TOKYO -- "At the time, there was a law reflecting eugenic ideology, and obstetricians and gynecologists simply responded to the wishes of the government and parents based on that law," Japan Society of Obstetrics and Gynecology head Katsuyuki Kinoshita, 77, recalled. The society was established in 1949, a year after the eugenics protection law came into force, and its predecessor, the Japan Association for Maternal Welfare, had been actively supporting the government's eugenic protection policy.
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The eugenics protection law (1948-1996) was enacted as a bill initiated by Diet lawmakers. It was put forward by House of Councillors member Yasaburo Taniguchi and House of Representatives member Tenrei Ota, both deceased, and others with backgrounds in maternal medicine. After Taniguchi's death, articles appeared in journals in 1963 lauding his efforts, saying things such as, "He was full of compassion," and "He held on tightly to his ideals."
On the other hand, Taniguchi continued to make discriminatory remarks about people with disabilities. In a November 1948 meeting of the House of Councillors Health and Welfare Committee, he is recorded as having requested of the health minister that "doctors at health care centers should apply without hesitation" to have forced sterilization surgeries performed on even "the homeless and other people of the lowest social status, and people like beggars" in order to "prevent the birth of (children with) undesirable traits." Taniguchi was also a central figure in the 1952 revision to the eugenics law that expanded the targets of the surgeries to non-hereditary diseases such as "psychosis (mental illnesses)" and "feeble mindedness," the term used at the time to describe those with intellectual disabilities.
There is no sign in the Diet records that anyone offered a dissenting opinion, and there was no societal backlash, either.
It was during this time that Taniguchi established the Japan Association for Maternal Welfare as an organization of doctors designated to perform abortions based on the eugenics law. The number of abortions performed by its members annually from 1953 through 1961 exceeded 1 million, and became a source of income for private doctors across the country. The physicians also carried out forced sterilization surgeries performed on women, which accounted for roughly 70 percent of overall sterilization surgeries. The association held a monopoly over the "rights" to eugenic practices.
However, when the use of contraceptives began to spread, the number of abortions dropped. Forced sterilization surgeries also decreased. Instead, a "new kind of eugenics" was born in the form of the introduction of prenatal testing that could reveal any abnormalities before birth. Selecting to have an abortion after the test was passed off as an "independent choice."
In 1966, a movement against the birth of so-called "unhappy" children began in Hyogo Prefecture. The movement called for the "prevention of the birth of children with disabilities," and the medical community joined hands with local governments in realizing such policies as the prefecture shouldering the cost of amniotic fluid testing. The movement then spread nationally. With pushback from groups of individuals with disabilities and other organizations, the prefectural policy centers were eliminated in 1974, but the idea that "disabled children are unhappy" had already taken root in the consciousness of Japanese society.
Now that prenatal testing has become even more assessable with the advancement of technology, 72-year-old obstetrician and gynecologist Kodo Sato, who has been involved with the issue from the start, feels a sense of crisis. With the infiltration of businesses into the medical scene pushing easier methods for "screening" fetuses, if the trend of getting prenatal checks becomes the norm, then it will stir uneasiness among parents. What is waiting after that, he believes, is a world that has eliminated persons with disabilities -- exactly what the eugenic protection law aimed to accomplish.
"There are no physicians who perform abortions and sterilization surgeries because they like it," said 85-year-old obstetrician and gynecologist Sadao Horiguchi, a vocal critic of the forced surgeries under the law. "If we are to question the crimes of the doctors of the past, then society as a whole also has to consider at the same time how to create a society where it is a given that people with disabilities are accepted."
Obstetricians, who stand at the threshold of the birth of new life, have already had to face eugenics. They are the mirrors that reflect the goals of what a society strives to be, and also must be the ones to warn society about where it is going.
(Japanese original by Norikazu Chiba, Science and Environment News Department, overseen by Asako Kamihigashi, Lifestyle News Department)
This is Part 3 in a series.