Concerning the importance of the Oregon survey, we may quote Surgeon General H. C. c.u.mming: "the prevention and correction of mental defectives is one of the great public health problems of to-day. It enters into many phases of our work and its influence continually crops up unexpectedly. For instance, work of the Public Health Service in connection with juvenile courts shows that a marked proportion of juvenile delinquency is traceable to some degree of mental deficiency in the offender. For years Public Health officials have concerned themselves only with the disorders of physical health; but now they are realizing the significance of mental health also. The work in Oregon const.i.tutes the first state-wide survey which even begins to disclose the enormous drain on a state, caused by mental defects. One of the objects of the work was to obtain for the people of Oregon an idea of the problem that confronted them and the heavy annual loss, both economic and industrial, that it entailed. Another was to enable the legislators to devise a program that would stop much of the loss, restore to health and bring to lives of industrial usefulness, many of those now down and out, and above all, to save hundreds of children from growing up to lives of misery."
It will be interesting to see how many of our State Legislatures have the intelligence and the courage to follow in the footsteps of Oregon in this respect. Nothing could more effectually stimulate discussion, and awaken intelligence as to the extravagance and cost to the community of our present codes of traditional morality. But we should make sure in all such surveys, that mental defect is not concealed even in such dignified bodies as state legislatures and among those leaders who are urging men and women to reckless and irresponsible procreation.
I have touched upon these various aspects of the complex problem of the feeble-minded, and the menace of the moron to human society, not merely for the purpose of reiterating that it is one of the greatest and most difficult social problems of modern times, demanding an immediate, stern and definite policy, but because it ill.u.s.trates the actual harvest of reliance upon traditional morality, upon the biblical injunction to increase and multiply, a policy still taught by politician, priest and militarist. Motherhood has been held universally sacred; yet, as Bouchacourt pointed out, "to-day, the dregs of the human species, the blind, the deaf-mute, the degenerate, the nervous, the vicious, the idiotic, the imbecile, the cretins and the epileptics--are better protected than pregnant women." The syphilitic, the irresponsible, the feeble-minded are encouraged to breed unhindered, while all the powerful forces of tradition, of custom, or prejudice, have bolstered up the desperate effort to block the inevitable influence of true civilization in spreading the principles of independence, self-reliance, discrimination and foresight upon which the great practice of intelligent parenthood is based.
To-day we are confronted by the results of this official policy. There is no escaping it; there is no explaining it away. Surely it is an amazing and discouraging phenomenon that the very governments that have seen fit to interfere in practically every phase of the normal citizen"s life, dare not attempt to restrain, either by force or persuasion, the moron and the imbecile from producing his large family of feeble-minded offspring.
In my own experience, I recall vividly the case of a feeble-minded girl who every year, for a long period, received the expert attention of a great specialist in one of the best-known maternity hospitals of New York City. The great obstetrician, for the benefit of interns and medical students, performed each year a Caesarian operation upon this unfortunate creature to bring into the world her defective, and, in one case at least, her syphilitic, infant. "Nelly" was then sent to a special room and placed under the care of a day nurse and a night nurse, with extra and special nourishment provided. Each year she returned to the hospital. Such cases are not exceptions; any experienced doctor or nurse can recount similar stories. In the interest of medical science this practice may be justified. I am not criticising it from that point of view. I realize as well as the most conservative moralist that humanity requires that healthy members of the race should make certain sacrifices to preserve from death those unfortunates who are born with hereditary taints. But there is a point at which philanthropy may become positively dysgenic, when charity is converted into injustice to the self-supporting citizen, into positive injury to the future of the race.
Such a point, it seems obvious, is reached when the incurably defective are permitted to procreate and thus increase their numbers.
