What’s Wrong with the World

The men signed of the cross of Christ go gaily in the dark.


What’s Wrong with the World is dedicated to the defense of what remains of Christendom, the civilization made by the men of the Cross of Christ. Athwart two hostile Powers we stand: the Jihad and Liberalism...read more

The German euthanasia culture and our own

Via Wesley J. Smith comes a link to an important document that I had never read before. This is "Medical Science Under Dictatorship," published in 1949 by Dr. Leo Alexander. Alexander came to the U.S. from Austria in the early 1930's and later, in preparation for the Nuremberg trials, assisted the investigation of medical crimes committed by German doctors. While he was not a witness of what he reports, he was intimately involved in collecting and presenting evidence of the war crimes committed by doctors working under the Third Reich.

To say that Alexander's warnings are prescient and timely would scarcely be to say enough. Listen to this:

Whatever proportions these crimes finally assumed, it became evident to all who investigated them that they had started from small beginnings. The beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the acceptance of the attitude, basic in the euthanasia movement, that there is such a thing as life not worthy to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted and finally all non-Germans. But it is important to realize that the infinitely small wedged-in lever from which this entire trend of mind received its impetus was the attitude toward the nonrehabilitable sick.

It is, therefore, this subtle shift in emphasis of the physicians' attitude that one must thoroughly investigate. It is a recent significant trend in medicine, including psychiatry, to regard prevention as more important than cure. Observation and recognition of early signs and symptoms have become the basis for prevention of further advance of disease.

Wow. I remember quite well back in the 1990's when Hillarycare was all the rage. What did one hear most? Oh, how irrational it is to spend money on people who are dying. Oh, how much better that money would be spent on prevention. How can our healthcare dollars be most wisely spent? (Note the collectivist assumption.) The HMO's (it is sometimes forgotten now) were hugely on-board with the prevention-over-cure mantra. That was the very reason why they were called "health maintenance organizations" rather than "insurance companies."

More from Alexander:

The question that this fact prompts is whether there are any danger signs that American physicians have also been infected with Hegelian, cold-blooded, utilitarian philosophy and whether early traces of it can be detected in their medical thinking that may make them vulnerable to departures of the type that occurred in Germany. Basic attitudes must be examined dispassionately. The original concept of medicine and nursing was not based on any rational or feasible likelihood that they could actually cure and restore but rather on an essentially maternal or religious idea. The Good Samaritan had no thought of nor did he actually care whether he could restore working capacity. He was merely motivated by the compassion in alleviating suffering.
A certain amount of rather open contempt for the people who cannot be rehabilitated with present knowledge has developed. This is probably due to a good deal of unconscious hostility, because these people for whom there seem to be no effective remedies have become a threat to newly acquired delusions of omnipotence.
The trend of development in the facilities available for the chronically ill outlined above will not necessarily be altered by public or state medicine. With provision of public funds in any setting of public activity the question is bound to come up, "Is it worth while to spend a certain amount of effort to restore a certain type of patient?" This rationalistic point of view has insidiously crept into the motivation of medical effort, supplanting the old Hippocratic point of view.

I remember some years ago there was a little girl named Charlotte in the UK, born prematurely, whose parents tried to get the "free" national health service to give her every possible chance to live. I do not now remember all the details, but by my recollection she was removed from a ventilator and continued to breathe, so she was allowed to live, and did live, for at least several years. She was eventually taken away from her parents and placed into foster care when they divorced, and I lost track of her. But it was interesting to see how the rationale of public dollars was used to excoriate the parents as selfish wretches who cared nothing for the public weal in their desire to see their child live. Of course, as we have seen in other cases, the yen to get rid of the unwanted is not actually confined to cases where public dollars are used. That is only an excuse. And in the end, the Planners think of all of it as "our" healthcare dollars, anyway. I did not fully understand at the time the connection that Alexander is drawing here between the emphasis upon prevention and the euthanasia movement. But he makes an excellent point. The idea is to keep people healthy. Once people are really sick, even designated as dying, helping them is considered a bad use of funds, and it is even assumed that they must not have done enough to take care of themselves earlier. Where this leaves the chronically ill, the elderly (one does, after all, get old eventually), and those with congenital severe illness is...up for grabs.

