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Turning People into Paperwork
This collection makes evident the remarkable level of record-keeping in 20th century health institutions. Doctors and other institutional officials from nine California institutions kept copious records of their work. The digitized collection includes 50,000 sterilization recommendation forms, evaluation letters, protest letters, and related materials. Above in the viewer are a small set of examples of our archival materials, you can view them all by clicking on the scroll button or click on the media for a more detailed view.
The volume of material we have attests to the commitment institutional officials made to keeping good records, even if not to taking good care of their patients in a modern sense. They capture the degree to which medical record keeping became a central feature of the daily routine of officials. In the forms we can see how routine and bureaucratic the sterilization of people had become in the 20th century. Reading the recommendations and evaluation letters can give us a sense of how doctors and other officials labelled and medicalized people in ways that were deeply dehumanizing and marginalizing. The forms and protest letters together offer us a window into how consent procedures operated very differently than our current consent mandates.
In many ways, these forms demonstrate how medical paperwork encouraged doctors to understand their patients in terms of boxes to check and pre-defined diagnoses. One of the goals of Eugenic Rubicon is to make the phenomenon of turning people into paperwork visible - to uncover a history of bureaucratic procedures and forms. It is also important to us to respond to this dehumanization by representing people as fully as we are able - to understand them as whole individuals and community members.
Representing the past is a difficult job and we have several considerations in this particular project. The first is that no history can be complete and what we can recover from the past is always partial and from particular points of view. For example, we have little, beyond the protest letters, from the patient perspective. While the forms are frustrating in their reductivity, they are also part of the reason we can tell this story at all.
Beyond the everyday limits of archival history, there are also legal considerations. Patient records are sensitive information and modern-day guidelines require that identifying information about live or recently alive persons be kept private. In accordance with HIPAA laws, which require medical information remain private for 50 years after the death of an individual, some of our records are redacted - the identifying information like name, date of birth, and home address is blacked out. The microfilms that are the basis of this project are now held at the California State Archives, where the "75 year rule" means that such records become publicly available with no redaction rules 75 years after their date of creation. As a result, we are able to share more information about records from 1942 or earlier. With this comes ethical considerations - how should we treat information about diagnosis and surgical procedures, like sterilization, in order to best serve the present day communities that connect with these stories? Do we have particular ethical obligations to the patients who are no longer alive? What kinds of work should we do to offer context for these materials? Are there unintended consequences of making this information widely available?