Euthanasia Program Research Articles

The 'first to perish'. Child euthanasia in the Third Reich.

In an attempt to improve racial fitness, racial policy in the Third Reich targeted many groups, including physically and mentally handicapped children. An early program identified disabled children who were systematically selected and then transferred to various hospital centers where they were actively euthanatized. The program, directed by mainstream German physicians, was begun on the eve of war and was a harbinger of the evils to come. This article highlights the "scientific thought" that provided the rationale for this policy together with the details of implementation of the active euthanasia program and profiles one of the major participants, Werner Catel, DrMed, who was a distinguished pediatrician.

Psychiatry: an impossible profession?

To examine the disconcerting question as to whether psychiatry is a fully-fledged profession or not. A review of pertinent literature regarding the criteria of a profession, the vulnerability of psychiatry to abuse, and potential models for the proper practice of psychiatry. Psychiatry lost its professional anchorage entirely with its misuse to suppress dissent in the former Soviet Union and in the so-called euthanasia program in Nazi Germany. It remains vulnerable to abuse unless psychiatrists recognise the professional criteria they must satisfy. A new symbol, a humble stool, is proposed. Its, three legs represent the three equally significant dimensions of psychiatric practice: science, art and ethics. Psychiatry just 'scrapes home' in constituting a profession but only subject to three provisos:namely (i) that psychiatrists appreciate the need to achieve a coherent body of special knowledge through a genuine creative process which necessarily results in uncomfortable tension from time to time; (ii) that we promote the art of psychiatry by cultivating an ethos of caring and sensitivity; and (iii) that we function within an articulated ethical framework with respect for codes of ethics as guidelines.

Lessons From the Third Reich: Ethics and Economics-Reply

In Reply. —The comments from Dr Crawshaw properly call attention to the importance of economic forces in determining physician behavior, both individually and in the aggregate. The importance of such forces is not new, nor did it arise in Nazi Germany: in fact, the costs of caring for institutionalized children and adults in the United States were a lively topic of debate as early as the late 19th century. 1 The problem of cost was radicalized in the Third Reich, and provided much of the underpinning of the Nazi euthanasia program in the early 1930s. That economic forces are driving much of the current wave of change in US health care is beyond dispute, but the analogy to Nazi Germany is, I believe, overdrawn. German medicine was subverted by a number of powerful forces, including, most importantly, its incorporation as an extension of state policy and the extensive propaganda campaign that denigrated

Katholische Verbände und moderne Gesellschaft: Organisationsgeschichte und Vereinskultur im Bistum Münster 1918 bis 1945 by Christoph Kösters

