Saturday, September 11, 2004

It Can Happen Here: Eugenics, Abortion, Euthanasia, and Mental Screening

Sherwin B. Nuland, writing at The New Republic Online in "When Medicine Turns Evil:
The Death of Hippocrates
," says:
The exhibition [on eugenics at the United States Holocaust Memorial Museum in Washington] details the influence of eugenics on determining Nazi policy from the time of the party's assumption of power in 1933 until the end of World War II....Though some have thought of it as an applied science, eugenics is in fact more a philosophy than a science. Its proponents based their notions on genetics, having as their purpose the improvement of the breed. The word was defined exactly that way in 1911 in a book by the eminent American biometrician and zoologist Charles Davenport, director of the Eugenics Record Office at Cold Spring Harbor, New York (elected to the National Academy of Sciences in the following year), who called it "the science of the improvement of the human race by better breeding."

Eugenicists believed that it is possible, and even a good idea, to attempt to enhance the quality of our species by regulating the reproduction of traits considered to be inheritable....

When Gregor Mendel's forgotten experiments on inheritable characteristics were rediscovered in 1900, a certain biological legitimacy was conferred on these notions, as unknown factors (later shown to be genes) were identified as the source of traits immutably passed on to offspring, and it was perceived that some are dominant and others recessive....

Once the Mendelian laws of heredity were widely known, eugenics movements were founded in the United States, Great Britain, Canada, Russia, several of the nations of Europe, and even Latin America and Asia. Eugenics research institutes were established in more than a few of these countries, most prominently the United States, England, Germany, Denmark, and Sweden....

Not unexpectedly, eugenics was a creed that appealed to social conservatives, who were pleased to blame poverty and crime on heredity. Liberals--or progressives, as they were then usually called--were among its most vigorous opponents, considering the inequities of society to be due to circumstantial factors amenable to social and economic reform. And yet some progressive thinkers agreed with the eugenicists that the lot of every citizen would be improved by actions that benefited the entire group. Thus were the intellectual battle lines drawn.

It is hardly surprising that National Socialism in Germany would embrace the concept of eugenics. But from the beginning, there was more to Nazi support than the movement's political appeal or the promise of its social consequences. As is clear from the exquisitely structured and thoroughly reliable accounting of "Deadly Medicine," the stage was set for the emergence of a drive toward a uniquely German form of eugenics long before the average citizen had ever heard of Adolf Hitler....

The earliest hint of the coming storm had appeared around the turn of the twentieth century, when the German biologist August Weismann definitively showed that changes acquired by an organism during its lifetime cannot be inherited. Weismann's findings overthrew a theory promulgated a hundred years earlier by Jean-Baptiste Lamarck, holding that such adaptations could be passed down to succeeding generations. So-called Lamarckianism had incited controversy since its inception, and its debunking added fuel to the fire of those who believed that human beings inherit not only fixed physical characteristics but also mental and moral ones....

[M]any [eugenics researchers] were serious scientists whose aim was to discover ways in which the very best of the inherited characteristics might be encouraged and the very worst eliminated, with the ultimate goal of curing the ills of society...."By the early 1900s, proponents of eugenics everywhere began to offer biological solutions to social problems common to urbanizing and industrial societies."...

To large numbers of its host of well-meaning adherents, eugenics was a scientifically and even mathematically based discipline, and many of them actually thought of it as a measurable, verifiable branch of biology that held the promise of becoming an enormous force for good.

Though it must be admitted that the United States, Britain, and Germany became centers for eugenics in part because of each nation's certainty of its own superiority over all peoples of the world, the fact is that these countries were hardly more chauvinistic than most others. The primary reason they led in eugenic studies is traceable to a far more significant factor: their leadership in science....

The German-speaking institutions were so far ahead of those of every other nation that leading clinicians, researchers, and educators in Europe, Asia, and the Americas considered their training incomplete unless they had spent a period of study at such centers of learning and innovation as Berlin, Würzburg, Vienna, and Bern, or one of the small academic gems among the many outstanding universities in Germany, such as Göttingen, Heidelberg, or Tübingen....

The Germanic medical establishment was heir to a grand tradition of accomplishment and international respect; when it took on eugenics as a worthy goal, it was convinced of the righteousness of its intent. Even when some of its own members began to voice concerns about the direction in which the research and its application were going, many authoritative voices drowned out the relatively few protests.

The process rolled on within a worldwide cultural milieu conditioned by the universally accepted belief that the earth's population was divided into races, and further subdivided into ethnic groups within them....

