Have we Learned the Lessons of History?

September 12, 2006

I’ve just become aware of an outstanding article that deserves your thoughtful consideration. Published in March of this year in BMC Medical Ethics, the open access article examines the intersection of specific views on human dignity, atrocities committed by the Nazis, and today’s bioethics debates.

Whenever the word Nazi is invoked, one must be cautious, and the author, Dónal P O’Mathúna (Lecturer in Health Care Ethics, School of Nursing, Dublin City University, Dublin, Ireland) is.

Any attempt to draw connections between the Nazi Holocaust and contemporary bioethical debate must be done carefully. Too often connections are made that are tenuous at best, and completely wrong at worst. Some claim it is impossible to draw any meaningful lessons from what was basically an “irrational lust for murder” [8]. Any mention of the Holocaust can raise so many emotions that rational discussion becomes difficult [9]. Some are offended that anything today could be compared to the Holocaust since it is viewed as the icon of absolute evil. Yet similarities do exist between some of the practices carried out by the Nazis and practices currently being debated. Some emphasise these similarities while others focus on the differences to avoid any connection. The claim is often made that “then is not now, and there is not here, and they are not us” [10]. The assumption is that we could never do what they did.

Yet they were people like us. Part of the internal anguish in examining the Holocaust comes from wondering whether we actually could do what they did. Some claim the Nazis were completely psychopathic. Others disagree, like Elie Wiesel who wrote that, “They did not think that what they were doing was wrong. They were convinced that what they did was good” [11]. They thought they were doing what was best for humanity, or at least for their Volk. Then and now, the same questions were asked. “Who shall live and who shall die? And, Who belongs to the community entitled to our protection? Then and now, the subject at hand is killing, and letting die, and helping to die, and using the dead” [12]. Then and now, similar arguments based on similar worldviews were used to justify controversial practices.

Abstract
The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1472-6939/7/2

Background
The justification for Nazi programs involving involuntary euthanasia, forced sterilisation, eugenics and human experimentation were strongly influenced by views about human dignity. The historical development of these views should be examined today because discussions of human worth and value are integral to medical ethics and bioethics. We should learn lessons from how human dignity came to be so distorted to avoid repetition of similar distortions.

Discussion
Social Darwinism was foremost amongst the philosophies impacting views of human dignity in the decades leading up to Nazi power in Germany. Charles Darwin’s evolutionary theory was quickly applied to human beings and social structure. The term ‘survival of the fittest’ was coined and seen to be applicable to humans.

Belief in the inherent dignity of all humans was rejected by social Darwinists. Influential authors of the day proclaimed that an individual’s worth and value were to be determined functionally and materialistically. The popularity of such views ideologically prepared German doctors and nurses to accept Nazi social policies promoting survival of only the fittest humans.

A historical survey reveals five general presuppositions that strongly impacted medical ethics in the Nazi era. These same five beliefs are being promoted in different ways in contemporary bioethical discourse. Ethical controversies surrounding human embryos revolve around determinations of their moral status. Economic pressures force individuals and societies to examine whether some people’s lives are no longer worth living. Human dignity is again being seen as a relative trait found in certain humans, not something inherent. These views strongly impact what is taken to be acceptable within medical ethics.

Summary
Five beliefs central to social Darwinism will be examined in light of their influence on current discussions in medical ethics and bioethics.

Acceptance of these during the Nazi era proved destructive to many humans. Their widespread acceptance today would similarly lead to much human death and suffering. A different ethic in needed which views human dignity as inherent to all human individuals.

You know what I’m going to say. Read . . . the . . . whole . . . thing