History

Week 3, Session 5

April 10th, 2007

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Moral Model

• How Did It Evolve ?

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Antiquity (Greece, Rome): infanticide and fear of the gods

• Exposed “deformed” infants.– Not universal practice.– Variations from species “norm.”

• Birth defects as omen.– gods are displeased with some wrongdoing.– Sacrificed as appeasement.

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Medical Model

• Also present

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Greece

• Aristotle’s Politics (350BC)– Utopian, ideal leaders, beauty.– “Deformed shall not be reared.”– Impossible ideals; life span 40 years.

• Aristotle, Generation of Animals – Female as “mutilated male” (less heat, so less

perfectly formed).– “Monstrous” births (inhuman form) explained by

natural causes: male contributes “form,” female contributes “material.”

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Greece & Rome

• Roman laws deny rights to the deaf & mentally disabled, seen as irrational.

• Military medicine & support for wounded veterans.

• Hippocratic medicine (450BC-1600AD)– Imbalance of 4 body “humors” is the natural

cause of epilepsy, melancholy, etc.

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Moral: Ancient Greeks

• Ethiopians were often idealized as a pious and 'blameless' people

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Judeo-Christian traditions:

• Old Testament: Leviticus– List of disabled people who must be excluded from

rituals; don’t defile the divine with impurity.– Bear the burden of sin.

• New Testament– Jesus encounters the sick, blind (spiritually disabled?)– Disability becomes a target of charity.

• Christians judged by their conduct to others– Good deeds lead to salvation– Ethics, mercy

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European Christian

• Ethiopians were monstrous principally owing to their black skin, which was considered a demonic feature.

• St Jerome stated that Ethiopians will lose their blackness once they are admitted to the New Jerusalem

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Monsters as “unnatural”: stories, wonders, moral symbols through the ages

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Charity in medieval Europe: moral/tragedy model

• One large category of “misfortune.”– Poverty & illness & disabilities.– All seen as inevitable; part of God’s diverse creation

(Saint Augustine 400AD). disabilities= God’s power over the natural world.

– Salvation of the rich thru gifts to poor.

• Small “hospices,” Hotel-Dieu, not medical role.– 19,000 leprosariums; leprosy shunned.

• Begging as occupation– License, guilds, competition.– Children deliberately maimed for profit; faking.

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Dark Ages

• 1348 Black Death, social disorder & fear, scapegoat the poor.

• Medieval & Renaissance royal court amusement.– Jester/dwarf, fool/idiot,

epileptic, conjoined twins as objects of ridicule; bought as gifts, pets.

– Royalty display their “curiosity” collections.

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MIDDLE AGES4th – 16th C.

Family - Center of activities• Monasteries – Refuge for blind

• 1403 – Bethlehem – Oldest Mental Institution in Europe

• Rampant Poverty - Begging

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Religion (Protestant & Catholic)

• Disability as sin– Demonic seizures. – Birth defects tied to

witchcraft.– Martin Luther 1517

mentally disabled have no soul & should be killed.

• Faith healing– 1495 Miracle of

Cosmas and Damian (saints transplant leg)

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MIDDLE AGES4th – 16th C.

• 1484 Pope Innocent VIII proclaimed a war against witches • next 300 years=100,000 witch trials. 

• mental illness was treated by tying up people in church other disabilities had the sign of the cross shaved into their heads. 

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Mental illness in the Middle Ages was very often diagnosed as

witchcraft

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MIDDLE AGES (cont)

• 1388  The Statute of Cambridge ("Poor Law") distinguished between "sturdy beggars" capable of work and "impotent beggars“ (not able) incapacitated by age or infirmity;

• No special provision for maintaining the sick poor. For the next two centuries the aged and infirm depended upon charity for survival.

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Early modern Europe (16-17C):

• 1601 English Poor Law– First state welfare.– Divides the poor into

deserving (disabled) and undeserving (able to work).

– Notoriously meager.

• Renaissance art: ideal body glorified again.

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The Enlightenment: mind & education (18thC France)

• Philosophers promote REASON over authority.– rational, universal “man” as liberal democratic ideal.– “natural” inferiority based on gender, race.

• 1690 John Locke & tabula rasa (blank slate)– Ideas come from sense perceptions.– So all minds can be trained.

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Early Modern – 18th C.

