A state statute permitting the compulsory sterilization of institutionalized individuals found to have hereditary forms of insanity or imbecility does not violate the Due Process or Equal Protection Clauses of the Fourteenth Amendment when adequate procedural safeguards are provided.

• The case arose in the context of the eugenics movement in the early 20th century, which promoted the idea that societal problems could be reduced by preventing reproduction among individuals considered genetically unfit or "defective."
• Virginia enacted a statute in 1924 reflecting these views, allowing for the sterilization of inmates of certain state institutions if deemed beneficial for the patient and society, based on concerns about heredity and the societal burden of supporting "defective persons."

• Carrie Buck was an 18-year-old woman committed to the Virginia State Colony for Epileptics and Feeble Minded.
• She was identified as "feeble minded" within the meaning of the Virginia statute.
• Her mother was also institutionalized in the same facility and considered "feeble minded."
• Carrie Buck had given birth to an illegitimate child who was also deemed "feeble minded."
• The Superintendent of the State Colony, Dr. Bell, initiated proceedings under the 1924 Virginia Act to have Carrie Buck sterilized by salpingectomy (cutting the Fallopian tubes).
• The Superintendent believed sterilization was in the best interest of Buck and society, based on the view that her condition was hereditary and she was a "probable potential parent of socially inadequate offspring."
• The statutory procedure involved a petition, notice to the inmate and guardian, a hearing before a special board, and rights of appeal to the state courts.
• All procedural steps required by the Virginia statute were followed in Buck's case.

• The Virginia sterilization statute is void under the Fourteenth Amendment because it denies plaintiff in error (Carrie Buck) due process of law and the equal protection of the laws.
• The attack focused primarily on the substantive law, arguing that such a sterilization order could not be justified under any circumstances, or at least not on the grounds presented (heredity, welfare of Buck and society).
• The law violates equal protection because it unfairly targets only the small number of individuals confined to state institutions, while not applying to similarly "feeble minded" individuals living outside these institutions.

• The Virginia statute provides extensive procedural safeguards, including notice, hearing, and multiple levels of appeal, fully satisfying the requirements of procedural due process.
• The substantive law represents a valid exercise of the state's police power to protect public health and welfare, similar to the power upheld in compulsory vaccination cases.
• Sterilization prevents "manifestly unfit" individuals from procreating, thereby avoiding societal costs associated with crime, poverty, and institutionalization, and benefiting both the individual and society.
• The classification limiting the law's application to institutionalized individuals is rational, as the state is addressing the problem where it is most apparent and manageable, and the law aims to eventually bring all similarly situated individuals within its scope as means allow.

• Does the Virginia statute authorizing the compulsory sterilization of individuals deemed "feeble minded" and confined to state institutions violate the Due Process Clause of the Fourteenth Amendment?
• Does the Virginia statute authorizing the compulsory sterilization of individuals deemed "feeble minded" and confined to state institutions violate the Equal Protection Clause of the Fourteenth Amendment?

• The Supreme Court affirmed the judgment of the Supreme Court of Appeals of Virginia, upholding the constitutionality of the sterilization statute.
• The Court found no violation of procedural due process, noting the statute's careful provisions for notice, hearing, and appeal rights, which were scrupulously followed in Buck's case.
• Addressing substantive due process, the Court held that the state's interest in protecting public welfare can justify infringing on individual bodily integrity, comparing sterilization to compulsory vaccination and stating the public welfare can demand such sacrifices from those who "sap the strength of the State."
• The Court rejected the equal protection challenge, reasoning that the law need not be perfectly comprehensive; it is permissible for the state to address a problem incrementally, starting with those readily identifiable within institutions, with the potential to expand its reach later. The Court concluded the classification was not arbitrary.

• Police Power: The inherent authority of a state government to regulate private affairs to protect or promote the public health, safety, morals, and general welfare. The Court invoked this doctrine to justify Virginia's enactment of the sterilization law as a measure for societal benefit.
• Due Process (Fourteenth Amendment): This principle guarantees fair procedures (procedural due process) and protects fundamental rights from unreasonable government interference (substantive due process). The Court found the statute's procedures adequate and the substantive infringement justified by the state's interest.
• Equal Protection (Fourteenth Amendment): This clause requires states to apply laws equally to similarly situated persons. The Court found the statute's classification (targeting institutionalized individuals) was not arbitrary or unreasonable, thus satisfying equal protection, as the state could address the problem incrementally.
• Eugenics: Although not explicitly named as a legal doctrine, the Court's reasoning heavily relies on the eugenic principles underlying the Virginia statute – the belief in hereditary transmission of traits like "feeble-mindedness" and the goal of improving society by controlling reproduction.

• "We have seen more than once that the public welfare may call upon the best citizens for their lives. It would be strange if it could not call upon those who already sap the strength of the State for these lesser sacrifices... in order to prevent our being swamped with incompetence."
• "It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind."
• "The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes."
• "Three generations of imbeciles are enough."

• Jacobson v. Massachusetts, 197 U.S. 11: Cited as precedent establishing the state's authority under its police power to compel actions (like vaccination) for the public welfare, even if it infringes on individual liberty or bodily integrity. The Court found this principle analogous and sufficient to justify compulsory sterilization under the Virginia statute.

• Fourteenth Amendment to the U.S. Constitution: Specifically, the Due Process Clause and the Equal Protection Clause were the basis for Buck's challenge to the Virginia statute.
• Act of Virginia, approved March 20, 1924: This is the specific state statute authorizing the sterilization of certain institutionalized individuals, which was the subject of the legal challenge.