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| "She did not want to be hugged or kissed. Her family felt they had lost her." Portrait Source |
The Washington Post recently ran this story: "A catatonic woman awakened after 20 years. Her story may change psychiatry."
In no way was this woman comatose, in any kind of a vegetative state, but the trend in many countries ‒ Canada is the most controversial example at present ‒ is for those with a mental illness to be dealt with by recourse to physician-assisted death even though it is a nonterminal condition. The point is that this woman might not have survived if her's was an unloving family and a vigorous euthanasia regime had taken hold.
According to one survey in the United States, being politically liberal and not religious gives rise to greater support for PAD-nonterminal cases in a variety of circumstances for the patient. Isn't this the trend in the world generally? The key element for decision-making was "quality of life" - the “perceived discrepancy between the reality of what a person has and the concept of what the person wants, needs, or expects” (Source). A materialistic outlook, holding there is no meaning in life beyond possessions and a high status as determined by others.
It is easy to transpose the reactions of a family with a member who survives in an indeterminate vegetative state in deciding to end the life of that member to the reactions of a family with a member in a long-term mentally disabling state in requesting a physician to end that member's life.
"April was unable to recognize, let alone engage with, her family. She did not want to be touched, hugged or kissed. Her family felt they had lost her." - The Washington Post.
A deeply relevant excerpt from a chapter in a 2022 book Bioethics and the Holocaust makes the point that mindset common within the present culture is markedly of a kindred kind to that under the cultural hegemony of the Nazis:
Today, physician-assisted suicide and/or euthanasia are legal in several European countries, Canada, several jurisdictions in the United States and Australia, and may soon become legal in many more jurisdictions. While traditional Hippocratic and religious medical ethics have long opposed these practices, contemporary culture and politics have slowly weakened opposition to physician-assisted suicide and euthanasia.
Our chapter examines how assisted suicide and euthanasia have been presented in cinema, one of the most powerful influences on culture, by Nazi propagandists during the German Third Reich and by Western filmmakers since the end of World War II.
Almost all contemporary films about assisted suicide and euthanasia, including six winners of Academy Awards, promote these practices as did Ich klage an (I Accuse) (1941), the best and archetypal Nazi feature film about euthanasia. The bioethical justifications of assisted suicide or euthanasia in both Ich klage an and contemporary films are strikingly similar: showing mercy; avoiding fear and/or disgust; equating loss of capability with loss of a reason to live; enabling self-determination and the right-to-die; conflating voluntary with involuntary and nonvoluntary euthanasia; and casting opposition as out-of-date traditionalism.
Economics and eugenics, two powerful arguments for euthanasia during the Third Reich, are not highlighted in Ich klage an and are only obliquely mentioned in contemporary cinema. One dramatic difference in the cinema of the two periods is the prominence of medical professionals in Ich klage an and their conspicuous absence in contemporary films about assisted suicide and euthanasia. A discussion of the medical ethos of the two time periods reveals how cinema both reflects and influences the growing acceptance of assisted suicide and euthanasia.
A point to take from that statement is how the cultural elite can direct social attitudes, as we see occurring in the push toward widespread acceptance of euthanasia.
Two films in the category discussed above, Amour (2012) and Million-Dollar Baby (2004), were sympathetic to euthanasia wherein both involved the murder on falsely based compassionate grounds of those deemed a victim of a loss of quality of life, but both instances were also intellectually dishonest. In the first, the elderly couple could have sought quality medical services such as a hospice; in the second, the death of a young woman was presented as the only supportive option, whereas, in fact, her immediate distress would most likely have turned to acceptance and the determination to make the best of the situation, given the character of that "heroine".
The terminology in this realm of human regression ‒ the only honest way of looking at the movement afoot ‒ is indicative of the threat to a God-less modern society:
Nonvoluntary euthanasia refers to the intentional termination of the life of a patient who lacks decision-making capacity, such as a child or a mentally incompetent adult, with either parental, guardian, or family concurrence or the presumptive consent of the patient. Involuntary euthanasia refers to the intentional termination of the life of a patient who objects, or whose loved ones object.
The authors of the Holocaust excerpt also point out that "withholding life-saving measures (sometimes confusingly dubbed “passive euthanasia”) should not be confused with either physician-assisted suicide or euthanasia". They note that in ethically appropriate cases of forgoing life-saving measures the intention is to avoid placing an excessive burden on the patient, to avoid dangerous or extraordinary actions, or any disproportionate to the expected outcome, which is imminent death. Here, one does not will to cause death; one’s inability to impede it is merely accepted. There is also the factor of acting to treat the patient's condition, such as a terminal patient in extreme pain, where the goal is not to end the life of the patient, even if death can be anticipated on account of the treatment, and this is according to the principle in ethics of double effect.
