The Legacy of Nazi Medicine
Toward the beginning of “Deadly Medicine: Creating the Master Race,” the U.S. Holocaust Memorial Museum’s new exhibit on German eugenics, there is an illustration of Adolf Hitler bending over to face a smiling apron-clad farmgirl. He holds her wrist in what initially seems like an effort to draw the girl near. But a closer look reveals that he is taking her pulse. The caption is startling: “Adolf Hitler as the Doctor of the German Nation.”
The exhibit, which opened this April, focuses on the period from 1933 to 1945. It traces the rise of “positive eugenics” in Germany’s public health campaigns, to the forced sterilization programs, to the euthanasia of mentally and physically disabled children and adults, to the inhuman experiments on Jews and other prisoners in Nazi concentration camps. It shows how the eugenic idea took hold of German scientists and the German public, and how it degenerated to the systematic use and slaughter of the “unfit” in the Final Solution.
The exhibit begins with a life-size, anatomically correct, glass model of a male, whose organs, muscles, and bones can be seen through a clear plastic skin. His arms are outstretched as if in prayer, and his head is tilted upward to appear just the way he would have to visitors of the German Hygiene Museum in the 1930s. This fascination with the workings of the human body — in the original, the different organs lit up as different buttons were pressed — is a consistent theme throughout the exhibit. One video shows a model of the body, sliced up in horizontal sections, moving together and apart in slow motion. Another film, from the 1930s, is about the “miracle” of the human body and ends with the invocation — “O Health.” The goal of perfecting and glorifying the human form was a German obsession in the years leading up to the Nazi regime. Its legacy was treating some human beings as animals for experiments — to be poked, prodded, used, and murdered.The Eugenic Seduction
To understand the rise of eugenics in Germany, one must know something about the miseries of German life between the wars. The exhibit includes pictures of the millions of German graves left after World War I, along with information about the declining birthrate, the economic depression, and the loss of Germany’s colonies in the Treaty of Versailles — all contributing to a sense of doom among the population. In the 1920s and 1930s, science was increasingly seen as a potential savior, able to provide an antidote to the suffering, death, and destruction brought about by the war. Advances in industry, medicine, and the fledgling science of genetics promised extraordinary scientific breakthroughs and new pathways to human improvement. Though many now look back on this period as an ominous sign of things to come, “Deadly Medicine” shows how the new science brought hope to a devastated population, with pictures of crowds flocking to eugenic exhibitions.
At universities and hospitals, researchers in psychology, anthropology, and biology began to play fast and loose with science. They extended theories about individual biology into theories about entire populations, and turned ideas about the evolution of animal species into recipes for better human breeding. These scientists suggested that the “Nordic” population was headed for “extinction,” and that its only chance for survival lay in strengthening and purifying its race. It is alarming to see how quickly these ideas trickled down into high school and college textbooks. In one characteristic textbook page, the heads of individuals from different races are shown in profile, and the descriptions underneath give the distinct impression that these skulls represent different species.
The tools of this trade are scattered throughout the exhibit — calipers for measuring head size, eye and hair color charts, and a device that looks fit for torture that was used to make subjects sit up straight for measurements. During the early part of the century, German scientists used these tools to undertake extensive surveys of different racial populations for general anthropological purposes. Once the Nazis took power, the state even began to sponsor trips to search for the Aryan roots of the population. One trip to Tibet, which was extensively filmed, shows scientists doing face moldings of the natives. They produced highly detailed racial maps, using different colors to show the predominance of different human types in various geographic regions. The eugenic theories of these scholars were accompanied by some actual science, and at times a visitor to the exhibit could be forgiven for mistaking which is which.
The German people were encouraged to diagram their family trees and exhorted not to marry into a “diseased” family. “Don’t Go Blindly into Marriage!” reads the title of a 1924 public health poster showing a man and woman walking blindfolded over the edge of a cliff. The pseudo-religious overtones of the scientific movement reappear in “The Ten Commandments of Marriage,” with instructions to marry only “Nordic people” and to avoid mates with hereditary illnesses in their families.
