By Richard Weikart,
Professor emeritus, Department of History
California State University, Stanislaus
When pressing for legalization of euthanasia and assisted suicide today, proponents generally try to sell it as an act of compassion toward those enduring horrendous suffering. They also claim that they are promoting freedom and autonomy, since the laws only allow for voluntary euthanasia or assisted suicide.
However, from the time the euthanasia movement arose in the late nineteenth century until today, it has often manifested a darker side: a tendency to support the involuntary killing of people with disabilities. From the 1870s, when the earliest public discussions of euthanasia began, through the early twentieth century, euthanasia was closely tied to the eugenics movement, which aimed at improving human heredity by eliminating people deemed “unfit” or hereditarily “inferior” and fostering reproduction of those deemed “superior” biologically. Of course, not all eugenics proponents endorsed killing people with disabilities; some thought compulsory sterilization would suffice (leading to compulsory sterilization laws in many states of the US and in some European countries).
In 1894 the British philosopher F. H. Bradley published an essay in the International Journal of Ethics that exemplified some of these problematic attitudes. He rejected the idea that humans lives are equally valuable and expressed utter contempt for those with mental illnesses: “I am disgusted at the inviolable sanctity of the noxious lunatic,” he admitted. They should not be institutionalized, he thought, since “it seems wrong to load the community with the useless burden of these lives.” Rather he argued that those who are “worse varieties” of humans should face “punishment.” Of course, the “punishment” he wanted meted out to those he called “dangerous specimens” was death.(1)
Bradley was not the only famous intellectual to promote involuntary euthanasia. In 1870 in Germany the leading Darwinian biologist Ernst Haeckel became one of the first to publicly endorse killing infants with disabilities, when he endorsed the idea in a popular book on biological evolution.(2) Like many others in the eugenics movement, he overtly rejected the idea that human lives are equally valuable. Then, in a 1904 book he condemned the idea that we should always preserve human life, “even if it is completely worthless.” In that book he not only defended infanticide, but he also vigorously argued that people with mental illnesses should be put to death, if a panel of physicians deemed it proper.(3)
The nineteenth-century German philosopher Friedrich Nietzsche, like Haeckel, radically rejected the idea of human equality, and he believed that those he deemed superior—the so-called Supermen—should dominate and even destroy the inferior masses. Nietzsche vociferously rejected moral ideals, such as love and compassion. In The Genealogy of Morals (1887) Nietzsche stated, “To sacrifice humanity as mass to the welfare of a single stronger human species would indeed constitute progress.”(4) He also wrote, “The great majority of men have no right to existence, but are a misfortune to higher men.”(5) Nietzsche overtly promoted suicide, and in 1882 he wrote a parable about a man who brought a “miserable and deformed” child to a saint. The saint advises the man to kill the child, and when some bystanders criticize him for this advice, he responds, “But isn’t it crueler to allow it to live?”(6) Thus Nietzsche’s philosophy, which is still quite popular in many intellectual circles, undermines the value of human life (at least of most human lives) and opens the door to involuntary euthanasia.
When the Euthanasia Society of America (ESA) was founded in the 1930s, the organization decided to focus on legalization of voluntary euthanasia. This was mostly a tactical move, as many of their members supported involuntary euthanasia, too, largely as a eugenics measure. One of the early presidents of the ESA, the New York neurologist Foster Kennedy, actually opposed voluntary euthanasia for the terminally ill, but supported killing the “hopelessly unfit.” He stated, “I am in favor of euthanasia for those hopeless ones who should never have been born—Nature’s mistakes.” He proposed that if parents and physicians agreed, five-year-old “defective” children should be killed.(7)
One of the most famous scientists in mid-twentieth-century America, Alexis Carrel, promoted involuntary euthanasia. Carrell was a Nobel-Prize-winning biologist who was featured twice on the cover of Time magazine in the 1930s. In a 1935 article on “The Right to Kill,” Time reported, “The Rockefeller Institute’s famed Nobel Prizeman Alexis Carrel declared that sentimental prejudice should not obstruct the quiet and painless disposition of incurables, criminals, hopeless lunatics.”(8)
The most flagrant and shocking example of eugenics leading to involuntary euthanasia was the Nazi program to kill people with disabilities. The ideology underpinning this murderous program had been laid out in 1920 in a controversial book, Permitting the Destruction of Life Unworthy of Life, which was coauthored by the psychiatry professor Alfred Hoche and the law professor Karl Binding. In that book Binding stated that mentally ill people, whom he defined as “life unworthy of life,” are “not only absolutely worthless, but existences with negative value.” Binding and Hoche not only considered such people’s lives useless, but also warned that they were an economic burden on everyone else.(9) These ideas were controversial at the time, but nonetheless, a substantial number of German physicians and medical professors embraced them. This was not just a Nazi idea.
