Health care reform = Nazi euthanasia: The equivalent of Holocaust denial?

I hadn’t planned on writing about this topic again. Really, I hadn’t. The reason is mainly that politics is usually not my bag. I’ve said it time and time again: political bloggers are a dime a dozen, and I have no reason to suspect that my pontifications and bloviations on politics would be any more valuable or worthy of your attention than anyone else’s pontifications and bloviations on politics. Besides, I’ve made quite the little niche for myself in the blogosphere writing about skepticism, critical thinking, and science in medicine, in particular how unscientific or pseudoscientific health care modalities are increasingly finding their way into medicine. Shockingly, even to someone as full of himself (at least on the blog) as I am, I even appear to have become one of a handful of go-to bloggers when it comes to the anti-vaccine movement. All of this represents a good place to be if you’re a blogger, so much so that it even got me a gig being on a panel at TAM7.

How cool is that?

However, another topic that I’ve had an intense interest in since the very beginning of this blog, a topic I first wrote about way back in January 2005. Oddly enough, when I wrote snarky posts about how the opponents of President Obama’s healthcare reform initiative have been delving deeply into Godwin territory, I hadn’t thought that there might be a connection between my interest in skepticism and critical thinking as applied to medicine and Holocaust denial. I hadn’t thought that there would be a way to link Holocaust denial with the sheer idiocy coming from the right about how President Obama supposedly wants to euthanize your babies and kill your grandma. But I should have. Fortunately, for me, a man whom I greatly admire, bioethicist Arthur Caplan showed me the error of my ways (or at least the limitations of my vision):

Rush Limbaugh and those invoking the Nazi analogy to attack President Barack Obama’s effort to reform health care in America are not “insane” as David Brooks pronounced on last Sunday’s “Meet the Press.” Limbaugh, Glenn Beck, Sarah Palin and the rest of the loud-mouthed right wing are, when they even hint at an analogy to the Nazis in talking about Obama’s health reform effort, engaged in something far worse than insanity. They are engaged in the vile evil of Holocaust denial.

Dr. Caplan is right. He nailed it. This is exactly what Rush Limbaugh, Sarah Palin, and their ilk are doing whether they realize it or not. They are trivializing the Holocaust. In essence, if they truly believe that the provisions of President Obama’s health care reform initiative are the equivalent of the Holocaust, they are doing the functional equivalent of denying the Holocaust, and Caplan explains why:

For some time now, Iran’s president, Mahmoud Ahmadinejad, has held the title of the world’s most dangerous anti-Semite due to his denial that the Holocaust occurred. Limbaugh and his ilk who have been throwing around references to Adolf Hitler, National socialism and Nazi medicine without hesitation have surpassed the danger posed by the Iranian president. They are offering a false view of why the Holocaust happened. Their flagrant, deliberate and invidious distortion of what happened to medicine in Nazi Germany must not be allowed to stand. Not just because health reform is too important an issue but also because the truth is too important to let ignoramuses destroy it.

Speak it, brother Caplan! Why didn’t I see this before? Now I know exactly what was bothering me about the casual argumentum ad Nazium and argumentum ad Hitlerium. It was something that was below the surface but profoundly disturbing above and beyond the thermonuclear burning stupid of the brain dead analogies being being so casually thrown about by historically ignorant ignoramuses like Rush Limbaugh. Caplan tells us why:

Contrary to what Limbaugh and other Holocaust deniers would have you believe, German medicine and science were not brought into the Nazi party once Hitler took power. They fueled the fire for what became Nazism with bigotry proffered as science.

What distinguished the doctors and scientists of Germany pre-Hitler was that so many of them were firm believers in racial hygiene — the view that the Aryan race’s very existence was threatened by inferior peoples such as Jews, blacks and Slavs. They felt the only way to protect their “race,” a concept that itself made little biological sense, was to prohibit reproduction with inferior people and, ultimately, to destroy them. It was racism masquerading as science that formed the basis for Nazi science and medicine right down to the gas chambers and ovens that my dad found himself staring at in 1945.

As Caplan points out, Nazi medicine was racist to its very core. Indeed, to the eternal shame of German medicine, physicians were among the most enthusiastic supporters of the Nazi Party. The reason was simple. If you want the full story, I highly recommend Robert Jay Lifton’s The Nazi Doctors: Medical Killing and the Psychology of Genocide and Robert N. Proctor’s Racial Hygiene: Medicine Under the Nazis. Both of them explain how the Nazi vision was a biomedical vision in which the race (Volk) was more important than individual health and physicians had a higher calling than just treating the individuals. They were to be the professional class that both shaped and implemented that vision.

But what did that vision involve?

