While researching the euthanasia issue recently, I came across an article, now forty years old, that deserves widespread consideration even today. Called “Medical Science under Dictatorship,” it was published in the New England Journal of Medicine in July 1949. Written by psychiatrist Leo Alexander, the article discussed the atrocities committed in Germany during World War II and how Nazi propagandists manipulated public opinion and conscience to pave the way for such appalling crimes.
Dr. Alexander, along with other post-war investigators, believed that the horrendous war crimes became possible after the attitudes of people had been changed through less obviously horrible practices. “It started,” he wrote, “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.
The small beginnings of a Nazi holocaust were the killing of the chronically ill, the mentally disturbed and the infirm aged. With chilling efficiently, the bureaucratic organizations in charge of the extermination programmes were given euphemistic names. People in institutions were channeled through the “Realm’s Work Committee of Institutions for Cure and Care.” Children came under the “Realm’s Committee for Scientific Approach to Severe Illness Due to Heredity and Constitution.” The “Charitable Transport Company for the Sick” transported the victims to their deaths. The “Charitable Foundation for Institutional Care” had the job of “collecting the cost of the killings from the relatives, without, however, informing them what the charges were for; in the death certificates the cause of death was falsified.
Any number of parallels will spring to mind when reading that public opinion was manipulated through the media. A movie called “I Accuse” was about euthanasia. Writes Alexander, “This film depicts the life history of a woman suffering from multiple sclerosis; in it her husband, a doctor, finally kills her to the accompaniment of soft piano music rendered by a sympathetic colleague in an adjoining room.”
High school children were propagandized through what we today call values clarification techniques. A mathematics textbook included problems “stated in distorted terms of the cost of caring for and rehabilitating the chronically sick and crippled. One of the problems asked, for instance, how many new housing units could be built and how many marriage allowance loans could be given to newly wedded couples for the amount of money it cost the state to care for “the crippled, the criminal and the insane.”
The “small beginnings” of today’s holocaust have been apparent for some time. When abortion was legalized in Canada in 1969 it was supposed to be permissible only under certain circumstances. No pro-lifer needs to be reminded how quickly that law became a sham. Today there is little outcry when anencephalic babies are kept alive to provide “spare parts” for others, indeed, the majority opinion seems approving. When an abortion-provoking pill (manufactured by a company controlled by the huge conglomerate that made the cyanide gas for the Nazi death camps), is taken off the market in Europe following worldwide protest, a government orders the company to resume production. Elderly people and disabled newborns are starved to death in hospitals – because food and water is now classified as “extraordinary” treatment. All the signs are present, and have been for some time.
Forty years ago, Leo Alexander wrote that the “enormity” of an anti-life movement was present in North America. He believed however, that a democracy would not follow the same path as a dictatorship and that the goals of such a movement would not be achieved. Dr. Alexander had served as an expert consultant at the Nuremburg War Crimes Trials in 1947. It must have seemed totally impossible to him that a civilized society would ever ignore the evidence of what can come to pass from “small beginnings.”
However, Leo Alexander lived long enough to see that the unthinkable had become a reality. Village Voice journalist Nat Hentoff recently reported that Dr. Alexander had been very disturbed by an article that he read in the New England Journal of Medicine in April 1984. This article, “The Physician’s Responsibility Toward Hopelessly Ill Patients,” was written by 10 respected doctors. Writes Hentoff, “With courtly expressions of great sympathy, these healers advocated the withdrawal of artificially administered nutritional support, including fluids, from various kinds of patients, such as those seriously and irreversibly demented. They were to be starved to death.
On reading this article, Alexander is said by Hentoff to have turned to a friend and remarked, “It is much like Germany in the 20s and 30s. The barriers against killing are coming down.” Dr. Alexander was being too gentle: the barriers against killing have come down. It is up to each one of us to do something to build them up again.