Advertisement

Intensive Care Medicine

, Volume 32, Issue 9, pp 1304–1310 | Cite as

“Euthanasia”: a confusing term, abused under the Nazi regime and misused in present end-of-life debate

  • Andrej Michalsen
  • Konrad Reinhart
Review

Abstract

Background

Legal provisions in The Netherlands and Belgium currently allow physicians to actively end a patient's life at his or her request under certain conditions. The term that is used for this is “euthanasia.”

Discussion

The same term, “euthanasia,” was used in Germany during the Nazi regime for a program of cleansing the “German nation” in which untold thousands of persons were denied human empathy or medical care and were thereby condemned to death. The medical profession played a leading role in the planning, administration, and supervision of this “euthanasia” program, with a large proportion of German physicians proactively shirking all moral responsibility and ultimately paving the way for the Holocaust.

Conclusion

The term “euthanasia” was so abused during the Nazi regime as a camouflage word for murder of selected subpopulations with the willing participation of physicians, we believe that, regardless of the benevolent goals of current euthanasia practices, for historical reasons the term “euthanasia” must not be used with regards to current end-of-life care.

Keywords

Euthanasia National Socialism End-of-life care Racial hygiene Intensive care 

Notes

Acknowledgements

A. Karenberg, MD, PhD, Cologne, and R. Hoff, MD, Utrecht, reviewed early versions of the manuscript; their help is gratefully acknowledged. This article is based on the presentation “Euthanasia—History and Definition” by A. Michalsen, given at the 18th Annual Congress of the European Society of Intensive Care Medicine, Amsterdam, September, 2005.