The problem of the dependent, delinquent and defective elements in modern society, we must repeat, cannot be minimized because of their alleged small numerical proportion to the rest of the population. The proportion seems small only because we accustom ourselves to the habit of looking upon feeble-mindedness as a separate and distinct calamity to the race, as a chance phenomenon unrelated to the s.e.xual and biological customs not only condoned but even encouraged by our so-called civilization. The actual dangers can only be fully realized when we have acquired definite information concerning the financial and cultural cost of these cla.s.ses to the community, when we become fully cognizant of the burden of the imbecile upon the whole human race; when we see the funds that should be available for human development, for scientific, artistic and philosophic research, being diverted annually, by hundreds of millions of dollars, to the care and segregation of men, women, and children who never should have been born. The advocate of Birth Control realizes as well as all intelligent thinkers the dangers of interfering with personal liberty. Our whole philosophy is, in fact, based upon the fundamental a.s.sumption that man is a self-conscious, self-governing creature, that he should not be treated as a domestic animal; that he must be left free, at least within certain wide limits, to follow his own wishes in the matter of mating and in the procreation of children.
Nor do we believe that the community could or should send to the lethal chamber the defective progeny resulting from irresponsible and unintelligent breeding.
But modern society, which has respected the personal liberty of the individual only in regard to the unrestricted and irresponsible bringing into the world of filth and poverty an overcrowding procession of infants foredoomed to death or hereditable disease, is now confronted with the problem of protecting itself and its future generations against the inevitable consequences of this long-practised policy of LAISSER-FAIRE.
The emergency problem of segregation and sterilization must be faced immediately. Every feeble-minded girl or woman of the hereditary type, especially of the moron cla.s.s, should be segregated during the reproductive period. Otherwise, she is almost certain to bear imbecile children, who in turn are just as certain to breed other defectives. The male defectives are no less dangerous. Segregation carried out for one or two generations would give us only partial control of the problem.
Moreover, when we realize that each feeble-minded person is a potential source of an endless progeny of defect, we prefer the policy of immediate sterilization, of making sure that parenthood is absolutely prohibited to the feeble-minded.
This, I say, is an emergency measure. But how are we to prevent the repet.i.tion in the future of a new harvest of imbecility, the recurrence of new generations of morons and defectives, as the logical and inevitable consequence of the universal application of the traditional and widely approved command to increase and multiply?
At the present moment, we are offered three distinct and more or less mutually exclusive policies by which civilization may hope to protect itself and the generations of the future from the allied dangers of imbecility, defect and delinquency. No one can understand the necessity for Birth Control education without a complete comprehension of the dangers, the inadequacies, or the limitations of the present attempts at control, or the proposed programs for social reconstruction and racial regeneration. It is, therefore, necessary to interpret and criticize the three programs offered to meet our emergency. These may be briefly summarized as follows:
(1) Philanthropy and Charity: This is the present and traditional method of meeting the problems of human defect and dependence, of poverty and delinquency. It is emotional, altruistic, at best ameliorative, aiming to meet the individual situation as it arises and presents itself. Its effect in practise is seldom, if ever, truly preventive. Concerned with symptoms, with the allaying of acute and catastrophic miseries, it cannot, if it would, strike at the radical causes of social misery. At its worst, it is sentimental and paternalistic.
(2) Marxian Socialism: This may be considered typical of many widely varying schemes of more or less revolutionary social reconstruction, emphasizing the primary importance of environment, education, equal opportunity, and health, in the elimination of the conditions (i. e.
capitalistic control of industry) which have resulted in biological chaos and human waste. I shall attempt to show that the Marxian doctrine is both too limited, too superficial and too fragmentary in its basic a.n.a.lysis of human nature and in its program of revolutionary reconstruction.
(3) Eugenics: Eugenics seems to me to be valuable in its critical and diagnostic aspects, in emphasizing the danger of irresponsible and uncontrolled fertility of the "unfit" and the feeble-minded establishing a progressive unbalance in human society and lowering the birth-rate among the "fit." But in its so-called "constructive" aspect, in seeking to reestablish the dominance of healthy strain over the unhealthy, by urging an increased birth-rate among the fit, the Eugenists really offer nothing more farsighted than a "cradle compet.i.tion" between the fit and the unfit. They suggest in very truth, that all intelligent and respectable parents should take as their example in this grave matter of child-bearing the most irresponsible elements in the community.
(1) United States Public Health Service: Psychiatric Studies of Delinquents. Reprint No. 598: pp. 64-65.
