Tom is a Research Fellow at Newcastle University. His non-fiction books include Genetics Politics: from Eugenics to Genome and The Sexual Politics of Disability.
Lessons from history
16th January 2005
Yet the enormity of Nazi eugenics and euthanasia - and the wider Holocaust for which they paved the way - should not obscure the fact that eugenic sentiments were ubiquitous in the years before 1945. Nor should revulsion from these horrors lead us to make trite analogies with contemporary issues at the beginning and end of life.
"On the towpath we met and had to pass a long line of imbeciles ... It was perfectly horrible. They should certainly be killed." This diary entry by the novelist Virginia Woolf, written in January 1915, is a chilling reminder that eugenic prejudice was common across the political spectrum in Europe and America in the first half of the twentieth century. A few years earlier, Winston Churchill had advocated compulsory sterilisation of "the feeble minded and insane classes". It may never have become official British policy, but eugenic sterilisation was enthusiastically adopted by many US states, all the Nordic countries, and many other nations in the 1920s and 30s. In some places it continued until the 1960s.
Nazi eugenics was explicitly modelled on American initiatives, and was promoted primarily as a way of saving money by eliminating costly asylums and residential hospitals. Immoral medical experiments - for which the Nazis were notorious - were not confined to Germany. The infamous Tuskegee experiment, which took place for forty years between 1932 and 1972, allowed a group of African American men to degenerate from syphilis to gain "scientific data". The history of medicine shows that institutionalised children have often been used as guinea pigs for experiments - for example in the case of tuberculin tests on American orphans in 1909 and 1912 and polio vaccine trials in the 1930s. In Sweden, a physician advocated experimenting on institutionalised children as they were "cheaper than calves".
Doctors played a central part in the Nazi eugenics and euthanasia programs, as well as these other twentieth century abuses. But it should be remembered that lawyers, carers, religious organisations and family members were also complicit in the removal of vulnerable disabled people, and hundreds of ordinary administrators and workers were involved in the bureaucracy of genocide. The Nazi experience demonstrates that, in certain circumstances, ordinary people will willingly participate in atrocities and ignore basic human rights. Stanley Milgram's psychological experiments proved that most individuals were willing to abuse others, if the instruction came from an authority figure. More recent atrocities in Rwanda, the former Yugoslavia and Sudan show that awareness of human rights has not changed basic human psychology. The most important lesson of the Nazis is about our capacity to distance ourselves from other human beings and their suffering.
Some pro-life and disability rights campaigners have argued that genetic screening is a throwback to the abuses of the Nazi past. In my opinion, the comparison is not valid, and the use of terms like 'fascist' and 'Nazi' is misleading and dangerous polemic. These labels stop people thinking about difficult questions. The practice of antenatal screening can be problematic, particularly when it is based on inadequate information or covert pressure, but I support the right of individuals to make choices about their pregnancies, including abortion. The doctors and nurses with whom I work are not Nazis, and it is insulting to use these labels to demean their professionalism, or to gloss over the difficult dilemmas which some parents encounter.
At the other end of life, recent proposals about assisted suicide have also been attacked using the Nazi analogy. However, I think this is scaremongering. The point of the Joffe Bill (Assisted Dying for the Terminally Ill) is to enable people in the last stages of terminal illness to make choices about how they want to die. It is not an attempt to kill disabled people against their will.
I support the rights and choices of disabled people at every stage of our journey through life, including our views on how we wish to die if we decide that living has become unbearable. Recent research shows that a large percentage of disabled people support the legalisation of assisted suicide, within carefully controlled circumstances. There are a range of views within the disability community on both these subjects, but we should debate such bioethical issues using good evidence and careful argument.
I do not believe that the Nazi analogy is relevant to state policy and professional practice in democratic countries. However, it will always tell us something important about our own capacity for moral distancing and cruelty, which is why we should never forget the Holocaust and its victims.
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