Análisis de la producción científica mundial sobre esterilización forzada de mujeres con discapacidad entre 1997 y 2016 / World scientific production analysis in forced sterilization of women with disabilities between 1997-2016

Objetivo: Caracterizar la literatura publicada durante dos décadas (1997-2016) en todo el mundo, en inglés y español, sobre esterilización forzada de mujeres con discapacidad. Método: Se realizó un estudio bibliométrico descriptivo, longitudinal-retrospectivo. Se estudiaron los indicadores de productividad, colaboración y materias. Se empleó la herramienta de evaluación CASP (Critical Appraisal Skills Programme) como marco basado en la evidencia para la revisión de artículos originales y revisiones de la literatura. Resultados: Se recopilaron 139 documentos, en los cuales participaron 114 instituciones de 24 países. Los resultados muestran que la mayor productividad se concentra entre 2007 y 2016, existe un predominio de autoría femenina, de difusión en formato revisión de literatura, en idioma inglés y que proviene mayoritariamente de las universidades y del activismo de mujeres con discapacidad. Conclusiones: Se concluye que este tema ha sido insuficientemente estudiado en ambos idiomas; no obstante, se observa una tendencia al crecimiento. En sus contenidos se impone la denuncia de esta práctica como vulneración de derechos humanos, con mayor énfasis tras la Convención sobre los Derechos de las Personas con Discapacidad. La violencia contra las mujeres con discapacidad es un problema de salud mundial, y esta ha sido una de sus manifestaciones con menor visibilidad en la literatura. Que los gobiernos, profesionales de salud y comunidades tengan acceso a este conocimiento aumenta su concienciación y las probabilidades de erradicar toda forma de violencia

Objective: To explore world scientific production in forced sterilization of women with disabilities between 1997 and 2016, written in English and Spanish. Method: We carried out a descriptive, retrospective longitudinal study. The bibliometrics indicators of productivity, collaboration and subject-matter were studied. Critical Appraisal Skills Programme (CASP) was used as an evidence-based framework to evaluate original articles and literature reviews. Results: A total of 139 documents were studied, in which 114 institutions from 24 countries participated. The results show that the greatest productivity was between 2007 and 2016, with predominance of studies written by female authors, based on literature review methodology, written in the English language. The majority of the authors were affiliated with a university and from activism of women with disabilities rather than any other organization. Conclusions: It is concluded that while insufficiently explored in either language, there is a growing interest in this issue. There is a prominent focus in the literature on denunciation of this practice as a violation of human rights, with greater emphasis after The Convention on the Rights of Persons with Disabilities. Violence against women with disabilities is a global health problem; one of its manifestations has been the practice of forced sterilization, which has received relatively little attention in the literature. Governments, health professionals and communities must have access to this knowledge, awareness and the likelihood of eradicating all forms of violence must be increased

[World scientific production analysis in forced sterilization of women with disabilities between 1997-2016]. / Análisis de la producción científica mundial sobre esterilización forzada de mujeres con discapacidad entre 1997 y 2016.

OBJECTIVE: To explore world scientific production in forced sterilization of women with disabilities between 1997 and 2016, written in English and Spanish. METHOD: We carried out a descriptive, retrospective longitudinal study. The bibliometrics indicators of productivity, collaboration and subject-matter were studied. Critical Appraisal Skills Programme (CASP) was used as an evidence-based framework to evaluate original articles and literature reviews. RESULTS: A total of 139 documents were studied, in which 114 institutions from 24 countries participated. The results show that the greatest productivity was between 2007 and 2016, with predominance of studies written by female authors, based on literature review methodology, written in the English language. The majority of the authors were affiliated with a university and from activism of women with disabilities rather than any other organization. CONCLUSIONS: It is concluded that while insufficiently explored in either language, there is a growing interest in this issue. There is a prominent focus in the literature on denunciation of this practice as a violation of human rights, with greater emphasis after The Convention on the Rights of Persons with Disabilities. Violence against women with disabilities is a global health problem; one of its manifestations has been the practice of forced sterilization, which has received relatively little attention in the literature. Governments, health professionals and communities must have access to this knowledge, awareness and the likelihood of eradicating all forms of violence must be increased.

Disproportionate Sterilization of Latinos Under California's Eugenic Sterilization Program, 1920-1945.