Other posters from the time emphasize the burden that the mentally and physically disabled place upon society as a whole. A picture from a Nazi-era high school biology textbook shows a German man struggling under the weight of a barbell, with a smallish Neanderthal-looking creature on each side. “You Are Sharing the Load,” reads the title. “A hereditarily ill person costs 50,000 reichsmarks on average up to the age of sixty.”
Eugenics, of course, was not only a German phenomenon. A surprising number of countries embraced racial theories, including the goal of creating a more “pure” population. Pictures and movies from Japan, Brazil, and the Soviet Union give some sense of the breadth of the eugenic movement. The Soviet Union held “healthy baby contests,” while Great Britain seriously considered a national voluntary sterilization law (patient consent would supposedly have been sought) in the early 1930s.
Another panel in the exhibit displays Supreme Court Justice Oliver Wendell Holmes, Jr.’s famous majority opinion in the 1927 case Buck v. Bell, upholding a forced sterilization law in Virginia. Holmes famously concluded that Carrie Buck, who was deemed the “feebleminded” product of a mother who was not of very hearty stock, could be sterilized along with her daughter. As the opinion famously declared, “three generations of imbeciles are enough.”
By 1931, 28 states had compulsory sterilization laws — indeed, the image of the blindfolded couple walking over the cliff was first published by the Louisiana Department of Public Health. But there was also opposition from public intellectuals like Clarence Darrow, whose article, “The Eugenics Cult,” appears next to Holmes’s words in the exhibit. Despite the faith in science he demonstrated at the Scopes Trial a few years earlier, Darrow clearly understood the dangers of eugenics. “Those in power would inevitably direct human breeding in their own interests,” he wrote. “It would mean that big business would create a race in its own image.... [I]t would mean with men, as it does with animals, that breeding would be controlled for the use and purpose of the powerful and unintelligent.”
In Germany, public opposition to eugenics was virtually non-existent, and as the Nazis began to take over in the 1930s, there was little opportunity for dissent. The exhibit even contains a picture of Richard Goldschmidt, a Jewish doctor who left Germany in 1936 to become a eugenicist in the United States. Unlike America, which prized (at least in principle) human equality and human rights, Germany hungered for national greatness and renewal. As Joseph Goebbels declared: “Our starting point is not the individual, and we do not subscribe to the view that one should feed the hungry, give drink to the thirsty, or clothe the naked.... Our objectives are entirely different: we must have a healthy people in order to prevail in the world.” This obviously anti-Judeo-Christian message is made even more ominous by the presence of the first-person plural pronoun — “we.” Eugenics was to become the ideology of the whole German people, and victory was to be shared by the German Reich.The Corruption of Medicine
The first significant step down this road was the forced sterilization campaign that began in 1933 under the Law for the Prevention of Genetically Diseased Offspring. The law applied to men and women who were afflicted with “feeblemindedness, schizophrenia, manic-depressive disorder, genetic epilepsy, Huntington’s chorea, genetic blindness, genetic deafness, severe physical deformity, and chronic alcoholism.”
The tools used for the vasectomies of men and the (often fatal) tubal ligations of women are shown in a display designed to look like a hospital room. The cold black and white tiles on the floor and the walls, the dressing screen, and the hospital gurney begin to drive home the very disturbing point that it was physicians and nurses at the forefront of these policies. As Robert Jay Lifton notes in The Nazi Doctors: “Psychologically, nothing is darker or more menacing, or harder to accept, than the participation of physicians in mass murder. However technicized or commercial the modern physician may have become, he or she is still supposed to be a healer — and one responsible to a tradition of healing, which all cultures revere and depend upon.”
Things degenerated quickly, as German doctors began to euthanize disabled children. One powerful display shows a picture of Dr. Ernst Wentzler caring for a healthy young child — right next to his signed orders for the killing of disabled children. As part of the campaign to cleanse the race, doctors would do anything to promote the health of the strong, while trying to eliminate the burden of the weak.
