Killing Babies, Compassionately, The Netherlands follows in Germany’s footsteps

by The Center for Bioethics and Culture on March 20, 2006

(from the weeklystandard.com) AT LAST A HIGH GOVERNMENT OFFICIAL in Europe got up thenerve to chastise the Dutch government for preparing to legalize infanteuthanasia. Italy’s Parliamentary Affairs minister, Carlo Giovanardi,said during a radio debate: “Nazi legislation and Hitler’s ideas arereemerging in Europe via Dutch euthanasia laws and the debate on how tokill ill children.”

Unsurprisingly, the Dutch, ever prickly about internationalcriticism of their peculiar institution, were outraged. Giovanardi’scritique cut so deeply that even Dutch Prime Minister Jan PeterBalkenende felt the need to respond, sniffing, “This [Giovanardi’sassertion] is scandalous and unacceptable. This is not the way to getalong in Europe.”

As is often the case in the New Europe, what is said mattersmore than what is done. Thus, the prime minister of the Netherlandsthinks that killing babies because they are born with terminal orseriously disabling conditions is not a scandal, but daring to pointout accurately that German doctors did the same during World War II,is.

That being noted, one wishes Giovanardi had thought twice beforeraising the Nazi specter. Partly, this is because nothing we aretalking about today matches the scope or magnitude of Nazi crimes. As aresult, accusing people of Nazi-like behavior allows those amplydeserving of moral condemnation to deflect reproaches. Thus, Giovanardisays that killing disabled babies is what the Nazis did, and the Dutchmerely retort (correctly) that they are not Nazis.

Still, the “Nazi” analogy is worth exploring, precisely because it is unequivocally true that German doctors didkill thousands of disabled babies, for which a few such physicians werehanged at Nuremberg. Dutch apologists know this, of course. But theyclaim that the Netherlands’ infant euthanasia program is substantiallydifferent: Dutch doctors are motivated by compassion whereas the Germans’ were motivated by the bigotry of racial hygiene. Of course it is the act ofkilling disabled and dying babies that is wrong, not the motivation.But even leaving that aside, the Dutch defense is not as persuasive asPrime Minister Balkenende would like to believe.

German Euthanasia 1938-1945

THE SEEDS OF GERMAN EUTHANASIA were planted in 1920 in the book Permission to Destroy Life Unworthy of Life (Die Freigabe der Vernichtung lebensunwerten Leben).Its authors were two of the most respected academics in theirrespective fields: Karl Binding was a renowned law professor, andAlfred Hoche a physician and humanitarian.

The authors accepted wholeheartedly that people with terminalillnesses, the mentally ill or retarded, and deformed people could beeuthanized as “life unworthy of life.” More than that, the authorsprofessionalized and medicalized the concept and, according to RobertJay Lifton in The Nazi Doctors, promoted euthanasia in thesecircumstances as “purely a healing treatment” and a “healingwork”–justified as a splendid way to relieve suffering while savingmoney spent on caring for the disabled.

Over the years Binding and Hoche’s attitudes percolated throughoutGerman society and became accepted widely. These attitudes were stokedenthusiastically by the Nazis so that by 1938 the German governmentreceived an outpouring of requests from the relatives of severelydisabled infants and young children seeking permission to end theirlives.

The key test came in late 1938 when the father of “Baby Knauer,” aninfant born blind and missing his leg and part of his arm, wrote Hitlerrequesting permission to have his child “put to sleep.” As described byLifton and other historians, Hitler was quite interested in the caseand sent one of his personal physicians, Karl Rudolph Brandt, toinvestigate. Brandt’s instructions from his Führer were to verify thefacts of the baby’s condition and, if found to be true, to assure thechild’s doctors and his parents that if he was killed, no one wouldface punishment. The doctors in the case who met with Brandt agreedthat there was “no justification for keeping the child alive.” BabyKnauer soon became one of the first victims of the Holocaust.

Hitler later signed a secret decree permitting the euthanasia ofdisabled infants. Sympathetic physicians and nurses from around thecountry–many not even Nazi party members–cooperated in the horrorthat followed. Formal “protective guidelines” were created, includingthe creation of a panel of “expert referees,” which judged whichinfants were eligible for the program.