It involved making sure that the best and the brightest of the “Aryan race” reproduced and that “racial undesirables” did not. It involved making sure that Jews, Gypsies, and other “inferiors” or threats to the Volk were not allowed to contaminate the Volk through interbreeding. This was accomplished through restrictions such as the Nuremberg Laws, which defined who was and was not a Jew and prohibited Jews from citizenship or marrying real “Aryans.” It involved not allowing “worthless eaters” and “life unworthy of life” to survive. It involved killing them under a bureaucratic program euphemistically known as the T4 euthanasia program. It involved the mass murder of millions of Jews. As Nazi Deputy Party Leader Rudolf Hess stated in 1934, a mere year after Hitler came to power, “National Socialism is nothing but applied biology.” As Robert Jay Lifton put it, “The entire Nazi regime was built on a biomedical vision that required the kind of racial purification that would progress from sterilization to extensive killing.”

And, as I mentioned before, to our eternal shame as a profession, German physicians were at the forefront of this movement. Indeed, as Caplan quite correctly points out, it wasn’t the Nazis who inspired physicians to develop racial hygiene. Rather, racial hygiene, which was first proposed by German eugenicist Alfred Ploetz, who introduced the term Rassenhygiene in his “Racial hygiene basics” (Grundlinien einer Rassenhygiene) in 1895. At that time, racial hygiene was more concerned with the declining German birthrate, the increasing number of mentally ill within German institutions, and other common social Darwinist concerns. By the late 1920s, however, racial hygiene had found an ideological soulmate in the Nazi Party, which enthusiastically co-opted this pseudoscientific discipline for its own purposes and infused it with the its paranoid vision of international Jewry as genetically inferior and the implacable enemy of the Volk.

Indeed, even before the ascent of the Nazi Party to power, physicians were a major component of its base. In 1929, at the Nuremberg Nazi Party Congress, a group of 44 German physicians formed the National Socialists Physicians League (Nationalsozialistischer Deutscher Arztebund–NSDAB) to “purify the German medical community of the influence of Jewish Bolshevism.” As Robert Proctor documents, its primary goals were to promote the knowledge of racial hygiene, racial science, and eugenics. By 1933, the League was a huge success, and physicians joined the Nazi Party in larger numbers than any other profession, including lawyers. Indeed, by 1934, the number of physicians wanting to join the League was so huge that the League put a moratorium on new applications until it could process the backlog. Ultimately, as many as 45% of all physicians joined the Nazi Party and 7% of all physicians were in the SS. It is not that difficult to understand why physicians so enthusiastically embraced the Nazi Party. After all, the Nazi Party promised to put them at the center of its biomedical vision and make them “physicians to the Volk.” The Nazi Party promised to make physicians among the most important people in its new Aryan society.

In any case, the biomedical vision of the Nazi Party was racist to its core. Caplan accurately describes the results:

Racism was at the core of Nazi medicine. Racism and a bizarre form of genetics that saw all manner of human frailty and weakness from prostitution to alcohol abuse to petty theft as highly heritable. When Hitler set out to kill the handicapped and the mentally ill he did it to protect the genetic future of Germany. When the “useless eaters” were targeted for euthanasia it was because of the threat they posed to the genetic health of future generations. When Nazi doctors mandated abortion it was to eliminate “mongrel” babies. When Nazi doctors analyzed how many of your ancestors had to be Jewish for you to be a Jew or when they killed all manner of Slavs, it was to remove these dangers from undermining the public health of the Reich.

This is what utter morons like Rush Limbaugh and Sarah Palin are comparing President Obama’s plan to. No matter what reasonable to this plan (and there are quite a few) may exist to be voiced, comparing it to the Nazi biomedical vision is so far beyond the pale as to be a transparently vile and despicable Godwinization of the whole debate. It is not meant as a serious criticism; it’s meant as nothing more than guilt by association. Never mind that the association is more tenuous than Rush’s grip on reality. Indeed, it’s historical ignorance–no, proud historical ignorance–writ large. No, on second thought, it’s a cynical exploitation of the historical ignorance of the vast majority of the America public, most of whom won’t recognize the lie inherent in likening the health care reform bill to the policies of the Nazi regime. Unfortunately, it may work.

Fortunately, Caplan exposes the lie:

Limbaugh, Beck, Palin and other Holocaust deniers ignore the core racist evil of Nazism. They reach for preposterous analogies between counseling people about living wills and the forced, involuntary mass murder carried out in the name of racism in concentration camps.

When the right wing, in their distaste for the President’s push to reform a heath care system that even the American Medical Association and the pharmaceutical industry recognize has to be fixed, suggest that the disabled will be targeted, or that the elderly will be killed or find themselves without health care due to rationing by government bureaucrats as happened in Nazi Germany, they marginalize the gross evil that was the racial bigotry that fueled Nazi programs to euthanize, sterilize, experiment upon and torture people in places that were in no way connected to hospitals, clinics or nursing homes.

Not that evil–yes, evil–idiots like Rush Limbaugh or Sarah Palin, or any of the rest of the right wing machine that is promulgating the lie that “Obama = Hitler,” “Democrats = fascists,” and “health care reform = the Holocaust” care care. Open, vigorous debate is not their intent. Their intent is to scuttle health care reform at all costs, no matter how much they have to lie and minimize the foul evil that was Nazi-ism to do it.