Not all consent is the same

You explored the history of consent. So, consent isn’t a new concept?
Jolien Gijbels: “No, the word ‘consente’ already appeared in literary and legal texts from the Middle Ages. Later, we began using the word ‘toestemming’ (permission), and the term faded from everyday language. In the context of the #MeToo movement, the English word ‘consent’ has made its way back into our vocabulary.”

“In the book, we define consent as the ability to make choices about your own life and body. That’s the perspective we used to look at history. So we didn’t start from the modern, liberal interpretation of the term – which is closely tied to the idea of free will – but instead broadened its meaning.”

“We also focus on the grey areas. Sometimes people agree to something that feels difficult or uncomfortable – a medical examination, for example – because it benefits their health. That kind of rational consent can be just as valid as enthusiastic agreement. The same goes for a woman in the Middle Ages who made the pragmatic choice to marry a man from a wealthy family in order to improve her situation. Reality is often messy. We wanted to acknowledge that complexity and nuance.”

If you look at the history of consent, has the situation gradually improved over time?
“We like to think that awareness has steadily grown over the years, eventually leading to a range of laws and ethical guidelines. But in the book, we try to offer a more nuanced view. There were also situations in the past where people considered consent important. Take, for example, the case of the caesarean section, which I’ve researched myself. In the 19th century, a caesarean was a highly invasive medical procedure that almost always resulted in the woman’s death. It wasn’t until the end of that century that the operation became less fatal due to advances in medicine – but even then, 3 in 10 women still didn’t survive it.

What’s interesting is that, for most of the 19th century, it was easier for women to refuse a caesarean than it was towards the end of the century. For a long time, doctors believed that such life-threatening procedures should only be carried out with the woman’s consent. But as survival rates improved, so did doctors’ confidence – which led to more authoritarian behaviour towards their female patients. Take Charlotte, for instance, who gave birth at a major hospital in Liège at the end of the 19th century. In previous pregnancies, she had been involved in decisions and made it clear that she didn’t want a caesarean under any circumstances. But during her final delivery in 1889, her husband and the surgeon decided together to perform a caesarean without her knowledge. It shows how these dynamics can shift over time.”

Another striking theme in the history of consent is the gap between theory and practice.
“Absolutely. In the 12th century, canon law introduced the principle that young people could choose whom to marry. From that point on, both partners had to give their consent. But even then, there were countless cases of forced marriage. My colleague Chanelle Delameillieure shows how even a spoken ‘I do’ could be preceded by manipulation. And when a woman later claimed in court that her marriage had been forced, attempts were often made to discredit her. Much like we still see today, judges would point to inconsistencies in her statements. Yet scientific research shows that our brains process traumatic experiences in such a way that inconsistencies in testimony are actually quite common. So yes, even when principles were established, reality was always more complex.”  

What can we learn from the past about how to shape consent today?
“The cases in the book show that, historically, consent was always closely tied to power imbalances. Take the example of women in the mid-19th century. Many of those who ended up in hospital with a pelvis too narrow for childbirth came from marginalised backgrounds – their bones had been deformed by poor living conditions. These women weren’t always properly informed by doctors about alternatives to a caesarean. Some chose to undergo an embryotomy (a procedure in which the dead foetus is cut into pieces and removed from the womb – ed.) without knowing that one in five women didn’t survive the operation.

In the chapter on intercountry adoption in post-war Belgium, written by Chiara Candaele, we read that parents were required to give permission to give up their child – but this consent was often far from truly voluntary. Colonial authorities in Belgian Congo and Ruanda-Urundi used all sorts of rhetorical tactics to persuade mothers to sign the adoption papers. Some families, for instance, believed their children were only going to Belgium temporarily to study.”

“Everywhere, you find people who were able to speak more freely, and others who weren’t. The same applies today – some people can speak openly, while others cannot. So if we truly want to realise consent today, we need to be aware that some voices carry less weight. Without paying attention to context, we’ll never achieve what’s been written into laws or set out in general principles.”

Today, there’s a lot of attention given to the feelings of people who weren’t able to give consent. But what do we actually know about those emotions in the past?
“That’s a major challenge in historical research. Marginalised groups often didn’t leave behind written records or personal documents. In my research on caesarean sections, all the sources come from doctors or other authorities. They rarely made notes about a woman’s grief during childbirth; at most, they would mention in medical jargon that a woman wished to have a living child. As a historian, you have to constantly remind yourself that you don’t have the full picture. Sometimes, you need to rely on your imagination. Even implicit language can be very revealing.”

The book brings together contributions from fellow historians. Was there a case that particularly struck you?
“Margot Luyckfasseel’s chapter on our colonial history. She explores, for instance, the exploitation of rubber in the Congo Free State. Leopold II had imposed strict rubber quotas. When the rubber plants in a village were depleted, people were forced to go to other areas. Because colonial officials didn’t know the terrain well, they relied on local inhabitants and, in exchange for certain benefits, tasked them with violently ensuring that neighbouring villages delivered enough rubber. If they refused to cooperate, they or their families risked being killed. Can you really speak of consent if someone agrees to take part under those circumstances? As a historian, it feels uncomfortable to use that word.

And again, you can draw parallels with today. In various parts of the world, regimes are becoming more authoritarian. Individuals are losing the space to make decisions about their own bodies and lives. That’s something we mustn’t forget: not everyone – not in the past, but also not today – has the same freedom to speak out.”