Renaissance

– – New Advances in Human Understanding (experience & reason)

• Reformation:

– Calvin / Luther – Preached that People with Mental Illness Possessed or Created by Satan

• Start of Biological Origin / Treatment - Understanding Difference - Intellectual Disability / Mental Illness

Europe – By 17th C. Poverty – suspect - Begging Outlawed Paris 1657

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18th – 19th C

• Denis Diderot’s 1749 “Letter on the Blind”– Rejects spiritual/sin ideas of blindness.– Blind people have skills & intelligence & should be educated.

• 1784 Paris, first school for the blind.• Early 1800’s - US: Moral Treatment by InstitutionsEarly 1800’s - US: Moral Treatment by Institutions• 1820 Louis Braille, blind student & teacher.• 1831 Boston, Perkins school (H. Keller ~1900).• Debate: institutionalization vs. integration.

– Assume all disabled people are dependent.– Residential & trade schools until 1970s.

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Charity Organization Societies (COS) 1870

• Urban poverty was caused by moral deficiencies of the poor

• individuals in poverty could be uplifted through association with middle-and upper-class volunteers ("friendly visiting" )

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19th CenturyDuring the nineteenth century theories of race were advanced both by the scientific community and in the popular daily and periodical press:

In much of the pseudo-scientific literature of the day the Irish, Blacks, Lower classes held to be an example of a lower evolutionary form, closer to the apes than their "superiors", the Anglo-Saxons. These “others” were seen as:

• Unreasonable, irrational, and easily excited

• Childlike

• Having no religion but only superstition.

• Criminal

• Excessively sexual

• Filthy

• Ape like qualities

1859 Charles Darwin published On the Origin of Species

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Education & developmental disabilities

• 1840s, Paris then US– Edouard Seguin, “apostle to the idiots.”– Teach sensory-motor “control.”– 1848 Boston, School for Idiotic and Feebleminded Youth.– Goal to train in job skills (if jobs available).

• 1870s, England and US residential schools.– Universal education & those who don’t fit.– By 1875, claims that “mental deficiency” was increasing, and

need to build larger custodial institutions, hidden away, permanent care, protect society.

– Inmates as unpaid workers; self-sufficient colonies.– 1894 Rome State Asylum for Unteachable Idiots.

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“Idiots” diagnoses and degeneration theory

1848 Samuel G. Howe, ON THE CAUSES OF IDIOCY

“E. G., aged 8 years. This poor creature may be taken as a type of the lowest kind of idiocy.

The probable causes are hereditary ones. The grand-parents were very scrofulous and unhealthy.

The parents were apparently healthy, but gave themselves up to excessive sensual indulgence.”

1866 J. Langdon Down, OBSERVATIONS ON AN ETHNIC CLASSIFICATION OF IDIOCY

“We have examples of retrogression…or departure from one type and the assumption of the characteristics of another.”

Down coined term “mongolism” to characterize people with intellectual impairment as equivalent to people of different races.

Evolutionary “throwbacks” to a “lower” ancestral race.

Also criminals were explained as throwbacks to animal type, lacking human moral sense.

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History of institutions for mentally impaired people

• By 1700, France had 100 “general hospitals,” mixed poor, sick, disabled, insane.

• 1377 London’s Bethlehem asylum (“Bedlam”)

• Until late 1800s, most lived in family, community– Able to contribute in pre-

industrial economy; work in home, fields; unpaid labor still valued.

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Abuses in madhouses (1700-1850)

Bedlam hospital provided Sunday afternoon entertainment. The chained patients were placed in cells and galleries. The asylum received large sums of money from the visitors until 1770 when it was decided that they tended to disturb the tranquility of the patients by making sport and diversion of the miserable inhabitants and that admission should be by ticket only.

1848 Dorothea Dix (Mass.): "More than 9000 idiots, epileptics, and insane in these United States, destitute of appropriate care and protection. Bound with galling chains, bowed beneath fetters and heavy iron balls, attached to drag-chains, lacerated with ropes, scourged with rods, and terrified beneath storms of profane execrations and cruel blows; now subject to jibes, and scorn, and torturing tricks, now abandoned to the most loathsome necessities or subject to the vilest and most outrageous violations."

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THE RISE OF THE AMERICAN INSTITUTIONMORAL TREATMENT

• 1841- 1870s Dorothea Dix – 30 state public institutions for people with mental impairments built

• 1870s Poor funding, growing size of institutions - Overcrowded, dirty institutions. Segregation of middle class / poor. Husbands could commit wives.

