The Approach to Nazi-History in Current Medical-Ethical Discourses

Autorin: Katrin Grüber
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The Approach to NS History in Current Medical-Ethical Discourses

Observers from abroad often believe to recognize in discussions of medical- ethical problems in Germany – also as a consequence of the local culture of memory and politics – an all too great sensitivity. Indeed in such debates allusions and references to NS history play a role ever and again and have explicitly or implicitly a formative influence on them. Yet the topic is also suppressed.

The references made in debates on human genetics, reproduction technologies, assisted dying and related themes to the medical crimes of the NS times are manifold; several of them shall subsequently be described. Advocates of new technologies emphasize the differences between present and past; critics see a comparability and continuity with NS history. But in both cases „an a-historical threatening posture supports the own position, instead of looking closely and analyzing in detail with regard to common features and differences.

The necessity of arguing in a more differentiated way is also shown in the criticism of the argumentation of the Federal Constitutional Court of 2008 on the prohibition of sibling incest. The majority of the Senate justified its verdict among other things with the argument that it serves the prevention of hereditarily determined ailments of children who are begot in an incestuous relationship. And referring to history the following supplementary statement is made: The eugenic aspect is „as a supplementary citation not excluded […] because it was historically misused for the disenfranchisement of persons with hereditary diseases and disabilities“. The jurist Hörnle criticizes that the majority of the Senate had introduced the controversial subject of eugenics with a superficial argumentation, which clouds the normative problems; moreover it seems as if the court had not really been at ease with the reference to history. Obviously Hassemer, who had as the only one of the judges voted against the decision, had not been able to convince his colleagues. In his opinion eugenic aspects are „as a constitutionally acceptable aim of a criminal provision” not admissible. In the public sphere this aspect of the verdict played no role, possibly because sibling incest is a taboo.

The reference to the NS time in a commentary of the National Ethics Council reads like lip-service. There it says that that several members favoured an acceptance of killing on demand, but that they believed prohibition necessary for longer because of the „political consideration of the special situation in which Germany finds itself in view of the history of the euthanasia crimes of the Nazi regime.

MP Lauterbach declared in a parliamentary debate on pre-implantation diagnostics: „The discrimination of disabled persons would be insufferable. This holds true for our country in a very special way. Our history obliges us to take this argument seriously in a special way.” In the following implicit hint that PID has no discriminating effect on disabled persons, he uses the reference to NS history, to reinforce his plea fort the permission of PID.

Dealing with Terms

There is a controversial discussion, if and in what way terms like „eugenics“, „selection“ or „euthanasia“, which evince a relation to the National Socialist medical crimes may be used. Some reject these terms, since they can be instrumentalized and would be considered as knockout arguments. MP Jerzy Montag for example defied in a parliamentary debate the use of the term „selection“ in connection with women’s decision for PID, since this word would be “associated with the darkest past of Germany” The Federal High Court of Justice, however, went back to this term in his verdict on the compatibility of pre-implantation and the Embryo Protection Law.
Some hold the position that the term „eugenics“ cannot be used in view of the difference between the NS time and the present. With regard to pre-implantation diagnostics they argue that it is not decreed by the state. To make clear that there are also forms of eugenics, which go without enforcement by the state, the terms „eugenics from the bottom“ respectively „liberal eugenics“ are used.

Personal Continuities

With the end of World War II the chapter eugenics was not finished. This derived also from personal continuities, which hampered critical discussion. Geneticists, who had participated in the enactment of the law, taught at German universities and were involved , among other things, in the Eugenic Working Group of the Protestant church from 1959 – 1966, in which eugenic interventions like sterilization were discussed. Moreover they played a role in the debate about amends for victims of enforced sterilization. In a parliamentary hearing on this question in 1961 they expressed the opinion that the measures had not been injustice, but an expression of the sense of responsibility of German doctors and had served the good of the German people.

In the Germany the Heredity Health Law („Erbgesundheitsgesetz“) was not abolished until 1974, after it had been merely suspended in 1949 in some allied zones. The German parliament banned the law not before 2007. The victims of enforced sterilization received only a low compensation.

Critical Debates and the Reference to Responsibility

It took a very long time for professional associations, members of which were involved in medical crimes during the NS time, to deal with their history. The Society of Human Genetics („ Humangenetische Gesellschaft“) drew up a commentary not until 1989, in which it explicitly opposed eugenic tendencies in the context of pregnancy conflict counselling. The confession of guilt came even later. In a statement referring to the anniversary of the Law for the Prevention of Genetically Diseased Offspring („Gesetz zur Verhütung erbkranken Nachwuchses”) of July 1933 the Society of Human Genetics declared,

German doctors and scientists participated decisively in the substantial preparation and the pseudo-scientific justification of this law as well as in the implementation of the measures enforced. By the abuse of their scientific authority and their cooperation in the wording and the implementation of the law, among other things, as consultants at the Hereditary Health Courts, the human geneticists have also laden heavy guilt on themselves.

The president of the German Society for Psychiatry, Psychotherapy and Neurology (DGPPN) apologized in 2010 that the association took seventy years to acknowledge the guilt of former members and colleagues and name their deeds:

In the time of National Socialism, psychiatrists despised men, deceived and lied to patients entrusted to them in their confidence, put off their relatives, permitted patients to be sterilized and killed and themselves killed. Patients were subjected to unjustifiable research tests , which damaged their health or even killed them.

The Max Planck Society set up in 1997 a presidential commission “History of the Kaiser Wilhelm Society in National Socialism” (Geschichte der Kaiser-Wilhelm-Gesellschaft im Nationalsozialismus). It was its primary aim to investigate the role of the Kaiser-Wilhelm-Gesellschaft as predecessor of the Max Planck Society in the NS system, but also to learn more about how the representatives of the society acted on the scientific, the political and the scientific-political level in the context of their activity. The press release on the occasion of the conclusion of the project says:

„The special feature of the National Socialist regime was not that it forced scientists to make criminal tests on humans. The difference to the democratic system consists in the annulment of ethical-moral rules and partially of internal scientific control. The unlimited ambition of all too many scientists sufficed as a motivation to use the unethical possibilities which the NS system offered to them.”

Another aspect is referred to by the historian Schmuhl.

“Above all with respect to NS euthanasia an astonishing result is to be noticed: All involved doctors cooperated voluntarily, most even euphorically, and not despite but because of their professional ethics. The shift of emphasis from a curative to a prophylactic (eugenically oriented) medicine which was introduced long before the Third Reich led – together with a fateful idealism – led to the result that curing and extermination became two sides of one and the same medal. Medicine was not instrumentalized by the ‘brown’ power-holders, but attempted to put into practice the National Socialist program of creating a „genetically healthy body of the people“ (erbgesunder Volkskörper).“

Conclusions

After the end of the war there were different phases and lines of dealing with the NS time. There are some indications that the effect of the debate has become less influential in the last years. On the other hand the German Society for Psychiatry, Psychotherapy and Neurology confessed only in 2010 to its responsibility for the participation of psychiatrists in in NS medical crimes. It is necessary to take a differentiated view at the NS time, for it was not an „a-historical manifestation of evil“. In order to draw conclusions for actual medical-ethical issues it is important to look at the respective context, to understand in what way and with what motivation men acted at the time of the NS regime. Only then can a connection be drawn to the present time in a reasonable way.

Numerous studies by historians have so far been discussed in professional contexts. Now the time has come for them to be perceived and discussed in a wider public. Historical reflection which looks closely can enrich the medical-ethical debate, although no unambiguous positions can be derived from it

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