Buck v.
Bell (SAMMY) daughter of a feeble-minded mother in the same institution, and the mother
274 U.S. 200 (1927) | Oliver Wendell Holmes | Due Process
PETITIONER: Carrie Buck
RESPONDENTS: John Hendren Bell, Superintendent of State Colony for
Epileptics and Feeble Minded
SUMMARY: The Racial Integrity Act of 1924 (Sterilization Act) was
approved on March, 20, 1924 for the sterilization of those people who are
mentally defective under the care of institutions supported by the
Commonwealth, by which if these people who are mentally defective will be
discharged now, would just become a menace to the society, but if incapable of
procreation, might be discharged with safety and become self – supporting with
the benefit to themselves and to the society. The sterilization may be conducted
through vasectomy in males and salpingectomy in females. It was believed to
promote the health and welfare of the society for eugenicists believes that
mental illness and retardation, epilepsy, alcoholism, and certain criminal
behavior were genetically inherited and was feared to be weakening the gene
pool of the general population. Carrie Buck is a feebleminded white woman
who was an inmate at Virginia State Colony for Epileptics and Feebleminded.
She is the daughter of a feebleminded mother in the same institution, and a
mother of an illegitimate feebleminded child as a result of rape.
The Board of Directors of the State Colony State Colony for Epileptics and
Feeble Minded: ordered the authorization for Buck’s sterilization
Buck and her guardian: Appealed contended that the due process clause
guarantees all adults the right to procreate which was being violated. They also
made the argument that the Equal Protection Clause in the 14th Amendment
was being violated since not all similarly situated people were being treated the
same. The sterilization law was only for the "feeble-minded" at certain state
institutions and made no mention of other state institutions or those who were
not in an institution.
State Court ruling: Buck, her mother, and her daughter were “feebleminded”
and that it was the state’s interest to have her sterilized. Carrie Buck is a
probable potential parent of socially inadequate offspring, likewise afflicted,
that she may be sexually sterilized without detriment to her general health, and
that her welfare and that of society will be promoted by her sterilization.
DOCTRINE: In order for society not to be “swamped with incompetence,”
having the sterilization of some mentally incompetent persons is permitted.
Further, the sterilization process cannot occur until after a long hearing
process. Justice Holmes, writing for the majority, noted that “[t]hree
generations of imbeciles are enough.”
FACTS:
1. Carrie Buck is a feeble-minded white woman who was committed to the
State Colony for Epileptics and Feeble Minded in due form. She is the
of an illegitimate feeble-minded child.
2. An Act of Virginia approved March 20, 1924 recites that the health of the
patient and the welfare of society may be promoted in certain cases by the
sterilization of mental defectives, under careful safeguard, etc.; that the
sterilization may be effected in males by vasectomy and in females by
salpingectomy, without serious pain or substantial danger to life.
3. It also stipulated that that the Commonwealth is supporting in various
institutions many defective persons who if now discharged would become a
menace but if incapable of procreating might be discharged with safety and
become self-supporting with benefit to themselves and to society.
4. The statute enacts that whenever the superintendent of certain institutions
including the above named State Colony shall be of opinion that it is for the
best interest of the patients and of society that an inmate under his care
should be sexually sterilized, he may have the operation performed upon
any patient afflicted with hereditary forms of insanity, imbecility, etc., on
complying with the very careful provisions by which the act protects the
patients from possible abuse. John
5. Hendren Bell, the superintendent of the state institution, sought an order for
the sterilization by salpingectomy of Buck. Notice of the petition and of the
time and place of the hearing in the institution is to be served upon the
inmate, and also upon his guardian. The board is to see to it that the inmate
may attend the hearings if desired by him or his guardian.
6. The Board of Directors issued an order for the sterilization of Buck, and
her guardian appealed the case to the Circuit Court of Amherst County,
which sustained the decision of the Board. The case then moved to the
Supreme Court of Appeals of Virginia.
7. The appellate court sustained the sterilization law as compliant with both
the state and federal constitutions. The state supreme court affirmed the
sterilization order. Buck sought review, contending that the operation of
salpingectomy, as provided for in the Act, was illegal in that it violated her
constitutional right of bodily integrity and was therefore repugnant to the
due process of law clause of the Fourteenth Amendment.
ISSUE/s: WoN the respondent by authorizing the petitioner’s sterilization denied her
right to due process and equal protection of laws? - NO
RULING: The decision of the Supreme Court of Appeal of Virginia is affirmed.
RATIO:
1. The Court found that the statute did not violate the Constitution. Justice
Holmes made clear that Buck's challenge was NOT upon the medical
procedure involved but on the process of the substantive law. Since
sterilization could not occur until a proper hearing had occurred (at which
the patient and a guardian could be present) and after the Circuit Court of
the County and the Supreme Court of Appeals had reviewed the case, if so
 requested by the patient. Only after "months of observation" could the
operation take place. That was enough to satisfy the Court that there was no