There was also a campaign to encourage healthy German mothers to have more children. They were awarded gold, silver, and bronze medals depending on the number of healthy babies they delivered, and paid a stipend as well. Mothers were pressed to take special care of their health while pregnant, and underground abortions were virtually halted. The value of healthy life was elevated to the highest ideal, while any deformity made a person worthless.
Though arguments for the euthanasia of “diseased children” had been advanced during the 1920s and 1930s, it was not until the war began that the Nazi government could distract the population enough to carry them out. Parents were told that their handicapped children were being taken to homes for special treatments, only to be murdered with a gradual overdose of Luminal.
In a small, darkened room of the exhibit, there are pictures of some of the 5,000 boys and girls who were euthanized between 1939 and 1945. The tile of the sterile hospital environment is a poignant contrast to the vibrant faces of these children. Some are smiling, some are screaming. They display the full range of human emotion, and killing them would have seemed like killing any other child. These were German children, too. Even if the doctors and nurses were convinced that Jews or gypsies or blacks were animals, how could they justify the murder of these “Nordic” youth?
One factor was the method of killing. Since Luminal is a sedative that was often administered in small doses to unruly children at the time — there was no other way to treat epilepsy, for instance — nurses often had no way of knowing who was administering the fatal dose. Nor could they tell whether a child was sleeping or entering into a comatose state. The more people who were in on the killing, the less culpability any one individual felt.
Most German parents didn’t realize what was going on until it was too late. Unlike the forced sterilization campaign, the euthanasia policy remained largely secret, with parents receiving letters declaring a false cause of death. In some cases, though, the parents actually supported the murder of their own children. In his book, Lifton offers the horrifying example of a father who proudly sent his child to this fate: “The Führer wanted to explore the problem of people who had no future — whose life was worthless.... From then on, we wouldn’t have to suffer from this terrible misfortune, because the Führer had granted us the mercy of killing our son. Later, we could have other children, handsome and healthy of whom the Reich could be proud.”
This normalization and bureaucratization of murder is displayed throughout “Deadly Medicine,” particularly as the euthanasia of Jewish and handicapped adults became commonplace. The exhibit is littered with forms, questionnaires, letters, testimony, charts, orders — murder became simply a matter of accumulating paper on the desks of state bureaucrats. Just as the eugenic theories had the hint of real science backing them up, so these horrifying orders always had some legitimate paper trail behind them.
There is an entire loose-leaf of expert testimony regarding the case of an Austrian man, who claimed that his biological parents were not Jewish and therefore should not be subject to deportation with the rest of the Jews. Page after page documents his various physical features and those of his family. The Hereditary Health Court, which was founded in 1933 to administer the Law for the Prevention of Genetically Diseased Offspring, processed thousands of such cases and produced reams of documents.
Toward the end of the exhibit, there are letters documenting the sale of human body parts, including one to the director of the anthropology department of the Natural History Museum in Vienna, offering the skulls of Polish and Jewish adults and children. There is an invoice for the receipt of 697 brains, delivered to Dr. Julius Hallervorden, who used them for research.
The most horrific experiments were performed in the concentration camps by Josef Mengele and his minions. At Auschwitz, Mengele and others used human subjects to learn about pain thresholds; they froze prisoners to study the effects of hypothermia; they put prisoners in pressure chambers to test human tolerance for high altitudes. Mengele had a special fascination with twins, which he subjected to perverse (and often deadly) experiments. At Dachau, prisoners were injected with malaria. At Ravensbrück, physicians deliberately infected prisoners’ wounds to test the effectiveness of the drug sulfonamide. At Buchenwald, prisoners were injected with smallpox, cholera, and typhus to test the effectiveness of different treatments. These human lab rats were going to die anyway, the doctors reasoned. Why not get some benefit from their misfortune?A Reminder of Human Evil
If there is a weakness of the exhibit, it is that Mengele is not even mentioned until the last room. It is surely worthwhile to show the eugenic mindset in its beginning stages, but the creators of the exhibit should have devoted more space to its ghastly end stages, when the great evil of eugenics-gone-mad was most vivid. But this weakness is also, perhaps, its strength. Only by understanding the rise of eugenics in Weimar Germany can we grasp how even a supposedly humanitarian science can end, as Flannery O’Connor put it, “in forced labor camps and in the fumes of the gas chamber.”
