Buck v. Bell, 274 U.S. 200 (1927)

In 1924, the state of Virginia passed a law granting certain state hospitals the authority to sterilize patients deemed mentally defective. After becoming pregnant out of wedlock, possibly from being raped, seventeen-year-old Carrie Buck was institutionalized by her foster parents. While institutionalized, she, like her mother before her, was deemed ‘‘feeble minded,’’ and the hospital recommended sterilization pursuant to the new statute. This decision was upheld through a review process that included a special hospital review board, a hearing before the state trial court, and review by the state supreme court.

Under the theories of eugenic sterilization that were popular during this era, the state argued that sterilizing those with unwanted mental deficiencies would lessen the presence of these traits in future generations, save government tax dollars spent on these individuals, and allow more patients to be released from state mental hospitals. Buck’s attorney argued that the statute violated her right of bodily integrity under the due process clause and cited equal protection concerns.

Based on a very limited and possibly one-sided record from the lower court, the Supreme Court found the state’s arguments convincing. With only one justice dissenting without comment, the Court found that the statute provided for ample due process through the statute’s review procedures and it did not violate her rights to equal protection. Justice Oliver Wendell Holmes, writing the Court’s opinion, noted that since the best citizens are often required to give up their lives for the good of society, ‘‘it would be strange if [the State] could not call upon those who already sap the strength of the State for these lesser sacrifices . . . in order to prevent our being swamped with incompetence.’’ Acknowledging that other mandatory medical procedures were considered acceptable, Holmes noted, ‘‘The principle that sustains Compulsory Vaccination is broad enough to cover cutting the Fallopian tubes.’’ Referring to Carrie Buck, her mother, and her newborn daughter, Holmes noted, ‘‘Three generations of imbeciles are enough.’’

Following the decision, several states passed similar sterilization laws and the number of sterilization procedures grew dramatically. While involuntary sterilization and the eugenics movements lost much of their support in the 1940s and 1950s, including the repeal of many states’ sterilization statutes, the decision itself has never been overturned. The case has been used as valid precedent in state courts to uphold sterilization laws and was cited by the Court in Roe v. Wade as an example of the states’ ability to limit privacy rights. However, the Court has taken some steps back from Buck v. Bell, such as striking down mandatory sterilization laws aimed at habitual criminals in Skinner v. Oklahoma and suggesting that the Buck decision upheld a ‘‘harsh measure’’ in Board of Trustees of the University of Alabama v. Garrett. Concurring in the 2004 case of Tennessee v. Lane, Justice David Souter went even further by citing Buck as an example of past judicial endorsement of disability discrimination. Debates over related issues, such as the sterilization of welfare recipients and criminals, whether voluntarily or involuntarily, have brought further attention to the legacy of Buck v. Bell, with many viewing it as one of the most intrusive encroachments into personal liberties.

TODD A. COLLINS

References and Further Reading

• Berry, Roberta M., From Involuntary Sterilization to Genetic Enhancement: The Unsettled Legacy of Buck v. Bell, Notre Dame Journal of Law, Ethics, & Public Policy 12 (1998): 1:401–48
• Blake, Meredith, ‘‘Welfare and Coerced Contraception: Morality Implications of State Sponsored Reproductive Control, University of Louisville Journal of Family Law 34 (1995): 311–44
• Lombardo, Paul A., Three Generations, No Imbeciles: New Light on Buck v. Bell, New York University Law Review 60 (1985): 1:30–63
• Reilly, Philip. The Surgical Solution: A History of Involuntary Sterilization in the United States. Baltimore: John Hopkins University Press, 1991

Cases and Statutes Cited

• Board of Trustees of the University of Alabama. v. Garrett, 531 U.S. 356 (2001) 
• Buck v. Bell, 130 S.E. 516 (Va. 1925) 
• Buck v. Bell, 274 U.S. 200 (1927) 
• Roe v. Wade, 410 U.S. 113 (1973) 
• Skinner v. Oklahoma, 316 U.S. 535 (1942) 
• Tennessee v. Lane, 541 U.S. 509 (2004) (Souter, J., concurring) 
• Virginia Sterilization Act, Act of Mar. 20, 1924, c. 394, 1924 Va. Acts 569, repealed by Act of Apr. 2, 1974, c. 296, 1974 Va. Acts 445 

See also Abortion; Eugenic Sterilization; Jacobson v. Massachusetts, 197 U.S. 11 (1905); Right of Privacy; Roe v. Wade, 410 U.S. 113 (1973); Skinner v. Oklahoma, 316 U.S. 535 (1942)