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Compulsory sterilisation in Sweden were sterilisations where the consent to be sterilised is considered to have been in some way faulty and had been accepted after varying degrees of pressure during the years 1906–1975 on eugenic, medical and social grounds. Physical restraint was never legal. An important reason for the legislation was to prevent sterilisation from becoming a contraceptive method in the hands of the individual. Between 1972 and 2012 sterilization was a condition for sex change.

Sterilization was meant as an alternative to institutional care for some 'feeble-minded', to prevent children from being born to parents unable to look after them, to reduce the number of mentally ill, feeble-minded and epileptic in the population, and as a crime-preventive measure. The Sterilisation Act of 1934 legalized sterilisation of the legally incapable but left it to the doctors to decide if the grounds were adequate for the legally capable.

The Sterilisation Act of 1941 curtailed the doctors freedom by making permission from a central authority necessary in most cases. The Sterilisation Act of 1975 made sterilisation of the legally capable free while at the same time making it impossible to sterilise the legally incapable.

There were other means to achieve the eugenic and social aims of a sterilisation law. The ancient requirement for legal capacity to enter marriage prevented unions. Since the 1700s epileptics had been forbidden to marry. In 1915 the mentally ill, the 'feeble-minded' and the epileptics were forbidden to marry. The purposes behind the 1915 law were eugenic. The law was ineffective in this respect. Another measure to prevent procreation among the 'feeble-minded' was interment. Internment on a scale large enough to have the desired results was considered contrary to sentiments of justice. It would also be economically infeasible.

Driving forces for sterilisation on social grounds were the psychiatrists in charge of the build up of institutional care. The advocates of sterilisation as a crime-preventive measure belonged to the fields of criminology and social medicine. The opponents were the adherants to qualitative and quantitative population theories. The race-hygienists believed that if sterilisation was left in the hands of the doctors, harm would be done to the nation's genetic stock. Supporters of quantitative population theories opposed contraception and, albeit they found eugenics a valid reason for sterilisation, since it would not have the desired effects and as it would pave the way for birth control, they tried to put strict limits on the doctors freedom.

Sterilisation on eugenic grounds lost out as social medicine turned from nature to nurture.

Sterilisation always had a close relationship to abortions. When abortion was made legal in 1975, sterilisation was as a consequence also made the decision of the indivudal. The intention was to keep provisions for the sterilisation of the incapable. A dedicated lobby managed to remove these.

Indications

 * Eugenic, where the purpose was to reduce the percentage of mentally or physically sick in the population.
 * A sterilisation was carried out on social grounds if the motive was to prevent children from being born to parents who would not be able to look after them.
 * Sterilisation on medical grounds is done to save the individuals life or for other health reasons.
 * A sub-category of the medical indication is sterilisation for therapeutic reasons, where sterility is the predicted but unwanted outcome of an operation.
 * Sterilisation on humanitarian grounds would be done in the interest of the individual for other reasons than medical
 * The criminological indication was a special kind of the humanitarian. It wasn't a punishment or to prevent propagation but as a way to alleviate life for individuals suffering from a to strong sex drive. Castration was regulated in a different law.

In the 1934 Act the eugenic indication encompassed a risk to transmitt mental disorders or feeblemindedness to the offspring. The 1941 Act added physical disease or handicap. The social indication of 1934 was used for individuals who, on grounded reason, would be unable to take care of his children because of mental disease, feeblemindedness or other mental disturbance. In 1941 this indication was expanded to include an asocial way of life.

From the late 1940s the medical ground came to be the most important. Through the medical indication, sterilisation came to be used as a contraceptive for family planning or birth control. Permission wasn't needed for therapeutic sterilisations and they weren't tallied. An example of humanitarian reasons are if an individual is worried that he or she would transmit an hereditary disease to his or her offspring even though the probality for this is to low to motivate an operation in society's interest. Another example would be to allow an epileptic to marry.

Scope of the laws
The 1934 act only regulated sterilisation of the legally incapable whereas the act of 1941 applied to both the legally capable and the legally incapable. According to a statement in the motive to the 1934 act, sterilisation was permitted on adequate grounds for the legally capable. It was left to the doctors' judgment to find out if the reasons were sufficient. In 1941 sterilisation of the legally capable became subject to permission from the Medical Board.

The grounds for sterilisation of the 1934 act were the eugenic and social indications. Medical sterilisations were outside the scope of the law as were sterilisations on eugenic, social and humanitarian grounds on the legally capable. In 1941, sterilisation on medical grounds was included in the law with exception for the therapeutic indication.

The opening
In the early 20th century, the legality of sterilisation was governed by medical ethics, an intervention was considered permissible if it was in the best interest of a patient. However, individuals who could not legally consent were sterilised on eugenic or social grounds, the first in 1906, and the question arose if it was legal to sterilise patients who were not capable of giving a valid consent and where the benefit was to society or to prevent that children were born to parents who would not be able to look after them. In order to make it clear that a doctor would not commit a crime if he sterilised someone on social or humanitarian grounds, Alfred Petrén submitted a private member's motion in 1922 to make Parliament request that the Government should order an inquiry.

Petréns motion was passed by Parliament and the Government referred it to the Royal Medical Board. The Board asked for the opinion of the Council of the State Institute for Race-biology, which agreed that the time had come for a law, but in the Institute's view a law should only allow sterilisations on eugenic grounds and it ought to curtail the doctors freedom to decide in regard to sterilisation on other grounds than purely medical by making permission by a central authority necessary in each case. The Institute was against any compulsion and emphasized that, at the stage of science at that time, it was often not possible to make predictions with certainty as to the eugenic value of the offspring of a person.

