January 25, 2005


Ethicists warn doctors of Nazi medical horrors (JIM RITTER, January 25, 2005, Chicago Sun-Times)

Just before Adolf Hitler took power, Germany's medical establishment was the envy of the world.

Germany's researchers dominated Nobel Prizes, its universities reformed medical education and its health service was decades ahead in promoting breast cancer screening and anti-smoking campaigns.

But under the Nazis, those same doctors sterilized "undesirables," ran gas chambers and conducted horrific medical experiments.

Sixty years after the liberation of the Auschwitz death camp, today's doctors still can learn from the Nazis' perversion of medicine. And these lessons are the topic of a nationwide series of lectures sponsored by the American Medical Association and U.S. Holocaust Memorial Museum.

'We're human'

Could it happen here?

"None of us want to admit that, but of course it could," said AMA medical ethicist Dr. Matthew Wynia. "We're human."

On Monday, Wynia and Holocaust Museum historian Patricia Heberer kicked off the Chicago leg of the lecture series with a talk at DePaul University's downtown campus. They also will speak this week to medical students at University of Illinois at Chicago, Northwestern University and University of Chicago.

It didn't take long for the Nazis to corrupt German doctors. In July, 1933, only six months after Hitler took power, the government passed a compulsory sterilization law.

That's a comforting, but almost entirely fallacious, view of Biology as a tool rather than the mother of Nazism. The reality is far more disturbing, Death as Deliverance: Euthanatic Thinking in Germany ca. 1890-1933 (J. Daryl Charles, October 10, 2002, The Center for Bioethics and Human Dignity):
While it is commonly assumed that the moral atrocities associated with the Holocaust were the exclusive domain of Adolf Hitler and his loyal henchmen Joseph Goebbels, Hermann Goering, Heinrich Himmler and Albert Speer, this was only the final act, as it were, of a narrative whose beginnings are traceable to the turn of the century. Indeed it would appear, as authors as diverse as Alexander Mitscherlich, Robert Jay Lifton, Michael Burleigh, and Wesley Smith have documented, that the path to medical evil was prepared "long before Nazism was even a cloud on the German horizon." One of the tragic legacies of social Darwinism, rooted in the presupposition of biological determinism, is that it assisted in giving justification--frequently couched in the language of "compassion"--to the elimination of lebensunwertes Leben, life that is unworthy of living, or, in the language of Darwinists, life that is simply unfit.

In addition to the ascendancy of biological determinism, an important step in legitimizing the killing of the weak, the infirm, the terminally ill, and the incompetent was the shift in ethos among medical doctors and psychiatrists several decades prior to WWII. Historian Robert Proctor has argued persuasively that the Nazi experiment was rooted in pre-1933 thinking about the essence of personhood, racial hygienics and survival economics and that physicians were instrumental both in pioneering research and in carrying out this program. In fact, Proctor is adamant that scientists and physicians were pioneers and not pawns in this process. By 1933, however, when political power was consolidated by National Socialists, resistance within the medical community was too late. Proctor notes, for example, that most of the fifteen-odd journals devoted to racial hygienics were established long before the rise of National Socialism.

Few accounts of this period are more thoroughly researched than Michael Burleigh's Death and Deliverance: 'Euthanasia' in Germany ca. 1900-1945. Particularly important is Burleigh's discussion of psychiatric reform and medical utilitarianism during the Weimar period. During the years of WWI, it is estimated that over 140,000 people died in German psychiatric asylums . This would suggest that about 30% of the entire pre-war asylum population died as a result of hunger, disease or neglect. Following the war, evidence indicates that a shift in the moral climate had begun. In the Spring of 1920, the chairman of the German Psychiatric Association, Karl Bonhoeffer, testified before Association members at the GPA annual meeting that "we have witnessed a change in the concept of humanity"; moreover, in emphasizing the right of the healthy to stay alive, which is an inevitable result of periods of necessity, there is also a danger of going too far: a danger that the self-sacrificing subordination of the strong to the needs of the helpless and ill, which lies at the heart of any true concern for the sick, will give ground to the demand of the healthy to live.

According to Burleigh, Bonhoeffer went on in the 1930s to offer courses that trained those who in time would be authorized with implementing sterilization policies introduced by the National Socialists.

Already in the 1890s, the traditional view of medicine that physicians are not to harm but to cure was being questioned in some corners by a "right-to-die" ethos. Voluntary euthanasia was supported by a concept of negative human worth--i.e., the combined notion that suffering negates human worth and the incurably ill and mentally defective place an enormous burden on families and surrounding communities. It is at this time that the expression "life unworthy of being lived" seems to have emerged and was the subject of heated debate by the time WWI had ended.

One notable "early" proponent of involuntary euthanasia was influential biologist and Darwinian social theorist Ernst Haeckel. In 1899 Haeckel published The Riddle of the Universe, which became one of the most widely read science books of the era. One of several influential voices contending for the utility of euthanasia, Haeckel combined the notion of euthanasia as an act of mercy with economic concerns that considerable money might thereby be saved.

Further justification for euthanasia in the pre-WWI era was provided by people such as social theorist Adolf Jost and Nobel-Prize-winning chemist Wilhelm Ostwald. According to Ostwald, "in all circumstances suffering represents a restriction upon, and diminution of, the individual and capacity to perform in society of the person suffering." In his 1895 book Das Recht auf den Tod ("The Right to Death"), Jost set forth the argument--an argument almost forty years in advance of Nazi prescriptions--that the "right" to kill existed in the context of the higher rights possessed by the state, since all individuals belong to the social organism of the state. Furthermore, this was couched in terms of "compassion" and "relief" from one's suffering. Finally, the right to kill compassionately was predicated on biology, in accordance with the spirit of the age: the state must ensure that the social organism remains fit and healthy.

