Eugenisch motiviertes Denken und Handeln im «Burghölzli» am Anfang des 20. Jahrhunderts

Abstract

Eugenic theories and practice were widespread in Europe and the United States in the early decades of the 20th century. B. A. Morel's theories of degeneration, social Darwinism and Galton's concepts (Galton defined the term eugenics) were precursors of eugenics in the 19th century. The introduction of eugenics led to a biologically biased interpretation of social issues. Psychiatry was used to intervene with eugenic measures in healthcare and social policy issues. Eugenic concepts were important in the Swiss psychiatry of the time as well; it is noteworthy that the first castrations in Europe were carried out in Switzerland. The present article explores this subject concentrating on the Psychiatric University Hospital Zurich, Burgholzli, as an example. It deals in more detail with the dissertation of Emil Oberholzer, who wrote his thesis Castration and sterilisation of mental patients in Switzerland in 1911. This dissertation was submitted to Eugen Bleuler, who was the medical director of the Burgholzli at that time. E. Oberholzer worked as a resident at the Burgholzli from 1908 to 1910; he later became renowned in the international psychoanalytic association. In his thesis, he reports 19 cases: 11 from the Burgholzli and 8 from the asylum of Wil; 15 women and 4 men; diagnoses: mental deficiency (6 cases), moral insanity (3 cases), combination of mental deficiency and moral insanity (4 cases), epilepsy (1 case) and developmental defect (1 case). He uses eugenic arguments as indications for castration or sterilisation, which were performed in most of the cases. A detailed case history of 5 patients are given in this paper. E. Oberholzer's primary concern was to advance the thinking of birth control for subjects. To generate ill and degenerated children was for him the worst crime and also the greatest misery for the government and race. He therefore stressed the need to prevent such descendants. Oberholzer criticised the extensive bureaucracy and missing legal framework for eugenic measures. He claimed a new law, which would facilitate castrations and sterilisations. While there was no legal framework for eugenic treatments, Oberholzer for example suggested to use other medical indications for sterilisations. This article also examines to which extent sterilisations took place under coercion or under the patients' informed consent. The patients pften had only two alternatives: to agree to sterilisation or castration or to remain in the hospital for the rest of their lives. In order to complete Oberholzer's material, unpublished medical records and forensic expertises were used. The additional information from Eugen Bleuler and his co-workers allows us to understand the official contemporary policy concerning eugenic practice of the Burgholzli. Eugenic theory and practice was promoted even though there is no evidence for any racial hygiene, with the ultimate goal to prevent any hereditary diseased offspring, as was the case in Germany.