Tuesday, August 1, 2017

'Permitting the Destruction of Life Unworthy of Life': Brief Excerpts and Remarks on Scale and Scope

Binding and Hoche's book was a seminal work. It placed the question of life and death in a scientific, legal, and political contexts. But the concept of 'life unworthy of life' is normative and is broader and deeper than the medical context to which they applied it. The NSDAP and SS expanded it beyond Binding and Hoche's focus. This increased scale and scope was legitimate, and it retains warrant and relevance today.

Binding and Hoche's book, Permitting the Destruction of Life Unworthy of Life, was published in 1920 following Binding's death. It examines the theoretical, legal, and medical contexts of the question: "When is the state justifiably engaged in the ending of life?" Their answer: When it involves a life that is not worth living. An unworthy life, in their view, is one that burdens both the individual and his community: It involves a forfeiture or a loss of a will to live that is combined with a grave medical affliction or condition, along with costs it imposes on family and society. In such situations, ending life is laudible. To this end, the state must act to render the desirable possible and feasible.

Binding and Hoche restricted the concept of 'life unworthy of life' to medical contexts, and in particular, to cases of terminal illness. They saw the consequences of World War I in society, particularly the fatally crippled and terminally ill. Their book proposes cautious and systematic medical review of such cases, concluding that the state was weighted with the responsibility of carrying out killing when physicians decided it was necessary. The idea of 'life unworthy of life' was as much informed by the desired weal and quality of life in society as it was of the individual whose life would remain under review: They proposed extensive and exacting legal, scientific and psychiatric study and evaluation.

The book was published before Hitler became Reich Chancellor and NSDAP had formed a government. Both the NSDAP and Schutzstaffel, the SS, also made use of the concept of 'life unworthy of life.' But the NSDAP and SS both understood that the concept was normative, political, and prescientific. It was normative, in that it expressed a value. It was political, in that it referred to how a community ought to view certain of its members. But it was also prescientific. It existed before science formed an integrated institution. Binding and Hoche's use of it was legitimate, but for these reasons, so was the use of the concept by the NSDAP and SS, who expanded it to racial, ethnic, and other contexts.

Despite this, since World War II Anglo-American scholars have ridiculed the notion: 1) They have charged that Binding and Hoche themselves embraced a flawed notion, and injuriously extended it to medicine, and 2) the NSDAP and SS took an already flawed notion and then expanded it to other contexts.[1] But the reality is that every society has some basis for weighing the value of life. In the USSR, 20 million peopled died as a result of Stalinist purges, collectivization, and Gulag confinement. In the US, a chaotic democratic spectacle and blind market coalesce in abortion, tolerance of minority violence, promotion of ill health, poor diet, and abhorrent insurance practices.

The only real esteem that can be given to life arises from a regard for death.

The contemporary West has never been so openly contemptuous of itself, as it has been in the last few decades. It has combined an encouragement of the proliferation of the weak, the unfit, and the mentally and physically infirm with suicidal with a suicidal immigration and demographic policy. It not only permits the persistence of the mentally disturbed, retarded, and inept, but enshrines and elevates them. Normal, healthy, potentially productive youths are asked to share their social space with people of foreign descent as well as the least fit of their own kind. Obesity and gender ambivalence are openly promoted. The natural order is reversed, the most fit punished:
There was a time, now considered barbaric, in which eliminating those who were born unfit for life, or who later became so, was taken for granted.
That line comes at the end of Binding and Hoche's work.

The expansion of the concept by the NSDAP and SS was predicated on the fundamental racial and ethnic interests of the German people and of Europe taken as a whole. Peoples rise and fall, some suffering quiet retreat into diminution, countless dying for causes that remain invisible to them through death. The political expansion of the notion of unworthy life is entitled on the grounds that life and death should not be left to empty and hollow ideological abstractions or the fluctuations of a blind market, but from the vital, core interests of a given folk and its underlying racial foundations. These precede even human societies, and its natural imprints are evident from the distant past.