• Severe Economic depressions 1870 & 1880

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THE RISE OF THE AMERICAN INSTITUTION

• By 1850, 55 asylums - ~ 45,000 ''known insane persons'‘

• 1870 -1880 Census: – PWMD= 97 to 183 / 100,000– PWID= 64 to 153 / 100,000

by 1900, 328 institutions - ~ 200,000 patients

• The peaked in 1955 at ~ 560,000

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Statistical bell curve (1835) invented in the era of efficiency, progress, eugenics

• Statistics created “the tyranny of the norm,” really the ideal.– The disabled fall short.

• Statistician Francis Galton founded the eugenics program of eliminating deviations from the norm (in one direction only).

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The asylum: from moral to “medical”

• Initial benevolent goals of reformed asylums.• “Moral treatment” (self-control)

– Calm environment, social activities, baths/diet.– Small private retreats for the wealthy.– US run by Quakers.

• By 1870s, US and England public institutions– Huge size, poorly funded.– No real therapy, but premised on science of heredity

and idea of brain lesions as cause.– Growth of psychiatric profession, interests.

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1835 Lunatic Asylum, Columbus Ohio

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American Schools 1880-1920

• Schools based on the efficiency movement.

– workplace - learning was perceived in terms of productivity. Cubberly stated that schools should be like factories. Referring to the teachers as the factory workers and the students as the raw material to be turned into the product.

• The children who could not be processed to completion were considered as scraps. …. they were considered to be dropped out of the production line ="drop outs."

• http://www.nd.edu/~rbarger/www7/impbusin.html

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Eugenics

• Sir Francis Galton 1883:

"Eugenics is the study of the agencies under social control that seek to improve or impair the racial qualities of future generations either physically or mentally."

Francis Galton, Inquiries into Human Faculty and its Development (London: Macmillan, 1883).

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From segregation to prevention of “unfit” births = the eugenics movement 1900-1940

• Social costs, burden of supporting the “feebleminded” and their offspring.

• vs. desirable traits = white, middle-class norms…

• US sterilizes 60,000 people in institutions.

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Popular Culture Freak Show

• Captain Ahab, bitter and deformed, in Moby Dick• Classic children's tales - disabled

people are evil: – The deformed, cannibalistic witch in Hansel and

Gretel, 1845– Captain Hook, the "limb-missing”, patched-eye pirates

of Robert Louis Stevenson’s Treasure Island, 1885– "the queen in Snow White, who becomes a "wart-

nosed, hunched-over witch" to poison Snow White, and other disabled characters are wicked. 1845

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Social construction of “freaks”: How’d you like to become a giant?

• Circus sideshows, performers• 1840s-1940s• Display, entertain, skills• “Real” and not-real disabilities, identities.• Make a living (how exploitative?)• Replaced by medicalized power over disability:

bodies displayed at medical museum, presentations at scientific meetings, today’s documentaries.

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Sara Baartman, exhibited in Europe as Hottentot Venus, died 1815, dissected &

displayed

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IQ testing

• 1905 invented by Alfred Binet.– “abnormal” children can be educated.

• 1910s US psychologists corrupt this goal.– Mental testing industry.– Person’s intelligence is unchangeable.– Hereditary.– Measure & label & institutionalize.

• “Menace” to society. – Moron – imbecile – idiot scale.– By 1900, 328 institutions, with 200,000 people labeled mentally

impaired.

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Time Line

1920 “The Permission to Destroy Life Unworthy of Life,” Karl Binding , a lawyer, & Alfred Hoche, a psychiatrist. Germany.

• 1927 Buck v. Bell United States Supreme Court upheld the concept of eugenic sterilization for people considered genetically "unfit." Oliver Wendell Holmes, Jr., stated: "Three generations of imbeciles are enough.“

Upheld Virginia's sterilization statute which provided for similar laws in 30 states, under which an estimated 65,000 Americans were sterilized without their own consent

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Time Line

• 1933 Nazi Germany -between1933-1939, 375,000 people in Germany sterilized

• 1939 T4 program – Start of Germany’s Euthanasia program ~275,000 PWD murdered.

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ICE PICK

LOBOTOMY

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In 1936, Walter Freeman performed his first lobotomy operation. Inserting an ordinary ice pick above each eye of a patient with only local anesthetic, drive it through the thin bone with a light tap of a mallet, swish the pick back and forth like a windshield wiper and - a formerly difficult patient is now passive.