Hitler's stamp of approval
Once again referring to the chapter in Bioethics and the Holocaust, we are provided with the description of a book that was influential as Nazism took hold in Germany. The authors of the Holocaust text share this information:
In 1920, lawyer Karl Binding and psychiatrist Alfred Hoche wrote a short influential book The Permission to Annihilate Life Unworthy of Living. They argued that some lives were not worth living and promoted beneficent voluntary and nonvoluntary euthanasia for selected patients with incurable physical and/or mental disorders. Among their arguments in favor of euthanasia, two stand out. First, they argued that a higher morality should replace Western religions’ moral imperative to preserve life:
There was a time, now considered barbaric, in which eliminating those who were born unfit for life, or who later became so, was taken for granted. Then came the phase, continuing into the present, in which, finally, preserving every existence, no matter how worthless, stood as the highest moral value. A new age will arrive—operating with a higher morality and with great sacrifice—which will actually give up the requirements of an exaggerated humanism and overvaluation of mere existence. (Binding and Hoche 1920)Binding and Hoche also dismissed longstanding Hippocratic ethical objections to euthanasia: “The young physician enters practice without any legal delineation of his rights and duties-especially regarding the most important points. Not even the Hippocratic Oath, with its generalities, is operative today” (1920).
While imprisoned in 1924 for his failed Munich putsch, Hitler read Menschliche Erblichkeitslehre und Rassenhygiene (Human Heredity and Racial Hygiene) by Erwin Baur, Eugen Fischer, and Fritz Lenz (1921), the holder of the first chair in eugenics in Germany. The ideas in this book may well have provided Hitler with the basic substrate for the strange concoction of eugenics, anti-Semitism, politics, and violence that led Lifton (1986, 27) to describe National Socialism as a “biocracy.”
Hitler relied heavily on physicians to annihilate “life unworthy of life.” He told attendees at a 1929 Nazi Physicians’ League meeting that, if necessary, he could do without builders, engineers, and lawyers but that “you, you National Socialist doctors, I cannot do without you for a single day, not a single hour. If not for you, if you fail me, then all is lost. For what good are our struggles, if the health of our people is in danger?” (Proctor 1988, 64). In the same year, at the Nuremberg Party rally, Hitler praised Sparta’s policy of selective infanticide as a model policy (Welch 1983, 121).
Because physicians were pioneers, not pawns, in eugenics and euthanasia, they responded positively to Hitler’s flattery, incentives for academic and economic advancement, and opportunities to exercise power and gain prestige in his program of “Applied Biology” (Proctor 1988, 7). They willingly and enthusiastically chose to eliminate Jews from medicine, involuntarily sterilize nearly 400,000 German citizens to prevent transmission of their allegedly inferior genes, prohibit marriage and sexual relations between Aryans and non-Aryans, and, ultimately, murder nearly 200,000 people whose lives were considered not worth living.
The Nazi euthanasia programs began with an autonomous request directly from a family to Adolf Hitler to euthanize their child, Gerhard Herbert Kretschmar, who was blind, epileptic, physically disabled, and diagnosed as an “idiot”—it was approved (Schmidt 2002, 241–242). The Reich Committee for the Scientific Registration of Serious Hereditary and Constitutional Illnesses was created to secretly oversee the Children’s Euthanasia Program that claimed the lives of 5,000–7,000 children between 1939 and 1945 in 30 special children’s wards, most often by a nurse administering an overdose of tranquilizers (Hohendorf 2020a, 63–65).
The adult euthanasia program began in 1939 with the required registration of almost all patients in nursing homes and neuropsychiatric hospitals. The registration forms were sent to the recently formed Charitable Foundation for Institutional Care located at Hitler’s Chancellery whose address was Tiergartenstrasse 4, hence the name Aktion T4 for the adult euthanasia program. Three psychiatric experts reviewed the forms without examining the patients, and, together with the medical director of Aktion T4, initially psychiatrist Werner Hyde and, later, psychiatrist Paul Nitsche, selected which institutionalized patients were to be killed, primarily those deemed unable to do productive work and all Jews (Hohendorf 2020a, 65).
Patients selected for euthanasia were transported by the Charitable Society for the Transportation of the Sick from one transit institutions to another to obfuscate the program’s true purpose and to obscure the patients’ location from their families. Finally, the patients arrived at one of six killing centers in Germany and Austria where they were killed by physicians in gas chambers designed by physicians, chemists, and engineers according to Viktor Brack’s motto, “the syringe belongs in the hand of the physician” (Lifton 1986, 71; Sulmasy 2020, 229). Physicians then fabricated a cause of death for the death certificate that was sent to the patients’ families.
Significant public opposition to Aktion T4 arose after Clemens Count von Galen, the Bishop of Münster, addressed the issue of nonvoluntary euthanasia in an August 1941 sermon, which led to the end of the gassing but not the killing (Lifton 1986, 39). Some medical directors of institutions other than the six killing centers had already been starving their patients to death, and soon many more institutions were killing their patients by starvation, tranquilizers, neglect, exposure, and untreated infections in what was termed wild euthanasia (Hohendorf 2020a, 67). Nazi documents confirm 70,273 murders in the six killing centers, and the estimated number of murders during the period of decentralized euthanasia is between 90,000 and 130,000 (Friedlander 1995, 151–163).
