so what can i do about my bias? and for the critical thinking to be a much more vigilant offering equally patients of color. that is what i can think of. >> it is a curiosity. i would think that is a great equalizer. there is a steady 10 a series of studies that pediatricians have lower biases and other physicians

the foreign trade graduates the those who grew up in different countries with different sets of templates there is a lot of work to be done and. i thought this was a conversation in starter i felt the problem was too important not to talk about. we don't have a lot of information between that parings. that is a shortcoming what it does beyond the physician group we don't know clinical

pharmacist, there's practitioner or the influence of their treatment if you have been to the dentist they don't go back. and what influence do their bias have? i do believe even though we do cultural competency spending money that people no differences exist we have to do those nations to let your automatic thoughts overwrite your preference. that my mom would have to pull me back to make justice happened when i saw it

wasn't happening. it was digest's disparities it is digest automatic or ubiquitous but the implicit bias a given and the problems that date creates of injustice and the united states cannot continue to in tolerate dying sicker than whites just because of their color. thank you. [applause]

>> i feel reformed before you leave. >> [inaudible conversations] [inaudible conversations]

>> i am pleased to introduce our next speaker per courier times best selling author and lecturer at yale law school for lee served as a member of "the new york times" editorial board and is senior writer for "time" magazine marie has a weekly loss column as an education reform lawyer for the americans civil liberties union. graduate of harvard law school his previous books include the fdr inner circle and the manager days of modern america. to chronicle the supreme court decision in 18272 mulally virginia at to sterilize a woman.

an important new book takes us back to an era of our history relating a secular thought that eugenics law was an inspiration and. this is a page turner in the story that it tells is infuriated we are pleased to bring this conversation tonight please join me to welcome adam cohen. [applause] >> host: it is a pleasure to be here thinking to harvard bookstore for hosting i used to spend a lot of time here when i was here in a previous life in the key for turning out i had a book party recently in the york in automatically went out it is called "imbeciles" book party. [laughter]

what does it mean if they attended? site is is also the book talks so thank you for coming. [laughter] this feels like a homecoming we your equal distance between nine a freshman dorm and that paper were spent a lot of time so it takes me back. in 1927 the supreme court was asked to decide a simple question is should virginia be allowed to sterilize kerry barack? teetwenty rolf 42 had been declared to be feeble we did it lead to five decision that court ruled no part of the constitution and cannot offer for equal protection in a or due process to protect her from being sterilized against her will that it also strongly endorsed the eugenics movement of the clarion call to sterilize people at

justice holmes wrote they had to sterilize those assets at the strength of the state they could have been torn from the pages of eugenics people it is better for all the world instead of waiting to execute offspring are butting them star that society can prevent those from continuing their kind. ha the harvard educated said of kerry about that three generations are enough's. when they reach the worst decisions that competition is considerable. dread scott that he is leads man had no right to sue for his freedom. plessey vs. ferguson to uphold segregating road cars by race.

end with the court to upheld intered japanese-americans. there will always be arguments that not only was kerry but sterilized against her will the 70,000 were sterilized in many victims were perfectly normal mentally and physically in a desperately wanted to have children. the nazi party that wins on the rise to the supreme court's ruling ordered 375,000 eugenics sterilizations'. actually not he is responsible for the authorization in sight to the case of their defense.

even today it is not well remembered a constitutional lot. the leading american constitutional law for 1,700 pages so let's talk about the case that became more interested in the mower i read about it. the united states in the twenties were caught in the media that drive to use science among the followers and a full-fledged intellectual crazy now had a new enemy and threatened to bring down bill holds even race leading the charge to save humidity.

alexander graham bell those who took to the pages of a national magazine forbid to leave offspring with the committee is to report on the best practical means of the population. that was the intellectual issue of the day women's clubs invited lecturers to speak on the subject clergymen can attributed with rigid and eugenics does the church have any responsibility for improving stock? led to inspire that would a phone message. and conferences were held.

