From the nation that defeated Nazi Germany comes news from the front lines of medical-ethical progress:

The article, published in the Journal of Medical Ethics, says newborn babies are not “actual persons” and do not have a “moral right to life”. The academics also argue that parents should be able to have their baby killed if it turns out to be disabled when it is born.

The journal’s editor, Prof Julian Savulescu, director of the Oxford Uehiro Centre for Practical Ethics, said the article’s authors had received death threats since publishing the article. He said those who made abusive and threatening posts about the study were “fanatics opposed to the very values of a liberal society”.

The article, entitled “After-birth abortion: Why should the baby live?”, was written by two of Prof Savulescu’s former associates, Alberto Giubilini and Francesca Minerva.

They argued: “The moral status of an infant is equivalent to that of a fetus in the sense that both lack those properties that justify the attribution of a right to life to an individual.”

Rather than being “actual persons”, newborns were “potential persons”. They explained: “Both a fetus and a newborn certainly are human beings and potential persons, but neither is a ‘person’ in the sense of ‘subject of a moral right to life’.

You have to laugh at the irony of a man responsible for publishing an article calling for infanticide taking umbrage at the outraged, in the name of defending liberal society. The grim Savulescu continues:

Speaking to The Daily Telegraph, he added: “This “debate” has been an example of “witch ethics” – a group of people know who the witch is and seek to burn her. It is one of the most dangerous human tendencies we have. It leads to lynching and genocide. Rather than argue and engage, there is a drive is to silence and, in the extreme, kill, based on their own moral certainty. That is not the sort of society we should live in.”

The lack of historical awareness beggars belief. From Robert J. Lifton’s history of the Nazi genocide, excerpted in the New York Times Magazine in 1986:

The Nazis, however, used the term ”euthanasia” to camouflage mass murder. Just how the Nazis were able to do that has been made clearer by recent historical research and by interviews I was able to conduct during the last decade with German doctors who participated in the killing project.

Nazi medicalized killing provided both the method – the gas chamber – and much of the personnel for the death camps themselves. In Auschwitz, for instance, doctors selected prisoners for death, supervised the killings in the gas chambers and decided when the victims were dead.

Doctors, in short, played a crucial role in the Final Solution. The full significance of medically directed killing for Nazi theory and behavior cannot be comprehended unless we understand how Nazi doctors destroyed the boundary between healing and killing.

The Nazi principle of killing as a therapeutic imperative is evident in the words of the Auschwitz S.S. doctor Fritz Klein. Klein was asked by an inmate how he could reconcile Auschwitz’s smoking chimneys with his purported fealty to the physician’s Hippocratic oath, which requires the preservation of life. ”Of course I am a doctor and I want to preserve life,” replied Klein. ”And out of respect for human life, I would remove a gangrenous appendix from a diseased body. The Jew is the gangrenous appendix in the body of mankind.”

As is the unwanted newborn, according to Giubilini and Minerva. More Lifton:

The Nazis justified direct medical killing by use of the simple concept of ”life unworthy of life” – lebensunwertes Leben. While this concept predated the Nazis, it was carried to its ultimate racial and ”therapeutic” extreme by them.

Of the five identifiable steps by which the Nazis carried out the destruction of ”life unworthy of life,” coercive sterilization was the first. There followed the killing of ”impaired” children in hospitals, and then the killing of ”impaired” adults -mostly collected from mental hospitals – in centers especially equipped with carbon monoxide. The same killing centers were then used for the murders of ”impaired” inmates of concentration camps. The final step was mass killing, mostly of Jews, in the extermination camps themselves.

Once in power – Hitler took the oath of office as Chancellor of the Third Reich on Jan. 30, 1933 – the Nazi regime introduced an early sterilization law with a declaration that Germany was in grave danger of Volkstod -”death of the people,” ”nation” or ”race” – and that, to combat it, harsh and sweeping measures were imperative.

Mandatory sterilization of those termed the ”hereditarily sick” was part of the Nazi vision of racial purification. No one knows how many people were sterilized; reliable estimates range from 200,000 to 350,000 people.

For a doctor, there is a large step between ligating spermatic cords, cutting fallopian tubes, even removing uteri, and killing or designating for death one’s own patients. But, by the time the Nazis took power in Germany, some of the philosophical groundwork allowing for this transition had already been laid.

The crucial theoretical work was Die Freigabe der Vernichtung lebensunwerten Lebens, or ”The Permission to Destroy Life Unworthy of Life.” Published in 1920, it was written jointly by two distinguished German professors, the jurist Karl Binding, retired after 40 years at the University of Leipzig, and Alfred Hoche, professor of psychiatry at the University of Freiburg.

Hoche argued in the book that a policy of killing was compassionate and consistent with medical ethics. He pointed to situations where doctors were obliged to destroy life – interrupting a pregnancy to save the mother, for example. He went on to claim that various forms of psychiatric disturbance, brain damage and retardation indicated that the patients were already ”mentally dead.” He characterized these people as ”human ballast” and ”empty shells of human beings” – terms that would later reverberate in Nazi Germany. Putting such people to death, Hoche wrote, ”is not to be equated with other types of killing.” It is, he wrote, ”an allowable, useful act.”

