By RANDY SOUDERS

During the years I served as Chairman of the Board for Jean Kennedy Smith’s Arts and Disability program, Very Special Arts (VSA at the Kennedy Center), I had there opportunity to meet a wide range of remarkable and courageous disabled Americans. Among the lasting friendships is a painter and visual artist, Randy Souders, who was rendered quadriplegic at the age of 17 in a 1972 accident. His concerns of late have been heightened by Trump and MAGA Republicans. I share his communication with his permission here in the hope that tech designers and others will be alert to the fact that great care is required at this point, lest history repeat. — Mike Magee MD

When I was injured at the age of 17 the world was still quite closed for people like me. That was a year before passage of HR 504 of the Rehabilitation Act of 1973. As I recall that law was the first to mandate access to public places that received federal funds. A year later Jean Kennedy Smith founded VSA (Very Special Arts) which has provided important arts opportunities to literally millions of people with disabilities around the globe. It was a very different world back then and artistic achievement was an important way people such as myself could prove their worth to a society that still saw little evidence of it.

It’s unbelievable to think there are serious threats to roll back many of those hard won gains in the name of deregulation and profitability. Disability is costly and people with disabilities are still woefully underemployed. So when a billionaire presidential candidate repeatedly mocks people with disabilities, how long till the “useless/ unworthy” excuses rise again? The old term describing a person with a disability as an “invalid” has another meaning. The adjective use is defined as “Not valid; not true, correct, acceptable or appropriate.”

Few today are aware that the first victims of the Holocaust were the mentally, physically and neurologically disabled people. They were systematically murdered by several Nazi programs specifically targeting them. The Nazi regime was aided in their crimes by perverted “medical doctors and other experts” who were often seen wearing white lab coats in order to visually reinforce their propaganda.

Branded as “useless eaters” and existing as “lives not worthy of life,” people with disabilities were declared an unbearable burden both to German society and the state. As Holocaust historians have documented, “From 1939 to 1941 the Nazis carried out a campaign of euthanasia known as the T4 program (an abbreviation of Tiergartenstrasse 4 which itself was a shortened version of Zentral Dienststelle-T4: Central Office T4) the address from which the program was coordinated.”

These most vulnerable of humans were reportedly the first victims of mass extermination by poison gas and cheaper CO2 from automobile exhaust fumes. But first “a panel of medical experts were required to give their approval for the euthanasia/ ‘mercy-killing’ of each person.”

In the end an estimated quarter million people with disabilities were killed in gas chambers disguised as shower rooms. This model for killing disabled people was later applied to the industrialized murder within Nazi concentration and death camps such as Auschwitz-Birkenau.”

Much has been written on this topic but few seem to know the chronology and diabolical history of how these “beneficial cleansings” of undesirables often start. The Nazi’s enlisted medical doctors to provide them with a veneer of moral justification for their atrocities.

Throughout history, authoritarian political despots have also worked diligently to silence dissent and co-opt religion in order to assist in their mutual quests for total control and dominance of others.

And theocrats are convinced their particular splinter of a schism is the ultimate authority on earth as well as the entire universe. Stoning, beheadings and the hanging of transgressors and non-believers are arbitrarily justified by interpretations of their particular holy book.

There is much to fear when politicians exploit the religious beliefs of medical professionals in order to pass laws denying the rights of others to control their own bodies. This blatant pandering for votes by promising to deliver on religious wedge issues creates a positive feedback loop resulting in politicians being deified by their religious influencers. This is aided by a campaign of rationalization absolving them of their obvious failings. Such a campaign of apologetics by religious leaders is active and widespread in America as I type.

Examples include “God doesn’t call the qualified…He qualifies the called” (Exodus Chapter 4) and “God calls imperfect men to do His perfect will.” Is there even a red line where such “imperfect men” becomes an existential threat? Apparently not. I’m sure most citizens of the Third Reich didn’t think so until everything imploded.

The current Republican candidate for President is on the record as being a believer in the “racehorse theory” – the idea that selective breeding can improve a country’s performance, which American eugenicists and German Nazis used in the last century to buttress their goals of racial purity. On September 18, 2020 he told a mostly white crowd of supporters in Bemidji, Minn. “You have good genes. A lot of it is about the genes, isn’t it? Don’t you believe? The racehorse theory. You think we’re so different? You have good genes in Minnesota.”

This is one of many such statements he has made regarding genetics that has resulted in his personal superiority and that of his family. The New York Times reports “Mr. Trump was talking publicly about his belief that genetics determined a person’s success in life as early as 1988, when he told Oprah Winfrey that a person had ‘to have the right genes’ in order to achieve great fortune.”

These statements combined with those “about undocumented immigrants poisoning the blood” of America should equate to a 100 alarm fire.