OBJECTIVES: To compare population-based sterilization rates between Latinas/os and non-Latinas/os sterilized under California's eugenics law. METHODS: We used data from 17 362 forms recommending institutionalized patients for sterilization between 1920 and 1945. We abstracted patient gender, age, and institution of residence into a data set. We extracted data on institution populations from US Census microdata from 1920, 1930, and 1940 and interpolated between census years. We used Spanish surnames to identify Latinas/os in the absence of data on race/ethnicity. We used Poisson regression with a random effect for each patient's institution of residence to estimate incidence rate ratios (IRRs) and compare sterilization rates between Latinas/os and non-Latinas/os, stratifying on gender and adjusting for differences in age and year of sterilization. RESULTS: Latino men were more likely to be sterilized than were non-Latino men (IRR = 1.23; 95% confidence interval [CI] = 1.15, 1.31), and Latina women experienced an even more disproportionate risk of sterilization relative to non-Latinas (IRR = 1.59; 95% CI = 1.48, 1.70). CONCLUSIONS: Eugenic sterilization laws were disproportionately applied to Latina/o patients, particularly Latina women and girls. Understanding historical injustices in public health can inform contemporary public health practice.

[The Homburg clinic for nervous diseases in the National Socialist Era. Special features in the Saarland border region]. / Die Homburger Nervenklinik im Nationalsozialismus. Besonderheiten in der saarländischen Grenzregion.

BACKGROUND AND OBJECTIVES: When the National Socialists (NS) came to power in 1933, the German health care system was reorganized according to the principles of eugenics. Neuropsychiatric patients were victims of compulsory sterilisation and "euthanasia". As the Saar territory did not become part of the German Reich until the 1 March 1935, it is of special interest how quickly and completely NS health care policies were implemented. METHODS: The analysis is based on medical records of the Homburg State Hospital's (HSH) clinic for nervous diseases from 1929 to 1945 (n =7,816) found in the Saarland University Medical Centre. RESULTS: 1,452 patients were sterilised by force between 1935 and 1939 in the HSH. The most frequent diagnoses were congenital debility, schizophrenia, and epilepsy. Some of the 441 Homburg patients who were transferred to other mental hospitals from 1939 to 1940 were killed in the context of "Aktion T4" and presumably in a nonsystematic manner. CONCLUSIONS: NS health care policies were implemented immediately after incorporation of the Saar territory in 1935. Physicians of the HSH were involved directly in compulsory sterilisation of neuropsychiatric patients. An initial intention to kill by the time of patient transfers from Homburg cannot be proven. Further research concerning the killing centres is necessary.

Eugenics and Involuntary Sterilization: 1907-2015.

In England during the late nineteenth century, intellectuals, especially Francis Galton, called for a variety of eugenic policies aimed at ensuring the health of the human species. In the United States, members of the Progressive movement embraced eugenic ideas, especially immigration restriction and sterilization. Indiana enacted the first eugenic sterilization law in 1907, and the US Supreme Court upheld such laws in 1927. State programs targeted institutionalized, mentally disabled women. Beginning in the late 1930s, proponents rationalized involuntary sterilization as protecting vulnerable women from unwanted pregnancy. By World War II, programs in the United States had sterilized approximately 60,000 persons. After the horrific revelations concerning Nazi eugenics (German Hereditary Health Courts approved at least 400,000 sterilization operations in less than a decade), eugenic sterilization programs in the United States declined rapidly. Simplistic eugenic thinking has faded, but coerced sterilization remains widespread, especially in China and India. In many parts of the world, involuntary sterilization is still intermittently used against minority groups.

[Forced sterilisation based on the Law for the Prevention of Hereditarily Diseased Offspring. The role of the Heil- und Pflegeanstalt (State Hospital) Günzburg]. / Zwangssterilisationen nach dem Gesetz zur Verhütung erbkranken Nachwuchses. Die Rolle der Heil- und Pflegeanstalt Günzburg.

OBJECTIVE: From 1934 to 1945, 350,000-400,000 human beings were sterilised by force in the German Reich. Forced sterilisation was based on the Gesetz zur Verhütung erbkranken Nachwuchses (Law for the Prevention of Hereditarily Diseased Offspring). The Heil- und Pflegeanstalt (State Hospital) Günzburg was one of the institutions where compulsory sterilisation was practised. METHODS: Data evaluation was based on patient documents and annual reports of the archives of today's district hospital at Günzburg. Patient records were analysed with respect to predefined criteria. The municipal archives of Günzburg provided further historical sources and data. RESULTS: Between 1934 and 1943, 366 patients were sterilised in the Heil- und Pflegeanstalt (State Hospital) Günzburg. Age, sex and diagnosis were found to be criteria relevant for selection of patients for sterilisation. CONCLUSIONS: The study was able to show the active involvement of the Heil- und Pflegeanstalt (State Hospital) Günzburg in the compulsory sterilisation programme.

