Are Certain Lives Not Worth Living?

by Nat Hentoff 2/27/01

Dr. Leo Alexander served with the Office of the Chief Counsel for War Crimes in Germany after Hitler was defeated. He interviewed the physician defendants, German doctors who had been involved in practices such as euthanizing mentally handicapped Germans that led to the "final solution" for Jews and others. In a prophetic article in the July 14, 1949, issue of the New England Journal of Medicine, Alexander examined the initial causes of the Holocaust. "The beginnings," he wrote, "were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the acceptance, basic in the euthanasia movement, that there is such a thing as life not worthy to be lived."

The Nazis described the patients they killed as "useless eaters."

Not long before Alexander's death in 1984, he warned that the same lethal attitudes were taking root in this country. He cited the rise of the "death with dignity" movement, which advocated what later became more widely known as assisted suicide -- doctors providing the means for patients to kill themselves, which is now legal in Oregon.

Recalling his research for the Nuremberg trials, Alexander said of what was happening here: "The barriers against killing are coming down."

A new book by Wesley Smith, "The Culture of Death: The Assault on Medical Ethics in America," documents Alexander's concerns more fully and lucidly than any volume yet published on whether humanity will be able to remain humane.

Writing about "The Culture of Death," Dr. N. Gregory Hamilton, president of Physicians for Compassionate Care, points out that "prominent bioethicists now claim the value of each human life can be traded off in complex cost-benefit ratios. ... Members of the bioethics elite have quietly convinced many of our judges, hospital administrators and doctors that some human lives have relatively less value, and therefore less right to equal protection."

I have known and read Wesley Smith for a long time, and I have often cited him in this column because of the range, depth and accuracy of his research. His new book names a number of these bioethicists -- whom I called, years ago, "the new priesthood of death." He shows how their influence began and grew, and tells of patients who have been subject to final decisions by doctors -- often against the patients' wishes and the wishes of their relatives -- because it was thought that their lives were no longer worth living. It's called involuntary euthanasia.

As Smith says in "The Culture of Death": "With the exception of assisted suicide -- due mostly to the widespread media coverage of Jack Kevorkian -- most people are but dimly aware of what is happening." "Popular culture," he adds, "promotes many of these practices as a compassionate response to the trials and tribulations of illness."

Like Alexander in 1949, Smith is trying to alert all of us to the falling barriers against killing. Moreover, he warns that a consequence of this devaluing of disabled and otherwise fragile lives is the creation of "a duty to die." I have debated academics who seriously believe that people who are no longer "productive" should die rather than expect their families and the rest of society to pay what it costs to keep them alive.

In the Cambridge Quarterly of Healthcare Ethics last fall, there was this medical advice by Drs. Lawrence J. Schneiderman and Alexander Morgan Capron:

"A judge who orders that a severely disabled child be kept alive rarely sees firsthand the long-term consequences of that decision, which remain a continuing vivid experience for the health professionals who must provide care for the child."

Therefore, so that these "professionals" can be relieved of such a "vivid experience," a compassionate judge should order that the child not be kept alive. That is the culture of death.

Smith ends "The Culture of Death" with the following words: "We all age. We fall ill. We grow weak. We become disabled. A day comes when our need to receive from our fellows adds to far more than our ability to give in return. When we reach that stage of life ... will we still be deemed persons entitled to equal protection under the law?"

If only in self-defense, you ought to read "The Culture of Death" and discuss it with your doctors and your family. And put your wishes in writing.

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