Randy Souders is a Professional Artist, an Arts & Disability Advocate and has been Quadriplegic since 1972

By PHUOC LE, MD and BROOKE WARREN

In the 1970s, Jean Whitehorse, a member of the Navajo Nation, went to a hospital in New Mexico for acute appendicitis. Years later, she found out the procedure performed was not just an appendectomy – she had been sterilized via tubal ligation. Around the same time, a Northern Cheyenne woman was told by a doctor that a hysterectomy would cure her headaches. After the procedure, her headaches persisted. Later, she found out a brain tumor was causing her pain, not a uterine problem. Like Whitehorse and the Northern Cheyenne woman, thousands of Native American women have suffered irreversible changes to their bodies and psychological trauma that continues to this day. Most medical providers are unaware of our own profession’s role in implementing these racists policies that have direct links to the Eugenics movement.

Eugenics was a “movement that is aimed at improving the genetic composition of the human race” through breeding. From its origin in 1883, eugenics became the driving rationale behind using sterilization as a tool to breed out unwanted members of society in the United States. With the 1927 Supreme Court case Buck v. Bell permitting eugenic sterilization, 32 states followed suit and passed eugenic-sterilization laws. Although the outward use of sterilization declined after World War II because of its association with Nazi practices, sterilization rates in poor communities of color remained high throughout the United States.

The 1970s marked a period when Native American women were explicitly targeted by forced and coercive sterilization practices. Native women, as young as 15, were threatened, lied to, and manipulated into receiving these procedures. This continued the United States’ legacy of tribal assimilation and extermination. It is estimated that between 1970 and 1976, 25 to 50 percent of Native American women were sterilized.

For every 7 Native American babies born, one Native American woman was sterilized.

In 1975, Senator James Abourezk of South Dakota asked the General Accountability Office (GAO) to conduct a study on Indian Health Service (IHS) facilities in response to increasing reports of women being sterilized without proper consent. The report found that from 1973 to 1976, 3,406 Native American women were sterilized. Of these women, 3,001 were of child-bearing age (15-44). Additionally, hospitals did not meet the IHS requirements for giving their patients informed consent.

From the GAO report, Senator Abourezk stipulated that the number of Native American women sterilized at these four hospitals from 1973 to 1976 was comparable to 452,000 non-Native sterilizations.

Forced and coercive sterilizations were carried out by doctors threatening to have patients’ children put into the foster care system if they did not have the procedure, telling patients that hysterectomies were reversible, doing the surgery without approval, convincing patients that their welfare benefits would be taken away, and saying they would die if they did not have the procedure.

Dr. Connie Pinkerton-Uri (Cherokee/Choctaw) found further evidence supporting that most sterilizations were unjustified by studying the notes on 132 sterilizations done on Native American women in Oklahoma. The doctors classified 100% of the sterilizations as non-therapeutic, meaning they were done with the full purpose of preventing further pregnancy—not to treat medical conditions.

With Native American women’s reproductive rights controlled by physicians during the 1970s, the number of Native American women capable of bearing children dropped below 100,000 in the United States.

The legal system coupled with clinician paternalism is what allowed for forced sterilizations to occur on a large-scale. President Richard Nixon’s Family Planning Services and Population Research Act of 1970 provided federal funding for sterilization as a family planning service for IHS and Medicaid patients. This gave physicians with paternalistic and racist agendas the means to carry out thousands of unnecessary sterilizations in poor communities and women of color. In five years, sterilization of women had increased 350% with 1 million women sterilized each year.

Physicians were given the power to impose their “middle class attitude” onto their patients and be supported by the government for doing so, instead of learning to be culturally sensitive. The middle-class attitude carried the assumption that single mothers should not reproduce, poor families should not have children, and families should not exceed two children.

50 years later, we are still trying to understand the extent and impact of what happened to Native American women during this era in the United States. Native American women lost loved ones, could not carry on tradition, and ended their lives—all because of biases and manipulation in healthcare that resulted in their sterility.

For many Native American women like Jean Whitehorse, having children and taking care of a family are two of the most important roles one can hold in a lifetime. Taking away her ability to reproduce disconnected her from her Navajo traditions and family.

Although an unjust legal system allowed and incentivized sterilizations during the 1970s, it is doctors who enabled the system to be successful in its racist agenda.

Today, healthcare professionals must find ways to combat policies and systems that are still inherently racist. One strategy is practicing trauma-informed care as we discussed in one of our recent blogs. We can learn more about the communities we are serving and provide medicine that acknowledges what patients are experiencing both in and out of the healthcare setting. From organizations like  White Coats For Black Lives supporting #BlackLivesMatter to individual efforts like Dr. Connie Pinkerton-Uri who demanded research into forced sterilization of Native American women, clinicians have a responsibility to shed light on injustices in the system, and ultimately aid in the dismantling of racist structures that have a legacy of impacting countless vulnerable communities of color.

Internist, Pediatrician, and Associate Professor at UCSF, Dr. Le is also the co-founder of two health equity organizations, the HEAL Initiative and Arc Health. 

Brooke Warren is a Native American Studies major and recent graduate of UC Davis. She is currently an intern at Arc Health.

This post originally appeared on Arc Health here.