The medical procedure for euthanizing large numbers of disabled persons in gas chambers became the preferred technique to implement “The Final Solution.” The bridge from gas chambers for eugenic euthanasia to gas chambers for mass murder was Operation (or “Special Treatment”) 14f13 (Lifton 1986, 135). Experienced Aktion T4 psychiatrists were enlisted to select “asocial” patients from concentration camps for “special treatment” in gas chambers at a euthanasia center, which “widened indefinitely the potential radius of medicalized killing” (Lifton 1986, 136). Thus, after considering several potential methods for the mass murder of Europe’s Jews, the Nazis chose gas chambers because “the technical apparatus already existed for the destruction of the mentally ill” (Proctor 1988, 207). Physicians like Josef Mengele, the “Angel of Death” at Auschwitz, selected and gassed many of the 4,500,000 Jews considered undesirable or useless.
An appeal to doctors of our time
A similar mentality is abroad these days:
Public Health Scotland on June 1 reported that there has been an 84% increase in the number of abortions where a baby has Down syndrome, from 32 in 2021 to 59 in 2022.
Overall, the number of abortions recorded in Scotland in 2022 was the highest number ever on record. The national statistics on abortion revealed an increase of 2,659 abortions — equal to 19.08% — in one year, with the number of abortions increasing from 13,937 in 2021 to 16,596 in 2022. Abortions are allowed only in the first 13 weeks of a baby's life.
The agency stated that abortion rates rose sharply in both the deprived areas and in the least deprived areas, but...
Socioeconomic inequality widened in the last ten years in Scotland: termination rates for those living in the most deprived areas are now more than double that of those living in the least deprived areas.
Societies certainly have to take more responsibility in the care of mothers and babies. Similarly, end-of-life decisions are bound to follow those relating to seeking an abortion as a solution to personal predicaments. To waylay such "inhumanity to man", adequate care of the elderly and incapacitated is a social imperative.
But to continue with the theme of how a mentality of acceptance of euthanasia and worse takes hold of a society, the chapter from Bioethics and the Holocaust we are studying has a comprehensive overview of euthanasia in the contemporary West. It makes shocking reading as the horrors of the European and American eugenics movement are seen to be coming to pass in our own time, including the incidence of “termination of life without an explicit request”. Once again, here is the link to the chapter.
The authors of this study give an explanation as to why they chose cinema as the focus for studying the change in social attitudes to euthanasia. What they say bout the relationship between cinema and the medical profession has horrendous implications for public safety, but which is being borne out in the medical profession's capitulation to activism in support of the unscientific transgender ideology. They write:
We have chosen in this essay to highlight the ways in which film presents assisted suicide and euthanasia. Understanding history is important, understanding the impact of culture on medical practice may be more important still. The medical ethos—the distinguishing character, sentiment, moral nature, or guiding beliefs of patients, health care professionals, medical organizations, or medical institutions—is derived from three interacting factions: medicine, culture, and government (Roelcke 2016, 183). In Western democratic countries, we contend that the cinema is one of the most powerful influences on culture, and therefore, is very influential in determining the medical ethos.
And they write:
Film was one of the National Socialist government’s most effective propagandistic media. Contemporary cinema, likewise, is a powerful cultural medium that encourages simple solutions to complex and emotional end-of-life dilemmas and has promoted assisted suicide and euthanasia in many films including six Oscar winners.
The authors conclude their study with an appeal to all practitioners in the medical field:
Western culture and governments are well along in the process of discarding three millennia of traditional Judeo-Christian medical ethics and two millennia of Hippocratism. Films both reflect the culture and help to shape it. Contemporary films regarding PAS and euthanasia, like their progenitors in the Nazi era, dismiss traditional medical ethics and, using strikingly similar arguments, present a new ethic. One result of this change in ethics is that today, as in mid-century Germany, we are witnessing a not-so-subtle “shift in emphasis in the basic attitude of the physicians” (Alexander 1949, 44). These changes are generating an ever-increasing demand for and supply of physician-assisted suicide and euthanasia.
We conclude by encouraging physicians to seriously engage with the questions raised by the striking similarity between Nazi and contemporary cinematic portrayals of physician-assisted suicide and euthanasia. This similarity is not a coincidence. It is not an accident. It should be a warning to all of Western society and a call for physicians to take a stand and speak up for the benefit of the medical ethos, the medical profession, and, vitally, all their patients.
Two key phrases: “termination of life without an explicit request”, which sounds so anodyne; and the concept of a "strong" versus "weak" medical profession, with the Western experience being that the profession's braying of its scientific professionalism is betrayed at just about every test.
NOTE: Nevada Governor Joe Lombardo has vetoed state law SB 239. which would have legalized assisted suicide in the state. Lombardo said assisted suicide is “unnecessary” due to improvements in palliative care and pain management.
Ω See also:
When Is It Morally Acceptable to Forego Life-sustaining Treatments?
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