Binding and Hoche turned out to be the prophets of direct medicalized killing. Prior to the Nazis’ assumption of power, such thinking was not a majority view in German psychiatry and medicine. But under the Nazis, there was increasing discussion in medical and political circles of the legitimacy of mercy killing, of Hoche’s concept of the mentally dead, and of the enormous economic drain on German society caused by the large number of impaired Germans. A mathematics textbook of the period even asked students to calculate how many government loans to newly married couples could be granted for the money it cost the state to care for ”the crippled, the criminal, and the insane.”

And:

The child-killing program began with newborns, then proceeded to children up to the ages of 3 and 4 and soon to older ones. The authorization for the killing project was, at first, oral, secret and ”kept in a very narrow scope,” covering ”only the most serious cases,” according to Karl Brandt’s Nuremberg trial testimony. It later became loose, extensive and known among a wider and wider circle of physicians and officials.

… The actual killing was done in children’s institutions whose chiefs and prominent physicians were known to be politically reliable and ”positive” toward the goals of the Reich Committee. These killing centers were grandly referred to as ”Reich Committee Institutions,” ”Children’s Specialty Institutions” or even ”Therapeutic Convalescent Institutions.” Doctors, administrators and Reich officials proceeded as if the children were to receive the blessings of medical science.

No such separate institutions existed, of course. The children marked for death were usually dispersed among ordinary pediatric patients at children’s hospitals.

The falsification was clearly intended to deceive the children, their families and the general public. But, by expressing literally the Nazi reversal of healing and killing, the deceptions also served the psychological needs of the killers. A doctor could tell a parent that ”it might be necessary to perform a surgical operation that could possibly have an unfavorable result”; or he might explain that ”the ordinary therapy employed until now could no longer help” their child, necessitating ”extraordinary therapeutic measures.”

Read the whole thing. It’s important. The killing of newborns is a bright red line. We know this. We are monsters if we forget it. We are four years away from the centenary of Hoche and Binding’s seminal work. And yet, a leading medical journal in the United Kingdom dares to publish an essay calling for the extermination of life unworthy of life.

The authors of the modern essay at issue, says Dr. Savulescu, advocate for after-birth abortion “in consideration of maternal and family interests.” Ah yes. Tenderness leads to the gas chamber.

Again: we know this. 

We are responsible!

UPDATE: This story is from 2012, please note. It was sent to me today.

UPDATE.2: As I point out to a reader in the comments below, even though this is story is three years old, I’m leaving it here because the principles at stake are ever-relevant. Here, for example, is a Newsweek cover story from February, 2015, about the spread of euthanasia in Europe. Excerpt:

What she wants, if the circumstances merit it, is doctor-assisted euthanasia, which is booming in the Netherlands. In 2013, according to the latest data, 4,829 people across the country chose to have a doctor end their lives. That’s one in every 28 deaths in the Netherlands, and triple the number of people who died this way in 2002. The Dutch don’t require proof of a terminal illness to allow doctors to “help” patients die. Here, people can choose euthanasia if they can convince two physicians they endure “unbearable” suffering, a definition that expands each year. Residents here can now choose euthanasia if they’re tired of living with Lou Gehrig’s disease, multiple sclerosis, depression or loneliness. The Dutch can now choose death if they’re tired of living.

More:

The march toward euthanasia mirrors a trend spanning continents today: a growing number of countries are placing more value on individual freedom. This worries religious leaders, ethicists and disability advocates. Assisted suicide may ease suffering, they say, but it threatens our most vulnerable citizens—the elderly and the disabled, who already struggle to justify their lives. “I like autonomy very much,” says Theo Boer, a professor of ethics at the Theological University Kampen in the Netherlands. “But it seems to have overruled other values, like solidarity, patience, making the best of things. The risk now is that people no longer search for a way to endure their suffering. Killing yourself is the end of autonomy.”

And:

In 2005, lawmakers decriminalized another form of euthanasia—for babies. In recent years, the number of cases of newborn euthanasia has declined—because parents are acting sooner. The country introduced a new system of prenatal screening that allows parents to terminate pregnancy if ultrasound results reveal severe congenital malformations within 20 weeks of conception.

The Dutch didn’t stop at babies. Minors in the Netherlands are now allowed to choose euthanasia, too. Children ages 12 to 15 may ask to die if they can get parents’ permission. After age 16, young people can make the decision with only “parental involvement.”

Pediatrician Eduard Verhagen helped establish the Dutch euthanasia guidelines for infants. He says the law should go further. “If we say the cutoff line is age 12, there might be children of 11 years and nine months who are very well capable of determining their own fate and making their own decisions, but they’re not allowed to ask for euthanasia.”

It is hard to imagine an American pediatrician making that argument. But no one envisioned euthanasia in the Netherlands would expand the way it has in the past 13 years. Perhaps the U.S. isn’t far behind.

It’s all connected. The passage of three years since the publication of the British paper does not obviate its relevance to the present moment.

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