Dr Robert Jay Lifton THE NAZI DOCTORS:
                        Medical Killing and the
                            Psychology of Genocide ©
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“Euthanasia”: Direct Medical Killing  
Binding’s section explored the doctor’s legal responsibility in “death assistance” (Sterbehilfe) and the “killing of the consenting participant,” and in the killing of “incurable idiots” unable to consent. He advocated a carefully controlled juridical process, with applications for killing evaluated by a three-person panel (a general physician, a psychiatrist, and a lawyer). A patient who had given his consent to be killed would have the right to withdraw that consent at any time, but there was also an emphasis on the legal protection of physicians involved in the killing process.4

Hoche, in his section, insisted that such a policy of killing was compassionate and consistent with medical ethics; he pointed to situations in which doctors were obliged to destroy life (such as killing a live baby at the moment of birth, or interrupting a pregnancy to save the mother). He went on to invoke a concept of “mental death” in various forms of psychiatric disturbance, brain damage, and retardation. He characterized these people as “human ballast” (Ballastexistenzen) and “empty shells of human beings” — terms that were to reverberate in Nazi Germany. Putting such people to death, Hoche wrote, “is not to be equated with other types of killing. . . but [is] an allowable, useful act” He was saying that these people are already dead.5

Hoche referred to the tremendous economic burden such people cause society to bear; especially those who are young, mentally deficient, and otherwise healthy and who would require a lifetime of institutionalization. He specifically medicalized the organic concept of the state by his insistence that “single less valuable members have to be abandoned and pushed out.” He added a striking note of medical hubris in insisting that “the physician has no doubt about the hundred-percent certainty of correct selection” and “proven scientific criteria” to establish the “impossibility of improvement of a mentally dead person.” But he ultimately revealed himself to be a biological visionary: “A new age will come which, from the standpoint of a higher morality, will no longer heed the demands of an inflated concept of humanity and an overestimation of the value of life as such.”6

The Binding-Hoche study reflects the general German mood during the period following the First World War. Hoche was considered a leading humanitarian and, in a 1917 article, had rejected medical killing. Shortly afterward, his son was killed in the war, and he was said to have been deeply affected by both his personal loss and the German defeat. Like many Germans then, he felt himself experiencing the darkest of times, and the book was an expression of personal mission and a call to national revitalization Indeed, from the time of Jost, war had been invoked by advocates of direct medical killing. The argument went that the best young men died in war, causing a loss to the Volk (or to any society) of the best available genes. The genes of those who did not fight (the worst genes) then proliferated freely, accelerating biological and cultural degeneration.  
Medical Killing and the
Psychology of Genocide

Robert J. Lifton
ISBN 0-465-09094
© 1986
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