Healing by Killing: Medicine in the Third Reich

1. Healing by Killing: Medicine in the Third Reich

2. Part II. Eugenics: Healing by Killing in America and Germany • Eugenics: definition • A conflict of visions • Jewish values • Greek values • History of Eugenics in the Western World, primarily America and Germany

3. Eugenics • Oxford English Dictionary (OED) defines eugenics as “the science [sic] dealing with factors that influence the hereditary qualities of a race and with ways of improving these qualities, especially by modifying the fertility of different categories of people.” • German eugenics = racial hygiene • Positive eugenics: encourages the transmission of more desirable genetic traits. • Negative eugenics: discourages the transmission of less desirable genetic traits.

4. Eugenics (contd) • Practical positive eugenics or positive racial hygiene: • Encourages medical care and procreation for the superior races. • Practical negative eugenics or negative racial hygiene: • Discourages even inexpensive medical care and procreation for the inferior races.

5. Eugenics (contd) • A selective historical review is useful for the understanding of eugenics during the Third Reich and in America today: • A conflict of visions • Jewish values • Greek values • History of the Western World, primarily America and Germany, as it relates to eugenics.

6. Eugenics (contd) • Thomas Sowell: A Conflict of Visions: Ideological Origins of Political Struggles • At the core of every moral code there is a picture of human nature, a map of the universe, and a version of history. To human nature (of the sort conceived), in a universe (of the kind imagined), after a history (so understood), the rules of the code apply. • Walter Lippman: Public Opinion

7. Eugenics (contd) • An overly simple but useful distinction can be made between the unconstrained (or romantic) and the constrained (or classical) visions, which differ in major ways: • The nature of man • Trade-offs versus solutions • Social morality and social causation • Leadership

8. Eugenics (contd) • The nature of man • Unconstrained vision (e.g. William Godwin’s 1793 Enquiry Concerning Political Justice): • The intention to benefit others is “of the essence of virtue.” • Man is capable of feeling other people’s needs as more important than his own, and therefore of consistently acting impartially, even when his own interests or those of his family were involved. • Socially contrived incentives are disdained as unworthy and unnecessary expedients and our efforts should be bent to have people do what is right because it is right, not because of psychic or economic payments.

9. Eugenics (contd) • The nature of man • Constrained vision (e.g. Adam Smith’s 1759 Theory of Moral Sentiments): • Man’s moral limitations in general and his egocentricity in particular are inherent facts of life, the basic constraint in this vision. • The fundamental moral and social challenge is to make the best of the possibilities which exist within that constraint, rather than dissipate energies in an attempt to change human nature. • The goal is to determine how the moral and social benefits desired can be produced in the most efficient way within that constraint.

10. Eugenics (contd) • Sowell: “Clearly a society cannot function humanely, if at all, when each person acts as if his little finger is more important than the lives of a hundred million other human beings.” • Over 100 million people met a violent death in the twentieth century, 5 times as many as in the 19th century, and more than 10 times as many as in the 18th century. More than 60 million of these 100 million men, women, and children who met a violent death were victims of mass killing or genocide, all of which were man-made events.

11. Eugenics (contd) • Trade-offs versus solutions • Unconstrained vision: • Since man is “perfectible” then “solutions,” when it is no longer necessary to make a trade-off, even if the development of that solution entailed costs now past, are possible. • The goal of achieving a solution is what justifies the initial sacrifices or transitional conditions which might otherwise be considered unacceptable. • Condorcet anticipated the eventual “reconciliation, the identification, of the interests of each with the interests of all”—at which point, “the path of virtue is no longer arduous.”

12. Eugenics (contd) • Trade-offs versus solutions • Constrained vision: • Since man is not “perfectible,” the careful weighing of trade-offs or prudence, is all that we can hope for. • Burke said that “prudence is “the first of all virtues” and “nothing is good but in proportion and with reference.”

13. Eugenics (contd) • Social morality and social causation • Unconstrained vision: human actions are dichotomized by Godwin into the beneficial and the harmful, and each of these in turn was dichotomized into the intentional and the unintentional.

