Hans Asperger, National Socialism, and “race hygiene” in Nazi-era Vienna

Herwig Czech

Abstract

Background

Hans Asperger (1906–1980) first designated a group of children with distinct psychological characteristics as ‘autistic psychopaths’ in 1938, several years before Leo Kanner’s famous 1943 paper on autism. In 1944, Asperger published a comprehensive study on the topic (submitted to Vienna University in 1942 as his postdoctoral thesis), which would only find international acknowledgement in the 1980s. From then on, the eponym ‘Asperger’s syndrome’ increasingly gained currency in recognition of his outstanding contribution to the conceptualization of the condition. At the time, the fact that Asperger had spent pivotal years of his career in Nazi Vienna caused some controversy regarding his potential ties to National Socialism and its race hygiene policies. Documentary evidence was scarce, however, and over time a narrative of Asperger as an active opponent of National Socialism took hold. The main goal of this paper is to re-evaluate this narrative, which is based to a large extent on statements made by Asperger himself and on a small segment of his published work.

Methods

Drawing on a vast array of contemporary publications and previously unexplored archival documents (including Asperger’s personnel files and the clinical assessments he wrote on his patients), this paper offers a critical examination of Asperger’s life, politics, and career before and during the Nazi period in Austria.

Results

Asperger managed to accommodate himself to the Nazi regime and was rewarded for his affirmations of loyalty with career opportunities. He joined several organizations affiliated with the NSDAP (although not the Nazi party itself), publicly legitimized race hygiene policies including forced sterilizations and, on several occasions, actively cooperated with the child ‘euthanasia’ program. The language he employed to diagnose his patients was often remarkably harsh (even in comparison with assessments written by the staff at Vienna’s notorious Spiegelgrund ‘euthanasia’ institution), belying the notion that he tried to protect the children under his care by embellishing their diagnoses.

Conclusion

The narrative of Asperger as a principled opponent of National Socialism and a courageous defender of his patients against Nazi ‘euthanasia’ and other race hygiene measures does not hold up in the face of the historical evidence. What emerges is a much more problematic role played by this pioneer of autism research. Future use of the eponym should reflect the troubling context of its origins in Nazi-era Vienna.


Czech H.  Hans Asperger, National Socialism, and “race hygiene” in Nazi-era Vienna. Molecular Autism 2018;9(29)

You’re a surgeon. A patient wants to look like a lizard. What do you do?

As medical treatments advance, the need to accommodate conscientious objection in healthcare is more pressing

The Guardian
Reproduced with permission

David S. Oderberg*

Imagine that you are a cosmetic surgeon and a patient asks you to make them look like a lizard. Would you have ethical qualms? Or perhaps you are a neurosurgeon approached by someone wanting a brain implant – not to cure a disability but to make them smarter via cognitive enhancement. Would this go against your code of professional ethics? With the rapid advance of medical technology, problems of conscience threaten to become commonplace. Perhaps explicit legal protection for conscientious objection in healthcare is the solution.

There is limited statutory protection for those performing abortion, and there is some shelter for IVF practitioners. Passive euthanasia (withdrawal of life support with intent to hasten death) is also part of the debate over doctors’ conscience rights. That’s about it as far as UK law is concerned – though freedom of conscience is enshrined in numerous conventions and treaties to which we are party. Abortion, artificial reproductive technologies (involving embryo research and storage) and passive euthanasia are the flashpoints of current and historic controversy in medical ethics. The debate over freedom of conscience in healthcare goes to the heart of what it means to be a medical practitioner.

Curing, healing, not harming: these are the guiding principles of the medical and nursing professions. But what if there is reasonable and persistent disagreement over whether a treatment is in the patient’s best interests? What if a practitioner believes that treating their patient in a particular way is not good for them? What if carrying out the treatment would be a violation of the healthcare worker’s ethical and/or religious beliefs? Should they be coerced into acting contrary to their conscience?

