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Friday, April 14, 2017

Brief History of Euthanasia in Germany.

When I read this I could see the similarities of the use of DNRs to hasten the death of those who have a poor quality of life.  Canadian Bill C-14 requires "foreseeable death" but a DNR does not. 

Spicer and his critics are historically off


My Passover holidays were interrupted by the news, shared by friends in the synagogue, that the press secretary to the president of the United States had just said that Syrian President Bashar Assad was worse than Adolf Hitler because Assad gassed his own people.
I was astounded and saddened by the comment referring to an event in the village of Khan Sheikhoun on April 4. Press Secretary Sean Spicer’s remark was not, as my distinguished colleague professor Deborah Lipstadt said in The New York Times, “anti-Semitism,” masked or real, but ignorance pure and simple, an ignorance that should disqualify one from so exalted a position.
My mood didn’t lighten as I read critique after critique discussing the murder of German Jews by gas in such “extermination camps,” to use the Nazi term for killing centers, such as Auschwitz and Treblinka.
Their critique overlooked the origin of Germans gassing their own population, which had nothing to do with Jews.
Forgive the history lesson, but permit me to explain.
Mass murder began with the death of a few individuals. In October 1939, Hitler signed an authorization permitting his personal physician and the chief of the Führer Chancellery to put to death those considered unsuited to live. He backdated it to Sept. 1, 1939, the day World War II began, to give it the appearance of a wartime measure. In the directive:
Reich leader Philip Bouhler and Dr. Brandt are charged with responsibility for expanding the authority of physicians, to be designated by name, to the end that patients considered incurable according to the best available human judgment of their state of health, can be granted a mercy killing.
What followed was the so-called euthanasia program, in which men, women and children who were physically disabled, mentally deficient or emotionally disturbed were systematically killed. They were termed “useless eaters” and “life unworthy of living.”
Within a few months, the T-4 program (named for Berlin Chancellery Tiergarten 4, which directed it) involved virtually the entire German psychiatric community. A new bureaucracy, headed by physicians, was established with a mandate to “take executive measures against those defined as ‘life unworthy of living.’ ”
A statistical survey of all psychiatric institutions, hospitals and homes for chronically ill patients was ordered. At Tiergarten 4, three medical experts reviewed the forms returned by institutions throughout Germany but did not examine any patients or read their medical records. Nevertheless, they had the power to decide life or death.
Patients who doctors decided should be killed were transported to six main killing sites: Hartheim, Sonnenstein, Grafeneck, Bernburg, Hadama, and Brandenburg. SS members and other health care personnel in charge of the transports donned white coats to keep up the charade of a medical procedure.
The first killings were by starvation: starvation is passive, simple and natural. Then injections of lethal doses of sedatives were used. Children were easily “put to sleep.” But gassing soon became the preferred method of killing; 15 to 20 people were killed in a chamber disguised as a shower. The lethal gas was provided by chemists, and the process was supervised by physicians. Afterward, black smoke billowed from the chimneys as the bodies were burned in adjacent crematoria. Communities adjacent to these facilities could see that smoke even in the heat of summer and they could smell the burning flesh.
Families of those killed were informed of the transfer. They were assured that their loved ones were being moved in order to receive the best and most modern treatment available. Visits, however, were not permitted. The relatives then received condolence letters, falsified death certificates signed by physicians, and urns containing ashes. There were occasional lapses in bureaucratic efficiency, and some families received more than one urn. They soon realized something was amiss.
A few doctors protested. Karl Bonhoeffer, a leading psychiatrist, worked with his son Dietrich, a pastor who actively opposed the regime, to contact church groups, urging them not to turn patients in church-run institutions over to the SS. (Dietrich Bonhoeffer was executed by the SS just before the end of the war.) A few physicians refused to fill out the requisite forms. Only one psychiatrist, professor Gottfried Ewald of the University of Göttingen, openly opposed the killing.
Doctors didn’t become killers overnight. The transformation took time and required a veneer of scientific justification. As early as 1895, a widely used German medical textbook made a claim for “the right to death.” In 1920, a physician and a prominent jurist argued that destroying “life unworthy of life” is a therapeutic treatment and a compassionate act completely consistent with medical ethics.
Soon after the Nazis came to power, the Bavarian minister of health proposed that psychopaths, the mentally deficient and other “insane” people be isolated and killed. “This policy has already been initiated at our concentration camps,” he noted. A year later, mental institutions throughout the Reich were instructed to “neglect” their patients by withholding food and medical treatment.
Pseudoscientific rationalizations for the killing of the “unworthy” were bolstered by economic considerations. According to bureaucratic calculations, state funds that went to the care of criminals and physically and mentally disabled persons living in institutions could be put to better use, for example by loans to newly married couples. Incurably sick children were seen as a burden for the healthy body of the Volk, the German people. In a time of war, it was not difficult to lose sight of the absolute value of human life. Hitler understood this. Wartime, he said, “was the best time for the elimination of the incurably ill.”
Historian and Auschwitz survivor Henry Friedlander traces the origins of the Final Solution to the “euthanasia” program. The murder of handicapped people was a prefiguration of the Holocaust. The killing centers to which the disabled were transported were the antecedents of the death camps. The organized transportation of the disabled foreshadowed mass deportation. Some of the physicians and other health care workers and hospital personnel as well as ordinary guards and mechanics who became specialists in the technology of cold-blooded murder in the late 1930s later staffed the death camps. All their moral, professional and ethical inhibitions had long been lost.
Psychiatrists, voluntary participants in the German “euthanasia” program, were able to save patients, at least temporarily, but only if they cooperated by sending others to their death.
Gas chambers were first developed at the “euthanasia” killing centers. The perpetrators cremated the dead bodies. In the death camps, the technology was taken to a new level: thousands could be killed at one time and their bodies burned within hours.
The Roman Catholic Church, which had not taken a stand on the “Jewish question,” protested the “mercy killing.” Count von Galen, the Bishop of Münster, openly challenged the regime, arguing that it was the duty of Christians to oppose the taking of human life even if this were to cost them their own lives. It seemed to have an effect.
On Aug. 24, 1941, almost two years after the “euthanasia” program was initiated, it appeared to cease. In fact, it had gone underground. The total number of people killed in the Nazi “euthanasia” program is estimated to have been between 200,000 and 250,000. The majority were Germans, but Poles and Soviet citizens of various nationalities were also among the victims.
The killing did not end; mass murder was just beginning. Physicians trained in the medical killing centers went on to grander tasks. Irmfried Eberl, a doctor whose career began in the T-4 program, became the commandant of Treblinka, where killing of a magnitude as yet unimagined would take place.
Again, gassing did not begin with the Jews; it began with Germans who found the presence of fellow Germans of special needs an embarrassment to the myth of the “master race” and an economic hardship. Hitler initiative the process but the participation of German society and even its elite psychiatric community was as widespread as is was essential.

MICHAEL BERENBAUM is a professor of Jewish studies and director of the Sigi Ziering Institute at American Jewish University.

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