The rising power of the international eugenics movement manifested itself in predictable ways, from anti-immigration laws to compulsory sterilization for those deemed unfit, enacted in such "progressive" countries as Sweden, Denmark, Finland, Norway, and parts of Canada and Switzerland -- as well as the United States, where some two dozen states had enacted sterilization laws by the late 1920s. The most dramatic moment for Americans came on May 2, 1927, when the Supreme Court upheld the constitutionality of the state of Virginia's intention to carry out tubal ligation on a "feebleminded" young woman named Carrie Buck, who had given birth to an illegitimate daughter also judged to be retarded, as was Carrie's mother. Writing the majority opinion in Buck v. Bell, Justice Oliver Wendell Holmes Jr. stated
It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes.... Three generations of imbeciles are enough.
To a twenty-first-century sensibility, the equation with vaccination is at the very least questionable, but at the height of eugenic thinking, the eight-to-one majority among the justices reflected the general mood of a nation fifteen of whose states (the only ones of the twenty-seven reporting) would by 1933 have sterilized 6,246 of the insane, 2,938 of the feebleminded, fifty-five epileptics, sixteen criminals, and five persons with "nervous disorders." More than half of these procedures were carried out in four state mental hospitals in California. In almost every state, the law applied only to residents of public facilities, which meant that lower-income groups were affected far out of proportion to their numbers in the population. Some sixteen thousand Americans would eventually be sterilized.

At this time Germany had not yet enacted any sterilization laws, in spite of strong advocacy and much expression of admiration for the American system by the so-called racial hygienicists. All of this foot-dragging ended when Hitler came to power in 1933, and it ended with a vengeance....Between 1934 and 1945, some four hundred thousand people would be forcibly sterilized, most before the war began in 1939. These included, in 1937, about five hundred racially mixed children of German mothers and black colonial soldiers in the French army occupying the Rhineland.

The basis for sterilizing these children was the outgrowth of the notion that a hereditarily gifted nation can retain its greatness only if the heredity remains pure, a thesis that had been widely accepted in Germany (and by many citizens of other countries as well, including our own) for generations....By 1937, the principle of pure blood had manifested itself in many ways, most particularly in the persecution of Jews and the passage of the Nuremberg laws of 1935, officially called "the Law for the Protection of German Blood and German Honor," by which marriage and sexual relations were prohibited between Jews and people of "pure" German blood. Shortly thereafter the Reich Citizenship Law went into effect, declaring that only "Aryan" Germans were citizens and Jews were to be considered "subjects." This law defined who was a Jew and who was a so-called Mischling, an individual of mixed parentage. From these beginnings as an outgrowth of eugenics -- itself a misconceived attempt toward utopia -- Nazi racial policy would culminate in the murder of millions and the near-annihilation of European Jewry....

The theorists and the scientists who had until 1933 been able, and sincerely so, to claim detached objectivity for their research, could no longer delude themselves about the purposes for which it was being used. With the ascent to power of the Nazis, they had become, willy-nilly, active participants in the beginnings of genocide....

The murder of children was only the beginning. In October, 1939, Hitler authorized euthanasia for adults housed in German asylums....Between January, 1940 and August, 1941, some seventy thousand adult patients were gassed, their only crime being that they were unproductive members of the Nazi state....

But far worse was to follow....On January 20, 1942, the Wannsee Conference established the policy that would lead to the Holocaust, and from then on the real question became not whether but how....

Looking back with the wisdom of hindsight, it seems so clear that eugenics had always been a dangerous notion, and that its adherents were either deluded or racist. But the fact is that such a realization was slow in coming, and appeared only after matters had gotten completely out of hand and the stage set on which horrendous events would take place. Among the several reasons that medically trained students of eugenics allowed matters to turn so ugly was their failure to recognize a basic fact about the scientific enterprise, which is well known to historians and philosophers of the subject but continues to elude even some of the most sophisticated men and women who actually do the work. Though this fact characterizes science in general, it is even more applicable to the art that uses science to guide it, namely medicine, which was, after all, the underlying source of the momentum that drove the application of eugenic principles.

The basic fact to which I refer is that neither medicine nor science itself derives its "truths" in the thoroughly detached atmosphere in which its practitioners would like to believe they work. Especially in medicine and medical research, the atmosphere not only is not detached, but it is in fact largely the product of the very influences from which its participants seek to free themselves in order to isolate observations and conclusions from external sources and subjectivity. For an early explication of this, we may with profit turn to the father of Justice Holmes, Oliver Wendell Holmes Sr., who was for some years the dean of Harvard Medical School and bid fair to be called the dean of American medicine in the mid-nineteenth century. Here is what the elder Holmes said in an oration delivered to the Massachusetts Medical Society in 1860, titled "Currents and Countercurrents in Medical Science":
The truth is, that medicine, professedly founded on observation, is as sensitive to outside influences, political, religious, philosophical, imaginative, as is the barometer to the changes of atmospheric density. But look a moment while I clash a few facts together, and see if some sparks do not reveal by their light a closer relation between the Medical Sciences and the conditions of society and the general thought of the time, than would, at first, be suspected.
The medical theory of any era--and to a somewhat lesser extent the science on which it is based--arises in a setting that is political and social. Not only that, but its directions and even its conclusions are influenced by the personal motivations, needs, and strivings of those who practice it, some of which may not be apparent to these men and women themselves. Though we would have it otherwise, there is no such thing as a thoroughly detached scientific undertaking. The danger in this lies not so much in its truth, but in the inability of society and the community of scientists to recognize the pervading influence of such an unpalatable reality, which flies in the face of the claims that form the groundwork for our worship of the scientific enterprise....