The economics of race and eugenic sterilization in North Carolina: 1958-1968.

Theoretical justifications for state-sanctioned sterilization of individuals provided by Irving Fisher rationalized its racialization on grounds that certain non-white racial groups, particularly blacks due to their dysgenic biological and behavioral traits, retarded economic growth and should be bred out of existence. Fisher's rationale suggests that national or state level eugenic policies that sterilized the so-called biological and genetically unfit could have been racist in both design and effect by disproportionately targeting black Americans. We empirically explore this with data on eugenic sterilizations in the State of North Carolina between 1958 and 1968. Count data parameter estimates from a cross-county population allocation model of sterilization reveal that the probability of non-institutional and total sterilizations increased with a county's black population share-an effect not found for any other racial group in the population. Our results suggest that in North Carolina, eugenic sterilization policies were racially biased and genocidal.

Sterilized in the name of public health: race, immigration, and reproductive control in modern California.

In exploring the history of involuntary sterilization in California, I connect the approximately 20,000 operations performed on patients in state institutions between 1909 and 1979 to the federally funded procedures carried out at a Los Angeles County hospital in the early 1970s. Highlighting the confluence of factors that facilitated widespread sterilization abuse in the early 1970s, I trace prosterilization arguments predicated on the protection of public health. This historical overview raises important questions about the legacy of eugenics in contemporary California and relates the past to recent developments in health care delivery and genetic screening.

[Eugenist politics in the United States of America in the first xxth half-century]. / Les politiques eugénistes aux Etats-Unis dans la première moitié du xx e siècle.

The United-States were the first country which had devised eugenist politics. The applications of theories had taken place as far as the end of the 1960's. They were placed one's reliance on two points: on the one hand, immigration's limitation and on the other hand an obligatory sterilisation of criminels and feebleminde people.

Sterilisations in girls and young women: is it still happening?

OBJECTIVE: To determine whether sterilising procedures - hysterectomies, endometrial ablations or tubal ligations - are being performed in minors for non-therapeutic reasons, without Family Law Court approval. METHODS: Victorian Admitted Episode Dataset 1996-99 was used to identify all young women < 18 who had a sterilising procedure. Associated codes for indications and pathology were reviewed to exclude malignancies, congenital anomalies, potential miscoding and misleading codes associated with endometriosis. RESULTS: Although 40 procedures were identified from the dataset, the majority of these can be excluded after review of the associated codes. In two cases sterilising procedures were performed without clear therapeutic indications and it is likely they were done in young women with disabilities. No Family Law Court applications were heard in this time period, thus it is likely they represent unlawful sterilisations. CONCLUSIONS: It would appear that sterilisations without Family Law Court approval are probably occurring at very low rates in Victoria.

Sterilization and financial penalties imposed on registered peasant couples, Hebei Province, China.

Using fertility survey data from the 1980s for registered Han peasant couples in Hebei Province, this study examines whether China's family planning policy reflects couples' voluntary compliance with policy regulations, their coercion by means of government sanctions, or a combination of both. Three family planning regulations are considered: birth-quota status, contraceptive use, and length of prior birth interval. The results of the study provide support for both compliance and sanction perspectives and suggest that by the late 1980s, the state was less willing than it had been previously to negotiate with couples who had had three children. Evidence is found of cooperation between couples and the state to ensure that each family had at least one son.

Legal aspects of involuntary sterilization.

The foregoing discussion was intended as a review of the pertinent literature of involuntary sterilization. It is by no means all-inclusive (the number of cases precludes an exhaustive compendium) but does include those cases that, in the authors' opinion, are most representative of the contemporary attitude of the courts. The discussion has been confined primarily to the legal aspects of involuntary sterilization. We have omitted any substantial discussion of the moral and ethical aspects of this complex topic but acknowledge the intimate role these issues may play in any decision to undertake involuntary sterilization. As outlined, the presence or absence of statutory guidelines mandates in part the legal channels to be pursued. In the presence of statutes for involuntary sterilization, strict adherence to the specified requirements provides the optimal means of protecting the legal interests of all involved parties. In the absence of statutory guidelines, extreme caution must be exercised. In these circumstances, a validly executed court order observing procedural due process should provide optimal protection of patient and physician interests. The decisions of New Jersey and Alaska courts represent one potential method of securing a consent by use of the parens patriae doctrine. Recent notable efforts at a state level to dispense with lengthy hearings and implement committee review have been encouraging and await further trials to determine their ultimate role in authorizing sterilization of mental incompetents. Given the current legal climate and available avenues, parental substituted consent without adequate hearing and due process should not be considered a fulfillment of legal responsibilities.