Soon after Hitler came to power in 1933, he pursued eugenics by introducing compulsory sterilization for those with congenital disabilities. The Nazis were very radical in carrying this out, sterilizing 350-400,000 people during their short time in power. Once he was at war with Poland, Britain, and France, he secretly directed his personal physician, Karl Brandt, and other Nazi officials to organize a massive program to kill people with disabilities. From early 1940 to August 1941 they killed about 70,000 Germans with disabilities in gas chambers in six facilities. Then they shut down these killing factories, but they continued the murderous rampage in a decentralized process at numerous asylums and hospitals. Ultimately about 200,000 Germans with disabilities, plus tens of thousands of others in German-occupied territories, were exterminated by the Nazi regime.
After the Nazi atrocities, public support for eugenics and euthanasia declined in the US and Europe. However, in the late twentieth century the euthanasia movement would experience a resurgence, beginning in the Netherlands and Belgium, and then spreading to the United States and Canada. While proponents touted this as bringing individual freedom, the reality is that society had to decide who was eligible to receive euthanasia or assisted suicide. Thus some of the same attitudes that had been so problematic in the earlier eugenics movement resurfaced: some people’s lives were deemed too valuable to receive euthanasia or assisted suicide, while others were deemed not so valuable. While anti-suicide programs are spending millions of dollars trying to discourage (some) people from killing themselves, other categories of people are being told: It’s not only OK for you to kill yourself, but we will help you do it.
Further, surveys of people in Oregon who have opted for assisted suicide show that such people are usually not doing it to escape pain and physical suffering. Rather, many of them are lonely and socially isolated. Further, many report that they no longer want to be a burden on society, which is precisely the way that the eugenics movement portrayed people with disabilities. In Canada some people with disabilities or medical problems have been urged by medical professionals or social workers to get euthanasia, showing that social pressure—sometimes subtle, sometimes overt—plays a role in euthanasia, too. It is not all about individual freedom and autonomy. The line between voluntary and involuntary starts to blur in many instances (and evidence suggests that in countries that have legalized voluntary euthanasia, physicians tend to be more open to providing involuntary euthanasia–secretly, of course, because technically, it is still illegal.
I understand fully that many proponents of euthanasia and assisted suicide today reject some aspects of the earlier eugenics movement. However, some of the problematic attitudes that fueled the eugenics movement in the late nineteenth and early twentieth centuries persist in the euthanasia movement. Wittingly or unwittingly, euthanasia advocates perpetuate the idea that human lives are unequal in value—and, just as in the eugenics movement, those considered inferior are those with disabilities or serious medical conditions. In addition these allegedly inferior people are being portrayed as (and often feel like) burdens to society who should “get out of our way.”
The way out of this downward spiral is for us hold firmly to the truth that all people are equal in value. Further, we need to offer love and compassion to those who are disabled, ill, or suffering, for that is what they really need. (By the way, I am the primary caregiver for my mother-in-law, who has dementia, so I am not just saying this glibly—I know what it means to sacrifice my time and energy to help a person with mental illness have a better life).
End notes:
(1) F. H. Bradley, “Some Remarks on Punishment,” International Journal of Ethics 4 (1894): 269-84; quotations at 272, 280, 281, 283-84.
(2) Ernst Haeckel, Natürliche Schöpfungsgeschichte, 2nd edition (Berlin, 1870), 152-55; quote at 155.
(3) Ernst Haeckel, Die Lebenswunder: Gemeinverständliche Studien über Biologische Philosophie (Stuttgart: Alfred Kröner, 1904), 21-22, 134-36.
(4) Friedrich Nietzsche, The Genealogy of Morals: An Attack, in The Birth of Tragedy and The Genealogy of Morals, trans. Francis Golffing (Garden City, NY: Doubleday Anchor, 1956), Essay 2, § 12, p. 210.
(5) Nietzsche, Will to Power, part 872, quoted in Jean Gayon, “Nietzsche and Darwin,” in Biology and the Foundation of Ethics, ed. Jane Maienschein and Michael Ruse (Cambridge: Cambridge University Press, 1999), 183.
(6) Friedrich Nietzsche, Die fröhliche Wissenschaft, in Werke in Drei Bänden, ed. Karl Schlechta (Munich: Carl Hanser, 1966), § 73, vol. 2, pp. 84-85.
(7) Foster Kennedy, “The Problem of Social Control of the Congenital Defective: Education, Sterilization, Euthanasia,” American Journal of Psychiatry 99 (1942): 13-16; quotes at 13, 14.
(8) “The Right to Kill,” Time 26, 21 (Nov. 18, 1935): 59.
(9) Karl Binding and Alfred Hoche, Die Freigabe der Vernichtung lebensunwerten Lebens. Ihr Mass und Ihre Form (Leipzig: Felix Meiner, 1920), 27-32.
Richard Weikart recently published a book entitled Unnatural Death: Medicine’s Descent from Healing to Killing.
This article has been reprinted with permission and can be found at alexschadenberg.blogspot.com/2024/09/euthanasias-past-and-present-connection.html.