Court Opinion

ID: 9679028
Source: CourtListenerOpinion
Date Created: 2023-08-24 06:38:39.118233+00
Date Added: 2024-06-11T18:17:09.688904
License: Public Domain

Smith, J.,
dissenting.
The critical issue is whether the sterilization law denies substantive due process of law guaranteed by the Constitution of Nebraska. I too believe that the right of man to procreate is not absolute, that a balance must be struck between the private right and the police power. Two considerations are the statutory interpretation made by the court and the strength of reliable scientific opinion about involuntary sterilization.
The law applies, according to the court, to voluntary sterilization alone—an interpretation with which I do1 not concur. The court supplies, however, little guidance to anyone in solving problems of effective consent by the mentally retarded and of substitute consent. More important, the coercive feature is hardly masked by the Active option of sterilization or life imprisonment.
The factual approach to constitutionality begins with the record. The board members concluded that heredity, environment, or both produce mental retardation, and their conclusion is obviously undeniable. Some also found a probability that future offspring of Gloria would be mentally retarded, but nothing in the record shows the competence of anyone to make that judgment.
Outside the record, but within the ambit of judicial notice, a 1963 report on the mentally retarded in the Beatrice State Home reads: “The Director * * * made an extensive survey of all people admitted for the years 1940 through 1960 to determine changes as to age and level of retardation at time of admission * * *. Briefly, the findings (which are in line with the trends! in the United States) are: people are coming to the Beatrice State Home at an increasingly earlier age; they are more retarded; and they are evenly distributed in pro*724portion to population, with no apparent variation because of race, geography, or families’ social classes or level of intelligence. * * * more staff and services are needed * * * to study the cause of their mental retardation in order to be able to prevent damage to children yet unborn.” First Biennial Report, Department of Public Institutions of Nebraska, pp. 81-82.
The State itself cites an article that reads: “* * * Dr. Leo Kanner has written, Tn my 20 years of psychiatric work with thousands of children and their parents, I have seen percentually at least as many “intelligent” adults unfit to rear their offspring as I have seen such “feeble-minded” adults. I have—and many others have—come to the conclusion that, to a large extent independent of the I.Q., fitness for parenthood is determined by emotional involvements and relationships.’ Kanner, A Miniature Textbook of Fe,eble-Mindedness, p. 5.” Bligh “Sterilization and Mental Retardation,” 51 A. B. A. L, 1059.
The preceding quotations correspond with expert opinions cited by Elyce Ferster in 1966: “Concerning the claim of eugenicists that the efforts of society to- help the unfit works against the welfare of the race the Committee (of the American Neurological Association) said: ‘It is precisely in those communities where social care is good that we find the evidence of the finest culture and, on the whole, the best biology. It is in those communities where social care is poor that the population presents an appalling spectacle of degradation.’ * * *
“A recent opinion * * * (was) expressed by the Mental Health Committee of the South Dakota Medical Association * * *: ‘Medical science has by no means established that heredity is a factor in the development of mental disease with the possible exception of a very few and rare disorders. The Committee holds that the decision to- sterilize for whatever reason, should be left up to the free decision reached by patient and family *725physician mutually and that the State has no good reason to trespass in this area.’
“The scientific arguments against sterilization were ably summarized in 1960 by Dr. Bernard L. Diamond when he served as a special consultant to the American Psychiatric Association for its report on mental health legislation in British Columbia: * * In short, the present state in our scientific knowledge, does not justify the widespread use of the sterilization procedures in mentally ill or mentally deficient persons. ... It is sometimes proposed that sterilization is demanded, irrespective of the uncertainties of our knowledge of heredity, in that a mentally ill or feebleminded person is incapable of providing the emotional and material environment required to raise a normal child. Perhaps this is so, but it raises issues of a sociological and political nature of a very uncertain character and it may be most dangerous to apply such sociological concepts under the guise of a genetic thesis that is far from proven and highly uncertain in its application.’ ” Ferster, “Eliminating the Unfit—-Is Sterilization the Answer?,” 27 Ohio St. L. J., 591, 603-604.
Reviewing genetic aspects of intelligent behavior, Irving G. Gottesman warned: “The issues involved in eugenics are only partly based on a knowledge of genetics, the others being social, axiological, moral, economic, and political. * * * the preservation and improvement of these genetic attributes of man that have resulted in his favored evolutionary position are important but * * * premature attempts to apply our fragmentary knowledge in any dogmatic fashion would be extremely complex.” Ellis (Ed.), Handbook of Mental Deficiency, p. 291.
Neither the court nor the board specifies the elements of environment to mediate a significant judgment concerning sterilization. Lack of knowledge is inferable. Environmental deprivation was appraised in a 1964 comment on terms proposed to differentiate remediable from irremediable mental retardation:
*726“A central problem * * * is the lack of reliable, valid, and precise measurement techniques; for a differential diagnosis * * *, the problem of adequate measurement is crucial. For example, if the term mental retardation denotes remediable cases in which environmental or emotional factors are the primary causes of lowered functioning, the precise measurement of such factors would be sine qua non of accurate diagnosis. However, current measures of emotional disturbance and environmental deprivation are, at best, gross and relatively unreliable. * * * For a large proportion of the mentally retarded, particularly those functioning at a higher intellectual level, knowledge of etiology and prognosis hardly seems sufficient at the present time to warrant a clear-cut differentiation between remediable and irremediable.” Davitz, Davitz & Lorge, Terminology and Concepts in Mental Retardation, p. 11.
In determining the reasonableness of the sterilization law, we consider private deprivation, societal benefits, and possibilities of the state realizing those benefits at a lower cost. Appraisal of goals and remedies is difficult at best and impossible without identification of the environmental elements. I cannot imagine a causality vaguer than that of heredity, environment, or both; and that very vagueness warns of menacing power over bodily integrity. Judicial review is an empty safeguard when legislative, administrative, and judicial standards of protection are as deficient as those in this case. The sterilization law denies substantive due process of law guaranteed by the Constitution of Nebraska.
McCown, J., joins in this dissent.