in the state department sent out the department's. the driving force was the collective lazear's with record levels of immigration and were transforming to increase industrialization with family ties these would be redirected of sears of the unfit one for the threat without in one from the danger from within to limit those other non-european

they said high levels of physical and mental defects and among other things between 40 and 50% are right at ellis island that there are biological deficiencies. to have that invigoration act wintun eastern europeans most of all to those jews of eastern europe to find the door shut. we now know looking repeatedly for of be said for his life and his daughter he was turned down because of the act. think of fran frank it is

true she died in the concentration camp but also because the u.s. congress believed the same thing. in addition into emigration and limits it work to address the insert -- internal threat. to begin in connecticut and to find an unworthy. en to point to 80 dash state to people. battle the bad stick finally that term sterilization could be carried out starting in indiana in 1907

judged to have hereditary defects. with epilepsy and dependency. the greatest target is the feeble bleeds it for those or mentally challenged to be interested in sex and those to offended those of social workers. with a leading psychologist to underlie the social problems. to remove the quotation worthless one-tenth of the nation and virginia was late to adopt 70 years after indiana.

when they decided they didn't want to sterilize citywide all the way through the supreme court to create a test case. to be at the wrong place at the wrong time she was raised in poverty by a single mother and in a foster family getting wrong with her but she was pregnant out of wedlock she was determined feeble we did it was shipped off chirac for the superintendent was looking those to put in the center of the test case. and at divvying wedlock - - for that of wedlock she was deemed to flood the the issue with the -- effective as.

and all those that could help to establish a hereditary pattern. there is more to cover story but she was not a feeble light did despite the intelligence testing her school records were not interested in she was not epileptic and never had a seizure. they held the hearing but it was stacked against her that she should be in this was appealed through the courts. nations rely on and civil society for the nation's most respected positions lot and the judiciary each was on the wrong side the man

who selected kerry to be the first person a physician and he served as superintendent and also one of the beach people who lobby the legislature to pass the sterilization of lot. it is kim paid he had much of the medical profession behind him. medical journals were filled with articles with titles like suicide for social parasites the head of the office said new york gave his expert opinion and said it should be upheld that she should be sterilized although the bills, advocate he drafted the model law the states reusing to draft their own laws. and as a professor the of

the academic scientist that the center of that was right here at harvard addressing the 1912 advocating for racial purity to support sterilization is serving as vice president in london of 1912. among the most influential scientific advocates as a lawyer who drafted the law went to the courts. with the first in the nation in eugenics law to protect future generations with a

loss of heredity. those have had the last word makes the enormous prestige to the sterilization and cause. to give real pleasure and of all the professions it is the most disappointing and that chief justice was it william howard taft. of course, there were homes. in day got the facts wrong with legal analysis.

but to likely offer a simple explanation. the supreme court is, but did eugenics' but it was short-lived. end and like so many of the courts and then the court struck down the law to provide for sterilization and. and then the court expressly chosen not to overturn. and then to rule on the case of a mildly retarded woman. second there is nothing outdated from the organ bordet eugenics was still

functioning from 81. investigative reporters figured rand hundred 50 prisoners was not only with the woman's consent. in with disturbing regularity with a century of biology with the new biology and genetic research will of the genetic blueprint they can now have human embryos to have decider babies may kiev far easier to impose eugenics. of final reason this reads important it is those who have used it against those that do not. and asking for protection

from powerful people that wanted to do her harm in that has not been a dead position to be in which ancient babylonian laws that was in college -- and covered with those as liability for negligent acts the court also had the eloquent statement of its own purpose to bring about the of rule so that the strong should not harm the week. said now with the highest calling the bed with the dread scott they were weaker party said justly alarmed the key to the supreme court seeking justice in fact, a tendency to favor the powerful could be one of the defiant teachers this is the

