Dr Robert Jay Lifton THE NAZI DOCTORS:
                        Medical Killing and the
                            Psychology of Genocide ©
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“unscientific” and therefore a professional and personal threat. A distinguished German psychiatrist I discussed these matters with characterized that mentality as “the doctrine of the absence of empathy”* To be sure, this mentality in itself does not inevitably lead to killing in the name of  “euthanasia”; there were psychiatrists who expressed empathy for their patients and yet became leaders in the “euthanasia” project: Carl Schneider, with his compassionate work-therapy program, is a case in point. Yet the general principle characterizes the psychiatric atmosphere within which medical killing could be readily embraced.†

If, at the heart of one’s professional identity, one becomes easily susceptible to the idea that mental patients — and possibly other groups as well — lack ordinary human qualities, and hence to the idea of eliminating that group in favor of the ostensible health of all others, one might also be more amenable to embracing a new “therapy” that shows itself to be in accord with one’s organic-genetic perceptions. In that way (as described in the epigraph to this chapter), many psychiatrists could harmonize with, even epitomize, the larger Nazi vision of curing by killing.

The second influential factor in German psychiatry was the traditional relationship of the profession to the state. Individual German psychiatrists had always identified themselves as servants of the state, rather than as independent practitioners. Mental institutions especially were part of the administrative structure of the state, and the same could even be said of university medical departments. The long-standing arrangement, when internalized and buttressed by German cultural stress on authority and obedience, made it difficult for individual psychiatrists to consider — or even imagine — defying the state when summoned to participate in virtually any kind of project.
* Walter Ritter von Baeyer, personal communication.

†One may carry the argument still further. During the period from the First World War (and before) to the Nazi epoch, there had been fierce battles in German psychiatry concerning the emerging school of psychoanalysis. While Freud had doubts about the efficacy of psychoanalytic treatment for schizophrenia, psychoanalysis in general stood for the principle of empathy: the psychoanalyst or psychiatrist is to enter the mind of the patient, to try to feel as the patient feels. Most German psychiatrists strongly opposed psychoanalysis. Among the most vehement of all was Alfred Hoche, the coiner of the concept of “life unworthy of life.” At a medical congress, Hoche went so far as to read a paper on psychoanalysis called “A Psychical Epidemic among Doctors. ”³ Psychiatrists like Hoche clearly felt their identity as physicians and scientists to be threatened by the spread of psychoanalysis. That sense of threat could well have intensified their commitment to their own credo — that of the doctrine of the absence of empathy. That credo contributed to the development of violent somatic treatment procedures (whatever their efficacy), such as insulin and metrazol shock therapy, electroshock therapy, and lobotomy. Under duress, those who held to the doctrine of the absence of empathy might have been more ready than otherwise to collaborate in killing their own patients.   
Medical Killing and the
Psychology of Genocide

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