Eugenics and involuntary euthanasia
A recent article got me thinking about the T4 program again. Why it did so will become apparent in a moment, but first I would like to list a few quotes from the article. They are quotes justifying the "euthanasia" of the "feebleminded" from around the appropriate time period:
- But I am in favor of euthanasia for those hopeless ones who should never have been born – Nature’s mistakes.
- So the place for euthanasia, I believe, is for the completely hopeless defective: nature’s mistake; something we hustle out of sight, which should never have been seen at all. These should be relieved the burden of living, because for them the burden of living at no time can produce any good thing at all. . . . For us to allow them to continue such a living is sheer sentimentality, and cruel too; we deny them as much solace as we give our stricken horse. Here we may most kindly kill, and have no fear of error.
- ...to release the soul from its misshapen body which only defeats in this world the soul’s powers and gifts is surely to exchange, on that soul’s behalf, bondage for freedom.
- A third variety of reaction results from an accusing sense of obligation on the part of the parents towards the defective creature they have caused to be born. The extreme devotion and care bestowed upon the defective child, even with sacrifice of advantages for its normal brothers and sisters is a matter of common observation. This position is understandable, but to the impersonal observer may appear to partake of the morbid. Disposal by euthanasia of their idiot offspring would perhaps unbearably magnify the parents’ sense of guilt.
- It is submitted that the state of mind of the parents of an idiot may as fairly become a subject of psychiatric concern as the interrelationships in the families of psychotic patients, and the unwholesome reactions stand as much in need of correction in one case as in the other.
- It must be made clear to anyone suffering from an incurable disease that the useless dissipation of costly medications drawn from the public store cannot be justified. Parents who have seen the difficult life of a crippled or feeble-minded child must be convinced that, though they may have a moral obligation to care for the unfortunate creature, the broader public should not be obligated...to assume the enormous costs that long-term institutionalization might entail.
All but one of them didn't come from the Third Reich, however. Here are the sources:
- Kennedy, F. (1942) The problem of social control of the congenital sterilization, euthanasia. Am. J. Psychiatry, 99, 13–16.
- Anonymous (1942) Euthanasia. Am. J. Psychiatry, 99, 141–3.
- Pamphlet published by Dr. Heilig, representative of the Nazi Physicians' League. From: Robert N. Proctor, Racial Hygeine: Medicine Under the Nazis, Harvard University Press, Cambridge, 1989, p. 183
Also appearing in the same 1942 journal was an editorial against the killing of the "feebleminded" written by Leo Kanner. Yes, that Leo Kanner, the one who published the first major work describing the condition now known as autism in 1943. Indeed, as part of his argument against involuntary euthanasia of such children, he correctly invoked the Nazis, asking rhetorically, "Shall we psychiatrists take our cue from the Nazi Gestapo?" He did, however, comment that "sterilization is often a desirable procedure" for "persons intellectually or emotionally unfit to rear children," although he did object to sterilization performed "solely on the basis of the I.Q." Even though there was a "point-counterpoint" sort of debate in this journal, it should also be remembered that the journal itself came down on the side of Kennedy, not Kanner.
When looking back at the atrocities of the Nazi regime in the name of eliminating undesirables from the Volk, it is important to realize that the ideas the fueled their quest to kill those deemed burdens on society were not unique to Germany. Far from it. As this 1942 journal shows, advocacy of various types of eugenic measures was widespread in the U.S., including among the most elite physicians in the nation. True, no one was advocating selective breeding or the killing of "lesser races" in the service of producing a "master race," as the Nazis were, but there was a disturbing similarity in the thinking of the medical elite in the U.S. with that of Nazi advocates of racial hygeine. As the History of Psychiatry article points out:
It is surprising that a debate on murder could have appeared in the most prominent psychiatric journal in the USA at the time. But as historians have noted, eugenic sterilization was legally sanctioned in the USA long before the Nazi sterilization law of 1933. The logical progression from sterilization (killing presumed genes) to ‘euthanasia’ (killing presumed gene carriers) occurred much more slowly in the USA, but accelerated in the early 1940s under German influence. The progression from sterilization to killing is ‘logical’ because, once it has been established that the state should actively participate in preventing the reproduction of ‘genetically undesirable’ people through compulsory sterilization, it eventually seems more ‘efficient’ to wipe out the alleged gene carriers themselves. In a chilling and prophetic statement in 1923, Swedish Member of Parliament and sterilization opponent Carl Lindhagen asked, ‘Why shall we only deprive these persons, of no use to society or even for themselves, the ability of reproduction? Is it not even kinder to take their lives? This kind of dubious reasoning will be the outcome of the methods proposed today’.
It was only the postwar revelation of all the atrocities the Nazis committed in the name of eugenics and racial hygeine that utterly discredited this sort of thinking in the U.S. Yet, at the eve of our entry into the war, in the most prestigious psychiatric journal in the U.S., prominent physicians were debating, in essence, whether the Nazi approach to dealing with severely disabled children was the correct one, with at least as many prominent neurologists and psychiatrists arguing that it was as arguing that it was not. (Indeed, early in his regime, Hitler himself spoke approvingly of the compulsory sterilization programs that had been implemented in several states in the U.S. by the 1930's.) We should not forget that, particularly in an era in which the genetic basis of psychiatric diseases are being discovered, lest history repeat itself.