most troubling thing that it presents the stories to retrieve the a deal and the opposite. it teaches that purpose that this strong cannot harm the week. and it was the duty to help. the supreme court did not side but it enthusiastically insisted to be better for all the world and they simply finished off people once and for all even the ancient babylonians it was to obliterate the week is the very opposite of justice [applause] >> so i will take questions. >> unfortunately what you

said made we feel uncomfortable because i am an obstetrician for 40 years and i have done abortions and one of them made things was to eradicate monopole lloyd is some -- with the idea day 21 i feel uncomfortable with what i might have done. >> that is very interesting. obviously there is a lot of nuance and you could say what level that is very disturbing the kind of carrie but where put it on her that the state made a decision in she could not reproduce the you talk about

a different case with the parents have made a decision and. >> it is very common. >> with the consent of the parent. >> i am just distinguishing between the tube you are right. some people may not feel comfortable and if other people have thought so. >> and another journalist and i wonder with that current movement of donald trump that people feeling socially threatened and how

that makes them react in the authoritarian way. >> can we could draw some parallels at the time of high levels of immigration but those ever most-active the upper class the white protestants that you could see eugenics' as a form of authoritarianism. to talk about oliver wendell holmes the dieppe preteen that he was a member of the

boston class and then to take if you thought about that was intentional that the entire families of those that were cast that is the way he was brought up. that ancestor attending harvard that his people were better. and the white social class bore white sometimes it is called trash.

and that is the carrie but people and he sees the bottom of the hierarchy in the message should be obliterated. it is about power and control. and the 20. [inaudible] 2016. >> haven't some states like north carolina have done reparations? >> but the supreme court that the state has the power to sterilize people and it doesn't constitute constitutional problems and that is a legitimate reason so who knows what direction

going into the next president or congress if we get to a point where congress or the states think about eugenics so that is the concern. >> the culture is saturated the with the supreme court with citizens united and others what is the reaction that oliver wendell holmes? >> you are right to say it permeated the culture and that was largely positive. to say it was a good thing. and the press was in the

camp as well. so in those articles have been articles to counsel people but that press coverage was very positive leading up to it but there were some editorials that were more skeptical. . .

when the rest of the country was wrong. >> [inaudible] mentioned the church but as far as eugenics could be what happened because [inaudible]

we could also look at founders of big eugenics movement that led to the united the united states back to germany and the u.s. again because we look at what happened to puerto rican women because of immigration in the 1960s and the experiment and so forth with that case it was kept in miami because once you have a child born in the u.s. with citizenship. so my question is in terms of if every society has a technology control and a political economy of civilization to what extent is the fabric of the law to extend to be simply about this

technology of control? >> that is a very good point. you're absolutely right but in a more recent years it's been used a lot against african-americans and latinos but what was really so pro verse is that some people are surprised to learn that reason she was being sterilized as in virginia at the same time the same day virginia adopted the law adopted a second law which reads the penalties for interracial marriage and adopted the one drop of blood rule to put a strong wall between black and white races and the eugenicist had actually they were so racist that they had given up and they didn't think that it was worth trying to uplift. they didn't think it was possible so at that time it was

all about lifting up the white race and making sure they didn't intermingle with it so it was a level that was so extreme they were not even focusing because there was no point in diverse people from the lower echelons that were troubled because they wanted to lift up the white race and a superclass of people bringing it down. >> [inaudible] on what basis did the individuals single out certain groups for example jewish people or italian immigrants, people from southern european countries was at the data they were looking at patterns and

behavior? >> that's a great question and it's a bit of a chicken and egg kind of things that he didn't like the groups and created the data. it was only a visceral page read of jews and italians and asians and there was a guy named madison grant was a very popular writer at the time that wrote the bestseller called the passing of the great race that anticipated a lot of ideas and billy madison grant who was an upper-class new yorker went to columbia law school and was on the board of the museum of natural history the way that he spoke about the issue walking down the street and new york in their polish jewish clothing and they were going to marry american women there was so much h. grade that i think it created the data to show that the groups were inferior but it's also interesting how they chose the

