With euthanasia back on to the agenda thanks to the pro-death Greens, we need to recall the lessons of history. Without remembering the past we will be doomed to repeat its mistakes. And one of the biggest mistakes in human history was the complicity of the medical community in the Nazi euthanasia programs.
Numerous important books have appeared in the recent past documenting how doctors, scientists and all sort of other respected professionals became heavily involved in the Nazi death machine. I list below some key books and articles which we all need to be familiar with.
Here I simply wish to highlight in a very brief and outline form, the Nazi euthanasia program. And the first and perhaps most important fact to point out is euthanasia in Germany preceded and led relentlessly to the Final Solution. Both were part of a continuum.
Indeed, we need to trace the ideological roots of Nazism back into history, with the writings of Darwin and his cousin Galton (who coined the term ‘eugenics’) leading the way. But German thinkers closer to the time of the Nazis also played a major role.
Chief among them would be Alfred Hoche and Karl Binding who in 1920 released their influential book, Die Freigabe der Vernichtung lebensunwerten Lebens (The Authorization of the Destruction of Life Unworthy of Life). The book spoke of the “incurable feebleminded” who should be killed.
State-sponsored euthanasia was called for, with the idea that many humans had to be excluded from those deserving the right to life. Other writings appeared, with much discussion especially in the German medical community. All this helped pave the way for the Nazi programs when they came into power in the early 1930s.
As Henry Friedlander says in the opening of his important book, The Origins of Nazi Genocide, “Nazi genocide did not take place in a vacuum. Genocide was only the most radical method of excluding groups of human beings from the German national community. The policy of exclusion followed and drew upon more than fifty years of scientific opposition to the equality of man.”
His massive 400-page volume (300 pages of text with 100 pages of reference material) goes into minute detail about the Nazi euthanasia program, and the complicity of scientists and doctors. He makes it quite clear that there was a very real continuum between the German euthanasia program – aided and abetted by the medical community – and the Final Solution.
He concludes his valuable study with these words: “Auschwitz was only the last, most perfect Nazi killing center. The entire killing enterprise had started in January 1940 with the murder of the most helpless human beings, institutionalized handicapped patients, had expanded in 1941 to include Jews and Gypsies, and had by 1945 cost the lives of at least 6 million men, women, and children.”
Michael Burleigh also has written extensively on these matters. His celebrated 1994 volume, Death and Deliverance, is a very careful and detailed examination of euthanasia in Germany from 1900 to 1945. In 400 pages he makes the general case that “the ‘euthanasia’ programme and the Holocaust are intimately related”.
But more specifically his book “is an attempt to study the relationship between psychiatric reform, eugenics and government cost-cutting policies during the Weimar Republic and Nazi periods”. He documents how such eugenics programs had been widely advanced long before the Nazis came to power.
And he reminds us that Hitler did not accidentally stumble upon the euthanasia and eugenics initiatives. Instead, this program “was a carefully planned and covertly executed operation with precisely defined objectives. Those responsible believed in the necessity of what they were doing.”
And just to bring all this up to date, it is of real interest that Burleigh’s final chapter looks at one popular contemporary proponent of euthanasia, Peter Singer. He rightly points out that just as Binding and Hoche sought to relativise morality through a redefinition of the nature of personhood, so too is Singer today.
Robert Jay Lifton, writing in The Nazi Doctors (1986) carefully traces the complicity of the medical community in the Nazi program. He says that at the heart their involvement was “the transformation of the physician – of the medical enterprise itself – from healer to killer”.
He interviewed a number of these medical personnel, as well as some surviving Auschwitz prisoners. Together the information gleaned from these interviews makes for chilling reading. He discovered that for those doctors and other non-medical professionals involved, they formed a vital and necessary step to wholesale genocide.
Without the help of these individuals, and “the destruction of the boundary between healing and killing,” the Nazi death machine would have been less likely to succeed. He argues that sadism and viciousness alone cannot account for what happened – what was needed was a “bureaucracy of killing”.
Some five hundred pages are given over to documenting the Nazi doctors. “In sum,” he says, “we may say that doctors were given much of the responsibility for the murderous ecology of Auschwitz – the choosing of victims, the carrying through of the physical and psychological mechanics of killing, and the balancing of killing and work functions in the camp.”
These and other studies make it quite clear that when medicine moves from its role of healing to a role of killing, such atrocities as what took place 70 years ago are not hard to understand, and are likely to recur. And sadly we have the same temptation today. Doctors are now being asked to add killing to their job description.
As has been said so many times before, we must all learn from the lessons of history, or we will be doomed to repeat the mistakes of history. With so many calls for euthanasia now being made, more than ever we must revisit recent history so that its atrocities can be avoided.
For further reading:
Annas, George and Michael Grodin, eds., The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation. Oxford University Press, 1992.
Baumslag, Naomi, Murderous Medicine: Nazi Doctors, Human Experimentation, and Typhus. Praeger Publishers, 2005.
Brennan, William, Medical Holocaust I: Exterminative Medicine in Nazi Germany and Contemporary America. Nordland, 1980.
Burleigh, Michael, Death and Deliverance: ‘Euthanasia’ in Germany 1900-1945. Cambridge University Press, 1994.
Friedlander, Henry, The Origins of Nazi Genocide: From Euthanasia to the Final Solution. The University of North Carolina Press, 1995.
Gallagher, Hugh Gregory, By Trust Betrayed: Patients, Physicians and the License to Kill in the Third Reich. Henry Holt, 1990.
Hoedeman, Paul, Hitler or Hippocrates: Medical Experiments and Euthanasia in the Third Reich. Book Guild, 1991.
Kater, Michael, Doctors under Hitler. The University of North Carolina Press, 2000.
Lifton, Robert Jay, The Nazi Doctors: Medical Killing and the Psychology of Genocide. Basic Books, 1986.
Michalczyk, John, ed., Medicine, Ethics, and the Third Reich. Sheen & Ward, 1994.
Muller-Hill, Benno, Murderous Science. Oxford University Press, 1988.
Pichot, Andre, Pure Society: From Darwin to Hitler. Verso, 2009.
Proctor, Robert, Racial Hygiene: Medicine under the Nazis. Harvard University Press, 1988.
Sereny, Gitta, Into Darkness: From Mercy Killing to Mass Murder. McGraw-Hill, 1974.
Spitz, Vivien, Doctors from Hell: The Horrific Account of Nazi Experiments on Humans. Sentient Publications, 2005.
Weikart, Richard, From Darwin to Hitler. Palgrave Macmillan, 2004.
Weikart, Richard, Hitler’s Ethic: The Nazi Pursuit of Evolutionary Progress. Palgrave Macmillan, 2009.
Alexander, Leo, “Medical Science Under Dictatorship,” New England Journal of Medicine, 14 July 1949, pp. 39-47.
Brown, Harold O.J., “Euthanasia: Lessons from Nazism,” Human Life Review, 13, March 1987, pp. 88-99.
Burleigh, Michael, “Euthanasia and the Third Reich,” History Today, February 1990, pp. 11-16.
Neuhaus, Richard John, “The Way They Were, the Way We Are: Bioethics and the Holocaust,” First Things, March 1990, pp. 31-37.
Pellegrino, Edmund, “The Nazi Doctors and Nuremberg: Some Moral Lessons Revisited,” Annals of Internal Medicine, 15 August 1997, Vol. 127 Is. 4, pp. 307-308.