Constitutional violation. Citing the best interests of the state, Justice
Holmes affirmed the value of a law like Virginia's in order to prevent the
nation from "being swamped with incompetence . . . Three generations of
imbeciles are enough."
2. It was held by the Court that Buck, her mother, and her daughter were
“feebleminded” and that it was the state’s interest to have her sterilized.
3. The judgment finds the facts that have been recited that Carrie Buck is a
probable potential parent of socially inadequate offspring, likewise
afflicted, that she may be sexually sterilized without detriment to her
general health, and that her welfare and that of society will be promoted by
her sterilization.
4. Notice of the petition and of the time and place of hearing in the institution
is served to the inmate, and also upon his guardian and the board see to it
that the inmate attends his hearing if desired by him or his guardian.
5. In support of Justice Holmes’ argument that the interest of the states in a
"pure" gene pool outweighed the interest of individuals in their bodily
integrity, he expressed that “It is better for all the world, if instead of
waiting to execute degenerate offspring for crime, or to let them starve for
their imbecility, society can prevent those who are manifestly unfit from
continuing their kind.” And that "Three generations of imbeciles are
enough.”
6. The ruling legitimized Virginia's sterilization procedures until they were
repealed in 1974.
OTHER NOTES:
Buck applied the "rational basis test" (the least restrictive standard of legislative
scrutiny) under the 14th Amendment to sustain sterilization of women ("three
generations of imbeciles are enough" -- Oliver Wendell Holmes).
TRIVIA:
Buck v. Bell is significant because it legitimized eugenic sterilization, and it sparked
many states to adopt their own involuntary sterilization statutes. In fact, Adolf Hitler
cited Buck v. Bell as a model for his forced sterilization law to prevent “hereditarily
diseased offspring.” The Nazis even used Buck v. Bell as a defense during the
Nuremburg trials following World War II.
Buck v. Bell has not been expressly overturned. However, Skinner v. Oklahoma, 316
U.S. 535 (1942) made forced sterilization so difficult that it discouraged the practice.
By 1963, sterilization laws were almost entirely out of use.
But what makes this case truly a precursor of the rational basis test is how very little
the justices were concerned with the facts. They took for granted that Carrie Buck
was a promiscuous and mentally challenged woman. Yet she always maintained that
she was raped, which is what led to her having a child out of wedlock. Further, the
Supreme Court accepted that she had mental difficulties, ignoring the fact that her
school records showed otherwise. That is, the Supreme Court took the government at
its word that it had a good reason for sterilizing Carrie Buck. It did not make the
government present evidence to that effect and it did not weigh the competing
evidence. It took the government at its word that she was promiscuous and an
“imbecile.” Accepting the government’s assertions as true is the hallmark of the
rational basis test.
To pass the rational basis test, the statute or ordinance must have a legitimate state
interest, and there must be a rational connection between the statute's/ordinance's
means and goals.
Rational Basis Test Comparison
There are three judicial review tests: the rational basis test, the intermediate scrutiny
test, and the strict scrutiny test. The intermediate scrutiny test and the strict scrutiny
test are considered more stringent than the rational basis test.
The rational basis test is generally used when in cases where no fundamental rights
or suspect classifications are at issue.
The rational basis test is also referred to as "rational review."
NOTE:
Since Buck v. Bell was decided in 1927, there was no form of heightened scrutiny
for the courts to apply in analyzing the constitutionality of this statute, since strict
scrutiny was not developed until over a decade later, nor applied until 1967.
Judge Holmes evaluated the substantive due process claim in Buck v. Bell under the
rational basis test which required only proof that the law could rationally relate
to a legitimate government interest.
At the time, the only standard for judicial review of law with regard to substantive
due process issues was the rational basis test, which requires that the statute or
regulation be somehow related to a legitimate government interest.
It is important to note that rational basis only requires that the law be
POTENTIALLY supportive of any legitimate government interest.

rational test basis DOES NOT MANDATE that the specific interest cited be an
actual interest of the government, nor does it require proof that the legislation
was created with that interest in mind.

In applying this standard, Justice Holmes’ contention indicates the view that there is
a legitimate state interest in reducing the burden of incompetent persons on
government resources.

In fact, one recent scholar acknowledged it would be difficult for modern courts to
use Buck v. Bell to establish eugenic sterilization as a legitimate state interest,
specifically in cases involving hereditary genetic defects.

Like example: abortion

The Supreme Court has since required heightened scrutiny in cases where a law
would infringe on what is deemed to be a fundamental right. By the time many state
courts developed the current standards for sterilization of incompetent persons, the
Supreme Court had extended the right to privacy to include procreation as a
fundamental right.221 Since any law infringing on a fundamental right may only be
upheld if they are “narrowly drawn” to serve a “compelling state interest,”222 more
recent sterilization laws were held to a higher standard of scrutiny than the Virginia
statute at issue in Buck v. Bell.