During World War II, German doctors euthanized disabled babies and adults. As Robert Jay Lifton reported in The Nazi Doctors: Medical Killing and the Psychology of Genocide, no one forced these doctors to kill. Many of them believed euthanasia to be a “healing treatment” that ended “unlivable” lives, liberated families from the burden of caregiving, and kept the country from “wasting” scarce resources on the lebensunwertes leben (“life unworthy of life”). Such was the fruit of years of utilitarian indoctrination and the resulting societal acceptance of eugenics ideology.
At the time, Netherlander doctors were well aware that German medical ethics had devolved. Thus, when the German commander of the occupation, Arthur Seyss-Inquart (now known as “the Butcher of Holland”), commanded that Dutch medical practices adjust to the German way, Netherlander doctors courageously defied the order.
Seyss-Inquart was furious. First he exacted financial revenge, stripping doctors of their medical licenses. The doctors stopped signing birth and death certificates, but continued treating their patients. Seyss-lnquart then took lethal action. One hundred doctors were arrested at random and shipped to concentration camps, from whence few returned. Still, the remaining doctors held their ground. They would not turn on their most vulnerable patients.
Eventually, in a triumphant success story of peaceful civil disobedience, the Germans backed down and rescinded the order. The medical adviser to the Nuremberg Trials, Dr. Leo Alexander, wrote about the episode in the New England Journal of Medicine:
Thus, it came about that not a single euthanasia or nontherapeutic sterilization was recommended or participated in by any Dutch physician. They had the foresight to resist before the first step was taken, and they acted unanimously and won out in the end.
But times have changed, and not for the better. It is a painful irony that some of the very policies Seyss-Inquart could not force upon Netherlander doctors have been willingly embraced by their contemporary counterparts—including the technically illegal but widely accepted infanticide of disabled babies.
Today, most Dutch doctors openly embrace euthanasia and assisted suicide—and not only for those who are dying. A just-released study in the Journal of Medical Ethics delineates the profoundly corrupted medical morality of the Netherlands. The study asked doctors about their practice of, and attitudes toward, euthanasia. An astonishing 60 percent of respondents reported having lethally injected a patient. Demonstrating how thoroughly euthanasia consciousness has permeated medical ethics in the Netherlands, only 14 percent of respondents said that they could not conceive of killing a patient.
Even though 40 percent of the surveyed doctors had never performed euthanasia, almost all reported that they would under certain circumstances. Making plain the morally infectious nature of euthanasia, large percentages reported that they could “conceive of” killing patients who were not terminally ill or, in some cases, who were not even physically ailing. A whopping 34 percent could “conceive of” killing a patient as a way to end suffering caused by “psychiatric disease.” Forty percent of doctors are willing to kill “early-stage dementia” patients, and 33 percent are willing to kill “advanced dementia” patients who had requested as much in an advance medical directive. Death statistics bear out medical views: euthanasia killings of the mentally ill have sharply increased.
A wide swath of doctors expressed willingness to kill the elderly. More than a quarter (27 percent) of the doctors said they would kill an elderly person “with medical grounds for suffering but in the absence of severe physical or psychiatric disease.” Even more startling, 18 percent disclosed that they could “conceive of” euthanizing an elderly person who was simply “tired of living, without medical grounds for suffering.”
Mark Twain warned that there are damn lies and then there are statistics. But sometimes statistics tell hard truths. Decades of medicalized killing have euthanized Hippocratic values in the Netherlands. As our country debates whether to grant American doctors wider authorization to end lives, we should pay careful attention. If we allow our medical ethics to be remade in the Netherlander image, in a few decades it may be nearly impossible to find a doctor who is not willing to kill.