496BOOK REVIEWS Katholische Verbände und moderne Gesellschaft: Organisationsgeschichte und Vereinskultur im Bistum Münster 1918 bis 1945. By Christoph Kösters. [VeröffentUchungen der Kommission für Zeitgeschichte, Reihe B: Forschungen, Band 68.] (Paderborn: Ferdinand Schöningh. 1995. Pp. 684. 98 DM.) Christoph Kösters's work, a revised version of his University of Münster dissertation , is a study of the Intersection of the Church, society, and poUtics between 1918 and 1945,"the crisis years of classical modernism" (p. 18). Based on intensive research into primary sources, the book focuses on CathoUc, male youth groups In the Diocese ofMünster,the "CathoUc bulwark ofNorthern Germany " (p. 23).The author's ambitious inteUectual program includes a discussion of CathoUc responses to the social and poUtical crises of the first half of the twentieth century, and also a new evaluation of CathoUc resistance to the Nazi regime in the Ught of his research into the social history of reUgion. Kösters begins with an account of the construction of a network of CathoUc associations in the decades beforeWorldWar I. Such groups, he notes,were part ofa CathoUc subculture, separate from the rest of German society,but internaUy divided by social class. GeneraUy led by the clergy, the associations were nonetheless separate from parish life and diocesan structures. After the war, a growing number of Catholics felt that the old network of associations was no longer appropriate to new social and poUtical circumstances. They sought to break out of their confessional ghetto and create new kinds of organizations ,with distinct simUarities to contemporary non-CathoUc youth groups,that would tear down the barriers between social classes. Adherents of this course were often supporters of the eucharistie and Uturgical movements, that sought a renewal of reUgious Ufe by encouraging a greater and more intensive participation of laypeople In church services (the author detaUs the scandalous occurrences of priests saying Mass whUe facing the congregation), a current of reUgious renewal ultimately culminating in the SecondVatican CouncU. Although the author does not particularly emphasize this point, his own evidence shows that such Initiatives were the work of a distinct minority and met with relatively Uttle success.The new Catholic youth groups formed during the Weimar Republic had a much smaller membership than the older Kolping (journeymen 's) associations or the Marian SodaUties, and this apparently continued to be the case weU into the Nazi era.For aU their claims to overcoming class barriers , the new organizations tended to be as segregated by class as the older ones were. The bulk of the diocesan clergy showed no great enthusiasm for new Uturgical practices. These caveats are important, because Kösters argues against the notion, advanced by other social historians, that the CathoUc confrontation with Nazism was a clash between a traditionaUst religion and a modernizing totaUtarian regime. Instead,he asserts that it was the modernizing, dynamic,initiatives ofreUgious renewal,which provided the faithful in the Diocese ofMünster with the impetus needed to resist the Nazis.The author's detaüed discussion of the dio- BOOK REVIEWS497 cese under Nazi rule does not focus on the usual historical showpiece, Bishop von Galen's celebrated 1941 sermons denouncing the regime's euthanasia program , but on the relationship between the church and the state and party during the 1930's, as initial efforts at cautious co-operation quickly gave way to open hostiUty. WhUe Kösters emphasizes the role of members of the new Catholic associations and adherents of new forms of piety in CathoUc resistance to the Nazis,he downplays the way in which a number ofmembers ofthe new groups went over to the Nazis or the role that the more numerous members of older associations or supporters of older ideas had In opposing the regime. (Women, frequent among these, are not discussed in his book.) Bishop von Galen himself, as the author notes, was no particular friend of the new forms ofpiety. More convincing is the author's observation that the Nazi regime, by persecuting and ultimately prohibiting most Catholic associations, left the field open to the adherents of a parish-based, intensive lay participation in reUgious services .This transition from the old network of...

The Sorcerer's Apprentice: The Life of Franz von Papen by Richard W. Rolfs, S.J.

