Thursday, May 19, 2011


On BBC news this morning, I heard the film director Lars von Trier blather on like someone who loves to hear himself speak and counts on an editor to clean up the final product. Only Lars didn’t have an editor, so he went on about understanding Hitler, Israel being “a pain,” and other comments that made me remember a man who rolled up his sleeve and confronted me a quarter-century ago at L.A.’s Museum of Tolerance.

My wife and I had just watched gruesome Holocaust footage and were exiting a large room that served as a replica of a Nazi gas chamber. The stranger turned around, rolled up his sleeve, and exposed his forearm. He was short, I remember, had tears in his eyes and numbers tattooed on his arm. “This happened,” he said, with a piercing stare. “This really happened.”

I didn’t question that it happened, but the man made me uncomfortable and I didn’t comprehend why he so emotionally stressed the importance of remembrance. But I remembered him twice this week. Once while listening to the unthinking von Trier. The other while reading a quote that, in a different context, without the attribution -- and after months of reading about terminal diagnoses, treatment of merciless pain, and intractable disputes between doctors and patient/families -- I’d have found neither offensive nor outrageous.

The quote: “Patients considered incurable, on the basis of human judgement, can be granted mercy deaths after a critical diagnosis.”

“Can be granted,” in particular, implies a respect for patient autonomy, and who would deny the value of mercy? But the context and attribution exposed the lie behind this mercy and autonomy. The quote is on a wall about halfway through the exhibit “Deadly Medicine: Creating the Master Race” at Harvard Medical School’s Countway Library. It is taken from a note to Nazi doctors signed by Adolph Hitler.

In that moment, “death panel” took on deeper meaning. So did “human judgement,” and the challenge for a system in building trust among individuals.

“Deadly Medicine” was stirring, and I’d probably return before it closes in June if the facts and images hadn’t been so disturbing. After 90 minutes, I left unsure what to think. But I came away with resonant facts that I’ll carry with me:

  • Nazism’s effective devaluing of “defectives,” and measuring individual worth by value to society. Another Hitler quote: “The wishes and the selfishness of the individual must appear as nothing.”

  • In Nazism’s rise, doctors were among its earliest and strongest proponents.

  • Under Nazism, anti-Semitism was medicalized; “Jews are lice,” reads one poster from the time. And yet long before the Nazi era, and much closer to home, there were 295 eugenic sterilizations performed at Mendocino State Hospital in Northern California.

  • Another quote, this one from Joseph Goebbels, Nazi minister of propaganda: “Our starting point is not the individual, and we do not subscribe to the view that one should feed the hungry, give drink to the thirsty, or clothe the naked ... Our objective is entirely different. We must have a healthy people in order to prevail in the world.”

  • Conscious of religious opposition to rassenhygiene, or ethnic cleansing, the Nazis used war as cover.

  • Rising costs of institutional care fueled support for eugenics. Indeed, financial burden on society is cited often in Nazi literature.

To that man at the Museum of Tolerance, that unforgettable man, I’d like to say that, in studying the CEC’s bioethical questions, I’ll carry what I can from his memory as I consider the value of one human life.

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