Under all forms of dictatorship the dictating bodies or individuals claim that all that is done is being done for the best of the people as a whole, and that for that reason they look at health merely in terms of utility, efficiency and productivity. It is natural in such a setting that eventually Hegel's principle that "what is useful is good" wins out completely. The killing center is the reductio ad absurdum of all health planning based only on rational principles and economy and not on humane compassion and divine law. To be sure, American physicians are still far from the point of thinking of killing centers, but they have arrived at a danger point in thinking, at which likelihood of full rehabilitation is considered a factor that should determine the amount of time, effort and cost to be devoted to a particular type of patient on the part of the social body upon which this decision rests. At this point Americans should remember that the enormity of a euthanasia movement is present in their own midst.

Could the relevance get more stark? Oh, by the way, Holland is no longer far from killing centers, and neither is Switzerland.

The case, therefore, that I should like to make is that American medicine must realize where it stands in its fundamental premises. There can be no doubt that in a subtle way the Hegelian premise of "what is useful is right" has infected society, including the medical portion. Physicians must return to the older premises, which were the emotional foundation and driving force of an amazingly successful quest to increase powers of healing if they are not held down to earth by the pernicious attitudes of an overdone practical realism.

To be fair, in the decades since Alexander wrote his prescient article, the types of organizations he praises for helping those with chronic illness have flourished in the West, especially in the United States. In the same time period, however, the search and destroy mission for those same individuals--individuals with Down Syndrome and spina bifida, for example--has become ever more efficient when they are in utero, prompting one group to bring a complaint in the International Criminal Court against the government of New Zealand for its open attempts to exterminate individuals with these disorders before they are born.

Speaking of Holland, it is impossible to read without sadness the section of Alexander's article concerning the resistance the Dutch doctors made to the German euthanasia program.

It is to the everlasting honor of the medical profession of Holland that they recognized the earliest and most subtle phases of this attempt and rejected it. When Sciss-Inquart, Reich Commissar for the Occupied Netherlands Territories, wanted to draw the Dutch physicians into the orbit of the activities of the German medical profession, he did not tell them" You must send your chronic patients to death factories" or "You must give lethal injections at Government request in your offices," but he couched his order in most careful and superficially acceptable terms. One of the paragraphs in the order of the Reich Commissar of the Netherlands Territories concerning the Netherlands doctors of 19 December 1941 reads as follows: "It is the duty of the doctor, through advice and effort, conscientiously and to his best ability, to assist as helper the person entrusted to his care in the maintenance, improvement and re-establishment of his vitality, physical efficiency and health. The accomplishment of this duty is a public task."[16] The physicians of Holland rejected this order unanimously because they saw what it actually meant—namely, the concentration of their efforts on mere rehabilitation of the sick for useful labor, and abolition of medical secrecy. Although on the surface the new order appeared not too grossly unacceptable, the Dutch physicians decided that it is the first, although slight, step away from principle that is the most important one.

This is a striking passage because of the apparent innocuousness in the order. What could be so bad about re-establishing a patient's physical efficiency and health? Is that not the job of a doctor? But the Dutch physicians understood that all of this was code from the Germans. If the patient's physical efficiency and health could not be reestablished, then the physician would no longer be carrying out his proper task if he continued to help the patient. It took great insight and also great courage to recognize the Trojan horse and to refuse it. In our own day this Trojan horse goes by the name of "futile care theory," and Wesley J. Smith has taught us all about it.

