Carlson, Elof Axel. The Unfit: A History of a Bad Idea. Cold Spring Harbor, NY: Cold Spring Harbor Press, 2001. Cloth 0-87967-587-0.

Reviewed by Kathleen LeBesco, Marymount Manhattan College.

Elof Carlson's The Unfit: A History of a Bad Idea presents a careful history of the notion of genetically unfit people and of the political undertakings that ensured their demise at certain points in U.S. and European history. In three major sections divided into 21 smaller chapters, Carlson unfolds innovations in genetic science, discusses the rise of eugenics and the sometimes surprising intentions of its founders, and rues the racist and anti-Semitic uses of eugenics in Nazi Germany and beyond.

The book starts with a bang. Early on, Carlson investigates historical beliefs about and prohibitions against masturbation, a practice that, while remaining somewhat "undercover" today, is widely understood to exist without any of the foreboding consequences expected generations ago. Carlson quotes an 1835 manual that warned against masturbation, suggesting that "runts, feeble infants, and girls" would be produced by weakened sperm (29)—though Carlson passes up the opportunity to problematize the sexist, size-ist, and ableist assumptions inherent in this unsupported belief.

People with disabilities were often victimized by eugenics schemes, even while racial minorities were supported. In 1893, Henry Boies designated the welfare of "colored people" a "National obligation" (88). At the same time, he targeted the "mentally, morally, and physically defective" (88) as paupers, "gangrened member[s] of the body politic" (89) who must be physically or reproductively isolated from society. An interesting section on poor laws and degeneracy reveals that "the perception of the failures in American society shifted from one of pity and charity to one of fear, disgust, and rejection in less than one generation" (91), a shift Carlson attributes to the growth of science in the late 1800s.

Readers searching exclusively for information on eugenics and disability will have to examine the book's passages selectively, but will be rewarded by fascinating tidbits of disability-related information after careful scrutiny. Several of the progenitors of eugenics and scholars of genetics were either themselves disabled or had close contact with disabled people. Thomas Malthus, the philosopher preoccupied with population control, is reported to have had a cleft lip and palate (96); Robert Chambers, author of Vestiges of the Natural History of Creation, sported six digits on his hands and feet, and experienced debilitating foot pain due to slight deformations (116); Gregor Mendel, founder of the laws of heredity, went into science only after failing at a bid for the priesthood because he became ill at the sight of the sick and dying (132). Beyond this, Carlson offers coverage of state-sponsored euthanasia and forced sterilization of disabled people by the Nazis intertwined with his treatment of eugenic campaigns against other populations.

Perhaps the most interesting of the historical figures Carlson presents is Herbert Spencer, a progress-hungry thinker who believed that "all imperfection must disappear" (119) in order to move society toward greater freedom. Carlson beautifully presents the contradictions of Spencer's views, many of which "fit conservative philosophy, many more are pacifist, liberal, and radical" (120). Although Spencer's drive to eliminate those he deemed unfit is disturbing, he did uncannily recognize the tyranny of normalcy, as in this quote from his 1850 Social Statistics:

Conceive yourself one of a despised class contemptuously termed 'the great unwashed'; stigmatized as brutish, stolid, vicious; suspected of harbouring wicked designs; excluded from the dignity of citizenship; and then say whether the desire to be respectable would be as practically operative on you as now (cited in Carlson, 121).

Carlson's The Unfit offers a great contribution to the literature on the ways in which science has been used to denigrate and exterminate the ethnic and racial Other; his denunciation of racist eugenic practices is loud and clear, even as he attempts to present a nuanced reading of the motives of their proponents. Carlson also does well in alerting the reader to the fact that eugenics has never been a project solely of political conservatives, pointing out the involvement of progressives, radicals, and liberals of many stripes.

However, he appears less committed to an anti-ableist agenda. His language sometimes falters (as in "Darwin lamely explained...." (148) to describe an inadequate explanation) in a disability-unfriendly manner. When discussing the debates over prenatal genetic screening for disabilities, he downplays what he calls the "slippery slope" argument and allows medical geneticists to have the last word (367). Carlson contends that "many of the claims made against genetic screening and prenatal diagnosis are false" (376) and says that the effects of such testing will present "no major diminution of genetic variation" (377); pleased as punch, he argues that "what will diminish is the number of very sick babies born or conditions that have debilitating effects on children or young adults.

Each generation will add more conditions they would prefer to see prevented rather than treated" (377). It is the latter sentence that haunts us in the disability community, as we recognize that given enough time, people like us may well be preemptively prevented from existing.

Carlson claims that "only a few individuals are genetically well informed enough to raise questions" (368) about the effect of medical genetic diagnoses, abortions, or treatments for disabilities. I would argue, in contrast, that while it may be true that the layperson is not genetically well informed enough to answer these questions, it indeed seems incumbent upon citizens concerned about equal opportunity to raise them in order to prevent a reoccurrence of the eugenic atrocities of the 20^th century.