Unlike Nazi medical experiments, euthanasia during the Third Reich is barely studied or taught. Often, even asking whether euthanasia during the Third Reich is relevant to contemporary debates about physician-assisted suicide (PAS) and euthanasia is dismissed as inflammatory. Physician-Assisted Suicide and Euthanasia: Before, During, and After the Holocaust explores the history of euthanasia before and during the Third Reich in depth and demonstrate how Nazi physicians incorporated mainstream Western philosophy, eugenics, population medicine, prevention, and other medical ideas into their ideology. This book reveals that euthanasia was neither forced upon physicians nor wantonly practiced by a few fanatics, but widely embraced by Western medicine before being sanctioned by the Nazis. Contributors then reflect on the significance of this history for contemporary debates about PAS and euthanasia. While they take different views regarding these practices, almost all agree that there are continuities between the beliefs that the Nazis used to justify euthanasia and the ideology that undergirds present-day PAS and euthanasia. This conclusion leads our scholars to argue that the history of Nazi medicine should make society wary about legalizing PAS or euthanasia and urge caution where it has been legalized.
Sheldon Rubenfeld is clinical professor of medicine at Baylor College of Medicine and executive director of the Center of Medicine after the Holocaust (CMATH).
Daniel P. Sulmasy is André Hellegers professor of biomedical ethics in the departments of medicine and philosophy and acting director of the Kennedy Institute of Ethics at Georgetown University.
List of Tables
Part I: The History of Physician-Assisted Suicide, Euthanasia and the Third Reich, and Their Current State of Affairs in Europe
1. On a Slippery Slope: The Historical Debate on Euthanasia in Germany
2. International and German Eugenics from ca. 1880 up to Post-World War II Period: Medical Expertise—Political Ambition—Relations to Euthanasia in the Nazi Context
3. Euthanasia in Nazi Germany: Children’s Euthanasia Program, Aktion T4, and Decentralized Killing
4. Ethics and Ideology for Future Doctors: How Nazi Values Were Taught in the German Medical Curriculum 1939–1945
5. A Protagonist’s View of Euthanasia in the Netherlands Today
Eduard (A.A.E.) Verhagen
6. The Case Against Physician-Assisted Suicide and Euthanasia
7. Palliative Medicine and the Debate on Physician-Assisted Death in Germany
H. Christof Müller-Busch
Part II. Physician-Assisted Suicide and Euthanasia After the Third Reich
8. Helping the Few: Historical Perspectives on Aid-In-Dying
9. Palliative Care, Hospice, and Last-Resort Options
Timothy E. Quill
10. Race and Physician-Assisted Death: Do Black Lives Matter?
Alan Elbaum and LaVera Crawley
11. Understanding the Role of Suffering in Legalized Physician-Assisted Dying
Robert A. Pearlman
12. Physician Countertransference and Patient Requests for a Hastened Death
Diane E. Meier
13. The Value of Life vs. the Principle of Autonomy
14. The Distinction Between Voluntary and Involuntary Euthanasia and the Critical Role of Eugenics
15. Euthanasia Old and New: Lives Not Worth Living and Unequal Respect for Autonomy
Scott Y. H. Kim
16. Can a Person Ever Be “Not Useful”? A Critical Analysis of the Anthropological Roots of Euthanasia Under National Socialism and Today
Ashley K. Fernandes
17. The Best Physicians Are Destined for Hell
18. Pediatric Euthanasia: A Call for Civil Disobedience
19. “The Syringe Belongs in the Hand of a Physician”
Power, Authority, Control, Death, and the Patient-Physician Relationship
Daniel P. Sulmasy
About the Contributors
Physician-Assisted Suicide and Euthanasia offers thoughtful reflections of a group of scholars and palliative care physicians on involuntary euthanasia of “defective” persons, a concept that was endorsed by a large percentage of physicians in the Third Reich. While they are mostly successful in distinguishing this eugenics-based practice from contemporary PAD, some envision a slippery slope by which safeguards will decrease and nonautonomous persons will qualify for PAD in their own “best interest.” This is a stimulating, but sobering, book.
This is, at once, both a deeply engaging and deeply unsettling book. It is a rigorous and nuanced exploration of the complex topic of contemporary physician-assisted suicide and euthanasia as seen through the shadow of the Holocaust. It forces the reader to account for the dignity of the person and what it means to be human. This important book will long be discussed.
Physician-Assisted Suicide and Euthanasia: Before, During, and After the Holocaust is an erudite and timely volume that refracts the history of state-sponsored killing during the Third Reich against the contemporary debate over euthanasia and physician-assisted suicide. Rubenfeld and Sulmasy are to be commended for bringing together a stellar group of European and American scholars on both sides of the issue. Collectively they draw upon their expertise in the history of medicine, medical ethics, philosophy, and palliative care to inform and elevate the debate beyond the usual polemics. This brilliant anthology constitutes an enduring contribution to the literature.
What lessons does the Nazi experience of euthanasia and eugenics have for the contemporary debate about legalizing so-called 'physician-assisted dying'? As this timely, valuable and disturbing book shows, more than many might think.