Beginning in early 1939, babies born with birth defects or withcongenital diseases were euthanized. Their doctors would admit theseunfortunate infants to medical clinics, where they would be killed. Thepractice quickly became systematized. Regulations made it mandatory formidwives and doctors to notify authorities whenever a baby was bornwith birth defects. These cases would be reviewed by the euthanasiareferees to determine if the children were eligible for euthanasia.Those deemed killable were usually dispatched via an overdose of adrug, most typically a sedative called Luminal. The euphemism of choicefor this murder was “treatment.” Most, but not all, of this killing wasdone in secret.

IT IS IMPORTANT TO NOTE that throughout the years in whicheuthanasia was performed in Germany, whether as part of the officiallysanctioned government program or otherwise, the government did notforce doctors to kill. Participating doctors had become true believers,convinced they were performing a valuable medical service for their”patients” and their country.

Eventually, the “success” of the infant euthanasia program led tothe infamous “T-4” project in which adult disabled German citizens weremass murdered. Hitler eventually canceled the T-4 program in the faceof public protests but that didn’t matter. From around 1943 until a fewweeks after the end of the war, some doctors went on a eugenickilling rampage. Known today as “wild euthanasia,” during the later waryears German doctors killed any patient they pleased, often withoutmedical examination, usually by starvation or lethal injection.

Dutch Infant Euthanasia

IN 2004, Groningen University Medical Center made internationalheadlines when it admitted to permitting pediatric euthanasia andpublished the “Groningen Protocol,” infanticide guidelines the hospitalfollowed when killing 22 disabled newborns between 1997 and 2004. Themedia reacted as if killing disabled babies in the Netherlands wassomething new. But Dutch doctors have engaged in infanticide for morethan 15 years. (A Dutch government-supported documentary justifyinginfant euthanasia played on PBS in 1993. Moreover, a study published in1997 in the Lancet determined that in 1995, about 8 percent ofall infants who died in the Netherlands–some 80 babies–wereeuthanized by doctors, and not all with parental consent; this figurewas reproduced in a subsequent study covering the year 2001.)

As far back as 1990, the Royal Dutch Medical Association (KNMG)published a report intended to govern “life-terminating actions” takenagainst incompetent patients, including severely disabled newborns. TheKNMG approved of pediatric euthanasia if the baby is deemed to have an”unlivable life,” a concept disturbingly close to Binding and Hoche’s”life unworthy of life.”

The “livableness” of a newborn’s life is determined by a combination of factors, including the following:

* The expected measure of suffering (not only bodily but also emotional–the level of hopelessness)

* The expected potential for communication and human relationships,independence (ability to move, to care for oneself, to liveindependently), self-realization (being able to hear, read, write,labor), and the like.

* The child’s life expectancy.

If the infant’s “prospects” didn’t measure up,
the child could be euthanized.

The subsequently compiled Groningen Protocol–which is expected toform the basis for the official approval of Dutch pediatriceuthanasia–similarly created categories of killable babies: infants”with no chance of survival,” infants with a “poor prognosis and aredependent on intensive care,” and “infants with a hopeless prognosis,”including those “not depending on intensive medical treatment but forwhom a very poor quality of life… is predicted.” In other words,infant euthanasia is not restricted to dying babies but can be based onpredicted serious disability.

SO, WAS GIOVANARDI CORRECT in his comparison of Dutch infanteuthanasia with that of Germany circa 1938-1945? No and yes. Certainlythe breadth and scope of the killing in Germany far exceeded anythingthat is ever likely to happen in the Netherlands. And, to their credit,the Dutch unquestionably disdain the kind of pernicious socialDarwinism that helped fuel the German euthanasia pogrom. Nor doespediatric euthanasia seem to be financially motivated, which alsoplayed a part in German infant euthanasia.

But the Netherlands cannot escape this ugly fact: Dutch doctors killscores of babies each year and justify this fundamental abuse of humanrights upon the inherently discriminatory concept that they can decidethat another human being’s life is of such low quality it has nobusiness being lived.

In this sense, the Dutch infanticide program is explicitly akin tothe murder of Baby Knauer in 1938. Unless we decide to revise ourhistorical assessment of that crime and proclaim Hitler’s authorizationfor the baby’s euthanasia as compassionate and right, the systematicprogram of Dutch infant euthanasia should be loudly and universallycondemned.

Wesley J. Smith is a senior fellow at the Discovery Institute,an attorney for the International Task Force on Euthanasia and AssistedSuicide, and a special consultant to the Center for Bioethics andCulture. His updated Forced Exit: Euthanasia, Assisted Suicide and the New Duty to Die, from which some of this material was taken, will be released soon by Encounter Books.

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