BUCK v. BELL, Superintendent of State Colony Epileptics and Feeble
Minded, 274 U.S. 200 (1927).
Supreme Court of the United States. (No. 292.)
Argued April 22, 1927. Decided May 2, 1927.
 Mr. Justice Holmes delivered the opinion of the Court.
This is a writ of error to review a judgment of the Supreme Court of Appeals of the
State of Virginia, affirming a judgment of the Circuit Court of Amherst County, by which
the defendant in error, the superintendent of the State Colony for Epileptics and Feeble
Minded, was ordered to perform the operation of salpingectomy upon Carrie Buck, the
plaintiff in error, for the purpose of making her sterile. 143 Va. 310. The case comes
here upon the contention that the statute authorizing the judgment is void under the
Fourteenth Amendment as denying to the plaintiff in error due process of law and the equal
protection of the laws.
Carrie Buck is a feeble minded white woman who was committed to the State Colony above
mentioned in due form. She is the daughter of a feeble minded mother in the same
institution, and the mother of an illegitimate feeble minded child. She was eighteen years
old at the time of the trial of her case in the Circuit Court, in the latter part of 1924.
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, &c.; that the sterilization may be effected in
males by vasectomy and in females by salpingectomy, without serious pain or substantial
danger to life; 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; and that experience has shown that heredity plays an important part in the
transmission of insanity, imbecility, &c. The statute then enacts that whenever the
superintendent of certain institutions including the above named State Colony shall be of
opinion that it is for the best interests of the patients and of society than 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, &c., on complying
with the very careful provisions by which the act protects the patients from possible
The superintendent first presents a petition to the special board of directors of his
hospital or colony, stating the facts and the grounds for his opinion, verified by
affidavit. 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, and if there is
no guardian the superintendent is to apply to the Circuit Court of the County to appoint
one. If the inmate is a minor notice also is to be given to his parents if any with a copy
of the petition. The board is to see to it that the inmate may attend the hearings if
desired by him or his guardian. The evidence is all to be reduced to writing, after the
board has made its order for or against the operation, the superintendent, or the inmate,
or his guardian, may appeal to the Circuit Court of the County. The Circuit Court may
consider the record of the board and the evidence before it and such other admissible
evidence as may be offered, and may affirm, revise, or reverse the order of the board and
enter such order as it deems just. Finally any party may apply to the Supreme Court of
Appeals, which, if it grants the appeal, is to hear the case upon the record of the trial
in the Circuit Court and may enter such order as it thinks the Circuit Court should have
entered. There can be no doubt that so far as procedure is concerned the rights of the
patient are most carefully considered, and as every step in this case was taken in
scrupulous compliance with the statute and after months of observation, there is no doubt
that in that respect the plaintiff in error has had due process of law.
The attack is not upon the procedure but upon the substantive law. It seems to be
contended that in no circumstances could such an order be justified. It certainly is
contended that the order cannot be justified upon the existing grounds. The judgment finds
the facts that have been recited and that Carrie Buck "is the 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," and thereupon makes the order. In
view of the general declarations of the legislature and the specific findings of the
Court, obviously we cannot say as matter of law that the grounds do not exist, and if they
exist they justify the result. We have seen more than once that the public welfare may
call upon the best citizens for their lives. It would be strange if it could not call upon
those who already sap the strength of the State for these lesser sacrifices, often not
felt to be such by those concerned, in order to prevent our being swamped with
incompetence. 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. The principle that sustains
compulsory vaccination is broad enough to cover cutting the Fallopian tubes. Jacobson
v. Massachusetts, 197 U.S. 11. Three generations of imbeciles are enough.
 But, it is said, however it might be if this reasoning were applied generally, it fails
when it is confined to the small number who are in the institutions named and is not
applied to the multitudes outside. It is the usual last resort of constitutional arguments
to point out shortcomings of this sort. But the answer is that the law does all that is
needed when it does all that it can, indicates a policy, applies it to all within the
lines, and seeks
to bring within the lines all similarly situated so far and so fast as its means allow.
Of course so far as the operations enable those who otherwise must be kept confined to be
returned to the world, and thus open the asylum to others, the equality aimed at will be
more nearly reached.
Mr. Justice Butler dissents.
See also: "Carrie
Buck, Virginia's test case."