individual groups of regular old stock americans who should be sterilized and in the categories the then the categories the disabled, the death, the blind, and one of the villains in my book who ran the eugenics record office in the categories they chew up the model statute many states used for their own wall and one interesting aspect he included the people who shouldn't be allowed to reproduce because they were unworthy epileptics and it turns out harry was epileptic and it isn't clear exactly when he knew he was epileptic. he and his wife never have children but reading that one does wonder if it starts on page read was he so driven to eugenics in part because he thought he was unworthy even when he had his first seizures and everyone knew he was epileptic and his wife wouldn't let him drive anymore they never

removed it from the list to reproduce south it was a lot of mixed up in this bag. >> did he have a role in any of this? >> they claimed the term from the greek words and he was a half cousin of darwin and he was thinking in a moment right after darwin was coming up with his theory of evolution and he talked about how we can see how it works itself out for the survival of the fittest and the natural process, that he argued with his half cousin was writing about the eugenicist could speed up and do more humanely rather than everyone fight it out over years and years and the right of choosing and assorted designs the fittest would survive but

darwin himself was not a eugenicist and he wrote some rather eloquent passages where he said we could choose the people we think are the weakest and most unworthy to live but if he did that and we obliterated them we would be upgrading our own humanity so it's interesting that he understood this isn't how his ideas should be used. i wonder if you can try to predict the future a little bit in terms of genetics and not the science of genetics and prenatal testing and if you have any sense of the coming together of the fellows in terms of liberal disability rights activists and then conservatives who may be antiabortion in all cases so if you can talk about that.

>> it's a great question and there are so many aspects but one thing a lot of people are focusing on right now is as it emerged quite recently in china they have exiting the embryo so that is the creation of what they called designer babies where they can go in and edit some of the genes and rearrange them and create a baby that has been genetically designed into the changes will be carried on in future generations, so there's a big discussion going on about whether this should be allowed and a lot of people are saying doctor frankenstein and these are changes that will forever change humanity but it is going to happen. there is a researcher there to do it editing of a human embryo. so then we have the question how do we feel about this. i feel it's interesting when there was a hearing recently

about what to do ethically about editing the human genomes. one of the people that testified was a mother who is the bee had died d. had died at the age of six days probably with a genetically carried disease and she was weeping & just freaking do it, allow this because if she had been able to edit out the genes from her baby, the baby would have lived. in this discussion you see some of the people who are most in favor of allowing the human embryos are people who themselves carry these genetic markers, so as a scientist in washington whose mother contracted a terrible disease he may have that same disease he would like his children not to have it so we should allow this. it becomes an interesting twist where it's the people that are genetically unfit that are saying let us use this procedure

to make ourselves stronger. so i think that in many ways we may want to put some of our thinking and see that when we can start adding things maybe there will be a way to help rather than oppress them so that is one of the issues that will be out there. >> the one in virginia was just outside and they believed back then including feebleminded people in the country because they thought that working in the field and getting fresh air would help that although no one was ever cured and the colony system there were others through the country. it was one of these waves of reform. but people were sent there for possibly life. they let her leave the colony

after she was sterilized because the thinking was she was to longer a threat to humanity. she lived her whole life in this colony so these were sad places where people were trapped. they called them patients, but they were inmates. >> i know we've heard about prisons where they tested medications on people and the inmates were not aware this was being done and it wasn't their consent. how much did she have in these proceedings? was she completely informed of what was going on and did she have a lawyer that was able to argue on her behalf? >> the whole thing is so sad. a reporter in virginia asked me today if you could talk to her what would you ask her? i wish i knew in every stage of the process. we know that the hearings that were held in the colony she was

represented because the law required that but we don't know what she knew. she was quickly ordered it to be sterilized. there is one poignant find the transcript exists and you can read all the arguments there is one point where the lawyer is trying to sterilize her and turns and says does she have anything to say and she says she trusts her people, not clear who that is coming is at the, is that the guardian working for the people trying to sterilize her, then when they go up further and the guardian gets her lawyer because that is required under the statute of the warrior had been the chairman of the board of the colony come he was friends with for years on the other side and wanted her sterilized and wrote terrible briefs which are much shorter than the briefs on the other side. and you will be reading these like this last page and a half that's all the reason she should be sterilized. so this is what she had.

