Eugenics, literally “good genes,” is a science that is aimed at improving society by selective parenting of those with “desirable” genetic characteristics. In practice, this science has not so much promoted those characteristics as prevented those with “undesirable” characteristics from reproducing. In particular, forced sterilization has been a primary manner by which eugenics has been implemented.

Although it is most closely associated with mass sterilization (and murder) efforts in Nazi Germany directed at Jews and Roma/Sinti peoples, the US has a long history of such efforts. The first proposed law in the United States dates back to 1849, although no law was passed until 1907, when Indiana passed one legislating mandatory sterilization of the “feebleminded.” Laws were passed in a number of other states, and in 1927, these statutes were upheld by the US Supreme Court in Buck v. Bell. In the 8-1 majority opinion, Justice Oliver Wendell Holmes wrote “three generations of imbeciles are enough.” Nazi Germany used the US eugenics laws to justify their own laws. But with the revelation of Nazi atrocities after World War II, these laws understandably fell into disfavor, and most of the laws were repealed. The last known forced sterilization in the US occurred in 1981 in Oregon.

Or did it? This weekend, a whistleblower nurse within the US Department of Homeland Security (DHS) made an extremely disturbing report of numerous hysterectomies conducted on immigrants housed at a privately-run Immigrant and Customs Enforcement (ICE) detention center in Georgia. The cases reported by the whistleblower indicated such infractions as removing the wrong ovary only to remove the remaining ovary. Acts such as these resulted in a situation that left the nurse unable to explain to the patients why their uteruses were removed. One of the patients said of the doctor in the case, “is he the uterus collector?” Another asked why her uterus was removed. These cases suggest that the hysterectomies were not consensual, or at best, the reason for the procedure was not adequately described.

In the US, unethical research was conducted that involved exposing participants to unsafe pathogens, radiation, or other dangerous procedures without informing them of the risks. In response to this situation, Institutional Review Board (IRB) were impaneled starting in the 1970s to review research to ensure that it is conducted in an ethical and safe manner, such that the risks of such research is commensurate its potential benefits. The foundation of ethical research is the 1974 Belmont Report, which delineates three central principles: justice, beneficence, and respect for persons. The way in which these principles are instantiated for the research participant is the informed consent process. This process ensures that the participant is aware of the purpose, procedures, risks, benefits, and privacy protections involved in the study. Although informed consent was primarily developed in the research context, it has become a standard of care in medical facilities (i.e., people complete an informed consent procedure prior to any substantive and invasive medical procedure).

In the research setting, it is far harder to get consent from prisoners than from people who are free. This is because, by virtue of their incarceration, almost their entire existence is controlled by other people. Thus, their ability to make uncoerced decisions is substantially reduced. IRBs that review such research must have a prisoner advocate to provide additional protection of prisoner rights. Clearly, immigrants in an ICE detention center would fit that description.

If the story from Georgia turns out to be true, it is deeply disturbing for obvious reasons. First, the detainees are not taking part in an informed consent process. Second, they are detainees, who, as noted, must pass a higher bar to provide informed consent. Third, the procedures are occurring in a population that is detained because of a personal characteristic (namely, they are individuals whose immigration status is in question). This has all the hallmarks of discrimination on the basis of ethnicity and/or race. The treatment of these detainees violates all three prongs of the Belmont test. Does it show justice? No, these individuals are incarcerated solely because of their racial/ethnic demography. Does it show beneficence? No, how could one possibly argue that unnecessary and nonconsensual surgery benefits anyone. Does it show respect for persons? No, these surgeries represent the exact opposite of respect for persons.

But there is an even darker reason that this report is disturbing. The DHS has been charged with detaining undocumented immigrants under a zero-tolerance program put in place by former Attorney General Jeff Sessions. This highly controversial program has led to the separation of children (even infants) and parents. Although a large number of these people have been deported, record keeping was haphazard, leading to situations in which family members may not know of each others’ whereabouts. Whether they will ultimately be reunited is unknown, but in many cases, the odds are vanishingly small. The psychological harm to the detainees that will occur in the wake of these separations is incalculable. However, a number of these people have been long languishing in ICE detention centers throughout the US, and it is the people in the Georgia detention center that are bearing the burden of the set of alleged atrocities reported by the whistleblower.

It is hard to see this and not think of eugenics. Dating back to the announcement of his candidacy on June 15, 2015, Trump has scapegoated undocumented immigrants (especially those from central America) for a wide variety of the nation’s ills. He has consistently denigrated their rights and even their humanity. It is, after all, far easier to mistreat people who you don’t consider fully human.

This bigoted attitude alone is bad enough, but it is important to understand Trump’s own fascination with eugenics. He believes that he has “superior genes.” By implication, others have inferior genes, which need to be suppressed according to the eugenic doctrine. From there, it is a short step to mistreat those who you have dehumanized. This situation is particularly dangerous when the person holding these beliefs is the most powerful man in the free world. The worst part is that the legislative branch refuses to live up to its responsibility to hold Trump responsible, and Trump has kneecapped multiple attempts to limit or review his authority within the executive branch. It is unclear who will win in the next election, but it is clear that these policies cannot be continued in any kind of civil society. The curse “may you live in interesting times” appears particularly apt.