Such coercion, whether it involve threats of dismissal, denial of job opportunities or of promotion, or shaming for not being a team player, is a real issue. Yet in what is supposed to be a liberal, pluralistic and tolerant society, compelling people to violate their deeply held ethical beliefs – making them do what they think is wrong – should strike one as objectionable.

Freedom of conscience is not only about performing an act but about assisting with it. There are some people who ask doctors to amputate healthy limbs. If you were a surgeon, my guess is that you would refuse. But what about being asked to help out? Would you hand over the instruments to a willing surgeon? Or supervise a trainee surgeon to make sure they did the amputation correctly? If conscientious objection is to have any substance in law, it must also cover these acts of assistance.

This country has a long and honourable tradition of accommodating conscientious objectors in wartime – those who decline to fight or to assist or facilitate the fighting by, say, making munitions. They can be assigned to other duties that may support the war effort yet are so remote a form of cooperation as not to trouble their consciences. In any war, the objectors are a tiny fraction of the combat-eligible population. Yet when it comes to one’s rights, do numbers matter? Has their existence ever prevented a war from being carried out to the utmost? I fail to see, then, why we are tolerant enough to make adjustments for conscientious objectors in the midst of a national emergency, yet in peacetime would be reluctant to afford similar adjustments to members of one of the most esteemed professions.

Do we think medical practitioners should be no more than state functionaries, dispensing whatever is legal no matter how much it is in conflict with personal conscience and professional integrity – lest they be hounded out of the profession? Some academics think expulsion is not good enough. Or should healthcare workers be valets, providing whatever service their patients demand? Perhaps when practitioners find themselves faced with demands for the sorts of treatment I’ve mentioned – or perhaps gene editing treatments or compulsory sterilisation, society will act. Or maybe by then it will be too little, too late.

David S Oderberg is professor of philosophy at the University of Reading, and author of Declaration in support of conscientious protection in medicine

 

 

First compensation claim for compulsory sterilisation in Japan

BioEdge

Michael Cook

A Japanese woman in her 60s is planning to sue the government over her forced sterilization under a 1948 law. This will be the first time that state compensation has been sought for sterilisation. The mentally disabled woman in Miyagi Prefecture was a teenager when she was forced to undergo the procedure.

Records of 2,700 people who were sterilized under the Eugenic Protection Law — which was in force until 1996 — have been found in local government archives, a development which could help victims seek state compensation.

Like some Western countries, Japan has a dark eugenic past.

A 1948 Eugenic Protection Law (EPL) was intended to prevent the births of “inferior descendants” and to foster the health of mothers and pregnant women. It provided for both voluntary and involuntary sterilisation. Doctors could apply for permission for sterilisation to a regional board if a patient suffered from a range of conditions which were believe to be hereditary, including schizophrenia, manic-depressive psychosis, epilepsy, abnormal sexual desire, “remarkable criminal inclination,” Huntington’s disease, muscular dystrophy, albinism, achromatopsia, deafness, haemophilia, and so on.

The Ministry of Health issued guidelines in 1953 clarifying what doctors could do: “It is permissible to restrain the patient’s body, to administer an anesthetic, or to deceive the patient, etc.”

According to government statistics, between 1949 to 1994, 16,520 involuntary sterilizations were performed, 11,356 on women, and 5,164 on men. Most were performed on inmates of psychiatric hospitals and institutions for intellectually disabled people.

Compulsory sterilisation lapsed in 1996 with the passage of the Mother’s Body Protection Law. However, the Japanese government has refused to apologize to the victims of the law or offer them compensation.


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Polish baby left screaming for an hour before dying after botched abortion: reports

LifeSite News

Natalia Dueholm

March 21, 2016 (LifeSiteNews) – Physicians at Holy Family Hospital in Warsaw, Poland, left a child to die after a botched abortion earlier this month, according to local media.