14. Eugenics (contd) • Social morality and social causation • Constrained vision: In Adam Smith’s work, especially in his Wealth of Nations, the missing category in Godwin’s table is central: • The economic benefits to society produced by the capitalist were “no part of his intention(s)”, which were “mean rapacity.” • Intentions are irrelevant. • What matters are the systemic characteristics of a competitive economy or of a society, which produce social benefits from unsavory individual intentions.

15. Eugenics (contd) • Social morality and social causation • Unconstrained vision: • If human options are not inherently constrained, then the great evils of the world—war, poverty, and crime—cry out for explanations and for solutions. • Believers in the unconstrained vision seek the special causes of war, poverty, and crime. • There are no intractable reasons for social evils and therefore no reason why they cannot be solved, with sufficient moral commitment.

16. Eugenics (contd) • Social morality and social causation • Constrained vision: • If the limitations and passions of man himself are at the heart of these painful phenomena—war, poverty, and crime—then what requires explanation are the ways in which they have been avoided or minimized. • Believers in the constrained vision seek the special causes of peace, wealth, or a law-abiding society. • Whatever artifices or strategies restrain or ameliorate inherent human evils will themselves have costs, some in the form of other social ills created by these civilizing institutions, so that all that is possible is a prudent trade-off.

17. Eugenics (contd) • Leadership • Unconstrained vision • There exist intellectual and moral pioneers who lead humans toward ever-higher levels of understanding and practice. • These pioneers become surrogate decision-makers, pending the eventual progress of mankind to the point where all can make social decisions. • A transitional period of draconian measures, during which the leader may be exempted from either systemic or organized social constraints, may be necessary to achieve the desired social goals, usually an equality of outcome.

18. Eugenics (contd) • Leadership • Constrained vision • There is no human capability to deliberately plan and execute social decisions for the common good (although there exist vast differences within areas of specialization e.g. medicine, there is no general superiority of one group over another). • Evolved systemic processes—tradition, values, families, markets, for example—lead to the preservation and advancement of human life. • Freedom is more important than equality of outcome so that inequality of outcome does not justify imposition of draconian measures by leaders (who will promote their own interests).

19. Healing by Killing: Medicine in the Third Reich Sheldon Rubenfeld, M.D. Clinical Professor of Medicine Baylor College of Medicine

20. Course Outline • Medicine in Germany during the Third Reich (1933-1945) • Eugenics: Healing by Killing in America and Germany • Medicine after the Holocaust: From the Master Race to the Human Genome and Beyond.

21. Part I. Medicine in Germany during the Third Reich (1933-1945) • Sterilization Law • Nuremberg Laws • Child Euthanasia • T4 Program • Wild Euthanasia • Operation 14f13 • The Final Solution • Medical Experiments • Cover-up

22. Summary of medicine during the Third Reich (1933-1945) • More than 38,000 physicians, almost half of all doctors in Germany, had joined the Nazi party by war’s end. • More than 7% of all physicians were members of the SS, compared with less than 0.5% of the general population. • German physicians, nurses, other medical personnel, public health officials, and biomedical scientists accomplished the following:

23. Summary (contd) • More than 6,000,000 Jews selected and killed. • 400,000 German patients selected and sterilized. • 5,000 German children selected and euthanized. • 200,000 German adults selected and euthanized. • Only 15% of patients in German mental hospitals at the start of World War II survive. • Cruel, and murderous medical experiments on thousands of concentration camp inmates. • Only 23 physicians, bioscientists, administrators, and public health officials tried at Nuremberg.

24. Gen. Telford Taylor’s Indictment

25. Sentencing of Dr. Karl Brandt

26. Course Outline • Medicine in Germany during the Third Reich (1933-1945) • Eugenics: Healing by Killing in America and Germany • Medicine after the Holocaust: From the Master Race to the Human Genome and Beyond.

27. Part II. Eugenics: Healing by Killing in America and Germany • Eugenics: definition • A conflict of visions • Jewish values • Greek values • History of Eugenics in the Western World, primarily America and Germany

28. Eugenics • Oxford English Dictionary (OED) defines eugenics as “the science [sic] dealing with factors that influence the hereditary qualities of a race and with ways of improving these qualities, especially by modifying the fertility of different categories of people.” • German eugenics = racial hygiene • Positive eugenics: encourages the transmission of more desirable genetic traits. • Negative eugenics: discourages the transmission of less desirable genetic traits.