BOOK REVIEWS497 cese under Nazi rule does not focus on the usual historical showpiece, Bishop von Galen's celebrated 1941 sermons denouncing the regime's euthanasia program , but on the relationship between the church and the state and party during the 1930's, as initial efforts at cautious co-operation quickly gave way to open hostiUty. WhUe Kösters emphasizes the role of members of the new Catholic associations and adherents of new forms of piety in CathoUc resistance to the Nazis,he downplays the way in which a number ofmembers ofthe new groups went over to the Nazis or the role that the more numerous members of older associations or supporters of older ideas had in opposing the regime. (Women, frequent among these, are not discussed in his book.) Bishop von Galen himself, as the author notes, was no particular friend of the new forms ofpiety. More convincing is the author's observation that the Nazi regime, by persecuting and ultimately prohibiting most Catholic associations, left the field open to the adherents of a parish-based, intensive lay participation in reUgious services .This transition from the old network of associations to the new forms of piety went relatively smoothly in the rural areas of the diocese. In its industrial districts, though, just a smaU group of young men became intensively involved in parish life, whUe a much larger number were increasingly indifferent to religion , thus setting the stage for further developments afterWorldWar II. Appearing in the "Veröffentlichungen der Kommission für Zeitgeschichte," a major monograph series of "official" CathoUc historiography in Germany, the book emphasizes a number of themes previously discussed by authors of sharply differing viewpoints, such as Günter Plum, Ui his 1972 study of religion, politics, and society in the Aachen region, or Doris Kaufmann's 1985 account of the CathoUc mUieu in the city of Münster. This convergence of "official" and "dissenting" Catholic historiography is itself suggestive of the growing inteUectual maturity of the study of the social history of reUgion in central Europe, of which this work provides a fine example. Although I am not sure that I always agree with the author's conclusions (in part, because he often formulates them in an indirect and guarded fashion), I nonetheless found his deeply researched and unusuaUy well written study a consistent source of information and thought-provoking insights. Jonathan Sperber University ofMissouri, Columbia The Sorcerer's Apprentice.The Life ofFranz von Papen. By RichardW Rolfs, SJ. (Lanham, Maryland: University Press ofAmerica. 1996. Pp. xiii, 470. $58.00 clothbound; $42.00 paperback.) Professor Rolfs has written the first complete biography ofan individual who faciUtated the triumph of Nazism in 1933. Franz von Papen was dapper, charming , and clever. If he was rooted in anything, it was his Catholic heritage, which 498BOOK REVIEWS did little to enUghten his poUtical judgment. Born into theWestphalian nobUity, Papen began his adult Ufe as a cavalry officer.WhenWorldWar I began, he was the German military attaché inWashington, D.C., where he was expeUed for espionage . During the 1920's Papen was elected to the Prussian Landtag, in which he served as an ultra-conservative member of the CathoUc Center Party. Toward the end ofthis period Papen began an association with Kurt von Schleicher ,a poUtical general and wire-puller,who Papen thought was "a man of great clarity and vision. . . ." When someone suggested to Schleicher that Papen lacked a strong inteUect, the former replied that he did not need one: "He's a hat" (pp. 80-81). Papen soon demonstrated that he was as clever as the general. Both wanted to revise the German constitution in an authoritarian direction. From 1930 to May, 1932, these two remained in the background hatching new plots and schemes. The most overused word in Rolfs's book is "crafty." When President von Hindenburg lost confidence in ChanceUor Heinrich Bruening, Papen became the Weimar RepubUc's penultimate chanceUor because of the speU he exercised over the aging and confused president. Papen's most notable achievements during his six months in office were lifting the ban on Hitler's private army (the S.A.) and then removing Prussia's Socialist leaders from power because...

The Patient-Physician Relationship: Covenant or Contract?

The Patient-Physician Relationship: Covenant or Contract?

The Nazi doctors and the medical community; Honor or censure? The case of Hans Sewering

During the Nazi era, most German physicians abrogated their responsibilities to individual patients, and instead chose to advocate the interests of an evil regime. In so doing, several fundamental bioethical principles were violated. Despite gross violations of individual rights, many physicians went on to have successful careers, and in many cases were honored. This paper will review the case of Hans Sewering, a participant in the Nazi euthanasia program who became the President-elect of the World Medical Association. The appropriate stance for the medical and scientific community toward those who violate human rights and ignore fundamental ethical principles of the healing professions will be considered.

Clemens August Graf von Galen: Neue Forschungen zum Leben und Wirken des Bischofs von Münster ed. by Joachim Kuropka

