The Question of Unworthy Life

Alfred Ploetz, credit Wikipedia

The Question of Unworthy Life: Eugenics and Germany’s Twentieth Century; Dagmar Herzog, Princeton University Press, Princeton & Oxford, 2024, 302pp, reviewed by Leslie Jones

According to Dagmar Herzog, the history of racial hygiene (a term coined by biologist Alfred Ploetz) is essentially Manichean. It has its heroes and its villains, and she provides vignettes of both. One of the purposes of her book is to honour those individuals who challenged the de-humanization of the disabled, such as Swiss physician Johann Jakob Guggenbühl (1816-1863). Abendberg, his residential school for “children with cognitive challenges’, was a watchword for “love and kindness”. His guiding principle was the dignity and equality of all God’s creatures endowed with an immortal soul. Then, in stark contrast, we have lawyer Karl Binding and psychiatrist Alfred Hoche, authors of Permission to Annihilate Life Unworthy of Life (1921), a blueprint for the subsequent Nazi programme of coercive ‘euthanasia’. They highlighted the financial and psychological cost of caring for those whom Hoche called “ballast-existences”. Many people in Germany, subject to a high death rate and food shortages during the war, were receptive to this argument. According to Binding and Hoche, the death of so many of the disabled during the war due to malnutrition had made possible the survival of the fit.

In Permission to Annihilate, Binding criticised the Christian churches for opposing “assisted suicide”, a position which he deemed “contra-selective”. During the 1880’s and beyond, it was Christian authors, including some engaged in Protestant Church welfare work under the auspices of the Inner Mission, who questioned the depiction of the disabled as a “dead weight burdening a struggling society” (Herzog, p51). Heinrich Matthias Sengelmann, the founder of the Alsterdorfer in Hamburg, published a guidebook for disability care tellingly entitled Idiotophilus or Lover of Idiots (1888). Lutheran pastor Friedrich von Bodelschwingh, likewise, the founder in 1867 of the famous Bethel institution, challenged the view that disability sprang from moral turpitude, especially from sexual profligacy. He instructed his staff to “Keep company with those at the bottom; the lowliest path is the safest, the most blessed path”. Von Bodelschwingh believed that serving the most helpless was a privilege and beneficial to the carer. Herzog underlines the “radical theological egalitarianism” inherent in his vision (Herzog p52).

But what the author calls the ‘hierarchizing’ of the disabled into distinct groups, a hierarchy in which capacity to work was the pivotal factor, dated back to the 1880’s and became increasingly prevalent. Those professionals responsible for the disabled, notably Protestant leaders but also, remedial teachers and psychiatrists, “intensified antidisability animus ” (Herzog, p 66). In due course, the views of Guggenbühl and his epigones became passé.

Why was the Protestant church in Germany complicit in the Nazi programmes of sterilisation and “euthanasia”? It transpires that some of Binding and Hoche’ s Christian critics were themselves ambivalent about caring for severely disabled individuals. Witness Pastor Friedrich Lensch, who succeeded Sengelman at the Alsterdorfer. He referred candidly to “those who stand before this abyss of misery… [and] ask…if one cannot, if only for the sake of the ill ones themselves, liberate them from this life…” For Lensch, there were humanitarian objections to keeping the severely disabled alive. And in The Problem of Abbreviating Life ‘Unworthy’ of Life (1925), Evald Meltzer, a doctor and the director of the Katharinenhof in Saxony, compiled the opinions of some Protestant religious leaders who endorsed killing the seriously disabled. One such, a religious educator in Auerbach, opined that “abbreviating” life was moral if done out of “benevolence”. In similar vein, Berlin professor of theology Arthur Titius maintained that killing the severely disabled was compatible with “full love of God and genuine humanitarianism”.

At a meeting in May 1931 of leading figures in the Inner Mission, eugenics and “euthanasia” were on the agenda. The upshot was the “Treysa Resolution”, which proposed “differential care” for those disabled individuals unable to undertake productive labour. In addition, sterilization was accepted in principle to protect “the coming generation” and the Volk. According to the “Treysa Resolution”, 60 percent of “mental infirmities” are attributable to heredity.

