Culture of Death. Wesley J. Smith
“who have been irretrievably lost as a result of illness or injury, who fully understand their situation, posses and have somehow expressed and urgent wish for release.”25
2. “Incurable idiots,” whose lives Binding and Hoche viewed as “pointless and valueless,” and as emotional and economic burdens “on society and their families.” Hoche put it this way: “I have discovered that the average yearly (per head) cost for maintaining idiots has till now been thirteen hundred marks. . . . If we assume an average life expectancy of fifty years for individual cases, it is easy to estimate what incredible capital is withdrawn from the nation’s wealth for food, clothing, heating—for an unproductive purpose.”26
3. The “unconscious,” if they ever again were roused from their comatose state, would waken to nameless suffering.27
Permission to Destroy Life Unworthy of Life was thus a prescription for the medical cleansing of the most weak and vulnerable among Germany’s population, a prescription that would be filled with murderous precision by German doctors between 1939 and 1945.
Binding’s and Hoche’s philosophical approach was eerily similar to that espoused today by many contemporary bioethicists. It was utilitarian. It eschewed the Hippocratic tradition in favor of the quality of life ethic (ditto bioethics). Indeed, the Georgetown Mantra could be used to justify Binding and Hoche arguments (e.g., they described voluntary euthanasia as merely a matter of fulfilling the patient’s “urgent wish” [autonomy]; defined killing ill and disabled people as a “healing” act [beneficence]; and promoted euthanasia as necessary to fulfill other urgent societal needs that were going wanting because of the cost of caring for disabled people [distributive justice]).
Although modern bioethicists object to the manner in which Binding and Hoche’s proposals were ultimately implemented in Germany, and most would certainly object to the authors’ bigoted use of language, it is clear that the anti-sanctity of life values expressed in and the utilitarian philosophical foundation of Permission to Destroy Life Unworthy of Life fit snugly within the mainstream of the modern bioethics movement. As just one example, in 2010, Oxford bioethicists Dominick Wilson and Julian Savulescu advocated “organ donation euthanasia,” in which the dying unconscious could be killed via the process of organ harvesting.28
Permission to Destroy Life Unworthy of Life created a sensation among Germany’s intelligentsia, whose leadership—in conjunction with the growing acceptance of Social Darwinism, anti-Semitism, racial hygiene, and eugenics—helped the Binding/Hoche view to become soon accepted by much of German society. For example, 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.29 Thus, by the time the Nazis came to power in 1933, much of Germany, including its medical establishment, accepted the existence of some human beings as “life unworthy of life.”
Upon assuming leadership of Germany, Nazi rulers immediately sought to act against these “useless eaters.” In 1933, the German government sought to legalize voluntary euthanasia. (A front-page New York Times article described the proposal as making it possible for physicians to end the torture of incurable patients.) Protective guidelines were to be included in the law, many of which were remarkably similar to those espoused by euthanasia advocates today, including voluntary requests “expressly and earnestly” made and, if decided by relatives for incompetent patients, that the motive for killing (ironically) “not contravene morals.”30
These proposals were eventually withdrawn because of vehement opposition from German churches. However, mandatory sterilization laws were officially enacted within six months of Hitler becoming Germany’s chancellor, which made the sterilization statutes in the United States seem pale by comparison. Based on eugenics theories, special “Hereditary Health Courts” were established to judge the “hereditarily sick.” Among those targeted were people who were mentally retarded, mentally ill, alcoholics, with epilepsy, and had “grave body malformations.” At the law’s inception, it was estimated that more than 400,000 people would be sterilized from the hospitals and mental institutions alone. Sterilization was actually imposed on up to 350,000 disabled and other “undesirable” people between 1933 and 1945.31
Throughout the 1930s, the idea of actually killing useless eaters gained increased popularity, and not by accident. The Nazi government molded German public opinion. Popular entertainment became an especially effective tool in this unremitting propaganda campaign, particularly motion pictures, an industry that Joseph Goebbels effectively controlled.
The movie I Accuse (Ich klage an), one of the most notable of these many propaganda films, is particularly relevant to today’s medical climate. Wildly popular among German audiences (more than 15 million paid to see it),32 I Accuse was an all-out call for legalizing voluntary euthanasia and an apologia for murdering disabled infants. According to Professor Sobsey, the I Accuse filmmaker/propagandists cleverly promoted killing as an acceptable answer to medical difficulties by both intensely personalizing the issue of suffering caused by serious illness while, at the same time, depersonalizing killing as it related to disabled infants to make their murder easier to accept.
The movie was pure melodrama. The primary plot concerned a woman pianist who grows progressively disabled because of multiple sclerosis. Unable to play her beloved piano and deeply worried about becoming a burden to her physician husband, she begs for euthanasia. “The audience was supposed to relate to her deeply and accept as correct and compassionate her desire to die,” Sobsey says. Thus, I Accuse promotes euthanasia as beneficial, compassionate, and supportive of autonomous decision making in the same manner as do contemporary euthanasia activists.
As the wife and husband struggle with her MS, a subplot develops that is deeply utilitarian and dismissive of the moral worth of disabled people. The third main character, a university professor, lectures students on how in nature, only the “fit” survive. He illustrates his teaching with graphic documentary scenes of asylums from Nazi film archives, which depict the patients as grotesque and inhuman. It is in this context that the parents of a disabled infant beg the doctor to kill their child as an act of mercy. “The movie never shows the baby,” Sobsey says. “This is as a way of depersonalizing the infant and make its ultimate killing less shocking.”33
At the same time, as the husband desperately searches for a cure for MS, he cripples a mouse in his research laboratory and then thoughtlessly abandons it to suffer. A woman lab worker promises the mouse she will take care of him and later surreptitiously gives the animal a lethal injection as an act of compassion. The message is blunt and unremitting: the unfit should die, both as a matter of mercy and to keep the society healthy.
The parents of the disabled child continue to beg for the same consideration for their baby, and finally have their way. The baby is killed off camera, and depicted as a difficult but eugenically correct act that protects the overall health of the Volk. The wife commits suicide with her husband’s help, a scene played, to the sound of a mournful piano, for all the pathos it is worth. He is arrested. The movie ends with the husband’s impassioned accusation to the judges against the law for preventing euthanasia (the real accusation in I Accuse):
No! Now, I accuse! I accuse the law which hinders doctors and judges in their task of helping people. I confess . . . I have delivered my wife from her sufferings, following her wishes. My life and the lives of all people who will suffer the same fate as my wife, depends on your verdict. Now, pass your verdict.34
These words could have been taken from a transcript from one of the trials of Jack Kevorkian, many of whose victims were non-terminally ill women disabled by multiple sclerosis. Moreover, the word “deliverance” was once the favorite euphemism used by the Hemlock Society (now compassion and choices) to describe killing by euthanasia or assisted suicide. And that isn’t all. As we shall see, the moral values, philosophy, and even the words expressed through and in I Accuse are alive, well, and in practice in the United States, Canada, and much of the West more than seventy years after its release.
Indeed, in addition to the Kevorkian trials, the Debbie Purdy case in the United Kingdom tracks almost exactly