Even more disturbing because not only could it happen here but in large measure here's where they got the idea, Eugenics and the Left (John Ray, Orthodoxy Today). Indeed, though it's been buried under decades of propganda, the chief reason that William Jennings Bryan fought Darwinism was because of its repulsive social effects, not least its contribution to the German militarism of WWI that Vernon Kellogg described in Headquarters Nights.

Posted by Orrin Judd at January 25, 2005 11:44 AM

All due to an obvious misreading or misunderstanding of the new science generated through Darwin's work. The sophisticated understanding of science and the value of open inquiry is so ingrained upon the modern mind that such misunderstandings will no longer be a threat. We are so much wiser that those old fashioned, pre-Nazi German scientists.

Posted by: Tom C., Stamford,Ct. at January 25, 2005 2:07 PM

Margaret Sanger set up Planned Parenthood on the basis of the pre-WWI Germans, didn't she?

Posted by: jim hamlen at January 25, 2005 2:44 PM

They learned from her, not vice versa.

Posted by: oj at January 25, 2005 5:15 PM

The great mistake of the prewar eugenics movement was linking intelligence and 'fitness' to race, a clearly nonsensical proposition for which there is no evidence. All the braying from religious types and the bleeding hearts aside, it is clear than phenotypical variation is the result of genotypic and environmental variation, that while the genes are not our destiny, that they do in fact matter.

There is no good reason to encourage the mentally defective to breed and we would certainly benefit from the sterilization of violent felons. A similar argument can be made for those with genetic diseases, but some people with genetic diseases can contribute to society so it is a tougher one to make.

The 'Hitler did it so it must be bad' argument goes nowhere. First of all, Hitler practiced a precisely non-scientific policy based on myth. That does not mean a eugenics policy based upon demonstrable genetic realities cannot be successful. Also, does the fact that Hitler liked limited access toll-free highways keep you from using the Interstate system?

Posted by: Bart at January 25, 2005 5:28 PM

So Bart, if "race" were predictive of who is "contributing to society," would that make race-based eugenics and euthanasia moral?

The argument isn't that "Hitler did it so it must be bad," the argument is that a utilitarian view of human life leads to moral atrocity. The problem is that who gets to define what a "contribution" is a political question, not a scientific one.

Posted by: at January 25, 2005 5:40 PM


Your mistake is thinking that any society would think you fit.

Posted by: oj at January 25, 2005 5:44 PM

All in favor of sterilizing Bart, say "Aye." (Who says online polls are useless?)

Posted by: joe shropshire at January 25, 2005 5:56 PM

Institutionalizing and sterilizing.

Posted by: oj at January 25, 2005 6:07 PM

Little crossroads of history fact - Karl Bonhoeffer was Dietrich Boenhoeffer's father. I don't know if that is a symbol of hope for blueest of blue state children or as you sow so shall you reap or both. Drew

Posted by: Drew Craft at January 25, 2005 8:07 PM

Bart may already be both.

Posted by: at January 25, 2005 8:22 PM

Bart raises the point clumsily, but it is still there.

We could potentially eliminate, say, sickle cell anemia in a generation without killing anyone, by sterilizing the carriers.

Why not?

Posted by: Jeff Guinn at January 25, 2005 10:05 PM

Race is not 'predictive' so it is irrelevant. Since race cannot be intelligently defined, it is useless.

I pay a load of taxes and I don't break the law so I am by definition productive. Any other opinion as far as that goes is infantile.

It is noteworthy that the religious types decided to descend to namecalling instead of actually answering my basic question,'Why should we allow the mentally defective and the felonious to breed?' The reason is that they don't have answers, only dogma and prejudice.

Heaven forbid they approach human reproduction as a scientific matter. If we can breed dogs and horses, we can certainly breed people.

'Moral atrocity'??? There is no greater moral atrocity than wasting my time and money for no good reason.

Posted by: Bart at January 25, 2005 10:19 PM


No, that's not productive, it's just money.

Posted by: oj at January 25, 2005 10:36 PM


Now you're just caricaturing yourself, right?

Posted by: oj at January 25, 2005 10:41 PM

Allrighty then: all in favor of sterilizing Jeff Guinn say "Aye." ( Let's try to keep this down to a manageable number of candidates, shall we? ) Oh, and count me in as far as Bart goes.

Posted by: joe shropshire at January 25, 2005 10:48 PM


Note that it is Jeff's argument that no one would choose to be gay, that it is perforce genetic. Note also that his brother is gay. So Jeff himself is arguing that he, and all the members of his family, should be sterilized. After all, we can lick this disease in one generation without killing anyone....

Posted by: oj at January 25, 2005 11:13 PM

Jeff: the answer to question is that a lethal recessive cannot be removed from a population even if it is 100% lethal when found in rr form. There is math to prove it, but it has been way to long (30 years) since I took genetics.

Furthermore, the human genome is way too complicated, there is currently no way of knowing if you would not be eliminating a valuable triat if you were breeding out a undesirable trait.

Posted by: Robert Schwartz at January 26, 2005 2:09 AM

Jeff: that's one answer. Another answer would be that there are some questions you just don't give a utilitarian response to, because experience teaches that you'll end up killing a lot of innocent people if you do. Let's learn something from this wretched century we've just endured.

Posted by: joe shropshire at January 26, 2005 2:51 AM