(2) The Problem of the Feeble-Minded: An Abstract of the Report of the Royal Commission on the Cure and Control of the Feeble-Minded, London: P. S. King & Son.
(3) Cf. Feeble-Minded in Ontario: Fourteenth Report for the year ending October 31st, 1919.
(4) Eugenics Review, Vol. XIII, p. 339 et seq.
(5) Dwellers in the Vale of Siddem: A True Story of the Social Aspect of Feeble-mindedness. By A. C. Rogers and Maud A. Merrill; Boston (1919).
CHAPTER V: The Cruelty of Charity
"Fostering the good-for-nothing at the expense of the good is an extreme cruelty. It is a deliberate storing up of miseries for future generations. There is no greater curse to posterity than that of bequeathing them an increasing population of imbeciles."
Herbert Spencer
The last century has witnessed the rise and development of philanthropy and organized charity. Coincident with the all-conquering power of machinery and capitalistic control, with the unprecedented growth of great cities and industrial centers, and the creation of great proletarian populations, modern civilization has been confronted, to a degree hitherto unknown in human history, with the complex problem of sustaining human life in surroundings and under conditions flagrantly dysgenic.
The program, as I believe all competent authorities in contemporary philanthropy and organized charity would agree, has been altered in aim and purpose. It was first the outgrowth of humanitarian and altruistic idealism, perhaps not devoid of a strain of sentimentalism, of an idealism that was aroused by a desperate picture of human misery intensified by the industrial revolution. It has developed in later years into a program not so much aiming to succor the unfortunate victims of circ.u.mstances, as to effect what we may term social sanitation. Primarily, it is a program of self-protection. Contemporary philanthropy, I believe, recognizes that extreme poverty and overcrowded slums are veritable breeding-grounds of epidemics, disease, delinquency and dependency. Its aim, therefore, is to prevent the individual family from sinking to that abject condition in which it will become a much heavier burden upon society.
There is no need here to criticize the obvious limitations of organized charities in meeting the desperate problem of dest.i.tution. We are all familiar with these criticisms: the common indictment of "inefficiency"
so often brought against public and privately endowed agencies. The charges include the high cost of administration; the pauperization of deserving poor, and the encouragement and fostering of the "undeserving"; the progressive destruction of self-respect and self-reliance by the paternalistic interference of social agencies; the impossibility of keeping pace with the ever-increasing multiplication of factors and influences responsible for the perpetuation of human misery; the misdirection and misappropriation of endowments; the absence of interorganization and coordination of the various agencies of church, state, and privately endowed inst.i.tutions; the "crimes of charity"
that are occasionally exposed in newspaper scandals. These and similar strictures we may ignore as irrelevant to our present purpose, as inevitable but not incurable faults that have been and are being eliminated in the slow but certain growth of a beneficent power in modern civilization. In reply to such criticisms, the protagonist of modern philanthropy might justly point to the honest and sincere workers and disinterested scientists it has mobilized, to the self-sacrificing and hard-working executives who have awakened public attention to the evils of poverty and the menace to the race engendered by misery and filth.
Even if we accept organized charity at its own valuation, and grant that it does the best it can, it is exposed to a more profound criticism.
It reveals a fundamental and irremediable defect. Its very success, its very efficiency, its very necessity to the social order, are themselves the most unanswerable indictment. Organized charity itself is the symptom of a malignant social disease.
Those vast, complex, interrelated organizations aiming to control and to diminish the spread of misery and dest.i.tution and all the menacing evils that spring out of this sinisterly fertile soil, are the surest sign that our civilization has bred, is breeding and is perpetuating constantly increasing numbers of defectives, delinquents and dependents. My criticism, therefore, is not directed at the "failure" of philanthropy, but rather at its success.