Leaders in Protestant welfare work welcomed the coercive Nazi sterilisation law which came into effect in January 1934 and the hospitals and charitable institutions they administered carried out regular sterilisations. But, once again, certain individuals bucked the trend. In a lecture in April 1933, Lutheran theologian Paul Althaus (University of Erlangen) rejected killing the disabled and programmes of mass sterilisation. The hereditary transmission of “feeble-mindedness” was not scientifically established, in his judgement. Contra Binding and Hoche, Althaus distinguished between “worth” and “dignity”, which “has no gradations”. Protestant physician Karl Stoevesandt was another trenchant critic of eugenics. The latter was a world view not a science in his estimation. In 1934, however, Stoevesanndt, under pressure, recanted.

Pastor Ludwig Schlaich, who from 1930 ran the Stetten asylum, was another member of Herzog’s band of righteous individuals. Although he authorised sterilisation, Schlaich drew the line at murder and in Autumn 1940 he strenuously opposed the transportation of his charges to a T4 gas chamber in Grafeneck. In Lebensunwert? Unworthy of Life? (1947), he described the victims of T4 as “persecutees of the Third Reich”. Unhappily it was only later that the German state adopted this position. In 1950-51, physician Walther Schmidt, director of the Eichberg institution, received staunch public support when facing prosecution in 1950-51 for murdering inmates. The West German government refused to compensate the victims of sterilisation on the grounds that eugenics was a science, and that sterilisation was morally acceptable. Psychiatrist Helmut Ehrardt, an expert witness at a meeting of the reparations committee of the Bundestag in 1961, claimed that the heritability of such conditions as “feeble-mindedness” and “schizophrenia” had been established. The Finance Ministry gratefully concurred.

Professor Herzog (Professor of History at the City University, New York) invariably cites the environmental and class factors supposedly driving disability. Her position on this issue, ironically, is close to that of the SED regime in the former German Democratic Republic. Note, however, that she acknowledges that for all their fine words, the treatment of the severely disabled was in practice no better in the GDR than in West Germany. Like the Nazis, communists have a problem with those unable or unwilling to work. Herzog maintains that rather than address the poverty that caused the unfavourable environmental conditions encouraging disability, the goal of racial hygiene was always “the eradication of disability through selective breeding and targeted killing” (Herzog, p38). Thus, in ‘The Reciprocal Relationships Between Mental Inferiority and Social Misery’ (1915), Martin Breitbarth, the rector of a remedial school in Halle, inverted the putative relationship between poverty and disability. Parents, he averred, may make bad choices of living conditions. He concluded that the poverty of many disabled children was attributable, through heredity, to the “mental and moral inferiority of their parents”.

The Federal Reparations Law of 1956 only acknowledged Nazi crimes motivated by “race, religion, or political world view”. Herzog therefore gives immense credit to historian Gisela Bock for demonstrating, in Zwangssterilisation im Nationalsozialismus (1986), that Nazi racial hygiene directed against the mentally deficient or unstable (the “deficient insiders” of the Volk) complemented the racism which targeted the “outsiders”, notably Jews, Poles, Roma etc. Both sets of victims were excluded from the so-called master race. In 1966, sociologist Theodor Adorno observed that “The inability to identify with others was unquestionably the most important psychological [pre] condition for…Auschwitz”. Adorno pointed out bitterly that there was resistance to “euthanasia” in Germany of non-Jewish members of the Volk (as, for example in the famous 1941 sermon of Clemens August Graf von Galen, Cardinal and Bishop of Münster) but not to the extermination of German Jews.

The focus of this review has been on the baneful influence of racial hygiene on the treatment of disabled people. But there is more to The Question of Unworthy Life than this. The author chronicles the long but mainly successful struggle to establish the equality and dignity of the disabled despite the persistence of anti-disability prejudice. There were campaigns to integrate disabled children into mainstream education and to dismantle or reform residential institutions. Some of the physically disabled themselves played an important role in this struggle, as in the Cripple-Movement of the 1980’s. We commend Professor Herzog’s authoritative and at times moving account.

Bishop Clemens August Count von Galen, credit Wikipedia

Dr Leslie Jones is the Editor of Quarterly Review