Physicians’ assertions of authority over the right to terminate a pregnancy and other issues of reproductive health did not begin with Roe. As the Roe opinion noted, in the late 19th century, the American Medical Association’s Committee on Criminal Abortion had denounced abortion and asserted that it should only be permitted if “at least one respectable consulting physician” also concurred with the decision. Thus, even when physicians took positions allowing for some access to abortion, they insisted that medical professionals hold an an outsized voice in the process.
In the early 20th century, elites associated with the American Eugenics movement advocated for laws permitting states to sterilize individuals without their consent, in their efforts to rid the population of those they deemed “undesirable” or “unfit.” Doctors were again critical to this effort to supervise and legitimate curbs on reproductive freedom.
In the 1930s, a group called the American Eugenics Society organized meetings of doctors to encourage them to play an active role in the eugenic sterilization programs as an extension of their responsibility as medical professionals. Having doctors on state eugenic boards gave these sterilization schemes the aura of respectability, as they were overseen by medical professionals. As one physician explained to his colleagues at a 1937 conference on the subject, “There is no longer any doubt but that the physician has a eugenic responsibility. In any eugenic scheme of society, the physician, and particularly those concerned with preventive medicine, must play an important part. He will function most in the therapeutic measures of sterilization and birth control.” Doctors thus framed their role not only as treating individual patients but as also having authority over policy and law, especially over issues related to reproduction.
Appeals to physicians to use their authority in this manner continued well after the public respectability of the American eugenics movement waned. In the 1950s and 1960s, some obstetricians and other doctors advanced similar arguments about their obligation to advocate for population control policies. Dr. C. Lee Buxton, Chief of Obstetrics and Gynecology at the Yale School of Medicine argued in a medical journal in 1966 that “the medical profession should accept a major responsibility in matters related to human reproduction as they affect the total population and the individual family.” Doctors would play a significant role in the growing population control movement, again deploying their medical expertise and authority to advance laws rooted in social control.
This authority was not just a legal right; by this logic it was a professional obligation that doctors could not refuse. Consequently, doctors served on state eugenics boards that oversaw systematic non-consensual sterilizations until into the 1970s. At least 60,000 documented involuntary sterilizations were approved and performed by state bodies in the 20th century.