These dangers inherent in the very idea of humanitarianism and altruism, dangers which have to-day produced their full harvest of human waste, of inequality and inefficiency, were fully recognized in the last century at the moment when such ideas were first put into practice. Readers of Huxley"s attack on the Salvation Army will recall his penetrating and stimulating condemnation of the debauch of sentimentalism which expressed itself in so uncontrolled a fashion in the Victorian era. One of the most penetrating of American thinkers, Henry James, Sr., sixty or seventy years ago wrote: "I have been so long accustomed to see the most arrant deviltry transact itself in the name of benevolence, that the moment I hear a profession of good will from almost any quarter, I instinctively look around for a constable or place my hand within reach of a bell-rope. My ideal of human intercourse would be a state of things in which no man will ever stand in need of any other man"s help, but will derive all his satisfaction from the great social tides which own no individual names. I am sure no man can be put in a position of dependence upon another, without the other"s very soon becoming--if he accepts the duties of the relation--utterly degraded out of his just human proportions. No man can play the Deity to his fellow man with impunity--I mean, spiritual impunity, of course. For see: if I am at all satisfied with that relation, if it contents me to be in a position of generosity towards others, I must be remarkably indifferent at bottom to the gross social inequality which permits that position, and, instead of resenting the enforced humiliation of my fellow man to myself in the interests of humanity, I acquiesce in it for the sake of the profit it yields to my own self-complacency. I do hope the reign of benevolence is over; until that event occurs, I am sure the reign of G.o.d will be impossible."
To-day, we may measure the evil effects of "benevolence" of this type, not merely upon those who have indulged in it, but upon the community at large. These effects have been reduced to statistics and we cannot, if we would, escape their significance. Look, for instance (since they are close at hand, and fairly representative of conditions elsewhere) at the total annual expenditures of public and private "charities and corrections" for the State of New York. For the year ending June 30, 1919, the expenditures of public inst.i.tutions and agencies amounted to $33, 936,205.88. The expenditures of privately supported and endowed inst.i.tutions for the same year, amount to $58,100,530.98. This makes a total, for public and private charities and corrections of $92,036,736.86. A conservative estimate of the increase for the year (1920-1921) brings this figure approximately to one-hundred and twenty-five millions. These figures take on an eloquent significance if we compare them to the comparatively small amounts spent upon education, conservation of health and other constructive efforts. Thus, while the City of New York spent $7.35 per capita on public education in the year 1918, it spent on public charities no less than $2.66. Add to this last figure an even larger amount dispensed by private agencies, and we may derive some definite sense of the heavy burden of dependency, pauperism and delinquency upon the normal and healthy sections of the community.
Statistics now available also inform us that more than a million dollars are spent annually to support the public and private inst.i.tutions in the state of New York for the segregation of the feeble-minded and the epileptic. A million and a half is spent for the up-keep of state prisons, those homes of the "defective delinquent." Insanity, which, we should remember, is to a great extent hereditary, annually drains from the state treasury no less than $11,985,695.55, and from private sources and endowments another twenty millions. When we learn further that the total number of inmates in public and private inst.i.tutions in the State of New York--in alms-houses, reformatories, schools for the blind, deaf and mute, in insane asylums, in homes for the feeble-minded and epileptic--amounts practically to less than sixty-five thousand, an insignificant number compared to the total population, our eyes should be opened to the terrific cost to the community of this dead weight of human waste.
The United States Public Health Survey of the State of Oregon, recently published, shows that even a young community, rich in natural resources, and unusually progressive in legislative measures, is no less subject to this burden. Out of a total population of 783,000 it is estimated that more than 75,000 men, women and children are dependents, feeble-minded, or delinquents. Thus about 10 per cent. of the population is a constant drain on the finances, health, and future of that community. These figures represent a more definite and precise survey than the rough one indicated by the statistics of charities and correction for the State of New York. The figures yielded by this Oregon survey are also considerably lower than the average shown by the draft examination, a fact which indicates that they are not higher than might be obtained from other States.
Organized charity is thus confronted with the problem of feeble-mindedness and mental defect. But just as the State has so far neglected the problem of mental defect until this takes the form of criminal delinquency, so the tendency of our philanthropic and charitable agencies has been to pay no attention to the problem until it has expressed itself in terms of pauperism and delinquency. Such "benevolence" is not merely ineffectual; it is positively injurious to the community and the future of the race.
