„The Continent of Murder: Disability and the Nazi „Euthanasia‟ Programme in the Euthanasia Debates of Britain and the United States, 1945-Present‟. Emmeline Burdett UCL Submitted for the Degree of Doctor of Philosophy. 1 I, Emmeline Burdett, confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the thesis. 2 Abstract This thesis considers the impact that ideas about disability and disabled people have had on debates about euthanasia in Britain and the United States since the end of the Second World War. I demonstrate that the debate has long been characterized by a deeply paternalistic attitude, in which assumptions and stereotypes about disabled people are held to be of such truth and relevance that the idea of having disabled people contributing to the debate simply does not occur. To this end, the thesis looks at the debates through the prism of Disability Studies, and shows that the stereotypical and outdated ideas about disability and disabled people with which these debates abound are not simply down to a chance shared inclination amongst the participants exhaustively to discuss some aspects of the issue whilst not even acknowledging others, as might easily be assumed. Instead they are based upon the assumption that, when „euthanasia‟ is debated, the impairment of the individual(s) concerned is the only relevant issue. Though pervasive and often unquestioned, these ideas are now being challenged by such people as disability theorists, campaigners, and academics in the new field of Disability Studies. I will discuss this in greater detail in my Introduction. The thesis begins with the Nuremberg Medical Trial of 1946-47, at which the perpetrators of Nazi medical crimes were prosecuted. These crimes included the „euthanasia‟ programme. Despite being cruel, systematic and totally non- consensual, the programme was not treated properly as a crime, the judgment stating that a state was perfectly at liberty to subject classes of its citizens to euthanasia – in other words to subject them to non-consensual killing.. The thesis then explores the reactions of outsiders to the Nuremberg Medical Trial. This reveals that the judges‟ view of the programme was unchallenged by observers in the UK and US press, and by medical and 3 legal commentators, who saw the Trial as solely concerned with the prosecution of Nazi perpetrators of human vivisection. Chapters Three, Four and Five continue to explore these themes of paternalism and moral inconsistency. This is done by looking at historians‟ perceptions of the Nazi „euthanasia‟ programme (Chapter Three), cases of individual euthanasia and how they are dealt with in English and US law (Chapter Four), and the use of the Nazi analogy in bioethical debates on the subject (Chapter Five). I conclude that, though paternalism and dismissive attitudes are still problematic, things are beginning to change, thanks to such factors as greater civil rights, greater scope for participation in society as a whole, and new academic disciplines such as disability studies and disability history. 4 Table of Contents Abstract 3 Acknowledgements 6 Dedication 7 Introduction 8 Chapter One: „A Question That Does Not Enter Into the Issues‟ – The Nuremberg Medical Trial and the Nazi „Euthanasia Programme 39 Chapter Two: „German Doctors Accused of Atrocities‟: How the Outside World Saw the Nuremberg Medical Trial 71 Chapter Three: „Usually the Topic Has Been Mentioned Only in Passing‟: Historians‟ Perceptions of the Nazi „Euthanasia‟ Programme 125 Chapter Four: The „Law in Action‟ versus the „Law on the Books‟: Legal Issues Relating to „Euthanasia‟ in the United States and Britain, 1947-Present 191 Chapter Five: „The Expression of a Rational Moral Principle‟: Disability, „Euthanasia‟, and the Nazi Analogy in Bioethical Debates 246 5 Conclusion 299 Bibliography 307 Acknowledgements My thanks must go firstly to my supervisor, Dr Mark Hewitson, who has not only been helpful and encouraging, but has also forborne from expressing frustration about my speed of work, which would probably have disgraced an arthritic snail! Dr Brian Balmer and Professor Colin Barnes made sterling suggestions, and displayed a truly touching commitment to the thesis, as well as a desire to ensure that it was as good as it could be. Without their assistance, the thesis would have been much poorer (remaining faults are my own, obviously!). My thanks are also due to the seminar participants at Liverpool Hope University‟s Centre for Culture and Disability Studies, especially Dr Alex Tankard and Dr David Bolt, for their help and enthusiasm. I am also grateful to Ian Dowbiggin, Professor Carol Thomas, Dr Mererid Puw Davies and Professor Mary Fulbrook, for their words of wisdom and encouragement. Thanks also to the staff of University College London Library, the British Library, the Wellcome Library and Senate House Library for their assistance in locating books, and demonstrating how to use databases and search 6 engines. I would also like to thank my parents for not insisting that I should hurry up and get „a proper job‟, and for their support and respect for my privacy. This thesis is dedicated to Michael Moir Patterson: „May your soul live. May you spend millions of years, o lover of Thebes, with your face to the north wind and your eyes beholding happiness‟. 