and i think at some point she didn't realize what was happening and the more charge excoriates her younger sister also in the colony for epileptics and feebleminded. after kerry was sterilized after the ruling, doris was sterilized right after and she's not told what was done to her. they tell her that she's having an appendectomy or something and then years later when kerry and her sister are listed by the then head of the colony years later in the 70s, a good guy that doesn't agree with what was done, she first finds out what was done to her and she and her husband were told the news began beeping and if they we spend our whole lives trying to get pregnant and we would go to the buck and they mentioned that she had a scar and she thought it was an appendectomy so she learned as an old woman would have been done to her and this

wasn't uncommon but unfortunately because we don't have histories and journals, we don't know who found out when many women were never told and baby died not going to this day what was done to them. it's very sad. >> so the culture of medicine until relatively recently was that doctors told patients what to do and patients complied with the doctor's orders. so when did the informed consent be something to cut -- become something the patients were supposed to understand what was being done to them? >> it was just starting before they began working for the system and it is a case in new york state where the court of appeals ruled very strongly that the patients had the right to be informed and without their consent is a form of assault. this way was beginning to happen and they were worried that if

that doctor began to spread were brought to you could be in that position but it was really after this became much more because you're right, if that had been a robust doctrine at the time certainly it was being found by eugenicists. >> [inaudible] there's a significant percentage went you are dealing with that large of a population. >> i haven't heard of any examples of that. they had all kinds of nefarious ways of dealing with things. she is pregnant when she was ordered to the epileptics and feebleminded and her family just wants her to go. the doctor says we don't accept

pregnant women or children. it's actually she's with another family until she gives birth and then the question of what to do with her baby boy and behold, the foster family that raised a baby as their own and then they don't let her come back and join them later so i think that they were being passed around and all kinds of things were worked out but i'm sure that it was all done in a terrible way for the individuals involved. >> great question. there was no dissent but the one justice that voted against was the one catholic on the court and the conservative member on the court and there were some that had written about the silence was what he had said and it's hard to know.

he was very cranky. sometimes he objected to the activities in various kinds and he didn't like the government in people's lives but he was also a very great religious catholic and the result is he probably objected on moral grounds which is heated and say that we really wonder what they were thinking and for me one of the questions was what was louis brandeis thinking? he was known as the people's attorneys when he practiced law. he was the great champion and he just signed on. so, early on in this process i was excited to learn there was a 900 page biography of louis brandeis and i wanted to see what someone in his entire life said and once again we see the theme. it was mentioned in the footnote in that book. there was so much about the parliament and international

zionism and the childhood and all that and then the footnote saying of course he was a majority. as far as i can tell, he said in an interview at one point something ski doesn't vote with the majority and the chief justice at the time was very big on building, he liked that close unanimity so the dynamic might have been that he kind of let him twist his arm but it amazes me that no one has really explained that. so there's a lot of silence as in the case which will never be filled in. >> was very question back there? >> does your book make the connection between the 1927 ruling and the 1947 willowbrook mental institution which was the

biggest state-run institution in the united states which closed in 1987 with a lasting sterilization and a closed. did your book make that connection? >> it doesn't get that far into the future. but it's something we all wrestle with because what was going on when it was over and felt like the way in which the inmates were horribly mistreated and shut away and so forth but the aclu to its credit the critique now is that the weather system was put in place, so what we have now is do we have a humane system for taking care of folks i think that is a national problem but i guess in part

because i wasn't aware that sterilization occurred that the but the larger problem is how we deal with people who are developmentally disabled and i think not enough attention is given to it as a policy matter or as writers and readers i think we just should be learning and thinking more about it. >> i was wondering if anybody knows what happens to her daughter and she ever found out about her mother. >> sometimes when i talk to people about the story they're like what is the happy part of it clicks there are no heroes and there is no happy parts of it is a good lead up to the question. vivian died at the age of six of something like measles and so she never learned any of this.