29. Eugenics (contd) • Practical positive eugenics or positive racial hygiene: • Encourages medical care and procreation for the superior races. • Practical negative eugenics or negative racial hygiene: • Discourages even inexpensive medical care and procreation for the inferior races.

30. Eugenics (contd) • A selective historical review is useful for the understanding of eugenics during the Third Reich and in America today: • A conflict of visions • Jewish values • Greek values • History of the Western World, primarily America and Germany, as it relates to eugenics.

31. Eugenics (contd) • An overly simple but useful distinction can be made between the unconstrained (or romantic) and the constrained (or classical) visions, which differ in major ways: • The nature of man • Trade-offs versus solutions • Social morality and social causation • Leadership

32. Eugenics (contd) • A selective historical review is useful for the understanding of eugenics during the Third Reich and in America today: • A conflict of visions • Jewish values • Greek values • History of the Western World, primarily America and Germany, as it relates to eugenics.

33. Jewish Values “The Jews started it all—and by “it” I mean so many of the things we care about, the underlying values that make all of us, Jew and gentile, believer and atheist, tick. Without the Jews we would see the world through different eyes, hear with different ears, even feel with different feelings. And not only would our sensorium, the screen through which we receive the world, be different: we would think with a different mind, interpret all our experiences differently, draw different conclusions from the things that befall us. And we would set a different course for our lives.” Thomas Cahill: The Gift of the Jews

34. Jewish Values (contd) • “God said, ‘Let us make a human in our image, as our likeness.”…And thus God created the human being in His image. In the image of God, he created the human being; male and female, He created them.’” (Exodus 1:26-27) • In Jewish thought, the human body and soul are both sacred, both created by God and must function in harmony to fulfill God’s purposes in the world. • “He who saves one life…it is as if he saves an entire universe. He who destroys life…it is as if he destroys an entire universe.” (Mishna, Sanhedrin 37a)

35. Jewish Values (contd) • “See I have put before you today life and death, blessing and curse and you shall choose life so that you and your seed shall live.” (Deut 30:19) • Practically speaking, this means: • No child sacrifice. • Strict limitations on abortion. • No euthanasia. • No culture of death. • This is a constrained or classical view of humanity, which quickly came into conflict with the unconstrained view as exemplified by Pharaoh.

36. Jewish Values (contd) • Biblical eugenics: • A new king arose over Egypt, who did not know of Joseph. • “Behold! The people, the Children of Israel are more numerous and stronger than we.” • The king of Egypt said to the midwives of the Hebrews, “When you deliver the Hebrew women, and you see them on the birthstool, if it is a son, you are to kill him, and if it is a daughter, she shall live.”

37. Greek Values • Thomas Cahill in Sailing the Wine Dark Seas: Why the Greeks Matter notes that the Greeks taught us: • How to fight: the warrior in Homer’s Iliad • How to feel: the wanderer in Homer’s the Odyssey • How to party: the poet in Hesiod’s Theogony • How to rule: the politician and the playwright in Aeschylus’ trilogy of plays, the Oresteia • How to think: the philosopher (lover of wisdom) in Plato’s the Republic • How to see: the “Kritian boy” and other erotic nudes

38. Greek Values (contd) • Aristotle argued in his Politics that killing children was essential to the functioning of society. He wrote, “There must be a law that no imperfect or maimed child shall be brought up. And to avoid an excess in population, some children must be exposed. For a limit must be fixed to the population of the state.” • Infanticide (Oedipus Rex by Sophocles) • Perfection sought in athletic contests, such as the Olympic games (re: Rome, see Gladiators)

39. Greek Values (contd) • Plato, referring to Asclepius, the Greek god of medicine and healing, says in The Republic, “But he makes no attempt to cure those whose constitution is basically diseased by treating them with a series of evacuations and doses which can only lead to an unhappy prolongation of life, and the production of children as unhealthy as themselves. No, he thought no treatment should be given to the man who cannot survive the routine of his ordinary job, and who is therefore of no use either to himself or society.”