But there is a special type of philanthropy or benevolence, now widely advertised and advocated, both as a federal program and as worthy of private endowment, which strikes me as being more insidiously injurious than any other. This concerns itself directly with the function of maternity, and aims to supply GRATIS medical and nursing facilities to slum mothers. Such women are to be visited by nurses and to receive instruction in the "hygiene of pregnancy"; to be guided in making arrangements for confinements; to be invited to come to the doctor"s clinics for examination and supervision. They are, we are informed, to "receive adequate care during pregnancy, at confinement, and for one month afterward." Thus are mothers and babies to be saved. "Childbearing is to be made safe." The work of the maternity centers in the various American cities in which they have already been established and in which they are supported by private contributions and endowment, it is hardly necessary to point out, is carried on among the poor and more docile sections of the city, among mothers least able, through poverty and ignorance, to afford the care and attention necessary for successful maternity. Now, as the findings of Tredgold and Karl Pearson and the British Eugenists so conclusively show, and as the infant mortality reports so thoroughly substantiate, a high rate of fecundity is always a.s.sociated with the direst poverty, irresponsibility, mental defect, feeble-mindedness, and other transmissible taints. The effect of maternity endowments and maternity centers supported by private philanthropy would have, perhaps already have had, exactly the most dysgenic tendency. The new government program would facilitate the function of maternity among the very cla.s.ses in which the absolute necessity is to discourage it.
Such "benevolence" is not merely superficial and near-sighted. It conceals a stupid cruelty, because it is not courageous enough to face unpleasant facts. Aside from the question of the unfitness of many women to become mothers, aside from the very definite deterioration in the human stock that such programs would inevitably hasten, we may question its value even to the normal though unfortunate mother. For it is never the intention of such philanthropy to give the poor over-burdened and often undernourished mother of the slum the opportunity to make the choice herself, to decide whether she wishes time after to time to bring children into the world. It merely says "Increase and multiply: We are prepared to help you do this." Whereas the great majority of mothers realize the grave responsibility they face in keeping alive and rearing the children they have already brought into the world, the maternity center would teach them how to have more. The poor woman is taught how to have her seventh child, when what she wants to know is how to avoid bringing into the world her eighth.
Such philanthropy, as Dean Inge has so unanswerably pointed out, is kind only to be cruel, and unwittingly promotes precisely the results most deprecated. It encourages the healthier and more normal sections of the world to shoulder the burden of unthinking and indiscriminate fecundity of others; which brings with it, as I think the reader must agree, a dead weight of human waste. Instead of decreasing and aiming to eliminate the stocks that are most detrimental to the future of the race and the world, it tends to render them to a menacing degree dominant.
On the other hand, the program is an indication of a suddenly awakened public recognition of the shocking conditions surrounding pregnancy, maternity, and infant welfare prevailing at the very heart of our boasted civilization. So terrible, so unbelievable, are these conditions of child-bearing, degraded far below the level of primitive and barbarian tribes, nay, even below the plane of brutes, that many high-minded people, confronted with such revolting and disgraceful facts, lost that calmness of vision and impartiality of judgment so necessary in any serious consideration of this vital problem. Their "hearts" are touched; they become hysterical; they demand immediate action; and enthusiastically and generously they support the first superficial program that is advanced. Immediate action may sometimes be worse than no action at all. The "warm heart" needs the balance of the cool head. Much harm has been done in the world by those too-good-hearted folk who have always demanded that "something be done at once."
They do not stop to consider that the very first thing to be done is to subject the whole situation to the deepest and most rigorous thinking.
As the late Walter Bagehot wrote in a significant but too often forgotten pa.s.sage:
"The most melancholy of human reflections, perhaps, is that on the whole it is a question whether the benevolence of mankind does more good or harm. Great good, no doubt, philanthropy does, but then it also does great evil. It augments so much vice, it multiplies so much suffering, it brings to life such great populations to suffer and to be vicious, that it is open to argument whether it be or be not an evil to the world, and this is entirely because excellent people fancy they can do much by rapid action, and that they will most benefit the world when they most relieve their own feelings; that as soon as an evil is seen, "something" ought to be done to stay and prevent it. One may incline to hope that the balance of good over evil is in favor of benevolence; one can hardly bear to think that it is not so; but anyhow it is certain that there is a most heavy debt of evil, and that this burden might almost all have been spared us if philanthropists as well as others had not inherited from their barbarous forefathers a wild pa.s.sion for instant action."
