The Deadly Legacy of Eugenics

We’ve seen it happen: A new assault on the sanctity of human life appears—say, infanticide being promoted in a major bioethics journal, or officials in Iceland bragging that no children with Down syndrome are born there, thanks to prenatal genetic screening—and some horrified opponents respond in horror, “That’s what the Nazis did!” It’s an easy accusation to wield, but rarely a wise one. Often, these proposals and policies have little to do with the crimes of Hitler and his minions—and a great deal to do with the eugenicist movement that preceded them.

Take the euthanasia killings of people with disabilities in the Netherlands, Belgium, and Canada. Certain analogies to Nazi horrors spring to mind: German doctors killed disabled babies between 1939 and 1945—as is happening today in the Netherlands, despite being technically illegal. And German doctors terminated disabled adults in hospitals. In the latter example, however, there are some crucial differences. Unlike legal voluntary euthanasia of disabled people in Belgium, the Netherlands, and Canada, the disabled victims of the Nazis were part of mass killing experiments at the start of the Holocaust. And since people who are accused of Nazi thinking don’t appear threatening—they don’t wear “SS” insignia on tailored black leather coats or boast funny mustaches, and they haven’t swallowed the poisonous ideology of fascism—the Nazi epithet is more likely to undermine the accuser’s credibility than persuade his audience.

So, what are we supposed to do, Wesley? Ignore history? Not at all. In fact, I think a more apt thought connection to the culture-of-death practices and proposals of today can be made to the invidious beliefs that animated eugenics—a movement still disdained by most people. This analogy is less likely to be rejected out of hand.

Here’s an example. Many people believe that German crimes in the medical context were Hitler’s idea, or were purely a product of Nazi ideology. Not true. The doctors who committed these crimes had embraced the eugenicist ideology that views some lives as of lower “quality” and, hence, lower value than others. The support among German medical, legal, and academic intelligentsia for euthanasia and terminating the disabled long predated Hitler’s rise to power.

Medical historian Robert Jay Lifton has identified the 1920 book Permitting the Destruction of Life Not Worthy of Life (Die Freigabe der Vernichtung Lebensunwerten Lebens), written by law professor Karl Binding and physician Alfred Hoche, as “the crucial work” promoting the agenda of death. Permitting the Destruction of Life profoundly influenced the values of the general public and the ethics of the German medical and legal communities—to the point that a 1925 poll of the parents of disabled children reported that 74 percent of them would agree to the painless killing of their own children!

The book is a truly chilling read, not only because of its crass advocacy for killing the defenseless, but also because of the ways in which it mirrors many concepts propounded by bioethicists and euthanasia advocates today. Binding and Hoche believed that some lives are so degraded that they constitute “life not worthy of life.” Who were these unfortunates?

1. Terminally ill or mortally wounded individuals who “have been irretrievably lost as a result of illness or injury, who fully understand their situation, possess and have somehow expressed an urgent wish for release.” This view is virtually identical to the euthanasia and assisted suicide policies urged upon us today.
2. Binding and Hoche believed it was permissible to euthanize “incurable idiots,” whose lives they denigrated as “pointless” and “valueless.” They were deemed an economic and emotional “burden on society and their families.” Today’s advocates do not depict the developmentally disabled as “idiots,” nor do most go as far as Hoche and Binding did in calling for non-voluntary killing. However, the economic cost of caring for those labeled as having a low quality of life is frequently noted by euthanasia advocates and asserted as grounds for healthcare rationing and the withdrawal of wanted life support.
3. The “unconscious,” who “if they ever again were roused from their comatose state, would waken to nameless suffering.” The United States and other Western nations already allow terminating such individuals by withholding tube-supplied sustenance—as vividly exposed in the legal and cultural conflagration over the court-ordered dehydration death of Terri Schiavo.

More explicit eugenics advocacy of the era is also analogous to culture-of-death arguments made today. From around the 1910s through the end of World War II, eugenicists promoted not only involuntary sterilization of the so-called “unfit,” but also infanticide of disabled babies (which was not carried out beyond Germany). Helen Keller, of all people, argued that killing disabled children was merely the “weeding of the human garden,” apparently believing that she would be spared because her significant disabilities were not congenital. The eugenicist and social Darwinist Margaret Sanger also used the “weeds” metaphor to support the infanticide of “human waste.” Such denigrating terms are not deployed today, but how are those views different from the public policies that support aborting fetuses with Down syndrome and other genetic conditions?

Once again, we are in a time of pronounced danger for the medically vulnerable. Once again, the prospect of medical cleansing casts a dark shadow over the ethics of healthcare and the practice of clinical medicine. But to the opponents of these policies, I say: Yes, support the equality and sanctity of human life. Yes, when appropriate, bring up historical precedents. But leave the Nazis out of it. If that point is going to have any chance of resonating, let your listener come to that conclusion on his own, which will make it more likely to stick.

The sad fact is that not every wrong idea or wicked public policy is traceable to Hitler. There are many other paths off the ethical cliff.

Award winning author Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism and a consultant to the Patients Rights  Council.