7 Introduction „Whether or not a state may validly enact legislation which imposes euthanasia upon certain classes of its citizens is a question which does not enter into the issues. Assuming that it may do so, the Family of Nations is not obligated to give recognition to such legislation when it manifestly gives legality to plain murder and torture of defenceless and powerless human beings of other nations‟.1 This statement was made by the United States judges who presided over the Nuremberg Medical Trial (also known as the Nuremberg Doctors‟ Trial – or NMT) which began in December 1946 and delivered its judgment in August of the following year. The statement demonstrates – in a very stark way – that those who had been made victims of the „euthanasia‟ programme had also become victims of the Nuremberg Medical Trial judges, who actually stated that killing them had just been something which a state was entitled to do. It did not constitute a crime, and would not attract international censure, unless the policy were to be applied in a manner which was racist, or threatening to inhabitants of nations other than the one which introduced it. This moral inconsistency regarding the question of non- consensual killing is the enduring theme of my thesis. I demonstrate that the dismissive and paternalistic assumptions and stereotypes about disabled people on display in the Nuremberg Medical Trial judgment are certainly not unique to the time in which the Trial took place, or to the judges presiding over it. Though those who either advocate, or simply remain unperturbed by, the practice of non- 1 FO 646, Case 1 Medical, (U.S. v. Karl Brandt et al), Vol. 23, p.11395. 8 consensual „euthanasia‟ have not always expressed themselves so chillingly, it remains true that there is a widespread assumption that (a) people subjected to non- consensual „euthanasia‟ are not in possession of any characteristics bar that of irredeemable suffering; (b) killing such people is simply not the same as the murder of another sort of person would be; and (c) the person or people in question do not suffer from being killed. The various chapters show this in a number of different ways. Chapter One exposes the way in which the prosecution team and the judges at the Nuremberg Medical Trial were trying the perpetrators of the Nazi „euthanasia‟ programme whilst clearly not believing that the programme had really been wrong. Chapter Two continues this theme, showing how prominent newspapers, legal journals and medical journals from both countries understood the Trial as being exclusively devoted to the prosecution of Nazis who had performed medical experiments upon concentration camp inmates. Chapter Three looks at how historians have written about the Nazi „euthanasia‟ programme, and finds that, until recently, the programme was treated as a dry ethical issue and the victims were rendered invisible by a preoccupation with the protests against the programme. Chapter Four considers the legal situation in both England and Wales and the US, and shows that though the types of „euthanasia‟ under discussion have widened considerably, the underlying problems of how „other‟ lives are perceived have still not been solved. Chapter Five draws similar conclusions with regard to bioethical debates. All the chapters draw extensively on the contributions of participants in such debates, linking primary sources to the secondary literature on „euthanasia‟. The nature of 9 the enquiry means that the thesis relies largely on published sources. This is because I am not investigating events as such, but rather how those events have been perceived by other people. The aim of this approach is to show the extremely widespread and tenacious nature of stereotypes and assumptions about disabled people in the distinct but connected debates of lawyers, historians, philosophers, medics and, where it stood in close relationship to academic discourse, the press. Inevitably, such an approach crosses boundaries between disciplines and requires analysis of very different types of discourse. It is justified by the interconnectedness of the different debates. Indeed, it is that very interconnectedness of vision which is so remarkable As a consequence, my aim is to examine the transfer, reception, convergence and evolution of certain conceptions of disability and „euthanasia‟ within much broader sets of discourses rather than to do full justice to those discourses as a whole. The juxtaposition and comparison of the debates of lawyers, historians and bio-ethicists reveals a widespread and alarming continuity and acceptance of common and – one would have hoped – outdated stereotypes.