are found necessary to protect life, health, and property.  But is there any more reason why the state should see that offensive and mephitic vapors and gases should be promptly neutralized by chemical agents, why nuisances should be abated or removed from civilized communities, than there is why the state should interfere to arrest the descent, through long lines of generations, of the germs of incurable diseases, which are sure to become the object of the world’s pity when allowed to develop into the full proportions which we witness in our hospitals and public alms houses?  Should it be the province of a state board of health to tell me that my sewers need chloride of lime or carbolic acid, and not be their function to tell me that my posterity will be smitten with incurable insanity, provided a contemplated marriage is consummated?  Should he be allowed to intrude into my back yards and order me to remove the offal, which carried on its wings the pestilence and plague, and yet must not be allowed to have at least some voice in arresting, by counsel or by law, the descent of those congenital disorders, that prey at an earlier or later date on half the population of the civilized world.

We take remarkable pains in selecting and crossing breeds of the domestic animals.  Here at least we try to study and harmonized with the laws of nature.  The royal and aristocratic families of Europe are very strict in the marriages of their sons and daughters.  We recognize the universal law that physical qualities, character, breeding and education begin long anterior to birth.  But unfortunately for the ruling classes of Europe, the primary principle on which their intermarriages are based, is not in respect to the laws of nature.  Their idea is a purely conventional one, and their society is purely artificial, where nature and her economy in the processes of reproduction, are as much ignored as with the bulk of mankind elsewhere.  Their intermarriages come from rank, based on wealth, and on freedom from the restraints of law and labor; a condition of things best calculated to deteriorate what there is good in any generation of men. If the doctrine is true, that the fittest only should live, then it follows as a rational corollary that, in a society of rational men, where the interests of a race capable of indefinite development are blended, that “the fittest only should be born.” To reproduce and fill the world with posterity is not always a duty.   Certainly not always a privilege.  The law makes it a crime where the parties have not taken the legal steps to provide, as far as may be for the protection, the education and general well being of future offspring.  Why should not the law adopt the sound maxim, that no person has the right to throw upon the charities of the world, his diseased, deformed and insane offspring.

The laws of generation are now sufficiently well established so that good scientific and medical authority can determine with tolerable certainty the probable issue of a given marriage, so far as health is concerned.  Yet, even this generation continues to introduce into the world, children marked with these congenital defects, as if it were a matter of the slightest concern whether children were well or ill born.  Society should erect an impassable barrier, so that no person, man or woman, who failed to present the requisite credentials of a sound mind in a sound body, free from all forms of congenital and organic disease, no matter what social standing or wealth might distinguish them, should become the head of a family of children.  This is the aristocracy of nature.  No man is well born who inherits the appetite of a drunkard or the feebleness and frailties of a consumptive.  No person is ill born who comes into the world with all his mental and physical faculties bright with the bloom of health and vigor.  All theories of progress and true social development are useless and abortive unless these ends are first secured.

But should our legislators see practical difficulties in the way of a system of legislation so radical and revolutionary in the social life and economy of the people as the above programme would indicate, still the least it can do is introduce these biological remedies to the attention of the public, in the education of the young.  It is ignorance that has destroyed us in generations past.  It is ignorance of the functions of life and of the laws of reproduction that destroys us to-day.  We cultivate with more skill even the grapes and grains than we do the propagation and reproduction of our own species.  Marriage is a hap-hazard affair, the result of caprice or fancy, instead of being the result of judgement and knowledge of the fundamental laws of being.  Science and the public law, are alone, perhaps insufficient to do justice to this noble cause.  They invoke the aid and cooperation of the pulpit and of the public teacher.  A wise supervision of this subject is indispensable to the future wellbeing of the race.  False standards of delicacy must be set aside.  Morbid sentimentalism must give way to the suggestions of common sense and a rational philosophy.