Do We Owe the Nazi Doctors an Apology?

aryan-master-raceIn 1933, Nazi Germany established the Law for the Prevention of Hereditarily Diseased Offspring, which allowed compulsory sterilization of any citizen who suffered from a potential genetic disorder as determined by a “Genetic Health Court” (similar forced sterilization policies were in place at that time in California as well). These movements were largely based upon the well established eugenics movement in the United States.

By 1934, over 5,000 people per month were being forcibly sterilized in Germany. California eugenicist, C. M. Goethe boasted to a colleague:

You will be interested to know that your work has played a powerful part in shaping the opinions of the group of intellectuals who are behind Hitler in this epoch-making program. Everywhere I sensed that their opinions have been tremendously stimulated by American thought . . . I want you, my dear friend, to carry this thought with you for the rest of your life, that you have really jolted into action a great government of 60 million people.

A thought that is now disturbing and chilling to today’s average American. Or is it?

On February 4th, the New York Times ran an article in their Health section with the headline, “Gene Tests, Healthy Children and Ethical Doubt.” The writer of the article, Gina Kolata, tells the story of Bradley and Amanda Kalinsky, who, in order to eliminate the possibility of their children contracting a rare, genetic neurological disease that runs in Amanda’s family, opted for in vitro fertilization.

Kolata reports:

Genetic testing of embryos has been around for more than a decade, but its use has soared in recent years as methods have improved and more disease-causing genes have been discovered. The in vitro fertilization and testing are expensive — typically about $20,000 — but they make it possible for couples to ensure that their children will not inherit a faulty gene and to avoid the difficult choice of whether to abort a pregnancy if testing of a fetus detects a genetic problem.

The process of embryonic testing requires the creating of an embryo in a petri dish by fertilizing the egg of a female with the sperm of a male. The embryos are then tested for the genetic abnormality and the potentially diseased embryos are then destroyed in favor of the embryos that do not test positive for a certain disease.

The Kalinskys had 12 embryos from the in vitro fertilization process. Six of which tested positive for the disease she carries and were subsequently destroyed. “That was a really hard thing to do,” Ms. Kalisky admitted. But for her, “destroying a fetus that is already growing inside of me was much different than discarding embryos that had not yet implanted.”

Her statement raises a couple of questions. First, why was the discarding of the diseased embryos such a “hard thing to do”? It seems that she is accepting the fundamental fact that those embryos were indeed human beings. Which brings me to the second question, why is it so much more difficult to discard a diseased embryo than to discard a diseased fetus? If her ultimate motivation is the quality of life for her children, then there should be no moral or ethical difference between the destruction of an embryo verses the destruction of a fetus.

Some bioethicist claim that preimplantation diagnostic testing is morally obligatory to spare the next generation from these types of diseases. Why stop at the preimplantation stage? If discarding potentially diseased embryos is morally acceptable, then discarding potentially diseased fetuses is also morally acceptable. As is discarding potentially diseased pre-born babies. And as the nation of Belgium has recently decided, discarding terminally ill children at any age is also morally acceptable.

Think of the benefits of eliminating everyone with a genetic disease! We could create an entire race of human beings that are genetically pure and thus superior! We could call them “The Master Race!” Oh wait, someone already tried that. In fact, under Nazi eugenics policy, it was required that marriage partners be tested for any hereditary diseases in order to preserve the racial purity of the Aryan race. So, in Nazi Germany, medical testing for genetic diseases was obligatory in order to spare the next generation from potential diseases. Sound familiar?

In essence what is being done here is the same thing that German medical ethicists were doing in the 1930s. Back then they called it lebensunwetes leben, or “life unworthy of life” and it was the standard operating procedure for the Nazis. Today we call it embryonic genetic testing. The only difference is that modern medical technology has given us the ability to recognize potential diseases in a person prior to adulthood, birth, and even implantation. It makes one wonder what the Nazis would have done if today’s medical technology would have been available to them 80 years ago. I submit that it would look a lot like what we are doing today with embryonic testing.

What kind of message is this sending to those that have already been born that suffer from some kind of disease? Are bioethicists saying that people with genetic diseases would have been better off if they were never born? Ironically, by opting to discard the embryos that tested positive for the potential genetic disease that she has, Ms. Kalinsky is essentially saying that it would have been better had she, herself, never been born.

In August of 1947, 14 Nazi doctors were found guilty of war crimes and crimes against humanity, which included “planning and performing the mass murder” of human beings, including the “incurably ill” and “deformed”. Seven of the doctors were sentenced to death and the remainder were given prison sentenced ranging from 10 years to life.

Interestingly, in the late 1940s, historians began to distance the eugenics movement in the United States from the Nazi eugenics movement, in spite of their obviously common roots. Following WWII there was a deafening outcry against the barbaric behavior of eugenics and the practices of the early 1900s were largely rejected. But not for long. The eugenicists have rebranded themselves as “reproductive geneticists” and made their practices less visible. There needs to be a regeneration of the furor against these immoral and unethical practices, or else we ought to reevaluate the Nazi eugenics policies and apologize to those 14 doctors that were found guilty.