Eugenics and (Pseudo-) Science

Eugenics

Learning objectives

1. Describe eugenics and its early development in the United Kingdom and the United States.
2. Describe how eugenics was integrated into Nazi policies and racial hygiene programs.
3. Explain how eugenics led to the Holocaust.
4. Explain the role medical professionals played in the Nazi eugenics programs.

Introduction

Eugenics, which is derived from the Greek for good (eu) and birth, stock, or race (genos), was a pseudoscience that captivated scientists, doctors, and politicians across the globe in the twentieth century, with the promise of encouraging the development of “well-born” individuals for the betterment of their respective nations and humanity more broadly. Eugenics emerged in the late nineteenth century, derived from the racial sciences of the eighteenth century, and became the basis for social policies in many different countries.

Eugenics can be divided into two branches: positive eugenics, ways of increasing the number of people thought to be genetically strong by encouraging the reproduction of individuals deemed to be of “good stock,” and negative eugenics, ways of decreasing the number of people considered genetically weak by restricting the reproduction of individuals deemed to be of “low stock” (Kelves, 2014).  Most countries that adopted eugenics policies implemented a mix of both these approaches. The Nazis used eugenics as the basis for their “racial hygiene” policies, which in the 1930s included the restriction of marriages between Germans and Jews and the sterilization and often murder of those deemed “unfit.” Those subjected to mass atrocities by the Nazi state included individuals with disabilities and/or intellectual limitations, Jews, Sinti (Roma), political opponents, and Slavs, among others. Racial and other “hygiene” policies were precursors to the Holocaust, which was presented in pseudo-scientific terms as the “final solution” to “eliminate the unfit” in Nazi Germany.

Origins of Eugenics

The roots of eugenics lie in a desire to divide and classify everything, including people. The rise of such scientific classification can be traced to biological taxonomy and specifically Carl Linneaus and his binomial nomenclature, which subdivided homo sapiens into geographical groups that were embedded with racialized views of difference: (Latin) Europaeus albus (white Europeans), Americanus rubescens (reddish Americans), Asiaticus fuscus (brown Asians), and Africanus niger (black Africans). Such categorization, combined with the development of evolutionary theories in the nineteenth century, paved the way for Francis Galton, the so-called Father of Eugenics and cousin of Charles Darwin, to develop his theory of eugenics. Although Galton did not coin the term eugenics until 1883, the concept was explored in his earlier works, including Hereditary Genius (1869), in which he argued for inheritance of ability and lamented that the least capable individuals were reproducing at a rate that far exceeded the most capable.

This classification of unfit and fit, which would later become “low stock” and “good stock,” was based on a loose use of race as a concept, meaning it could include race as we understand it today, as well as social class and even ability/disability (Turda, 2010). While eugenicists claimed eugenics was a science, it was a bastardization of evolutionary theories, applying scientific thinking to social problems and identifying good stock as that of the dominant groups (white, middle-class, and able-bodied), thereby defining all others as inferior. Such distinctions are not scientific; they are discriminatory practices that are rationalized with (however illogical) claims to scientific authority.

Galton’s solution to his perceived threat to society’s “good stock” was to advocate for education and what he saw as socially beneficial reproduction. His proposal included prioritizing eugenics as a national concern, providing education about heredity and eugenics, collecting data about how various groups (specifically classes) and families have contributed to society, and encouraging fit families to marry and reproduce and unfit families to be regarded as unfavorable or be socially banned (Galton, 1904). While the United Kingdom did not adopt Galton’s plan, the popularity of eugenics certainly interested a number of high-profile intellectuals, including author H.G. Wells and future prime minister Winston Churchill, both of whom were members of the Eugenics Education Society (renamed the Eugenics Society in 1926). The United Kingdom did adopt one eugenics policy in the early twentieth century: the Mental Deficiency Act of 1913 (repealed in 1959), which established categories of difference among people with intellectual disabilities (e.g., idiots, imbeciles, feeble-minded persons, and moral imbeciles) and allowed the government to segregate these individuals into colonies to limit both their ability to procreate and interact with society (Caleb, 2019).

