"WINSTON-SALEM, N.C. From 1929 to 1974, North Carolina ran one of the nation's largest and most aggressive human sterilization programs, approving more than 7,600 sterilizations.

More than 30 states had similar programs, but unlike most, North Carolina dramatically expanded the program after 1945, targeted blacks in the general population and gave social workers the power to recommend sterilization, according to sealed records obtained by the Winston-Salem Journal.

The state approved 90 percent of the sterilization petitions it received.

"That's quite astounding," said Steve Selden, a professor at the University of Maryland and author of "Inheriting Shame: the Story of Eugenics & Racism in America."

Paul A. Lombardo, director of the Program in Law and Medicine at the University of Virginia's Center for Biomedical Ethics, said North Carolina was "a unique example."

Lombardo is an expert on the 1927 Buck v. Bell case in which the U.S. Supreme Court upheld Virginia's sterilization statute, clearing the way for tens of thousands of sterilizations nationwide. Under the banner of eugenics, Virginia forcibly sterilized about 8,000 people.

The Journal examined records from about 7,000 North Carolina cases. Among the findings:

*North Carolina law allowed three reasons for sterilization: epilepsy, sickness and feeble-mindedness. But those who ran the sterilization program often approved sterilization based on a number of other things, from alleged promiscuity to homosexuality.
*From the program's start in 1929 to 1940, 79 percent of those sterilized were white, but by the late 1960s, more than 60 percent were black.
*More than 2,000 people 18 and younger were sterilized in many questionable cases, including a 10-year-old who was castrated. Many children were sterilized over the objections of their parents, and the process for gaining the parents' consent was often a sham.
*Doctors sometimes performed sterilizations without state authorization, and the state backdated its approval in violation of its policy.
*Individual counties engaged in illegal sterilization campaigns beyond the state program.
*The program was run by the Eugenics Board of North Carolina, a panel of five bureaucrats who usually decided cases in a few minutes. It was inspired by the eugenics movement, which claimed that mental illness, genetic defects and social ills eventually could be eliminated by sterilization.

The system granted excessive power to social workers, browbeat women into being sterilized and had ineffective safeguards, the board's records show.

Many of the program's more than 7,600 victims are still alive, and they bear witness to a bureaucracy that trampled on the rights of the poor and the powerless.

"I think I'm sort of still hiding," said Elaine Riddick Jessie, of Atlanta, who was sterilized in Edenton in 1968, "but there's nothing I can do. It made me dislike myself. And I don't ever think I can like myself."

But the picture presented by the Eugenics Board files is not a simple one, said Johanna Schoen, an assistant professor at the University of Iowa who gave the Journal access to most of the records that she was allowed to copy more than 10 years ago. Since that time, the N.C. State Archives has declined other requests, including the Journal's, and the records are officially closed to the public.

"This view that we often have of sterilization - and particularly eugenic sterilization - of just being this evil thing that the state does got extremely complicated once I was confronted with these individual stories," Schoen said.

"There are stories of the state doing incredible evil, and then there are stories of women who really want the sterilization, and then there are stories of women and men who are so mentally ill that they really are totally unable to take care of children."

California led the nation with more than 21,000 sterilizations; Virginia was second and North Carolina third.

The eugenicists' views of human heredity were embraced by Virginia leaders in adopting racist statutes for policing the color line and preserving white racial purity. Earlier this year, Virginia became the first state to apologize for its sterilization program.

On May 2, the 75th anniversary of the Buck v. Bell decision, Virginia Gov. Mark R. Warner delivered a written apology, saying the eugenics movement "was a shameful effort in which state government never should have been involved."

The apology followed examination of Virginia's eugenics history by scholars and the news media, including a series by the Richmond Times-Dispatch. In addition, the legislature adopted a resolution expressing "profound regret" in 2001.

North Carolina Gov. Michael F. Easley apologized last week for his state's eugenics program, Oregon Gov. John A. Kitzhaber apologized earlier this month for that state's program. Many states that had sterilization programs have lost the records or, in Oregon's case, destroyed them.

Schoen said that in her close examination of more than 7,000 of North Carolina's records, she found just 446 cases in which the patient clearly desired the operation.

While almost all of the sterilization petitions showed the "consent" of a relative, patient or guardian, Schoen said, "you can't talk about this consent being freely given." Patients in state institutions were told that they had to agree to sterilization as a condition of release, and in many cases people on welfare were threatened with loss of benefits, she said.

Whether people were sterilized often revolved around the attitude of an individual social worker. As a result, some counties did large numbers of sterilizations, while others did almost none.

Medical and legal experts say a debate over the eugenics movement is not just one for the history books.

"The ethical issues that were raised by eugenics are likely to be the very same ethical issues that are being raised with genetic research, now and in the future," said Selden, the University of Maryland professor.

"They didn't have the technology [then] to achieve their goals. We do." " (Kevin Begos and Peter Hardin, Richmond Times-Dispatch, December 15, 2002)

Kevin Begos is a staff writer for the Winston-Salem Journal.
Times-Dispatch Washington correspondent Peter Hardin contributed to this report.