Euthanasia in Germany before and during the Third Reich (review)

This slim work of eighty-three pages of text consists of a translated and slightly updated version of three chapters from Benzenhöfer’s earlier book, Der gute Tod? Geschichte der Euthanasie und Sterbehilfe (Göttingen, Vandenhoeck & Ruprecht, 1999; The Good Death? History of Euthanasia and Assisted Suicide). Der gute Tod? provided an excellent survey of the history of euthanasia from ancient times to the present, with an emphasis chronologically on the twentieth century and geographically on Germany.

Benzenhöfer is a trustworthy guide to the history of euthanasia in Germany. Like Hans-Walter Schmuhl in Rassenhygiene, Nationalsozialismus, Euthanasie (Göttingen, Vandenhoeck & Ruprecht, 1984) and myself in From Darwin to Hitler: Evolutionary Ethics, Eugenics, and Racism in Germany (New York, Palgrave, 2004), Benzenhöfer argues forcefully that social Darwinism—such as that espoused by Ernst Haeckel and Alexander Tille—was one of the most important intellectual influences on the early formation of euthanasia ideology in Germany. In addition to Haeckel and Tille, he also argues that Nietzsche, despite the ambiguity of many of his statements, still contributed to the acceptance of euthanasia in Germany.

Eugenics was another important movement contributing to euthanasia ideology in the early twentieth century. It stressed biological determinism, biological inequality, and the need to rid the world of those deemed “unfit” or “inferior.” Though many eugenicists hoped this could be achieved through controlling reproduction, a few began to promote the idea that some people were “lives unworthy of life,” a term popularized by the jurist Karl Binding and the psychiatrist Alfred Hoche.

Nazi officials and many cooperating physicians imbibed these ideas and implemented them in radical fashion. Before World War II broke out in September 1939, Hitler had already ordered his underlings to organize a campaign to kill the disabled. In German-occupied Poland, mental patients were shot or gassed in late 1939 and 1940. In Germany, the infamous T-4 program set up six killing centers, which primarily used carbon monoxide gas to kill about seventy thousand. After Hitler called off the T-4 program in August 1941, tens of thousands were still killed in a more decentralized process.

This new book is a missed opportunity in several respects. First, it covers much of the same territory as several excellent books, such as Henry Friedlander’s Origins of Nazi Genocide: From Euthanasia to the Final Solution (Chapel Hill, University of North Carolina Press, 1995) and Michael Burleigh’s Death and Deliverance: Euthanasia in Germany, 1900–1945 (New York, Cambridge University Press, 1994). Despite Benzenhöfer’s claims that both these works contain errors, his own brief work will not likely supplant these as the standard scholarly works on the subject. Second, I lament that the entire book was not translated, because the chapters from Der gute Tod? that were not translated really would have filled a scholarly lacuna. Ian Dowbiggin’s Concise History of Euthanasia: Life, Death, God, and Medicine (Lanham, Maryland, Rowman & Littlefield, 2005) is an excellent survey, but Der gute Tod? contains greater depth on many topics. Third, the translation is not great. Most of it is serviceable, but some word usage makes me suspect that the translators are not native English speakers (such as misusing the word “overhear” on p. 21).

The most important sentence of the book is convoluted and illustrates the translation problem: “If I were forced to condense my book into one sentence, it would read: during the Nazi period, against the background of the (planned) war, bureaucrats close to Hitler and the doctors willing to perform euthanasia they rather quickly made their accomplices were able, with Hitler’s approval, to apply the ideology of ‘the destruction of life unworthy to life,’ which had previously been only a theory, an opportunity they were able to take not least due to numerous helpers and innumerable people who allowed it to happen, with deadly consequences for many physically and mentally...