By itself, each of the small steps taken by the eugenics movement in the early part of the twentieth century seemed not just innocuous but actually of real interest as a subject for consideration. Attached to the names of highly regarded scientific thinkers, the theories intended to improve the general level and functioning of a nation had a certain appeal to men and women concerned about social issues....

At what point would I have realized the direction in which all of this was hurtling? Perhaps not until it was too late. Looking back with unbridled condemnation on the beginnings of racial hygiene does not enlighten today's thoughtful man or woman in regard to how he or she might have responded at the time....

This is not to say that there had not from the beginning been enough evil men lurking at the ready to push the notion of racial hygiene down the slope whose slipperiness they recognized long before men of goodwill awoke to the reality of what they had wrought. Nor is it to say that -- even when the worst was becoming evident -- many others did not continue to allow the slide to take place and to accelerate because, after all, those being sterilized and euthanized were so unlike themselves. But it is most certainly to say that there is good reason for so many wags and wise men down the centuries to have repeatedly observed that the road to hell is paved with good intentions. Sometimes "anarchy is loosed upon the world" not because "the best lack all conviction," but because they firmly and honestly believe they are doing the right thing.

Doing the right thing: there has never been a period in the modern era when our species has relaxed its fascination with the idea of improving itself....A century ago the buzzword was eugenics. Today it is enhancement. Eugenics is meant to improve the breed and enhancement is meant to improve the individual, but they are too similar in concept to allow us to rest easy with either one.

Today's molecular biologists and geneticists have dipped a very powerful oar into the ongoing stream of debate about heredity versus environment. Every year -- every month -- we read about newly discovered genetic factors determining not only physical characteristics but those of morals and mind as well. Sometimes we are even told their precise locations on the DNA molecule. No one knows how much of this will hold up in the coming decades, but we can be sure that a significant proportion of it will be confirmed. Some authoritative scientific voices are telling us that we should take advantage of the new knowledge to fulfill our fantasies of improving ourselves and indeed our species.

These new findings -- and the enthusiasm of some of our scientists -- take us huge steps beyond the ultimately shaky theoretical platform on which the eugenics movement stood. The debate has for several years been raging between those who look to the lessons of the past and shout warnings and those who see only the utopia of an enhanced future and shout encouragement. In a powerful discourse against reproductive cloning -- only one manifestation of the brave new world being foreseen -- Leon R. Kass wrote in these pages of "a profound defilement of our given nature ... and of the social relations built on this natural ground." At the far other end of the spectrum is Gregory Stock, director of the Program on Medicine, Technology, and Society at UCLA and one of the new breed called "futurists," whose enthusiasm for bio-psychoengineering (Kass's cautionary term for such feats of creativity) and a post-human future is so unbounded that he has gone so far as to title his most recent book Redesigning Humans: Our Inevitable Genetic Future. Inevitable! Even more frightening than the confidence of Stock's vision for his fellow men and women is the title of the book's first chapter, in which he outlines his image of how the laboratory will come to control evolution: he calls it "The Last Human," meaning those few of us remaining whose bodies and minds have been formed by nature alone.

This is genuinely terrifying stuff. Not since the first half of the twentieth century have prominent thinkers been so starry-eyed at the thought of controlling the future of our species, or at least that privileged portion of it that will have the financial, cultural, and other wherewithal to take advantage of the offer being presented to us....Though I admire Stock for his sincerity and the magnitude of his intellect, I am sure that I would have admired more than a few of the early German eugenicists for the very same reasons had I known them as well as I know him. What concerns me is not the progression of the technology, but the inherent creeping hazards in its philosophical underpinning, which is ultimately to improve the breed.

It all sounds very familiar. Looking backward, we can now see the danger in state-enforced policies of improvement, but too many of us have yet to awaken to the equally dangerous reality of improvement that is self-determined. We are once again standing on the slope, from the top of which the future we may be wreaking is already visible. Now is the time to recognize the nature of human motivation -- and the permanence of human frailty.
Now, think about the "progressive" impulses that underlie abortion (especially selective abortion), involuntary euthanasia, and forced mental screening -- all of them steps down a slippery slope toward state control of human destiny.