The United States was much more committed to eugenics throughout the twentieth century, with a focus on promoting reproduction among those deemed good stock (white, middle class, and able-bodied) and limiting the reproduction rights of individuals with intellectual disabilities, persons of color, and indigenous Americans. Events such as Fitter Family and Better Baby competitions arose across the country, sponsored by local eugenics societies, and county fairs regularly featured educational information and displays about eugenics and reproduction for the good of the nation. While reproductive fitness was celebrated for some, it was denied to others via state legislation. In 1895, Connecticut passed the first eugenics law, which prohibited individuals with epilepsy and those considered imbeciles (defined as a category of mental deficiency) or feebleminded (those deemed to be socially unproductive) from marrying if the woman was under 45, with an aim to prevent such individuals from reproducing (the law was repealed in 1967). Anti-miscegenation laws, enacted in 41 states, were based on the same thinking about maintaining the purity of the white race. In 1907, Indiana passed the first forcible sterilization law, which allowed for the involuntary sterilization of so-called socially deviant individuals, including rapists, criminals, imbeciles, and idiots (also a category of mental deficiency). Although the law was struck down in 1921 for violating the fourteenth amendment, it was replaced with a new law in 1927 that removed criminals and rapists from the list of deviant individuals and added people deemed to be insane. The Supreme Court ruling in Buck v. Bell (1927), in which Oliver Wendell Holmes claimed “three generations of imbeciles is enough,” upheld the legality of forcible sterilizations. In total, 32 states had forceable sterilization laws on the books, resulting in the legal sterilization of an estimated 70,000-100,000 Americans; an additional 100,000-150,000 Black women were involuntarily sterilized by doctors who were acting outside court orders, though it is likely these numbers are much higher given known underreporting (Washington, 2006).

The rhetoric and policies of eugenics in the United Kingdom and the United States informed German science and medicine even before the rise of the Nazi party. In 1880, Dr. Robby Kossmann, zoologist and physician, argued “the human state […] must reach an even higher state of perfection, if the possibility exists in it, through the destruction of the less well-endowed individual, for the more excellently endowed to win space for the expansion of its progeny…The state only has an interest in preserving the more excellent life at the expense of the less excellent” (qtd. in Weikart, 2007, p. 78, emphasis in original). Kossmann’s words not only evoke negative eugenics, they also set the stage for a claim to Lebensraum, or space for the Aryan race to grow and thrive, a nationalist policy advocated by Friedrich Ratzel in 1897 and central to the political agendas of Weimar and Nazi Germany (Heffernan, 2000). Responding to a perceived declining birthrate among the “productive” class (and an increasing birthrate among the unfit) and the massive loss of life during World War I, German eugenics during the Weimar republic established a basis for the Nazi programs, both in perpetuating eugenic values among the populace and empowering medical professionals to develop and implement eugenic policies and programs.

Nazi eugenic policies: regulating marriage and reproduction

Using the language of hierarchy developed by Galton and perpetuated by German scientists in the late nineteenth- and early twentieth centuries, the Nazis categorized people to determine who was eugenically fit and who was not. Thus, the use of Untermensch (subhuman) to describe eugenically “inferior” individuals was derived from Galton’s term “residuum,” used to describe the same category of ‘low-stock” people (Caleb, 2019). More directly, Hitler and the Nazis used US marriage restriction laws (including anti-miscegenation laws) and sterilization programs as models for their own eugenic laws and practices (Whitman, 2017), thereby perpetuating the pseudoscience.

Like the American program, early enactments of eugenics laws under the Nazi regime sought to promote marriage among the eugenically fit (“Aryans”) and restrict marriages between the fit and unfit (namely Jews). Seen as the future of the nation, Aryan mothers were encouraged to marry and reproduce with fit Aryan men. Marriage and reproduction were incentivized in a number of ways, including through specialized loans, state welfare benefits, and honors, such as the Honor Cross of Motherhood, awarded to Aryan women who had four or more children (Proctor, 1988). The creation of the Mother and Child Relief Agency in 1934, which provided clothing, food, and education for new mothers, further emphasized the importance of Aryan motherhood (Pine, 2007). The focus of the education, however, was Nazi ideology regarding reproduction and Aryan loyalty to the Volkskörper, a Nazi concept of the nation as a living and organic national body whose health was threatened by the unfit bodies that resided within its boundaries. This medicalization of motherhood and reproduction as a social imperative served to further the positive eugenics of the Nazi government. Such eugenic value was further enforced through the requirement of a public health certificate confirming the fitness to marry, enacted on October 18, 1935 through the Law for the Protection of the Hereditary Health of the German People.

