What’s the link between eugenics and euthanasia?

How do we get from euthanasia to eugenics?

Posted Dec 19, 2010

Here are some headlines you might have seen in the last couple of years "How healing becomes killing: eugenics, euthanasia and extermination"; "Euthanasia in Canada means "eugenics is starting all over again" a "great and powerful evil is here"". The first of these is a headline about an art exhibition by that name. The art exhibition, by Dr Sheldon Rubenfeld (M.D) is about some of the worst atrocities perpetuated during the Third Reich by the Nazis. The second is a headline quoting Glenn Beck, a conservative radio and television host in the US.

But what exactly is the link supposed to be, between eugenics on the one hand, and euthanasia, on the other? One obvious connection between the two, strongly suggested by both of the headlines just mentioned, is that the Nazi's practiced both. When people link eugenics, euthanasia and Nazism they are not usually intending merely to point out an historical fact, the way I am intending to point out an historical fact when I tell you that the ancient Romans watched gladiatorial combat and wore sandals. The undercurrent of that particular link is a tacit argument of the form: the Nazis practiced eugenics and euthanasia, the Nazis were morally abhorrent, therefore eugenics and euthanasia are morally abhorrent. This argument is pretty clearly a bad one. The Nazis used toilet paper and had pets, the Nazis were morally abhorrent, therefore using toilet paper and having pets is morally abhorrent. No one would be inclined to take the previous argument seriously as a reason for objecting to people owning pets or using toilet paper. It seems trivial to note that not everything the Nazis did was ethically objectionable, and that the mere fact that the Nazis did something does not therefore make it objectionable. But sometimes these things need saying.

That is not to suggest that the kind of eugenics and euthanasia practiced by the Nazis was not abhorrent. Of course it was. The kind of euthanasia practiced by the Nazis was morally repugnant for at least two reasons. First, because the motivation for their policy was a particularly nasty view about racial purity and a belief about people they took to be undesirable and unworthy of living. Second, the sort of euthanasia the Nazis practiced was what we would now call involuntary euthanasia. Involuntary euthanasia is euthanasia against the express will of the person in question. This is to be contrasted with voluntary euthanasia, euthanasia at the express request of the person in question, and non-voluntary euthanasia, euthanasia where the person in question is no longer able to consent.

Involuntary euthanasia is obviously ethically abhorrent: it is the ending of the life of someone who does not want their life ended. Involuntary euthanasia in the service of a policy of racial purity by those who take themselves to be racially superior is perhaps even worse. But other than the use of the word "euthanasia" there is little in common between the Nazi practice of euthanasia and the kind of euthanasia envisaged by those who defend the legalisation of that practice today.

Contemporary defenders of euthanasia defend the right of individuals suffering certain conditions to decide, for themselves, when and how they end their lives. This would be voluntary euthanasia. They might also defend the rights of families, in some circumstances, to engage in non-voluntary euthanasia of patients who, for instance, are in a permanent state of disability with no hope of improvement and from which state they cannot consent. Whether we ought to decriminalise these kinds of behaviours is an important question that demands debate. But neither of these two kinds of scenarios looks at all like the mass killing of persons against their will, the behaviour the Nazis engaged in. There may well be ethical issues raised by the prospect of legalising either voluntary or non-voluntary euthanasia. But noting that the Nazis engaged in involuntary euthanasia, an almost entirely different practise, does little to help us reflect on the ethical and legal repercussions of voluntary and non-voluntary euthanasia. So that particular link seems to be an unhelpful one.

Here's another link to think about: the link between euthanasia and eugenics. Once again we could link these two practices by noting that in some form or other they were both practiced by the Nazis. That suggests, or is intended to suggest, that not only are those practices somehow related to one another, but also that they are both morally ambiguous. Indeed, for the Nazis the two practices were importantly related. For them, both practices were a means to a particular end: the end of racial purity; the end of bringing into being a particular "desirable" state of human kind in which society rids itself of "undesirable" persons and then breed "better "persons. The two practices of eugenics and euthanasia, in the forms practiced by the Nazis, were two distinct means to fundamentally the same end. Also, some of the involuntary euthanasia practices of the Nazis were also practices of eugenics. Since some of the many people that the Nazis murdered under the guise of euthanasia were children and young adults, and since these young people were thereby prevented from having children and passing on their genes, the mass murder of those persons was a form of eugenics.