Used it for everything - psychosis to depression to neurosis to criminality. He developed assembly line lobotomies, going from one patient to the next with his gold-plated ice pick.

Between 1939 and 1951, over 18,000 lobotomies were performed in the US, and many more in other countries. It was often used on convicts, and in Japan, it was recommended for use on “difficult” children. The old USSR banned it back in the 1940s on moral grounds!

In the 1950s protests began. The general statistics = ~ a third of lobotomy patients improved, a third stayed the same, and the last third actually got worse!

Francis Farmer, an eccentric actress, was committed to Western State hospital.

Rosemary Kennedy, sister to John, Robert, and Edward Kennedy, was given a lobotomy when her father complained about the mildly retarded girl’s embarrassing new interest in boys. Her father never informed the rest of the family about what he had done. She lived out her life in a Wisconsin institution and died January 7, 2005, at the age of 86. Her sister, Eunice Kennedy Shriver, founded the Special Olympics in her honor in 1968.

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                 Life Magazine   "Bedlam 1946"                                      

Philadelphia State Hospital, known as Byberry, originally built in 1912. Byberry has been investigated so many times that in 1987, an 18-member task force decided to close the hospital in the interest of the patients. The hospital officially closed its doors in 1990.

http://www.abandonedasylum.com/psh1.html

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"Bedlam 1946" by Albert Q. Maisel, Life Magazine (5/6/46)

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"Bedlam 1946" by Albert Q. Maisel, Life Magazine (5/6/46)

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"Bedlam 1946" by Albert Q. Maisel, Life Magazine (5/6/46)

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Byberry: "Four hundred patients were herded into this barn-like dayroom intended for only 80. There were only a few benches; most of the men had to stand all day or sit on the splintery floor. There was no supervised recreation, no occupational therapy.. Only two attendants were on this ward; at least 10 were needed." (the Shame of the States,

Albert Deutsch)

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"Bedlam 1946" by Albert Q. Maisel, Life Magazine (5/6/46)

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This is the bed-jammed corridor of Ward N-7, for female patients, at Bellevue Hospital as sketched by Eric Godal immediately after a personal tour in the summer of 1947. City

Hospitals Commissioner, Edward M. Bernecker, refused permission to take photographs inside the hospital, so Godal sketched this drawing. (the Shame of the States)

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Time Line (cont)

1952 Thorazine – 1st Major Psych Drug1950s-1970s Deinstitutionalization State

Institutions

1972 The appalling conditions at Willowbrook State School in New York City for people with developmental disabilities are exposed as the result of a television broadcast by Geraldo Rivera from the facility. (POP ~5,700)

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Time Line (cont)

1935 The Social Security Act, providing federal old age benefits and grants to the states for assistance to blind people and children with disabilities, becomes law. 1937 The March of Dimes is founded 1940 National Federation of the Blind 1947 Paralyzed Veterans of America is organized 1950 The Association of Retarded Citizens (theARC)

— William Stokoe's paper on Sign Language Structure legitimizes American Sign Language and ushers in the movement of Deafness as culture.1962 Edward Roberts sues to gain admission to the University of California, the same semester that James Meredith requires a lawsuit to become the first black person to attend the University of Mississippi.1964 The Civil Rights Act

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1938

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Time Line (cont)

1950s-1970s Deinstitutionalization State Institutions

1972 The appalling conditions at Willowbrook State School in New York City for people with developmental disabilities are exposed as the result of a television broadcast by Geraldo Rivera from the facility. (POP ~5,700)

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Time Line (cont)

1975 Vietnam War ends1977 Following nationwide demonstrations by disability activists, HEW SecretaryJoseph Califano signs the regulations for Section 504 and the Individuals withDisabilities Education Act.1977 Black Deaf Advocates is founded 1983 ADAPT, American Disabled for Accessible Public Transit, (American Disabled For Attendant Programs Today)1985 Society for Disability Studies 1988 The Gallaudet University uprising - first deaf president

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Eugenics Lives On 1994

The Bell Curve: Intelligence and Class Structure in American Life

Richard J. Herrnstein (professor of psychology at Harvard University) and Charles Murray

Human Genome Project

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WHERE WE ARE NOW

• 2000 + years of Religion / Superstition

• New Religion of Reason & Rationality

• Massive Social Changes

• Social Construction of Disability