Useless eaters: disability as genocidal marker in Nazi Germany

The methods used for mass extermination in the Nazi death camps originated and were perfected in earlier use against people with physical, emotional, and intellectual disabilities. This article describes the historical context of attitudes toward people with disabilities in Germany and how this context produced mass murder of people with disabilities prior to and during the early years of-World War II. Several key marker variables, the manipulation of which allowed a highly sophisticated Western society to officially sanction the murder of people with disabilities, are examined. Important implications must continually be drawn from these sad events as we work with people with disabilities at the dawn of a new century.

Would you, if you were a cripple, want to vegetate forever?--Dr. Tergesten, in the propaganda film Ich Klage an! (I Accuse!, 1941)

Even given the passage of time and the necessary exposure of many people to commonly known historical events about Nazi Germany, some facts are more familiar than others. Historically, the focus has remained on the state-sanctioned genocide of the war years, which resulted in the extermination of Jews and to a lesser extent other populations, such as the Gypsies, political prisoners, and homosexuals (Yahil, 1987). In secular terms, images of death camps and the Nuremberg Trials represent the nadir of a humanitarian conflagration that began with the invasion of Poland in 1939 and ended with Germany's surrender and political and physical partitioning in 1945.

However, relatively little attention has been paid to significant precipitating historical events that served as a catalyst for what later became known as the Holocaust. These events, rooted in powerful societal and scientific perceptions of difference with parallel extensions in state policy and action, were intensified and codified with the rise of National Socialism and Hitler's assumption of power in 1933 (Aly, Chroust, & Pross, 1994; Friedlander, 1995). Official notions of difference, which would later find their most diabolical expression in the murder of the Jews, were first expressed in state-sanctioned killings of children and adults with a wide range of physical, emotional, and intellectual disabilities.

I draw on the relatively few but important sources available in English to illustrate a neglected historical aspect of perceptions of people with disabilities for several purposes. First, I provide a description of the historical context under-girding perceptions of and attitudes toward people with disabilities in Germany and how this context produced mass murder of people with disabilities prior to and during the early years of World War II. Second, I examine several key marker variables, the manipulation of which allowed a highly sophisticated Western society via state law and policy to sanction the murder of people with disabilities. Third, I provide a brief synopsis of implications that can be drawn from this conflagration that influence work with and on behalf of people with disabilities in the 21st century.

The idea of societies disposing of people with disabilities was hardly new at the dawn of the 20th century. There is ample evidence that both medical and legal debates across Europe, including in Germany in the 19th century, included fatal solutions for inmates of asylums and others with physical, emotional, and intellectual disabilities. These historical attitudes gathered momentum, however, in the late 19th and first half of the 20th centuries.

Along with the rest of Europe after the Enlightenment, Germany sought to address difficult issues related to people with disabilities. As in the United States, late-19th-century German efforts to meet the needs of this population consisted largely of custodial care either privately by family members and church institutions or in state asylums. These efforts were reflected in a significant increase in the number of publicly sustained German asylums, which increased from 93 in 1877 to 226 in 1913 (Burleigh, 1994). There was also a concomitant increase in the number of private institutions providing various levels of residential care to those with a wide spectrum of disabilities. This state of affairs remained relatively stable until World War I.

The outbreak of war in 1914 precipitated significant changes for people with disabilities across Germany. The logistics and material requirements of fighting a major conflict soon had social and economic repercussions among all sectors of the population. For asylum inmates, the most debilitating outcome was the wartime rationing of food. Caregivers, despite their best efforts, were unable to compensate for their patients' nutritional losses. At the Berlin-Buch asylum, for example, the average daily caloric intake for inmates decreased from 2,695 in 1914 to 1,987 by January 1918 (Burleigh, 1994). Unable to supplement their meager rations via hoarding or purchases on the public black markets, inmates soon deteriorated. In addition, most asylums strictly adhered to cost-cutting measures of less heating and clothing. Medicine, a critical need for the war effort, was relatively scarce for those in custodial care. These high levels of deprivation and neglect, along with overcrowding and poor sanitary conditions, soon led to marked increases in communicable diseases and elevated mortality rates. The relatively stable pre--World War I annual institutional mortality rate of approximately 5.5% escalated to 30% by the end of the war. In real terms, by 1918, more than 140,000 people had died in psychiatric asylums across Germany (Burleigh, 1994).

The privations of the war had a marked effect on perceptions of disability among institutional caregivers and the public. Caregivers generally acknowledged the deplorable state of affairs in asylums but also understood the necessity of shifting resources to those able to conduct the war effort. Among the general public, the war effort's reallocation of resources also highlighted the divide between those who were healthy and able to contribute and survive unaided, and those with disabilities, who could not. Thus, by the end of World War I, an implicit but palpable public perception of higher economic worth was attached to people without disabilities, and lesser worth was attributed to people with disabilities. Later, the economic worth of human life under the Nazis proved a key distinction for creating and sanctioning genocide against people with disabilities.

By 1918, a trend toward institutional contraction emerged. Many private and public asylums had closed. Others were transformed into convalescent homes for injured soldiers or hostels for refugees. Still others stood empty as supporting funds were redirected to convalescing patients with predictable recoveries who would again enter the workforce to help the country recover economically. Also, asylum populations remained low because of the now exorbitant cost of admitting and caring for new patients. These circumstances soon generated various models of cheaper outpatient treatment that controlled expenses and bolstered progressive social reforms attempting to soften the image of asylums as nothing more than prison warehouses.

Ah yes, now all of Europe is accepting the concepts of euthnasia that were considered crimes against humanity at the end of WW2. Holland seems to be the leader, such a turn after its revulsion of Hitler during the 40s. And here in the USA, the spiritual descendants of Hitler's theories, the socialists and abortion backers are furthering his cause. How soon will we hear a call for the rehabilation of Hitler, because he lead the way in controlling health care costs and saving social security?

Good post. Yes, that is the "slippery slope" to Hell that will solve the financial problems of Social Security and Medicare.

Living wills, etc. It has to be authorized by you only. That I accept. Euthanesia is a slippery slope agreed but if it you authorizing it for yourself, personal choice is more important.

I am, oh, 63% in agreement with you here. But what disturbs me is how many people seem to think that they should be able to write down "I want to be killed if X Y Z happens to me" and, no matter what, that should be respected.

Even if X = blindness?

Y = amputation?

Z = half-facial paralysis from stroke?

There are certainly terminal, painful, suffering, horrible conditions in which I'd want to be mercifully helped as I shuffle off this mortal coil, just as much as the next guy. But why do people seem to be assuming, or speaking as if, there is some sort of universal right to suicide, no matter what, for any condition of your choosing?

There is not.

That is why I get a little nervous, and am slightly resistant, when people say stuff like "Euthanesia where you specifically have authorized a professional to end your life humanely" is always, no matter what, A-OK.

If that's what you think then you would be saying that you approve of the following situation: A teenager is depressed about a breakup, specifically authorizes a professional to end his life humanely, and so he does.

"authorizing it for yourself" is not and cannot be the only requirement here.

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