This particular form of eugenics - mass murder - is undeniably bad. But again, that doesn't tell us much about eugenics itself, since mass murder is only one way of engaging in a program of eugenics. In fact, depending on what one means by "eugenics", lots of technologies that we currently use might count as engaging in eugenics. On one understanding of what eugenics means, it is a social practice aimed at changing, in some particular respect or respects, the genetic composition of the population. In this strong sense, eugenics is a social policy that aims to alter, by some means or other, the genetic traits in the population. A weaker sense of eugenics takes eugenics to include any practices that do, as a matter of fact, change the genetic composition of the population. This weaker sense of the meaning of "eugenics" does not require that there is any centralised notion of, or policy aimed at, changing the genetics of the population in any particular way.

Contrast two different scenarios. The first is one in which there is a policy, supported by government, in which couples are financially rewarded for having children with brown eyes and brown hair, and where technology is available to enable couples to determine what colour eyes and hair their child will have. This scenario represents eugenics in the strong sense. The social policy described is one designed to change the frequency of the genes for brown hair and brown eyes in the population.

Now consider a second scenario. In this scenario, a government offers to couples the capacity to determine, through genetic selection, the colour of their child's hair and eyes. Here, however, we may suppose that there is no social policy designed to favour those with any particular coloured eyes and hair, and no policy that will favour the parents of children with any particular eye colour and hair colour. We can therefore suppose that only some couples will take advantage of the technology, and that of those who do use the technology, different hair and eye selections will be made. That is, some couples will chose brown hair and eyes, and others green eyes and red hair, and other blue eyes and brown hair and so forth. In this scenario, we might expect that the distribution and frequency of certain genes in the population will be changed as a result of the choices of individual couples, and thus that this practice is a form of eugenics - but it is a form of eugenics in the weak sense.

Indeed, in this weak sense of the meaning of "eugenics" many technologies that we use today involve the practice of eugenics: the termination of certain pregnancies, fertility treatments, contraception, genetic screening and so forth are all practices that individuals can choose, and which affect the genetic composition of the population even though none of these technologies are being used with the purpose of changing the genetic composition in a particular way.

Whatever one thinks of the use of these technologies, it is difficult to see what eugenics as we find it today - eugenics in the weaker sense - has to do with euthanasia in the form in which we find it defended today (voluntary and non-voluntary). Some people argue, however, that a broad policy of euthanasia amounts to eugenics. This contention does not seem to only amount to claiming that there are certain necessary connections between euthanasia and eugenics: the strong implication is that eugenics is a bad thing, and therefore that if euthanasia amounts to eugenics, then it follow that euthanasia too is a bad thing.

Why should a broad policy of euthanasia amount to a policy of eugenics? Defenders of euthanasia generally argue that individuals who suffer debilitating diseases for which there is no cure, should have the choice to terminate their life (or have someone assist them if they are unable to do so) if and when they decide to. Does this, then, amount of eugenics? It pretty clearly does not amount to eugenics in the strong sense of the word: it does not reflect a social policy of changing the genetic composition of the population in a particular way. Might euthanasia of this kind actually change the genetic composition in some way? Well of course it might.

If there is a particularly terrible disease that is hereditary, and if many people with that disease choose to terminate their lives by euthanasia before having children, then the genetic composition of the population will be altered with respect to the frequency of the genes responsible for that disease. The population genetics will be altered from what it would have been just so long as had there been no euthanasia available, the persons who in fact terminate their lives would have gone on to have children, but because there is euthanasia available, they do not do so. One suspects that in general, anyone sufficiently ill to consider euthanasia would not, had euthanasia not been available, instead be considering having children. If that is right, then there will be no changes at all in the genetic composition of the population.

But let us grant the rather implausible thought that legalising euthanasia would have a decided impact on people's choices regarding having children. In that case, making euthanasia available does change the genetic composition of the population so that the disease in question is less prevalent. Thus legalising euthanasia would, under these circumstances, amount to eugenics if by this we me no more than that under these circumstances there are changes to the genetic composition of the population.

Is this outcome one that would lead us to suppose that legalising euthanasia would be a bad thing? It is hard to see that it would. If the disease in question causes such suffering that so many of those who are afflicted choose to terminate their lives, and if in doing so the number of people suffering that disease diminishes because fewer children are born with the genetic predisposition towards contracting the disease, most of us would think that that is a good thing. Notice though, that this in no way reflects a general social policy that aims at eliminating the disease, nor does it reflect any view according to which those who suffer with the disease are somehow "undesirable" in any sense, nor any view that those who suffer with the disease ought not be given the best medial care available regardless of the decision they choose to make about the direction of their life.