'Euthanasia' in the Third Reich: Lessons for Today?
Vermaat, Ja Emerson, Ethics & Medicine
`At this stage I do not feel that I am going to die, but I don't want to die away later with my body being reduced to a little more than a lump. Please, promise to help me before this moment comes.'Today, many physicians are familiar with incurably ill patients requesting them to end their lives because of unbearable suffering. In the case of the above quote the request for euthanasia is not made by a desparate twenty-first century patient. One finds it in the Nazi film Ich Klage an (I Accuse) which was produced in 1941. The message of the the two hour long film was that doctors who submit to an incurable patient's death wish act legally and morally.1
Hanna, the beautiful young wife of professor Thomas Heyt, is suffering from multiple sclerosis. Her husband, the newly appointed director of the Anatomical Institute of Munich University, knows that there is little hope for his wife. Hanna first asks her personal physician and family friend Bernhard Lang to end her life should the moment of unbearable suffering occur. Lang refuses and says: 'I am your best friend, but I am also a doctor, and as such I am a servant of life. Life must be preserved at any cost:
Hanna then approaches her husband Thomas in a very emotional way: `You must help me. I want to remain your Hanna till the very end, I don't want to become somebody else who is deaf, blind, and idiotic. I wouldn't endure that. Thomas, if you really love me, promise that you will deliver me from this beforehand.'
Hanna's medical condition rapidly deteriorates. Thomas and Bernhard realize she has only a few weeks to live. One day they are together at Hanna's bedside. Hanna kindly asks Bernhard to leave the room. She wants to be alone with Thomas. Bernhard goes to the piano in the living room where he starts to play. While the piano music can be heard in the bedroom Thomas fetches a bottle containing a sedative and poors a fatal dose into Hannna's glass. Before passing away Hanna says, 'I feel so happy, I wish I were dead.' Thomas replies, 'Death is coming, Hanna. ' Hanna responds, 'I love you, Thomas! 'I love you, too, Hanna: says Thomas.
Bernhard is furious when Thomas informs him what has happened. Domestic servant Bertha then accuses Thomas of murdering his wife and takes him to court. At issue is: can a doctor be allowed to cause the death of a terminally ill patient after that person explicitly requested him to do so? One of the witnesses is Bernhard. He says that he initially also opposed Hanna's request, but now he sees things from a different perspective. `Thomas, you are not a murderer!' he says loud and clear in the courtroom. Thomas himself then accuses ('I accuse!') those doctors and judges who by adhering to strict rules fail to serve the people. `Try me! Whatever the outcome, your judgment will be a signal to all those who are in the same position like me! Yes, I confess: I did kill my incurably ill wife, but it was at her request:
From a propagandistic point of view the film was a success. The Gestapo, the secret state police, reported that the film received much attention in the whole Reich.2 A Dutch woman living in Dusseldorf at the time told me in an interview: `All my colleagues were impressed by the film. They suddenly understood the dilemma of a doctor who is confronted with an incurable disease.3
Hitler's 'Euthanasia Decree'
This remarkable propaganda film presents a case and a logic with which today's medical profession is quite familiar. It is not the crude Nazi ideology of killing `worthless life: Rather it makes a smart plea for a terminally ill patient's right to a 'humane' way of dying. 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. …