Byline: Marcia Mattson, Times-Union staff writer
Breakthroughs in genetic science could offer doctors unprecedented methods to create designer babies and to test people of all ages for undesirable genes. Princeton University has as its sole bioethicist a man who advocates giving parents 28 days to kill newborns considered defective.
And the Netherlands, which has allowed doctors to euthanize patients without prosecution for nearly three decades, in April became the first nation to legalize the practice.
To some medical professionals and ethicists, these developments carry eerie echoes of 19th-century medical ideas and practices that became tools of persecution in Nazi Germany.
"It started with acceptance of the attitude that there is a life not worthy to be lived, and spread from there," said Stephen Poff, a doctor and chairman of the Northeast Florida Bioethics Forum, a group that includes clergy, ethicists and medical professionals.
The forum recently met in Jacksonville to look backward in history for an ethical lesson -- and to warn doctors not to abdicate their ethical responsibilities as they pursue advancements in medicine.
The group examined the German medical establishment's role in designing, promoting and operating a euthanasia program in the 1930s that killed 72,000 mentally or physically disabled Germans.
The program took people from their homes to facilities where they were starved or gassed and then incinerated.
It became the blueprint for the Holocaust.
The "killing centers," as they were commonly known, were just one facet of the German medical community's failure in ethics -- fueled by doctors' ideals for a healthy, cost-effective, genetically strong citizenry.
Doctors also instituted a program that sterilized 300,000 Germans with mental or physical deficiencies, varying from alcoholism to low scores on intelligence tests, so they wouldn't pass on traits believed to be genetic.
And doctors conducted torturous, deadly medical experiments on captives in concentration camps to further the German military's goals or to satisfy their own curiosity.
"The methods that became the 'Final Solution' of the Holocaust were not a Nazi invention," Poff said. "They were a medical invention that the state seized when it became politically expedient to do so."
THE PAST, REDUX
Poff and others say they can see such activities happening again -- in the United States or elsewhere. Poff argues that the same ideas about rationing expensive health care, about genetic selection, and about some people's lives not being worth living -- are all alive to this day.
Doctors today struggle with insurers in getting patients the proper care under managed health plans.
They are on the cusp of having enough knowledge to alter the genetic make-up of people to select for traits such as eye color or height. Debates are raging over the ethics of using stem cells from aborted fetuses to try to grow organs or tissue and of using human subjects in genetic experiments because so little is known about genes' relationship to one another.
Watchdog groups warn that the new genetic knowledge could be used to discriminate against groups that have undesirable genes.
Jacksonville Rabbi Michael Matuson subscribes to the theory that Germans carried out unethical policies because they weren't thinking in terms of ethics. They were going with the flow of what German society's medical and political leaders said they should do.
"All of us are thinking it could happen again," Matuson said, "because you're not sure how society is going to define good and evil."
Jewish leaders now are studying genetics and trying to come up with ethical guidelines.
"The issues are eerily similar," Matuson said. "I think the answer is that people look at these issues, and not not just let it rest . …