40. Greek Values (contd) • Hippocratic Oath: • Invocation of ancient Greek deities. • Relationship to teachers and other physicians. • The end is benefit to the sick; do no harm. • No euthanasia or abortions, even if asked. • Consult those with greater expertise. • No voluntary injustice, mischief, or sexual deeds. • Patient privacy. • Covenant and (almost a) prayer.

41. Greco-Roman values meet Jewish values • To the Greek, the beautiful is holy. • To the Jew, the holy is beautiful. • Revolt of the Macabees against the Hellenization of Israel in 167 B.C.E. (Channukah). • The Great Revolt of the Jews against Roman rule, which began in 63 B.C.E. The revolt of 66 C.E. ended with the destruction of the Second Temple and the mass suicide atMassada. • The Bar-Kokhba Revolt of 132-135 C.E. ended with the destruction of Jerusalem and the exile of much of the Jewish population of Judea.

42. Greco-Roman values meet Judeo-Christian values • To the Greek, the beautiful is holy. • To the Jew, the holy is beautiful. • Christianity and Judaism were antagonistic until Judeo-Christian became a meaningful term with the founding of America.

43. Part II. Eugenics: Healing by Killing in America and Germany • Eugenics: definition • A conflict of visions • Jewish values • Greek values • History of Eugenics in the Western World, primarily America and Germany

44. Eugenics (contd) • Enlightenment and Emancipation in Europe • Europeans declared that liberty was contingent upon “reason,” a faculty shared unequally by different races and genders. • Jews were emancipated from European ghettos and given many rights. • Nationalistic movements arose e.g. the German Volk or (superior) nation, people, or race. • The Founding of America on two wings • The secular enlightenment. • The God of Israel championed by the nation’s first Protestants.

45. Eugenics (contd) No Christian community in history identified more with the People of the Book than did the early settlers of the Massachusetts Bay Colony, who believed their own lives to be a literal reenactment of the Biblical drama of the Hebrew nation. They themselves were the children of Israel; America was their Promised Land; the Atlantic Ocean their Red Sea; the Kings of England were the Egyptian pharaohs; the American Indians the Canaanites (or the Lost Ten Tribes of Israel); the pact of the Plymouth Rock was God’s holy Covenant; and the ordinances by which they lived were the Divine Law. Like the Huguenots and other Protestant victims of Old World oppression, these émigré Puritans dramatized their own situation as the righteous remnant of the Church corrupted by the “Babylonian woe,” and saw themselves as instruments of Divine Providence, a people chosen to build their new commonwealth on the Covenant entered into at Mount Sinai. Gavriel Sivan, The Bible and Civilization

46. Eugenics (contd) • Hebrew and Bible studies were required courses at Yale, Harvard, William and Mary, Rutgers, Princeton, Brown, Kings College (later Columbia), Johns Hopkins, Dartmouth, etc. • The seals of Yale, Columbia, and Dartmouth contain Hebrew words or phrases. • The first design of the official seal of the United States, recommended by Benjamin Franklin, John Adams and Thomas Jefferson in 1776, depicts the Jews crossing the Red Sea. The motto around the seal read, “Resistance to Tyrants is Obedience to God.”

47. Eugenics (contd)

48. Eugenics (contd) • The inscription on the Liberty Bell is a direct quote from Leviticus: “Proclaim liberty throughout the land.” • Dr. Benjamin Rush, in his editorials denouncing the Tea Act, drew inspiration from the Hebrew Bible: “What did Moses forsake and suffer for his countrymen! What shining examples of patriotism do we behold in Joshua, Samuel, Maccabees and all the illustrious princes, captains and prophets among the Jews.”

49. Eugenics (contd) • The basic framework of America, the Declaration of Independence, reflects the influence of the Bible and the power of Jewish ideas in shaping the political development of America: “We hold these truths to be self-evident that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among them are the life, liberty, and the pursuit of happiness.” • By many measures, America is the most religious democratic country in the world today.

50. Eugenics (contd) • “The Republic of the Israelites an Example to the American States.” A sermon preached by Samuel Langdon, D. D., at Concord in the State of New Hampshire before the Honorable General Court at the Annual Election. June 5, 1788. • Republic: a state in which the supreme power rests in the body of citizens entitled to vote and is exercised by representatives chosen directly or indirectly by them. • Federalism: the distribution of power in an organization (as a government) between a central authority and the constituent units.