In order to ensure the “purity” of the Aryan race, the Nazi government also enacted a number of laws restricting marriage and legal rights of so-called “unfit” individuals, based on the dividing practices developed by Linnaeus and perpetuated by Galton and a long-seated European antisemitism that viewed Jews as a race apart. Such antisemitism predates the Nazi regime; however, it was Nazi implementation of eugenics-based policies that medicalized antisemitism by dehumanizing Jews and designating this group as inferior. The Nuremberg Laws (enacted on September 15, 1935) were considered public health measures; they medicalized ethnicity and religion in order to perpetuate a eugenic ideal that gave privileges to, and exclusively retained human rights for, an Aryan race. The Reich Citizenship Law stripped Jews (and later Roma, Sinti, and Afro-Germans) of their Reich citizenship, allowing for the “medicalized racial discrimination” of these individuals (Weikart, 2017, p. 100). Similarly, the Law for the Protection of German Blood and German Honor forbade Aryans from marrying or having sexual relations with Jews; it later extended the prohibition to Roma, Sinti, and Afro-Germans. These laws created false divisions of personhood based on claims of blood purity, creating the categories of Deutschblütiger (German-blooded), Mischling zweiten Grades (second-degree mixed race, being ¼ Jewish), Mischling ersten Grades (first-degree mixed race, being 3/8 or ½ Jewish), and Jude (Jewish, defined as ¾ or more Jewish) (Reich Citizenship Law, 2013, p. 209). Aryans who had sexual relations with these prohibited groups (later to include foreigners, such as Poles) were charged with Rassenschande (racial defilement) and risked imprisonment and death (Weikart, 2017).

The regulation of reproduction—both the promotion of Aryan procreation and anti-miscegenation laws against ‘blood-mixing’—were means of enacting eugenic policies and creating public support for eugenics, based not on science but antisemitism and racism. Nazi leaders repeatedly asserted the imperative to keep Aryan blood pure in order to strengthen the nation, claiming “every people is [sic] damaged in its vital capacities by absorption of alien blood into the Volkskörper” (Wilhelm Stuckart & Hans Globke, qtd. in Neuman 2009, p. 172). Such rhetoric, combined with reward and punitive action, created large-scale support by Aryans for reproductive legislation, particularly as it was situated as not just a political but also a health necessity to enact such measures. Eugenic policies that rewarded “good-stock” procreation and legislated against miscegenation created the path for more radical and deadly programs that went beyond legislating reproduction to exterminating the Lebensunwertes Lebens: “life unworthy of life.”

Nazi eugenic practices: forced sterilization and murder

In order to ensure the “purity” of an idealized Aryan race, the Nazi government created legislation and programs to prevent the reproduction of individuals with mental illnesses and so-called hereditary disabilities. Modeled after the American sterilization laws, the Law for the Prevention of Offspring with Hereditary Diseases,” enacted on July 14, 1933, mandated the compulsory and forced sterilization of  these individuals, though the language was broad enough so as to also include Roma, Sinti, Afro-Germans, and “asocials,” a catchall category for individuals who did not contribute to the Volkskörper that included criminals, beggars, prostitutes, alcoholics, and the “work-shy.” Medical professionals, trained in and elevated by newly important “racial sciences,” advised on the law and its implementation, citing the importance of racial purity to the health of the nation. As part of the legislation, genetic health courts were established to determine who should be sterilized and to oversee any appeals, which were largely unsuccessful. From the activation of the law 1934 until the Nazi surrender in 1945, over 400,000 people were sterilized under this law (Heberer, 2010).