As Republika Television reports, the baby was born March 7, 2016 at the 24th week of gestational age and cried and screamed for an hour before dying. According to witnesses, the baby’s cry is impossible to forget. Nonetheless, medical personnel did not try to help the child in any way.

Hospital spokesperson Dorota Jasłowska-Niemyska explained that a patient at the end of the 23rd week of pregnancy came to the hospital, and her medical tests suggested that the baby had Down syndrome. The hospital claims that everything that happened thereafter was according to the law and medical procedures. The dignity of the patient and the dignity of the fetus were respected, she continued.

When asked by a reporter of Salve TV about the dignity of a child that had been born alive, Jasłowska-Niemyska said: “Those are details which I can’t talk about. It is confidential, and I am not allowed to comment on the details of this procedure.” . . . [Full Text]

 

With assisted suicide, what begins in compassion seems to end in eugenics

National Post

Andrew Coyne

The case for assisted suicide and euthanasia, at least as it has been presented, is that we may freely dispense with certain moral distinctions, once considered of some importance – between killing yourself and having someone else kill you; between refraining from prolonging life and deliberately ending it – while continuing to insist on any number of others.

The issue is thus invariably cast as if the practice would be reserved for adults of sound mind, in the final stages of a terminal illness, suffering unbearable physical pain, freely consenting to have done to them what they would surely choose to do themselves were they not so disabled. In its most complete form, the patient must not only consent, but actually initiate the process in some way (hence “assisted” suicide, versus euthanasia, where someone else does the deed). At all events we are assured the task would be performed by a licensed physician, no doubt with a sterilized needle. . . [Full text]

Richard Dawkins: ‘Immoral’ not to abort Down’s foetuses

BBC News

Kathleen Hawkins

The Oxford professor posted the message on Twitter in response to a user who wrote she would be faced with “a real ethical dilemma” if she became pregnant and learned that the baby would be born with Down’s syndrome.

“Abort it and try again,” Dawkins tweeted in reply. “It would be immoral to bring it into the world if you have the choice.”

His comments have caused anger online and have been dismissed by charities, but he insists his views are “very civilised”, tweeting: “These are fetuses, diagnosed before they have human feelings.” . . . [Full Text]

Genetic screening to improve intelligence

Writing in The Conversation, ethicist Julian Savulescu discusses recently published findings that indicate that children with two copies of a common gene (Thr92Ala) and low thyroid hormone levels apparently increase the likelihood of low IQ by a factor of four.  Since the “risk of low intelligence” depends upon both the genetic configuration and hormonal level, he suggests that such children could be treated with supplemental thyroid hormones “to enhance their intelligence.”

The “low intelligence” to which he refers is the 4 % of the U.K. population estimated to have an IQ of between 70 and 85.

“If we could enhance their intelligence, say with thyroid hormone supplementation,” he writes, “we should.”

Savulescu’s focus on intelligence in this case should not become a distraction.  Supplementing hormones seems to present no special ethical problems, since the goal in that case would not be eugenic perfectionism or enhancement, but therapeutic correction of a deficiency.  However, Savulescu goes beyond this to propose that IVF embryos be screened, and that embryos found to have two copies of the Thr92Ala gene not be selected for implantation.  What is unstated is that the ‘defective’ embryos should be killed.  This would be an ethical/moral problem for anyone who holds that deliberately killing human embryos is wrong.

 

Virginia enacts protection of conscience provision for genetic counsellors

 Governor’s attempt to force referral overridden by Senate

A bill concerning the regulation of genetic counselling in Virginia has been enacted with the original protection of conscience provision intact.  Identical versions of the bill had been passed unanimously by the Virginia House and Senate, but Governor Terry McAuliffe, apparently in response to lobbying from the American Civil Liberties Union (ACLU) and Planned Parenthood, attempted to insert a mandatory referral provision into the bill.  This was rejected by the Senate.  The law now requires an objecting counsellor to offer “to direct the patient to the online directory of licensed genetic counselors maintained by the Board.” [Family Foundation]