References

  1. 1.
    Sprung CL, Cohen SL, Sjokvist P, Baras M, Bulow HH, Hovilehto S, Ledoux D, Lippert A, Maia P, Phelan D, Schobersberger W, Wennberg E, Woddcock T, Ethicus Study Group (2003) End-of-life practices in European intensive care units. JAMA 290:790–797PubMedCrossRefGoogle Scholar
  2. 2.
    van der Heide A, Deliens L, Faisst K, Nilstun T, Norup M, Paci E, van der Wal G, van der Maas PJ, EURELD Consortium (2003) End-of-life decision-making in six European countries: descriptive study. Lancet 362:345–350PubMedCrossRefGoogle Scholar
  3. 3.
    Carlet J, Thijs LG, Antonelli M, Cassell J, Cox P, Hill N, Hinds C, Pimentel JM, Reinhart K, Thompson BT (2004) Challenges in end-of-life care in the ICU. Intensive Care Med 30:770–784PubMedCrossRefGoogle Scholar
  4. 4.
    Michalsen A, Reinhart K (2004) Die Versorgung Sterbender auf Intensivstationen. Anästhesiol Intensivmed Notfallmed Schmerzther 45:738–740Google Scholar
  5. 5.
    Draper R (1998) Encyclopaedia of applied ethics. LondonGoogle Scholar
  6. 6.
    Curtis JR, Rubenfeld GD (2001) Managing death in the intensive care unit. Oxford University Press, New YorkGoogle Scholar
  7. 7.
    Eerste Kamer der Staten Generaal (2001) Wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Vergaderjaar 2000–2001, 26691, no 137Google Scholar
  8. 8.
    Ministerie van Justitie (2002) Wet betreffende de euthanasie. Brussels, 28 MayGoogle Scholar
  9. 9.
    van der Maas PJ, van der Wal G, Haverkate I, de Graaff Cl, Kester JG, Onwuteaka-Philipsen BD, van der Heide A, Bosma JM, Willems DL (1996) Euthanasia, physician-assisted suicide, and other medical practices involving the end of life in the Netherlands, 1990–1995. N Engl J Med 335:1699–1705PubMedCrossRefGoogle Scholar
  10. 10.
    Legemaate J (2002) Vergelijkbaar maar niet hetzelfde-wetgeving voor euthanasie in Nederland en België. Med Contact 57:1855–1858Google Scholar
  11. 11.
    Kater L (2003) The Dutch model for legalising end-of-life decisions. Med Law 22:543–550PubMedGoogle Scholar
  12. 12.
    Onwuteaka-Philipsen BD, van der Heide A, Koper D, Keij-Deerenberg I, Rietjens JA, Rurup ML, Vrakking AM, Georges JJ, Muller MT, van der Wal G, van der Maas PJ (2003) Euthanasia and other end-of-life decisions in the Netherlands in 1990, 1995, and 2001. Lancet 362:395–399PubMedCrossRefGoogle Scholar
  13. 13.
    van der Wal G, van der Heide A, Onwuteaka-Philipsen BD, van der Maas PJ (2003) Medische besluitvorming aan het einde van het leven: de praktijk en de toetsingsprocedure euthanasie. Uitgeverij de Tijdstroom, UtrechtGoogle Scholar
  14. 14.
    Delden JJM van (2004) The unfeasibility of requests for euthanasia in advance directives. J Med Ethics 30:447–451PubMedCrossRefGoogle Scholar
  15. 15.
    Steinbock B (2005) The case for physician assisted suicide: not (yet) proven. J Med Ethics 31:224–235Google Scholar
  16. 16.
    Rurup ML, Onwuteaka-Philipsen BD, Jansen-van der Weide MC, van der Wal G (2005) When being ‘tired of life’ plays an important role in a request for euthanasia or physician-assisted suicide: patient characteristics and the physician's decision. Health Policy 74:157–166PubMedCrossRefGoogle Scholar
  17. 17.
    Jansen-van der Weide MC, Onwuteaka-Philipsen BD, van der Wal G (2005) Granted, undecided, withdrawn, and refused requests for euthanasia and physician-assisted suicide. Arch Intern Med 165:1698–1704CrossRefGoogle Scholar
  18. 18.
    Benzenhöfer U (1999) Der gute Tod? Euthanasie und Sterbehilfe in Geschichte und Gegenwart. Beck'sche Reihe, MünchenGoogle Scholar
  19. 19.
    Cohen S, Sprung C, Sjokvist P, Lippert A, Ricou B, Baras M, Hovilehto S, Maia P, Phelan D, Reinhart K, Werdan K, Bulow HH, Woodcock T (2005) Communication of end-of-life decisions in European intensive care units. Intensive Care Med 31:1215–1221PubMedCrossRefGoogle Scholar
  20. 20.
    Proctor RN (1992) Nazi doctors, racial medicine and human experimentation. In: Annas GJ, Grodin MA (eds) The Nazi doctors and the Nuremberg Code. Oxford University Press, New York, pp 17–31Google Scholar
  21. 21.
    Burleigh M (1994) Death and deliverance. Euthanasia in Germany 1900–1945. Cambridge University Press, CambridgeGoogle Scholar
  22. 22.
    Barondess JA (1996) Medicine against society-lessons form the Third Reich. JAMA 276:1657–1661PubMedCrossRefGoogle Scholar
  23. 23.
    Labisch A (2001) Die “hygienische Revolution” im medizinischen Denken. In: Ebbinghaus A, Dörner K (eds) Vernichten und Heilen. Der Nürnberger Ärzteprozess und seine Folgen. Aufbau-Verlag, Berlin, pp 68–89Google Scholar
  24. 24.
    Geiderman JM (2002) Ethics seminars: physician complicity in the Holocaust: historical review and reflections on the emergency medicine in the 21st century, I. Acad Emerg Med 9:223–231PubMedCrossRefGoogle Scholar
  25. 25.
    Bacharach S (2004) In the name of public health-Nazi racial hygiene. N Engl J Med 351:417–420CrossRefGoogle Scholar
  26. 26.
    Echternkamp J (2004) Im Kampf an der inneren und äußeren Front. Grundzüge der deutschen Gesellschaft im Zweiten Weltkrieg. In: Echternkamp J (ed) Die Deutsche Kriegsgesellschaft 1939 bis 1945 (erster Halbband). Deutsche Verlagsanstalt, München, pp 1–92Google Scholar
  27. 27.
    Binding K, Hoche A (1920) Die Freigabe der Vernichtung lebensunwerten Lebens. Meiner, LeipzigGoogle Scholar
  28. 28.
    Burleigh M (1994) Psychiatry, German society, and the Nazi ‘euthanasia’ programme. Soc Hist Med 1994 7:213–228CrossRefGoogle Scholar
  29. 29.
    Hanauske-Abel HM (1996) Not a slippery slope or sudden subversion: German medicine and national socialism in 1933. BMJ 313:1453–1463PubMedGoogle Scholar
  30. 30.
    Blasius D (1998) Psychiatrie im Nationalsozialismus. In: Kolb S, Seithe H, IPPNW (eds) Medizin und Gewissen. Mabuse-Verlag, Frankfurt, pp 72–85Google Scholar
  31. 31.
    Kater MH (2001) Die soziale Lage der Ärzte im NS-Staat. In: Ebbinghaus A, Dörner K (eds) Vernichten und Heilen. Der Nürnberger Ärzteprozess und seine Folgen. Aufbau-Verlag, Berlin, pp 51–67Google Scholar
  32. 32.
    Wiesing U (ed) Ethik in der Medizin, 2nd edn. Reclam, Stuttgart, p 60Google Scholar
  33. 33.
    Toellner R (2002) Wissen kann Gewissen nicht ersetzen—das Versagen der Ärzte im Dritten Reich und die Folgen bis heute. In: Härlin J, Klein K, Kolb S et al. (eds) Medizin und Gewissen—wenn Würde ein Wert würde. Mabuse-Verlag, Frankfurt, pp 26–41Google Scholar
  34. 34.
    Mitscherlich A, Mielke F (1949) Wissenschaft ohne Menschlichkeit. HeidelbergGoogle Scholar
  35. 35.
    Pross C (1992) Nazi doctors, German medicine, and historical truth. In: Annas GJ, Grodin MA (eds) The Nazi doctors and the Nuremberg Code. Oxford University Press, New York, pp 32–52Google Scholar
  36. 36.
    Bleker J, Jachertz N (eds) (1993) Medizin im “Dritten Reich,” 2nd edn. Deutscher Ärzte-Verlag, KölnGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Department of Anesthesiology and Intensive Care MedicineÜberlingen HospitalÜberlingen/SeeGermany
  2. 2.Department of Anesthesiology and Intensive Care MedicineKlinikum Friedrich Schiller University JenaJenaGermany

Personalised recommendations