BOOK REVIEWS 281 In sum, this book is written for specialists in the study of twentieth-century France by a young scholar of truly outstanding professional ability. It supersedes the earlier biography of Cardinal Saliège by Jean Guitton and sets a lofty standard for future biographers of church leaders. Francis J. Murphy Boston College ClemensAugust Graf von Galen: Neue Forschungen zum Leben und Wirken des Bischofs von Münster. Edited by Joachim Kuropka. (Münster: Regensburg . 1992. Pp. 439. DM 48.) Clemens August Grafvon Galen, Bishop of Münster (and, after the war, Cardinal ), earned the reputation of being a résister to National Socialism. At home and abroad, von Galen was depicted as a representative ofthe "other" Germany; the Germany which refused to be co-ordinated to Nazism's ideology. He received worldwide fame in August, 1941, when he delivered a series of sermons in which he took aim at Nazi policies, especially that ofthe euthanasia program. Von Galen, the strong Catholic prelate, opposed Nazism's attempts to interfere with the practice of Catholicism in Germany.Von Galen, the ultra-nationalist, at the same time praised the German invasion of the Soviet Union. This works suggests the complexities of a conservative German Catholic nationalist who chose his positions concerning National Socialism selectively. Several German monographs studying the bishop already exist. The present volume is a valuable collection of recent studies, edited by Joachim Kuropka. Brought up in an aristocratic and strict household, the young "Clau's" intellectual and spiritual development is explored in the first three essays. Barbara Imbusch cites von Galen's ultra-nationalism duringWorldWar I when he called for the replacement of the Lithuanian population by settling German Catholic nobility in their place (p. 39). Other essays, such as Klemen-August Recker's, show von Galen to have been not only ultra-nationalistic,but also anti-democratic and anti-socialist. Joachim Maier and Susanne Leschinski focus on the bishop's ideas of justice and natural rights. In the latter essay,the author emphasizes von Galen's overarching anti-Communism and his strong criticism ofthe British occupation forces in postwar Germany. Maier, like Leschinski, points out how throughout von Galen's religious career (which began in 1919 and ended with his death in 1946) he remained a nationalist who adamantly rejected any notion of German guilt. The essays by Willenborg, Koopmeiners, Damberg, and Arens examine von Galen on religious instruction. Willenborg and Koopmeiners highlight the bishop's constant struggle to ensure religious education for the young children in his diocese. Damberg argues that von Galen, at the Synod of 1936 in Münster, 282 BOOK REVIEWS laid the preliminary groundwork forVatican Council II by stressing the need for Catholics to participate in an urban, pluralistic society while still maintaining their faith through close networks of unions, associations, and educational groups within the Catholic community. Arens looks at what the three famous summer sermons came to mean and concludes that von Galen came to represent a "religious Führer" (p. 401) of Germany. Yet Teuber and Seelhorst provide evidence how the German episcopacy, including von Galen, backed away from speaking out forJews. Perhaps the most pivotal essay in the book is by the editor when he directly addresses the issue of how historians today are struggling to redefine what constitutes resistance. According to him, von Galen was a résister because he was so viewed by the Hitler government. The cement which holds this together is the theme that von Galen's postwar image remains largely intact. Beth Griech-Polelle Rutgers University El catolicismo mundialy la guerra de España. ByJavier Tusell and Genoveva García Quiepo de Llano. (Madrid: Biblioteca de Autores Cristianos. 1993. Pp. xiii, 384.) The Spanish Civil war was a defining moment for Catholics throughout the world. In this fine study, the authors measure the impact of that struggle upon Catholics in Spain, France, Italy, Britain, and the United States. The work is based on an exhaustive reading of the sources, primarily the press and the polemical writings of the engaged. Three major events of the war influenced Catholic views: the anticlerical fury of 1936 which resulted in the deaths of thousands of clergy...

Psychiatry's role in the holocaust

German psychiatrists proposed the extermination of mental patients before Hitler came to power. Then in Nazi Germany, organized psychiatry implemented involuntary eugenical sterilization and euthanasia, ultimately killing up to 100000 German mental patients. The six psychiatric euthanasia centers utilized medical professionals, fake death certificates, gas chambers disguised as showers, and the mass burning of corpses.Psychiatrists from the euthanasia program also participated in the first formalized murders in the concentration camps. Inmates were "diagnosed" on euthanasia forms and sent to the psychiatric euthanasia centers. These facilities later provided the training, personnel and technology for the larger extermination camps.Medical observers from the United States and Germany at the Nuremberg trials concluded that the holocaust might not have taken place without psychiatry. This paper summarizes psychiatric participation in events leading to the holocaust, and analyzes the underlying psychiatric principles that anticipated, encouraged, and paved the way for the Nazi extermination program.

Trends in Mental Health Care in Czechoslovakia

If we wish to examine the development of care of the mentally ill during the last 30-40 years in Czechoslovakia, we must, for the sake of the reader who is unfamiliar with the history of our country, draw attention to the most important events that have influenced that care. The following brief glance at the past will permit us to better understand not only the present and the successes we have achieved in coping with mental illness but also the problems that have appeared over time and that we have to solve. We shall divide the past into a series of stages according to sociohistorical events that, to a certain extent, have influenced mental health care and ensured services for the mentally ill. At each stage we shall describe the provision of pharmaceutical and technical treatment, the types of institutions and number of doctors involved, and the main trends in mental health care. We shall then examine the last 30-40 years in detail. The period from 1939 to 1945 will be omitted since everyone is familiar with the attitude of the German fascists toward the mentally ill, an attitude that culminated in a euthanasia program.