The Dutch physicians declared that they would not obey this order. When Sciss-Inquart threatened them with revocation of their licenses, they returned their licenses, removed their shingles and, while seeing their own patients secretly, no longer wrote death or birth certificates. Sciss-Inquart retraced his steps and tried to cajole them—still to no effect. Then he arrested 100 Dutch physicians and sent them to concentration camps. The medical profession remained adamant and quietly took care of their widows and orphans, but would not give in. Thus it came about that not a single euthanasia or non-therapeutic sterilization was recommended or participated in by any Dutch physician. They had the foresight to resist before the first step was taken, and they acted unanimously and won out in the end. It is obvious that if the medical profession of a small nation under the conqueror's heel could resist so effectively the German medical profession could likewise have resisted had they not taken the fatal first step. It is the first seemingly innocent step away from principle that frequently decides a career of crime. Corrosion begins in microscopic proportions.

This is, in itself, a story of triumph, and later losses do not dim its triumph. But we who know that Holland has since become the veritable killing fields of the euthanasia movement, infamous for its Groningen Protocol for the murder of disabled infants and its widespread administration of lethal injection, cannot help mourning the failure of later Dutch physicians to honor the memory of their brave predecessors.

Alexander's article as a whole makes for grim reading, and I admit that I did not read through all of the descriptions of horrific experiments he catalogs.

One point that Alexander discusses is the use or preservation of the bodies of murdered people for scientific purposes. One researcher, Dr. Hallervorden, received many perfectly preserved brains of the mentally disturbed and disabled who were systematically slaughtered in killing centers. He believed that these would be useful to dissect and examine for insight into the disorders the victims suffered from. These brains were delivered to Hallervorden by the Charitable Transport Company for the Sick, a name that sounds like it was made up for a dystopian novel. Hallervorden said that there was some "wonderful material" among the brains he received, but he felt that their scientific value was diminished by the fact that full autopsies were not also performed on the victims.

Hallervorden managed to tut-tut a bit about the "brutalization" and the loss of trust in the psychiatric profession caused by simply killing off patients in large numbers (ya think?), but he does not seem to have actually rejected the killing centers. He shrugged, "I accepted those brains of course. Where they came from and how they came to me was really none of my business." Oh, no, Dr. Hallervorden, none of your business at all.

Let's remember this story next time someone asks why we shouldn't just go ahead and use for research the stem cells extracted from murdered embryos. After all, they're already dead. Where those stem cells came from is really none of our business, right?

I cannot guarantee that I have found all of the stunningly prescient passages in this article, because I have not read every word of it. (I didn't want to give myself too many nightmares.) But it is so important that we need to make sure that the text is not lost. The fact that its text is appearing on some sort of independent web site may mean that it will not always be readily available. As Wesley J. Smith sadly notes, it is unlikely that the New England Journal of Medicine, the original publisher, would publish it today.

If we sound like Cassandras saying these things, let us go on nonetheless. God is sovereign, and the truth will be known in His time. Meanwhile, by reading and reflecting on Dr. Alexander's words, we help to keep the flame of truth alive and to ward off both our own corruption and, hopefully, the corruption of some others who hear our voice.

Comments (7)

But it was interesting to see how the rationale of public dollars was used to excoriate the parents as selfish wretches who cared nothing for the public weal in their desire to see their child live. Of course, as we have seen in other cases, the yen to get rid of the unwanted is not actually confined to cases where public dollars are used.

A friend of mine has a very severely mentally handicapped son. He's well into the category that many parents would want to abort if they could prescreen for that sort of thing. He's a pretty liberal guy, mainly out of admitted guilt since he relies on public assistance to take care of his son during the work day (kid's a late teen now and HUGE).

I observed to him that if you peel back the liberal rhetoric, what you find is that a great deal of what liberals want to do is eliminate genuine objects of mercy like his son so they can use welfare money to enable "freedom and equality" for those who want to eat, drink, screw, shoot up, etc. until the wheels come off and the car careens into a ditch. Because the reality is that overindulgence in vice destroys very quickly in most cases. Unrestricted freedom tends to annihilate equality in a hurry.