It is customary, I believe, to defend philanthropy and charity upon the basis of the sanct.i.ty of human life. Yet recent events in the world reveal a curious contradiction in this respect. Human life is held sacred, as a general Christian principle, until war is declared, when humanity indulges in a universal debauch of bloodshed and barbarism, inventing poison gases and every type of diabolic suggestion to facilitate killing and starvation. Blockades are enforced to weaken and starve civilian populations--women and children. This accomplished, the pendulum of mob pa.s.sion swings back to the opposite extreme, and the compensatory emotions express themselves in hysterical fashion.
Philanthropy and charity are then unleashed. We begin to hold human life sacred again. We try to save the lives of the people we formerly sought to weaken by devastation, disease and starvation. We indulge in "drives," in campaigns of relief, in a general orgy of international charity.
We are thus witnessing to-day the inauguration of a vast system of international charity. As in our more limited communities and cities, where self-sustaining and self-reliant sections of the population are forced to shoulder the burden of the reckless and irresponsible, so in the great world community the more prosperous and incidentally less populous nations are asked to relieve and succor those countries which are either the victims of the wide-spread havoc of war, of militaristic statesmanship, or of the age-long tradition of reckless propagation and its consequent over-population.
The people of the United States have recently been called upon to exercise their traditional generosity not merely to aid the European Relief Council in its efforts to keep alive three million, five hundred thousand starving children in Central Europe, but in addition to contribute to that enormous fund to save the thirty million Chinese who find themselves at the verge of starvation, owing to one of those recurrent famines which strike often at that densely populated and inert country, where procreative recklessness is encouraged as a matter of duty. The results of this international charity have not justified the effort nor repaid the generosity to which it appealed. In the first place, no effort was made to prevent the recurrence of the disaster; in the second place, philanthropy of this type attempts to sweep back the tide of miseries created by unrestricted propagation, with the feeble broom of sentiment. As one of the most observant and impartial of authorities on the Far East, J. O. P. Bland, has pointed out: "So long as China maintains a birth-rate that is estimated at fifty-five per thousand or more, the only possible alternative to these visitations would be emigration and this would have to be on such a scale as would speedily overrun and overfill the habitable globe. Neither humanitarian schemes, international charities nor philanthropies can prevent widespread disaster to a people which habitually breeds up to and beyond the maximum limits of its food supply." Upon this point, it is interesting to add, Mr. Frank A. Vanderlip has likewise pointed out the inefficacy and misdirection of this type of international charity.(1)
Mr. Bland further points out: "The problem presented is one with which neither humanitarian nor religious zeal can ever cope, so long as we fail to recognize and attack the fundamental cause of these calamities.
As a matter of sober fact, the benevolent activities of our missionary societies to reduce the deathrate by the prevention of infanticide and the checking of disease, actually serve in the end to aggravate the pressure of population upon its food-supply and to increase the severity of the inevitably resultant catastrophe. What is needed for the prevention, or, at least, the mitigation of these scourges, is an organized educational propaganda, directed first against polygamy and the marriage of minors and the unfit, and, next, toward such a limitation of the birth-rate as shall approximate the standard of civilized countries. But so long as Bishops and well meaning philanthropists in England and America continue to praise and encourage "the glorious fertility of the East" there can be but little hope of minimizing the penalties of the ruthless struggle for existence in China, and Nature"s law will therefore continue to work out its own pitiless solution, weeding out every year millions of predestined weaklings."
This rapid survey is enough, I hope, to indicate the manifold inadequacies inherent in present policies of philanthropy and charity.
The most serious charge that can be brought against modern "benevolence"
is that it encourages the perpetuation of defectives, delinquents and dependents. These are the most dangerous elements in the world community, the most devastating curse on human progress and expression.
Philanthropy is a gesture characteristic of modern business lavishing upon the unfit the profits extorted from the community at large. Looked at impartially, this compensatory generosity is in its final effect probably more dangerous, more dysgenic, more blighting than the initial practice of profiteering and the social injustice which makes some too rich and others too poor.