Hitler's justice: the courts of the Third Reich

Part 1 Prologue: Time to Raise an Outcry - German judges oppose the forces of reactions the enforcement of conformity the judges of the Weimar republic. Part 2 The German legal system from 1933 to 1945: the Reichstag Fire Trial jurists Coordinate themselves the legal system during the state of emergency treason and treachery - political opposition and the courts purges at the bar nazi jurisprudence civil servants become the Fuhrer's political troops creation of the concentration camps Protecting the Race the courts and eugenics the euthanasia programme defenders of the - the Supreme court as a Court of Appeals arbitrary decisions in everyday life the people's court summary courts of the Inner Front - jurisdiction of the special courts Correcting decisions - the judicial system and the police the legal officers' corps - military courts in the Second world War resistance from the bench. Part 3 Aftermath: collapse and reconstruction restoration in the legal system coming to terms with the past the opposition goes on trial again law schools punishing nazi criminals the deserving and the undeserving - reparations for the criminals and their victims jurists on trial injustice confirmed a latter-day Condemnation of nazi justice an attempt at an explanation.

Children of Perpetrators of the Holocaust: Working through One’s Own Moral Self

The present study tests stages in the ability of some children of perpetrators of the Holocaust in Germany to work through emotional and moral issues regarding their fathers' perpetrating role during the Third Reich. The following questions are raised: Did they try to distance themselves by playing down the Holocaust and the moral meaning of their fathers' involvement in it? Did any children try to work through issues relating to their fathers' impaired morality? Did any children successfully reach the stage of integration? Fifty-seven persons were contacted by the author between September 1985 and June 1987, of whom 9 refused to be interviewed. Thirty interviewees were children whose fathers had taken an active part in the implementation of the euthanasia program, in the Einsatzgruppen, in the extermination camps or in related activities. The fathers of the remaining 18 interviewees were affiliated with SS units at times and in places where the atrocities took place, but what they actually did or did not do was not proven. In general, there was an almost total silencing of accounts of the extermination process in homes and schools. Acknowledgment, if any, of the atrocities appeared through accounts of trials and friends and in newspapers or, only recently, through the children's active searching. When children who learned what their father-perpetrator had done during the war also came to understand the moral implications, they usually experienced severe emotional conflict, which they had to confront on their own. Only a few succeeded in walking across a very narrow bridge to a working through of the related issues and emotions. The implications of the present analysis for future research on the prevention and outcomes of genocide are discussed.

Changing Attitudes and Practices in Forgoing Life-Sustaining Treatments

Advances in medical technology and practices have been associated with improved patient outcomes. At times, the price of this progress has included great financial costs and human suffering. During the last two decades, there have been significant changes in medical practices in America. In the late 1960s and early 1970s, the removal of a respirator or hydration or nutrition from a patient who was not brain dead was considered a deviation from accepted medical practices. In 1976, the Quinlan case allowed the removal of a ventilator from a patient in a persistent vegetative state. Subsequent court decisions in the 1980s have equated hydration and artificial feeding with other forms of life-sustaining treatments and have allowed their withdrawal in patients who were not terminally ill. Prominent physicians have recently stated that it is not immoral for a physician to assist in the rational suicide of a terminally ill patient. Active euthanasia programs in the United States are likely in the near future.

Protest Views of Singer

In Reply.— Both Bongiovanni and Callie refer to Nazi Germany as a warning against abandoning the sanctity-of-life view. This appeal to the slippery slope argument is a gross oversimplification of the differences between our society and Hitler's Germany. Alexander, on whom Bongiovanni relies, neglects the importance of Nazi racism and of the fact that the Nazi euthanasia program was not intended for the benefit of the patients—it was conducted secretly, relatives were deceived about what happened, and privileged groups such as veterans were exempted from it.