Not satisfied with state-supported sterilizations alone, Nazi leaders and medical professionals advocated for the extermination of individuals with physical and intellectual disabilities, who were depicted as financial and genetic drains on society. The opportunity to pursue this agenda presented itself in the summer of 1939, when Richard Krestschmar wrote directly to Hitler to request a “mercy killing” of his son Gerhard, who had a number of severe physical disabilities.  The request was granted, ushering in the beginning of the euthanasia  program (Schmidt, 2008). In August 1939, under the leadership of Hitler’s Chancellery Philipp Bouhler and his private physician Karl Brandt, the Nazi leadership created the Reich Committee for the Scientific Registering of Hereditary and Congenital Illnesses, which required physicians to report children with severe disabilities. These children, conservatively estimated at 5,000, were murdered at children’s killing wards (Heberer, 2010).

Shortly after beginning the children’s euthanasia program, Nazi leaders created an adult euthanasia program, code-named Aktion T4 (after the address of its Berlin headquarters: Tiergartenstraße 4) and led by Bouhler and Brandt. Beginning on January 1940, the T4 program began registering and then murdering adults who were deemed a “threat” to the genetic purity of the Volkskörper, beginning with institutionalized individuals, including those with physical and/or intellectual disabilities, Jews, and prisoners who were determined to have diminished capacity. These murders were not only sanctioned by physicians; they were also carried out by the medical community. From January 1940 to August 1941, physicians in the T4 program murdered 70,273 in gas chambers constructed for this exact purpose; after a year-long pause, the program resumed, killing individuals deemed to be Lebensunwerten Leben via lethal injection and starvation (Heberer, 2010). An estimated 200,000 people were murdered under the Nazi euthanasia program (Heberer, 2010).

The implementation of negative eugenics via the T4 euthanasia centers were the precursors to the Holocaust and widespread elimination of all Lebensunwertes Leben, including individuals with physical and mental disabilities, criminals, gays, Roma, Sinti, and, most notably, Jews. All these groups were linked through the Nazi belief in their genetic inferiority and therefore threat to the Volkskörper; however, the targeting of Jews in particular was the medicalization of longstanding antisemitism in Europe, which was justified through an appeal to scientific authority via eugenics. The Nuremberg Laws and the creation of the T4 program were means to establish a claimed biological difference between Germans and Jews that would was used by the Nazis to justify the extermination of all Jews, grounded in claims for improving society and humans more broadly. Many newly trained and state-controlled scientists and medical professionals supported such policies and programs, which helped legitimize their existence and demonstrates the profound power of medicalized social policies that ranged from controlling reproduction to murder (Polgar, 2019). Since 2014, Berlin has hosted a Memorial and Information Point for the victims of the Nazi “euthanasia” killings at Tiergartenstrasse 4.

Ethics and the Medical Professions

There are several false claims regarding the participation of the medical community in the Holocaust (and eugenics programs leading to it), including the claim that physicians were coerced (or even threatened) to join the Nazi party, or that these medical professions abandoned their ethical codes, or they never had an ethics in the first place. These claims, however, are as dangerous as claiming Nazi doctors as Nazis first and doctors second, which risks vilifying them without critically evaluating the medical community as a whole—and not just their complicity but active involvement in eugenics programs. Importantly, these doctors were not incompetent or quacks but rather knowledgeable, sane, and willing participants in the Nazi eugenics programs (Caplan, 1992; Heberer, 2010).  Approximately 45% of all German physicians were members of the Nazi party, the highest rate of all professions (Proctor, 1988). Moreover, Nazi doctors did not abandon their ethical codes; rather, German medical ethics at the time were informed and influenced by eugenics and racial hygiene that predated the Nazi government and informed the related areas of medical education, practice, and ethics.

One might argue, however, that Nazi doctors were created, in that these physicians (and their profession) were products of government action that altered the nature of medicine itself. The well-intentioned creation of a national social health system by Otto von Bismarck in 1883 created a culture in which the medical community became accustomed to working with the State and benefitting from an elevated status. Moreover, the timing of this legislation coincided with the rise of eugenics, which increased criticism of not the health system itself but rather those who might use it without contributing much (or anything) to the good of the nation. In 1891, psychiatrist Wilhelm Schallmayer published Über die drohende körperliche Entartung der Kulturmenschheit und die Verstaatlichung des ärztlichen Standes (Concerning the Imminent Physical Degeneration of Civilized Humanity and the Nationalization of the Medical Profession),  in which he lamented the uncontrolled reproduction of the genetically weak and advocated for a eugenics-based public health controlled by physicians who could issue “health passports” (Weindling, 2010). Thus, the intimate relationship between physicians and the State, coupled with this call for state-based eugenics, ushered in “a new doctoral morality, which placed the welfare of the endangered Fatherland above the well-being of the individual sick person” (Esther Fischer-Homberger, qtd. in Dingwall & Rozelle, 2011, p. 39).