but she did have a little bit of a school record at the time and right before the initial trial, these affordable eugenicists sent an expert from god records office to examine the intent and he was able to swear she was mentally defective because you it could because compared to the other baby she seemed to smile once or react differently so that was enough to say that purpose three generations so she was reported as being an imbecile by visiting card. in fact she was a very bright and perfectly normal child and the hundreds of villains in my book the foster mother who throws her out and gets hurt committed because she's been raped by her nephew and then takes her baby when they go to talk to her after the baby has died she doesn't say there was nothing wrong with her she was

fine. so just sad in every direction you look including that one. >> i know there are some writers. if you are using the word editing. we all would have to have editors but what if it is hacking or splicing, what the outcome in the way we are thinking about the editing be the same? >> that's a great question and this is a live issue right now. you're right people use the word editing but there is a push back or maybe we shouldn't and maybe we should see if you want them edited so that your child doesn't inherit a bad trait maybe it is like editing but one other way that it figures in this is the three generations of their missiles are enough and

there are a million things wrong in this decision, the facts are wrong, it's barbaric but one point that bothers me is there were three different categories back then, very precise. idiots were at the bottom than in brussels were in the middle and morons were at the top and these were registered. i found out pamphlets with a nice little chart these were well-known categories. kerry and her mother who are probably just perfectly normal have been labeled morons when they got to the colony for epileptics and feebleminded. it's not a great degree but it is one of those imbeciles. so he denotes them in his decision and calls them in brussels which the record made clear though, in her case they were mid-level moron and in her mother's case, low-level but

they were not imbeciles. so he was a great wordsmith and one reason i use the word imbeciles for the title, there are several including the bigger question of who were the imbeciles and i would say not the people being stabilized the people doing the sterilizing. but it's such a resident word and his choice of it's one its one thing i loved that my publisher did, they sent me a picture of a cover that they had come up and we have designers that come up with this. one thing was they turned the word imbeciles into a dictionary definition and they put in the syllable and that was right because it was saying let's interrogate the word. who are the missiles, why did he choose the word, so that kind of nomenclature is everywhere and it's definitely part of his bag

of tricks and used to these purposes. >> i think the word editing is appropriate because the way that 'and the genetics are coming you read the stream so when you use the word editing -- >> as a journalist you may have a very benign view that anyone who gets edited fields that is evil. [laughter] to me it makes it [inaudible] into some horrible thing that they wanted to write. >> it was just going to say parts of the conversation reminded me about what was done in australia because they wanted to get rid of them but they

chose a humane way of marriage rather than incarcerating them. >> again, depressing stories but here they are. one other part of it is how we see the same over and over again. we see that the way we treated our african americans come our were cast by its very similar to how the indigenous were treated in other populations and then one of the porters of the story is seeing how closely what we were drinking to nazi germany. the nazis happily adopted what we were doing because we were doing what they were about to do. we have designated areas of being superior. madison and grant wrote a whole book about it. we were sterilizing people, something they were happy to do. so if the line was i think you are right we will see the same thing everywhere because there are only so many different ways

people are horrible to others and it falls into certain patterns. >> it would seem that oliver wendell holmes legacy has had a good public relationship to the team of preserving the positive reputation where in addition to the fabulous book and in a magazine article there had been the life and times in 2001 and 2003. it is was an article called and

it was a house in dupont circle in washington they would prop up his reputation and is about in the republic and and then it's been carried through yes he was wounded in battle three times. we hear the heroic stuff that's not some of racial decisions rejecting an that was so terrible that not only stop them from voting around for