The Medical Board found that a law was desirable and suggested that the Government should set up an inquiry with representatives from the fields of law, psychiatry and surgery to look into questions on sterilisation on humanitarian grounds of certain 'feeble-minded', mentally ill and epileptics, and produce a draft law.

The first draft
In 1927 a government inquiry chaired by the judge Gustaf Lindstedt started working on the issue and in 1929 the report, including a project for a law, was presented. It was based on eugenics and the principle of voluntarity. Permission for sterilisation could be granted on eugenic or combined eugenic and social grounds. It would only be possible to sterilise individuals capable of giving an informed consent. In other cases sterilisation was to become illegal. There were different opinions on whether the draft would make sterilisations on medical grounds criminal.

Lindstedt commented on the report in other forums. He believed that the inquiry's experts had shown that sterilisation was ineffective as a means for eugenic ends. It wouldn't have a measurable effect. The draft was based on the assumption that the mentally ill and the 'feeble-minded' would allways be in need of institutional care and that therefore this was no reason to make sterilisation legal. Lindstedt considered sterilisations for eugenic purposes in the interest of society a valid ground in itself, but since sterilisations would not achive these ends it was overridden by society's interest in preventing voluntary contraception. He also made reference to natalist population policy and expressed his doubts about measures that reduce fecundity at a time when the population was threatened with a reduction in numbers.

The Institute for Race-biology found the draft satisfactory in principle but with remarks. Alfred Petrén, the Royal Medical Board and the Royal Social Board all levelled harsh criticism against the proposal.

The Council of the Institute for Race-biology believed that one group of mental disorders, the manic-depressive, should not be a ground for sterilisation because manic-depressives were often highly gifted and socially valuable. On the other hand, there were cases were it was obvious that the individual should be sterilised, such as among the 'feeble-minded'. For these it ought to be sufficient to ask the guardian if the person did not consent, but they did not demand a change in the draft because of this.

According to Petrén the draft was unsatisfactory in that the eugenic principle dominated at the expense of social and humanitarian interests and that informed consent would be a requirement for sterilisation. He also believed that the proposal would make sterilisation on other grounds than eugenic criminal.

The Royal Social Board, in a statement on the draft written by its Director General Gunnar Huss and Olof Kinberg, demanded a new inquiry. They believed that a law could not be based on the 1929 proposal. The draft was too cautious and would be counterproductive. Its most important defect was that it was based on the principle of voluntarity. Voluntary sterilisations were already permitted and the proposed law would restrict the freedom doctors had to make decisions on sterilisations. It wouldn't be possible to ask those persons who the Board most wanted to sterilise to consent. The Board found it sufficently cautious if the law only made coercion allowed on certain conditions rather than mandatory.

The Medical Board agreed with the Social Board that the a law shouldn't be based on the draft. The Board criticized that the eugenic grounds had been emphasized at the expense of the social ones and that the principle of voluntarity had been extended to those who had no ability to understand the meaning of the operation. The Board agreed with the inquiry's experts that knowledge of hereditary transmission of diseases was poor and used that to argue that eugenic reasons shouldn't be given prominence. Particularly since the issues the inquiry had been set up to investigate had more to do with humanitarian and social conditions.

The second draft and the Act of 1934
In 1933 Petrén again submitted a private motion for a new government inquiry and the same year a draft along the lines desired by Petrén was produced. The Act of 1934 only regulated sterilisation of the legally incompetent and left it to the doctors to decide if the reasons were sufficient in other cases.

Nils von Hofsten found it hazardous to allow voluntary sterilisation without effective controls. He believed that the law would make sterilisation an ordinary contraceptive method. von Hofsten agreed that the 'feeble-minded' ought to be sterilised regardless of whether the condition was hereditary or not and suggested that for some categories of 'feeble-minded', sterilisation shouldn't merely be a right but mandatory before puberty. In May 1934 Parliament passed the Sterilisation Law. At the same time, based on a private motion by the conservative Member of Parliament Georg Bissmark, Parliament requested an inquiry into voluntary sterilisation of legally capable individuals. The government ordered the Royal Population Commission to also produce a draft law on sterilisation and the sub-committee was led by Nils von Hofsten. Its proposal became the basis for the 1941 act.

The third draft and the Act of 1941
Under the Sterilisation Act of 1941, permission was required for sterilisation on all grounds except for therapeutic reasons, i. e. where sterility is the predicted but unwanted consequence of an operation such as in some cases of cancer treatment. In some cases two doctors could make the decision and in an emergency permission wasn't needed.

The lobbies

 * The legislative process was opened by Alfred Petrén who wanted Parliament to make it clear that sterilisation on social and humanitarian grounds was legal. As one of those responsible for the build up of public care for the 'feeble-minded' Petrén wanted sterilisation as an option in order to reduce pressure on the institutions and to prevent children from being born to parents who would be unable to take care of them. Petrén's proposal was independent of biological heredity.


 * The criminologist and psychiatrist Olof Kinberg was the most energetic advocate of sterilisation as a crime preventive measure. A follower of the Italian School of Criminology, he proposed sterilisation of individuals who were considered biologically and socially unwanted.


 * The eugenicists at the Institute of Race-biology focused on positive eugenics. They feared that a liberal sterilisation law would allow persons with good qualities to escape their duty to become parents, and they were worried that sterilisation of the insane would lead to a loss of valuable traits. Nils von Hofsten believed that a sterilisation law shouldn't just allow wanted sterilisations but also prevent those not wanted.

Later views

 * Condemnation of sterilisation of the legally incapable in Sweden. (1975) (1997)


 * EU regulation (Resolution by the European parliament in 1992)


 * The situation elsewhere (UK) (US) (Spain) (Italy)