18 EThics & MED. 21 (2002).
Sixty years ago the Nazis occasionally used similar arguments as today's humane and sincere advocates of euthanasia. Karl Brandt, the head of Hitler's euthanasia program, claimed at his trial after the war: "The underlying motive was the desire to help individuals who could not help themselves and were thus prolonging their lives of torment." However plausible or humane this may sound, the reality was far from humane. Indeed, the Nazis went far beyond killing the incurably sick, and few of the "individuals" Brandt had in mind actually made a request that "their lives of torment" should not be prolonged.
"Euthanasia" in the Third Reich was even a prelude to the Final Solution (Endlosung). Euphemistic terminology and covering up was the rule. Hitler's Euthanasia Decree (Erlass) of 1 September 1939 ordered his personal physician Dr. Karl Brandt and Reichsleiter Philip Bouhler, head of the Reich Chancellery, "to enlarge the authority of certain physicians to be designated by name in such a manner that persons who, according to human judgment, are incurable can, upon a most careful diagnosis of their condition of sickness, be accorded a mercy death (Gradentod)." Hitler's decree was written on personal letterhead ("Adolf Hitler. Berlin") and highly secret. It was never made law, even when pressure was brought to bear to do so. The official bureaucracy was largely bypassed.
Nazi practices of euthanasia did not appear out of the blue. They were preceded by Social Darwinism and the debate on "eugenics." Racial and social hygiene and sterilization of inferior and worthless life were dominant themes in the Twenties. This was referred to as Schadlingsbekampfung ("pest control"). In July 1949 Leo Alexander, Chief U.S. Medical Consultant at the Nuremberg Crimes Trials, published his essay "Medical Science Under Dictatorship." The Nazi rule in Germany was preceded by "a propaganda barrage directed against the traditional compassionate nineteenth-century attitudes towards the chronically ill," Alexander writes:
Sterilization and euthanasia of person with chronic diseases was discussed
at a meeting of Bavarian psychiatrists in 1931.... Nazi propaganda was
highly effective in perverting public opinion and public conscience in a
remarkably short time. In the medical profession this expressed itself in a
rapid decline in standards of professional ethics.
The crimes which the Nazis would commit later had their origins in prior subtle changes as stated in the following:
The beginnings at first were a subtle shift in emphasis in the basic
attitude of the physicians. …