History Book: Medicine without ethics

Editor's note: The following text is a transcript of a podcast story. To listen to the story, click on the arrow beneath the headline above.

MARY REICHARD, HOST: Today is Monday, September 22nd. Good morning! This is The World and Everything in It from listener-supported WORLD Radio. I’m Mary Reichard.

NICK EICHER, HOST: And I’m Nick Eicher. Up next, the WORLD History Book.

In 1933 Adolf Hitler and his National Socialist party announce a troubling new law. One with its roots in the United States. WORLD’s Caleb Welde has the story.

CALEB WELDE: The Law for the Prevention of Offspring with Hereditary Diseases. Its name should have been warning enough. The details are much worse. The Nazi’s are seeking – in their words– "racial hygiene."

POELLE: This is a movement that really grew out of social Darwinist thinking.

Beth Griech-Polelle is chair of Holocaust studies at Pacific Lutheran University. Audio from the Midwest Center for Holocaust Education.

POELLE: And of course, at the root of social Darwinist thinking is the idea that there are certain groups of people who are of more value who are more superior to other people.

The law says anyone suffering from schizophrenia, manic-depression, Huntington's hereditary epilepsy, blindness or deafness, those with “severe physical deformities”, alcoholics, and anyone deemed “feeble-minded” can be forcibly sterilized starting on January 1st, 1934.

KOMRAD: What happened in Nazi Germany did not arise …from nowhere.

Mark Komrad teaches at Johns Hopkins, and he’s served two terms on the Ethics Committee of the American Psychiatric Association.

KOMRAD: The United States was not just a template for Hitler, but in fact, was an inspiration for Hitler.

The United States is the world-leader in eugenics research and legislation. When the Nazis pass their law twenty four American states already have forced sterilization laws on the books. Hitler personally studied several of these.

The U.S. Supreme Court ruled in favor of forced sterilization in 1927 saying it would be “better for all the world” if, “instead of waiting to execute degenerate offspring or let them starve for their imbecility” they were sterilized. Here’s Komrad reading more of Justice Oliver Wendell Holmes opinion:

KOMRAD: “We have seen that the public welfare may call upon the best citizens for their lives. It would be strange if it would not call upon those who already sap the strength of the state for lesser sacrifices.”

Holmes goes on to compare mandatory vaccination with mandatory sterilization saying since the government can mandate one it can mandate the other. More than ten-thousand Americans are forcibly sterilized by 1933.

Back in Germany the Nazis are busy creating a second national court system. “Heredity health courts” will be made up of a eugenist, a doctor, and a lawyer.

POELLE: Any person can recommend if they know that there is someone who should be investigated and be prohibited from reproducing, then they should submit those names for consideration to the hereditary health court system.

The Nazis promote eugenic ideas in magazines and on the radio. They specifically target women.

POELLE: If you denounce your neighbor, you are actually more womanly for denouncing them, because you're a caregiver, you're a nurturer, and as a nurturer, you're nurturing the health of German society.

The government is also asking all doctors, nurses, social workers, and school teachers to report anyone with disabilities who walks into their offices or classrooms. Midwives must report all so called "deformed" and “questionable” births.

January 1’st, 1934. When the courts open, they are inundated with reports.

POELLE: Between 1934 and 1936, over 259,000 victims were denounced to these hereditary health courts.

Ninety percent are forcibly sterilized. Hitler deputy Rudolph Hess says ''National Socialism is nothing but applied biology.'' People look for loopholes like purposefully getting pregnant.

POELLE: And then they would show up on their sterilization date at that clinic and say, Well, you can't sterilize me because I'm pregnant. And so the Nazis add in now that if a woman shows up to that sterilization appointment and is pregnant, the doctor should perform an abortion and then sterilize her, all at the same procedure.

Catholic and Confessing churches oppose the government mandates but to little effect.

KOMRAD: You know, physicians were cooperating with this. Physicians were falling in line with this. …and so that kind of legitimized it.

By 1938, Propaganda chief Joseph Goebbels is blunt. “Our starting point is not the individual, and we do not subscribe to the view that one should feed the hungry, give drink to the thirsty, or clothe the naked. Our objectives are entirely different: we must have a healthy people in order to prevail in the world.”

Sterilizations continue through the fall of 1939 when the Nazis issue a new decree. Doctors and midwives are told they must register all children and infants under three who they suspect may have a congenital disability. Midwives are paid two Reichsmarks– or about twenty dollars today– for each child they register.

POELLE: And as this information, as this data, is being collected, clinics, about 30 or so clinics all across Germany are being set aside for the so called care, in quotations, of these children.

Sterilization is not the only “hygiene” scheme. In 1933, the Nazi Ministry of Justice released a detailed memo saying they wanted to allow doctors “to end the sufferings of incurable patients.” They insisted euthanasia would only be available to those demanding relief that at least two doctors would have to sign off on it, and that only a doctor could administer lethal drugs.

The news makes it to the front page of The New York Times a day later. The headline reads: “Nazis plan to kill incurables to end pain; German religious groups oppose move.”

For WORLD, I’m Caleb Welde.

WORLD Radio transcripts are created on a rush deadline. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of WORLD Radio programming is the audio record.