Source: K. Binding und A. Hoche, Die Freigabe der Vernichtung lebensunwerten Lebens (Leipzig, Felix Meiner Verlag: 1920). German here. [1]

Dr. Karl Binding (1841-1920)

Dr. Alfred Hoche (1865-1943)

... Should permissible taking of life be restricted, except in emergency situations, to an individual's act of suicide as it is in current law, or should it be legally extended to the killing of fellow human beings, and under what conditions?

To what extent, then, is killing humans allowed today, again apart from emergency situations, and what is to be understood by this? Recognizing a right to kill would be the opposite of "allowing."

[...]

Are there human lives which have so completely lost the attribute of legal status that their continuation has permanently lost all value, both for the bearer of that life and for society?

Merely asking this question is enough to raise an uneasy feeling in anyone who is accustomed to assessing the value of individual life for the bearer and for the social whole. It hurts him to see how we handle the most valuable of lives (filled with and sustained by the strongest will to live and the greatest vital power), and how much labor, power, patience, and capital investment we squander (often totally uselessly) just to preserve lives not worth living - until nature, often pitilessly late, removes the last possibility of their continuation.

Reflect simultaneously on a battlefield strewn with thousands of dead youths, or a mine in which methane gas has trapped hundreds of energetic workers; compare this with our mental hospitals, with their caring for their living inmates. One will be deeply shaken by the strident clash of the sacrifice of the finest flower of humanity in its full measure on the one side, and by the meticulous care shown to existences which are not just absolutely worthless, but even of negative value on the other.

It is impossible to doubt that there are living people to whom death would be a release, and whose death would simultaneously free society and the state from carrying a burden which serves no conceivable purpose, except that of providing an examples of the greatest unselfishness. And because there actually are human lives, in whose preservation no rational being could ever again take any interest, the legal order is now confronted by the fateful question: Is it our duty actively to advocate for this life's asocial continuance (particularly by the fullest application of criminal law) or to permit its destruction under specific conditions? One could also state the question legislatively, like this: Does the energetic preservation of such life deserve preference, as an example of the general unassailability of life? Or does permitting its termination, which frees everyone involved, seem the lesser evil?

[...]

But I cannot find the least reason - legally, socially, ethically, or religiously - not to permit those requested to do so to kill such hopeless cases who urgently demand death.

[...]

Despite everything, this new question allows only a very slowly unfolding process of change and adjustment. The consciousness of the meaninglessness of merely individual existence when compared with the interests of the whole; the feeling of one's absolute obligation for integrating every available power and discarding all useless tasks; the feeling of being a totally responsible participate in a difficult and painful undertaking: these must all become part of the common understanding to a much greater extent than today before any of the ideas presented here can receive complete recognition.

[...]

... Goethe originated the model for how important human questions evolve. He saw them as a spiral. The core of this model is the fact that at regular intervals a spiral line rising in a particular direction perpetually returns to the same position relative to the axis crossing it but each time a step higher.

Eventually, this image will be apparent even in connection with the cultural question we have been discussing. There was a time, now considered barbaric, in which eliminating those who were born unfit for life, or who later became so, was taken for granted. Then came the phrase, continuing into the present, in which, finally, preserving every existence, no matter how worthless, stood as the highest moral value. A new age will arrive - operating with a higher morality and with great sacrifice - which will actually give up the requirements of an exaggerated humanism and overvaluation of mere existence. ...

--------------------
[1] A good example is "Binding and Hoche's 'Life Unworthy of Life': An Historical Analysis," by Howard Brody and M. Wayne Cooper. They regurgitate the Allied claim that the NSDAP and SS pirated Hoche and Binding's already pseudo-scientific concept.
[2] The English excerpts that I include in this post are cross-referenced with the translation of the National Legal Center for the Medically Dependent & Disabled, published in Issues in Law & Medicine, Vol. 8, No. 2, 1992: 231-265.