Der gute Tod? Euthanasie und Sterbehilfe in Geschichte und Gegenwart (review)

Udo Benzenhöfer. Der gute Tod? Euthanasie und Sterbehilfe in Geschichte und Gegenwart. Munich: C. H. Beck, 1999. 272 pp. DM 24.00; öS 175.00 (paperbound).

Doubtlessly Udo Benzenhöfer's intention in writing this book was to fill a gap, for a comprehensive description of Western ideas about euthanasia and assisting the dying from antiquity to the present, particularly in Germany, was lacking. He has well achieved this aim.

Proceeding in chronological order, euthanasia in antiquity is discussed from definitional, legal, philosophical, and medical points of view using the relevant international secondary literature. This also holds for a short chapter on Judaism and Christianity. Further contributions to "the good death" from the Renaissance to the first half of the nineteenth century are adequately reported: there are the utopias of Thomas More and Francis Bacon, along with those taking issue with Bacon in the early eighteenth century and those approving his use of drugs to ease the passage from life to death in the later eighteenth century. Quite influential among the latter were Nikolaas Paradys in Leiden and Christoph Wilhelm Hufeland in Berlin (Hufeland stimulated no fewer than seven Berlin M.D. theses on the subject between 1820 and 1850).

The focus of the book then turns to German discourses concerning the elimination of the feeble on the basis of social Darwinism, racial hygiene, and eugenics in the second half of the nineteenth century. The reception of Darwin in Germany, the propagation of his ideas by Haeckel (who radicalized them), Tille, Ploetz, and Nietzsche are well rendered. A short chapter deals with the Monistenbund, a German group advocating assisted suicide, mercy killing, and the extermination of "life unworthy to be lived" between 1895 and 1933. National Socialism then further radicalized these ideas--perverting them particularly by introducing the racial and dropping the voluntary elements--and put them into action systematically. The chapter on Nazi euthanasia recalls the horrid facts of the children's and adult euthanasia programs. The meaning of the word became completely perverted in German (while it has kept its original Greek meaning of "the good death" in English). As to the historiography of the Nazi period in Germany, Benzenhöfer accurately summarizes the current state of research: historians have worked hard on the issue as far as Germany is concerned, but less attention has been paid to other countries.

Because of the Nazi past, discussion of euthanasia was very difficult in post-World War II Germany; it was a kind of taboo area. Around 1960, however, when true prolongation of life became possible, the question of the conditions under which the new intensive care should not be used or continued came up in Germany--but the ethical guidelines for physicians were imported from Switzerland until the end of the 1980s. It is very interesting to compare the versions published by the German Federal Chamber of Physicians in 1979, 1993, and 1998 (which are textually reproduced in an appendix). It is also revealing to compare the German ethical and legal discussions on euthanasia and assisting the dying since the 1980s with those taking place in the United Kingdom, the United States, Australia (Peter Singer), and the Netherlands (with their liberal attitude toward voluntary mercy killing). The author summarizes these well, but does not do the comparisons himself, as he attempts neither to analyze nor to interpret critically his comprehensive description of the long-lasting and ever-controversial ideas and debates of "euthanasia," and therefore does not draw any general conclusions from history.

Benzenhöfer's very accurate, well-written, and therefore useful book identifies and categorizes ethical issues of death and dying--and sometimes attempts to historically contextualize them--over two millennia. Among other things, this makes it possible to contrast certain attractive ideas with the sometimes disastrous consequences when they were actually put into effect. The text is richly annotated, and there is an excellent...