O’Connor’s point was also a warning. What we are discovering in our own time is that nations built on the principles of individual rights and human equality may have their own reasons for pursuing eugenics — a “soft eugenics” of personal choice, not a totalitarian eugenics of racial purity and mass slaughter. In America, parents are free to choose “fit” children and abort the “unfit,” and many defenders of equality seem to believe that we should use our genetic knowledge to ensure that our offspring have the “best genetic endowments.” While it is perverse to compare our own baby-making practices to the German programs of sterilization and euthanasia, the exhibit could not have come at a better time.
Our tools for predicting the likelihood of certain genetic illnesses are much more accurate today, and perhaps even more widely used. Couples with family histories of hereditary disease often consult with geneticists to see whether they should try to have children together. Women who decide to keep a baby with Down syndrome rather than abort it are considered by many to be downright irresponsible. And there are even more extreme voices, like Peter Singer, who believe the mentally or physically handicapped should be killed before they become a burden on the rest of society.
In addition to giving us pause about the kind of physical and genetic manipulation that we now engage in — from amniocentesis to plastic surgery — “Deadly Medicine” should make us think about the rationale we use to separate the acceptable from the well-meaning from the misguided from the downright evil. What is one to think after viewing an exhibit of parents who willingly gave up their children to murderers, doctors who signed execution orders for thousands of children and adults, nurses who administered the fatal doses, and a population that accepted forced sterilization, euthanasia, and mass murder? And what, if anything, does this have to do with current practices?
A number of esteemed bioethicists have argued that we can rely to some extent on the moral repugnance that arises naturally in us — “the yuck factor” — when we think about things like human cloning, partial-birth abortion, choosing the traits of our children, or physician-assisted suicide. This argument rests on the idea that certain practices strike all human beings as unnatural violations, regardless of the political or cultural context. But if there is one thing that “Deadly Medicine” shows, it is just how far a community can stray from built-in notions of what is morally repugnant. Of course, part of this was the result of the bureaucratization of these eugenic practices — involving as many layers as possible of people and processes. This allowed individuals to feel as though they were not themselves culpable. It made evil deeds, as Hannah Arendt famously argued, seem “banal.”
But in a way, the goals of the German scientists and the Nazi Reich began to make a certain natural moral sense to the population. Loath as we are to admit it, we also have a natural aversion to disability. Parents have to teach their children that the mentally and physically handicapped are worthy of sympathy and respect, not mockery. And for obvious evolutionary reasons, we are not instinctually attracted to individuals who are not “healthy.” Though we can and should teach ourselves and our children that this is not the proper way to judge other people, there is no doubt that 1930s German scientists and leaders played on this natural “repugnance” to accomplish their aims.
On some level, the desire to perfect future generations is not entirely unnatural. As the ethicist William F. May has described, there are two kinds of love that parents feel for their children, “transforming love” and “accepting love.” Both of these loves are very natural. When they are balanced, we can push our children to accomplish more while accepting their limitations graciously. But transforming love seems to be on the rise, feeding a growing desire for genetically perfect offspring — a desire shared by German parents in the 1920s and early 1930s, and twisted by Nazi leaders to the most horrible ends. This impulse toward transformative “love” extended not just to one’s own children, but to all of one’s countrymen. Accepting love, meanwhile, simply fell by the wayside, as everyone put their trust in the Doctor of the German People.
America, thankfully, will probably never be seduced by such evil delusions. But we are not, as “Deadly Medicine” should remind us, wholly innocent of the eugenic impulse, which may grow more seductive in the years ahead.
Naomi Schaefer is an adjunct fellow at the Ethics and Public Policy Center.
Naomi Schaefer, "The Legacy of Nazi Medicine," The New Atlantis, Number 5, Spring 2004, pp. 54-60.