But no one on the left will say to a woman who says "I don't need no man to have muh keedz" "honey, you're a selfish c#$% and a parasite." Just like they won't say to say someone who is chronic drug addict that they're behaving like a parasite or tell someone who is 250lb overweight that they've eaten themselves into a position where society cannot assume liability for their health problems.

But hey, we can throw handicapped and premature kids to the wolves. Because freedom and equality.

Mike, I actually do appreciate your attempt to curb the language by putting in symbols and what-not, but I'm going to ask you to please dial it back yet another notch and just leave out the allusions to those particularly nasty swear words altogether. Thanks.

On the substance of your comment, I think that as a matter of the Hippocratic oath there is actually a form of medical professionalism that treats people even when they actually are the cause, through some long-standing bad habit, of their own present state. I'm pretty sure Dr. Alexander would agree with me. And I think there is a place too in a humane society for helping even those who have brought on their own problems. Various religious orders have done this, and I do not disdain them for it. There is also a lot of hazard, both moral hazard and epistemic hazard, in trying after the fact to determine the precise degree of guilt a person has for his own present state in exchange for treating his condition. Enablement is a different matter, and a very serious matter, but not all after-the-fact medical help is enablement.

Where precisely public funding comes into all of this is yet a different issue still. I suspect you and I might agree in many places as to outcomes (who should receive funding and who should not) without always agreeing on rationales--what I believe is known as extensional rather than intensional overlap.

In any event, I'm more concerned with actually deliberately killing people in a medical context (as opposed to not giving them welfare or something of that kind). And that's really where we are headed. And that shouldn't be happening to anyone. In fact, in one of my linked posts (which I was just re-reading today) I made the case that as our official medical establishment becomes more murderous, we would be doing people a favor by tossing them out to be cared for informally rather than bumping them off in a sterile environment.

That article really is hard to read, but thanks for bringing it to our attention, Lydia.

Mike, I actually do appreciate your attempt to curb the language by putting in symbols and what-not, but I'm going to ask you to please dial it back yet another notch and just leave out the allusions to those particularly nasty swear words altogether. Thanks.

No doubt one area where we disagree here is that I think a woman who displays that attitude is quite rightly called that particular word, to her face, in front of as many people who know her as possible. A woman contemplating deliberate single motherhood as an affirmation of her selfish desire to have children independent of consideration for their well-being is somewhere between a moral idiot and monster. I lean strongly toward the latter because the things that single motherhood often brings into a child's life tend to be extremely harmful.

Hey Mike: Lydia wasn't actually delineating an "area of disagreement"; she was asking you to act like a damned gentlemen and mind your tongue. I think we all agree that deliberately contemplating, out of some reckless notion of autonomy, raising a child without a father is a supreme act of selfish folly.

But what in the world does this thread have to do with female promiscuity anyway? You're saying you "lean strongly toward" publicly insulting misguided women with imprecations and maledictions? Monomania much?

Thank you, Paul. You put it well.

"The Good Samaritan had no thought of nor did he actually care whether he could restore working capacity. He was merely motivated by the compassion in alleviating suffering."

Such as Mother Theresa, who spent a good deal of time simply sheltering and comforting the dying she found in the streets--her detractors were forever criticizing her and her order for having "wasted" time and money on those too far gone to cure.

Post a comment

Bold Italic Underline Quote

Note: In order to limit duplicate comments, please submit a comment only once. A comment may take a few minutes to appear beneath the article.

Although this site does not actively hold comments for moderation, some comments are automatically held by the blog system. For best results, limit the number of links (including links in your signature line to your own website) to under 3 per comment as all comments with a large number of links will be automatically held. If your comment is held for any reason, please be patient and an author or administrator will approve it. Do not resubmit the same comment as subsequent submissions of the same comment will be held as well.