This utilitarian moral code informed much of the ethical writings leading up to and throughout the Third Reich. One of the most influential texts that legitimized euthanasia   via eugenics and medico-legal ethics was written by retired jurist Karl Binding and psychiatrist Alfred Hoche. Entitled Die Freigabe der Vernichtung Lebensunwerten Lebens (Allowing the Destruction of Life Unworthy of Life), this 1920 publication coined the term Lebensunwertes Lebens and was foundational to the medical justification for forced sterilization and murder. In his medical remarks about the ethics of euthanasia, Hoche claims a “higher civil morality,” which includes considering the economic and moral burden of the “mentally dead person” and “incurable idiots” (Binding & Hoche, 2015, pp. 36, 34). In evoking the language of eugenics, he condones such acts   by claiming the “disposal of the fully mentally dead does not represent any violation, any immoral act, any instinctive brutality, but rather an allowable useful act” (Binding & Hoche, 2015, p. 37).

While Binding and Hoche’s advocacy for euthanasia was not widely accepted by the medical community at the time of publication, it certainly resonated with some physicians, lawyers, and politicians, particularly when paired with the losses sustained during War World I. Moreover, the sentiment of the physician’s responsibility to the national body appealed to many in the medical profession, who saw the emphasis on social value and national good as grounded in the medical principle of “doing no harm”—the application, however, was to prevent harm to the nation, not to the individual (Pellegrino, 2010). Indeed, such thinking permeated medical education during the Third Reich, in which Germany universities established the first required medical ethics, but whose teachings perpetuated eugenic thinking about inferiority and justified the elimination of so-called “inferior” humans to protect the Volk.

Speaking before the National Socialist Physicians’ League in 1933, Hitler boldly claimed, “You, you National Socialist doctors, I cannot do without you for a single day not a single hour. If not for you, if fail me, then all is lost. For what good are our struggles, if the health of our people is in danger?” (qtd. in Proctor, 1988, p. 64). Calling for all German physicians to support racial hygiene and the aims of the party to enforce racial purity, Hitler mobilized physicians who were already largely supportive of eugenics and saw the Nazis as both supporting the profession and implementing measures for the good of the nation. The medical profession’s support for and willing participation in eugenics programs was a direct path to the realization of the Holocaust and the mass murder of all individuals deemed inferior.   As noted by Dr. Andrew C. Ivy at the Nuremberg Doctors’ Trial, “Had the profession taken a strong stand against the mass killing of sick Germans before the war, it is conceivable that the entire idea and technique of death factories for genocide would not have materialized” (qtd. in Chelouche & Brahmer, 2013, p. 114).

Conclusion

The pervasiveness of eugenic thinking was not limited to Nazi Germany.  However, it was implemented by Nazis in the most developed and deadly ways, moving well beyond Galton’s early proposals of encouraging eugenically “fit” marriages (positive eugenics) to systematically murdering individuals deemed unfit (negative eugenics). In 1934, Rudolf Hess declared, “National Socialism is nothing but applied biology” (Lifton, 2000, p. 31), which articulated, quite bluntly, how foundational eugenics was to the Nazi party and its political agenda. Thus, the party mobilized physicians by appealing to a rhetoric of national health and a growing belief in the pseudoscience of eugenics.

Legislating and supporting eugenics, including forced sterilization, are points on the path towards supporting   state-sponsored atrocities, including mass murder. Eugenic laws and policies are now understood as part of a specious devotion to a pseudoscience that actively dehumanizes to support political agendas and not true science or medicine. The physicians who participated in the eugenics programs may have imagined or stated that they had acted for the “good” of the nation in their role as “guardians of society’s resources” (Pellegrino, 2010, p. 15), abandoning their obligations to patient care and human rights in favor of rationalizing a false claim that was used to select, persecute, and perpetrate mass atrocities, all in the name of a “healthier national body.”

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