“Whatever proportions these crimes finally assumed, it became evident to all who investigated them that they had started from small beginnings.”
— Leo Alexander, M.D.
Fundamental truths are often forgotten, if not actively obscured in the Kultursmog. This is very much the case with respect to the integrity of the human person and the inalienable right to life. This week the nation observes the “black anniversary” of Roe and Doe, a good time to engage in the process of remembering.
In 1949, the late Leo Alexander, M.D. wrote a remarkable, compelling essay in the New England Journal of Medicine entitled, “Medical Science Under Dictatorship,” a topic he was uniquely qualified to discuss.
Alexander, a psychiatrist and neurologist, was of Jewish-Austrian ancestry having been born in 1905 during the last years of the Austro-Hungarian Empire. He graduated from the University of Vienna’s medical school and served his internship and residency at the University of Frankfurt, Germany. He came to the United States in 1933 and held positions at Boston City Hospital and Harvard Medical School. He also taught at Duke and Tufts Medical Schools.
Dr. Alexander was a medical investigator and consultant to Secretary of War, Robert P. Patterson, “on duty with the Office of the Chief Counsel for War Crimes, Nuremberg, United States Zone of Germany, 1946-1947.” In this capacity he was able to learn everything about the Nazi eugenics program that was the precursor of the Final Solution directed at European Jews. This program was a pioneering effort of both ideology and technique, research “devoted to the science of destroying and preventing life for which I have proposed the term ‘ktenology,’ the science of killing,” wrote Alexander. He had the opportunity to interview physicians who carried out a myriad of ghastly atrocities, a mockery of medicine in the service of a totalitarian ideology.
Alexander wrote the Nuremberg Code after World War II that established firm ethical norms for any experiments on human beings, especially that of informed consent.
Dr. Alexander saw the intellectual roots of Nazi and totalitarian medicine in the Hegelian principle of “rational utility,” which displaced traditional moral, ethical and religious values, leading to a decline in standards of professional ethics. This was manifested in such horrific medical “enterprises” as the mass extermination of the chronically sick to save “useless” expenses; the mass extermination of those considered socially disturbing or racially or ideologically unwanted; the “inconspicuous” extermination of those considered disloyal within the ruling group; and the ruthless use of “human experimental material” for medico-military research.
In 1931 Bavarian psychiatrists convened to discuss sterilization and euthanasia of persons with chronic mental illnesses.
Hitler’s first direct order for euthanasia was issued in September 1939 and an organization was set up to carry it out under the direction of Dr. Karl Brandt. Victims were selected entirely by means of a questionnaire, without physical examination, enquiring as to all patients who had been ill for five or more years and who could not work. This information was reviewed by professors of psychiatry, one of whom was responsible for evaluating 2,109 questionnaires alone. Those selected, many of them children, were taken to killing centers and the costs were collected from their relatives without informing them of the purposes. Death certificates were falsified. 275,000 perished with the collaboration of the medical profession.
This was just the beginning. Over time, exterminations included the mentally defective, psychotics (schizophrenics were a prime target), epileptics and “patients suffering from infirmities of old age and various organic neurological disorders such as infantile paralysis, Parkinsonism, multiple sclerosis and brain tumors.” Gas chambers, “baths,” “cyclone B” — all of these were utilized. One doctor amassed a collection of 500 brains for his research.
“It is rather significant that the German people were considered by their Nazi leaders more ready to accept the exterminations of the sick than those for political reasons,” said Dr. Alexander. “It was for that reason that the first exterminations of the latter group were carried out under the guise of sickness.”
A good many of the doomed were to be part of “terminal human experiments” in service of ktenology, again, the science of killing. These experiments were designed in such a way that success depended on the subject’s death. Mass killing, mass sterilization (including castration), and rapid executions were the focus of this “research.” After the war, Dr. Alexander arranged for treatment of 40 Polish survivors of concentration camps who had been crippled by injections of gas gangrene by Dr. Josef Mengele. He also provided psychiatric care to some of them.
Space does not allow for a description of the awful and devastating crimes related by Alexander, so many of which have come into our collective consciousness through decades of historical research, personal testimony, documentary film and photographs.
“Whatever proportions these crimes finally assumed, it became evident to all who investigated them that they started from small beginnings,” wrote Dr. Alexander. The beginnings at first were merely a subtle shift in emphasis in the basic attitude of physicians. It started with the acceptance, basic in the euthanasia movement, that there is such a thing as life not worthy to be lived [emphasis added].”
That last phrase is often translated as “Life unworthy of life.” In 1920, two academics, Karl Binding, a German attorney, and Alfred Hoche, a physician, published Die Freigabe der Vernichtung Lebensunwerten Lebens (“Allowing the Destruction of Life Unworthy of Life”). Neither were National Socialists or radical racists. Yet, they were providing fuel for the fire that eventually engulfed Europe in the 1930s and 1940s. Reading the book today, one might be forgiven making comparisons, say, to Peter Singer.
Few resisted these trends in Germany. Alexander, however, praised the Dutch: “It is to the everlasting honor of the medical profession of Holland that they recognized the earliest and most subtle phases of this attempt [against the “useless” or incurably sick] and rejected it.”
These doctors refused to carry out the orders of the Reich Commissar in the Netherlands which meant to align them with the German profession, characterizing such eugenics as a “public task.” The Dutch physicians rejected the order unanimously. When they were threatened with revocation of their licenses, they surrendered them and continued treating patients secretly, no longer writing birth or death certificates. One hundred doctors were sent to concentration camps, but the rest cared for their families, widows, and orphans.
“Thus it came about that not a single euthanasia or non-therapeutic sterilization was recommended or participated in by any Dutch physician,” observed Dr. Alexander. Unfortunately, a cursory review of the relevant documents on the website of the Royal Dutch Medical Association indicates that some successors of those brave doctors are a lot less squeamish about euthanasia today. But many still hold out. The recent growth in cases of euthanasia in the Netherlands may be due, in part, to the availability of mobile euthanasia units for patients whose doctors refuse to participate in the “mercy” killing.
The Nazis may have found a way to implement their demonic program of eugenics and genocide even without the moral corruption of the German medical profession. But the failure of those doctors to recall, and practice, the ancient maxim, Primum non nocere — “First do no harm” — made it an absolute certainty that evil would triumph in that hellish place and time.