When Treatment Becomes Torture

Many people who have encountered the mental health care system over the years have survived a variety of mistreatments, including the tragedy of coerced sterilization.

Several years ago I attended a conference on mental illness and the community at Simon Fraser University. Many of the participants identified themselves as “psychiatric survivors,” a term I had not heard before but which I learned was a self-descriptor used by people who had been through the mental health care system. Initially the term seemed presumptuous to me, even offensive, for its implied comparison of mental health care to torture and mental hospitals to concentration camps. I know that “survivor” has become a word of empowerment in the health field, but in this case it was not the illness that had been survived but the treatment, which was being compared to abuse. Instead of being grateful, these survivors seemed to resent the care they had received.

As I began to learn more about the history of mental health care, however, I came to acknowledge my own naïveté and admit the accuracy of the term “survivor.” People labelled mentally ill have routinely been abused, even tortured, by the professionals charged with their care. Images of the poor lunatic trussed up in a straitjacket or chained to a wall haunt the history of mental illness. Of course, those were the bad old days, but even after the most outrageous forms of physical restraint were abandoned, different therapies used the mentally ill as guinea pigs for experimentation. During the 1930s it was insulin shock therapy, by which patients received doses of insulin to induce hypoglycemia and a deep coma during which the brain supposedly “rewired” itself. In fact the patient’s brain cells were dying. By the 1940s more direct assaults on the brain were in fashion. Patients were mutilated by lobotomists or zapped with high-voltage electricity to induce convulsions. All these so-called “shock therapies” intentionally induced harm, in the form of brain damage, in order to achieve hypothetical results. Is this not a reasonably accurate definition of torture?

Which brings us to yet another episode in this long assault on the minds and bodies of the mentally ill: the story of the eugenics movement and more specifically the sexual sterilization of what used to be called the “feeble-minded.” In Canada sterilization was pursued most aggressively in Alberta. The details of that story are the subject of a new book, Facing Eugenics: Reproduction, Sterilization and the Politics of Choice, by the historian Erika Dyck (University of Toronto Press).

It is conveniently forgotten that between the World Wars the positive benefits of eugenics were a part of conventional wisdom in Canada, as they were elsewhere. Until Adolf Hitler and his Nazis gave it a bad name, eugenics, the science of selective breeding, was approved of by almost every progressive person. It was widely believed that society was deteriorating under the influence of large-scale immigration and the proliferation of the feeble-minded. Both groups were thought to pass on undesirable flaws to their offspring. By allowing them to reproduce, Canadians were said to be committing “race suicide,” a popular expression at the time. Dyck defines it as a fear “that the better classes would be subsumed by the lower classes.” The answer to this perceived crisis was to control fertility among certain groups, eradicate their deficiencies and improve the quality of the human stock. Eugenicists often compared population control to animal husbandry. Dyck quotes Irene Parlby, a leading advocate of eugenics in Alberta, from a 1924 speech: “Curious, is it not, that we cull our flocks and herds, allowing only the finest and most physically perfect to breed, and yet when it comes to the human race we allow the mating of the most diseased and imperfect both mentally and physically.”

As Dyck shows in her book, icons of early feminism such as Parlby and Emily Murphy were particularly drawn to eugenic theory. Women, they argued, were the “mothers of the race” and had a particular responsibility to oppose the degeneration of the stock. This meant targeting the mentally ill and disabled but also the immoral (e.g., single mothers), even the socially inferior (e.g., immigrants from eastern Europe). Of course feminists were not alone. Tommy Douglas, premier of Saskatchewan and first leader of the federal NDP, wrote a university thesis warning about the social and economic costs of unrestricted childbirth among the “subnormal” members of society. And Dyck cites the president of the University of Alberta, R.C. Wallace, lamenting in 1934 that “nature’s weeding-out process” was not allowed to take its natural course and stating that “children of the professional classes make a higher contribution through intellectual ability than those of the classes inferior in intellectual training.” For all its support among progressives, eugenics at times sounded like just another name for class warfare.

In 1928 Alberta passed the Sexual Sterilization Act, the first such legislation in Canada. It came into effect in January 1929 and involved the creation of a provincial Eugenics Board consisting of an academic philosopher, two surgeons and a recording secretary. Within a year the first person was sterilized under the terms of the legislation. The law remained in effect until 1972 and during that time Alberta sterilized 2,822 people, slightly more women than men. Most were residents of mental institutions. Many did not give their consent. Though eugenics and its related mental hygiene movement were popular across the country, British Columbia was the only other province to make sexual sterilization public policy; between 1933 and 1972, BC sterilized almost two hundred people.

The history of Alberta’s sexual sterilization law came to prominence in the 1990s with the case of Leilani Muir, to which Dyck devotes a chapter. Muir is an Alberta woman who successfully sued the provincial government for sterilizing her when she was a fourteen-year-old resident of the Provincial Training School for Mental Defectives back in the 1950s. Told she was having her appendix removed, the young Muir also had her Fallopian tubes snipped. Doctors did not request permission, at least from her, and she was not told what had happened. Only years later, when she was a married woman attempting to start a family, did Muir discover the truth. In 1996 a judge ruled that Muir should be compensated for the loss of her civil rights, and she was awarded a million-dollar settlement. Her case attracted international attention and was the subject of a National Film Board documentary. As Dyck writes, Muir went from being labelled a “mental defective” in her youth to becoming a “human rights heroine.” Following her legal victory, several hundred individuals with similar grievances joined a successful campaign to force compensation from the provincial government.

At the training school, doctors had labelled Muir a “moron” (i.e., having an IQ below 70), yet testing at the time of her court case showed her to have an IQ of 95, well within the average range. Her case, along with others presented by Dyck, is a cautionary tale, reminding us of how many people in the mental health care system have survived misdiagnosis and abuse in the name of one crackpot theory after another, and often endorsed by the most progressive voices among us.