White Coat Underground

Do you even know what real evil is?

There has been a murmur (albeit an insane one) at many of the anti-Obama and anti-health care reform rallies about the Nazi “T4″ program, something most Americans have never heard of. The absurd analogy apparently goes like this: the Nazis euthanized undesirables, and the proposed health bill would effectively do the same thing, therefore Obama is Hitler.

Let’s back up a bit. Aktion T4 was Hitler’s personal pet program of tasking the medical community to identify and murder those considered “incurable”. In practice, this meant the murder of the mentally ill and cognitively disabled—the total murdered was probably about 100,000 German and Polish children and adults with various mental and physical disabilities—-or at least said to have these disabilities. This was not a “euthanasia” program, but a carefully organized mass murder based on Hitler’s ideas of “fitness” and “hygiene”.


Even Hitler’s remarkable propaganda apparatus had difficulty coping with this program. While the rich were insulated (their disabled relatives normally being cared for in the home), the program affected a wide swath of everyday Germans, including many Catholics. The Church still had significant influence and was able to help rouse public opinion against the program (but famously failed to use this same power to help stop the Holocaust). The program was dismantled in 1941 and much of the apparatus re-tasked to the murder of Jews.

Rationing of limited health care resources is currently part of our health care system, although it isn’t overtly referred to as rationing. Rationing can be severe, as about 47 million uninsured Americans know, or subtle, as many others know when various tests and services are denied. Sometimes this rationing is a proper scrutiny of unnecessary care, and sometimes it is simply a cruel economic roadblock. What it is not is a program of mass murder. If rationing becomes more explicit, that is scarce resources recognized as such and in some circumstances limited, it is also not mass murder. The experience in countries with mostly socialized medicine, such as Canada, and those with hybrid systems, such as France, are not that of mass murder and death panels, and there is no reason to think that there would be such a thing here.

There is a fundamental non-equivalence between waiting a month for the MRI of your knee and being shot in a ditch for being autistic. Those who don’t recognize this—in fact anyone who equates the Obama administration’s policies to the Nazis—is probably beyond salvation. The level of hateful stupidity is nauseating, idiotic, and familiar.

Comments

  1. #1 Liz Ditz
    September 14, 2009

    Thank you for this heartfelt and strong post.

    From Amanda Baggs:

    http://ballastexistenz.autistics.org/?page_id=2

    Ballastexistenz means about what it looks like: Ballast-existence, ballast-life. Some of the other terms that were applied to disabled people at the same time included leeren Menschenhülsen (empty human-shaped shells/husks), and lebensunwertes Leben (lives unworthy of life).

    In using these terms, I do not for one moment forget the gravity of them. The ideas that gave rise to that terms have existed a long time and continue to exist. These ideas threaten the lives and well-being of disabled people everywhere. Autistic people are frequently described in these hateful ways, as empty shells without souls, burdens on our families and society, contributing nothing, ballast that merely weighs everyone else down.

    I put this name on my blog in witness to what can happen, has happened, and is happening when real human beings are thought of this way. I am a non-speaking physically disabled and autistic woman who’s lived in institutions, whose income comes from a disability check, and whose services are funded by the state. I am and have been exactly the sort of person who is meant when these awful concepts are used. I and the people I know and love are people, not burdens and ballast and wastes of space and money. All these ideas do is dehumanize us, and in contrasting these words with my real life I hope to show how wrong they are when applied to anyone.

  2. #2 Pascale
    September 14, 2009

    The hate- and fear-mongering that have characterized the “healthcare” debate have amazed me. No one has proposed anything resembling a “death panel.” Instead, there was a proposal to pay, via Medicare, for doctors to discuss end-of-life issues with patients; to ask them what measures they would and wouldn’t want taken if debilitated, and document their wishes. Many doctors do this now; they just don’t get paid for the service.

  3. #3 Ramel
    September 14, 2009

    The fact that any of this needs saying means something has gone horribly wrong.

  4. #4 R E G
    September 14, 2009

    Yet another weird thing about the Republican’s twisted view of health care…

    They seem to believe that it’s more important to block it than to design it. They can’t see everyday Americans as able to influence where health care reform can lead. In other countries citizens routinely “negotiate” through voting where the health care system goes.
    Right now in Canada I know of two initiatives working their way through the approval process.

    One seeks to harmonize approved cancer therapies among the provinces.

    The other is hoping that in vitro fertilization can make the approved list. Those people have a very compelling argument that the high cost leads parents to risk multiple births – leading to complicated pregnancies and fragile newborns. The pregnancy, birth and neonatal care must be covered by the taxpayers. Overall they argue, funding serveral in vitro attempts costs less than caring for multiple preemies. If their numbers are correct they will probably win the battle.

    Comparing Obama to Hitler??? I think anyone with firsthand experience of a fascist state knows that you strive to be invisible, not to create change. I guess Canada, Europe and Australia didn’t get the memo.

  5. #5 katydid13
    September 14, 2009

    No, we don’t. I think the term “nazi” has become almost synonymous with “someone who enforces rules others might see as petty” and therefore has kind of lost its power.

    Plus, based on the signs I saw this weekend, people don’t seem to understand that fascists, communists, and socialists, are not all the same that and aren’t just names for political policies you don’t like.

  6. #6 drcharles
    September 14, 2009

    Yeah, it is hard to hold an honest debate when such irrational name-calling begins. Is it a surrogate for even nastier name-calling, which is nottolerated?

  7. #7 Geoff Plourde
    September 15, 2009

    Doctor,

    While I agree that our healthcare system is broken, I do not believe that Obama’s system is a solution.

    All Obama wants to do is perpetuate and expand the current disaster. I have seen nothing that will attack the root of our defective delivery model. As Milton Friedman once pointed out, our problem stems from the insurance company stepping in and dictating what care is necessary and reasonable. I have worked in the healthcare industry and have seen this occur all too often, as I am sure you have. Whether done by private companies or the federal government, this is unacceptable and organized murder. President Obama’s reform shows no elimination of utilization review, pre existing conditions or other abusive practices. All he wants to do is pawn the defective product off on more people.

    Another area that raises the cost of healthcare is medical malpractice. Through increased charges, everyone pays for the exorbitant windfalls of abusive lawyers and litigants. Obama has consistently refused to work towards tort reform in this area, despite the cost savings it would mean.

    For these and other reasons, I find myself unable to support the poorly designed proposal that has been put forward.

  8. #8 Orac
    September 15, 2009

    I so have to do a post about this issue. The Holocaust and Holocaust denial are major topics of my blog.

  9. #9 Beauzeaux
    September 15, 2009

    One must READ to know anything about history.
    Your average wingnut would rather walk on hot coals than read anything except (when feeling very intellectual and very occasionally) USA Today.
    If you don’t read, you have no hope of understanding anything about the past and very little about the present. People who get all their news and historical perspective from TV are going to be ignorant. Seriously ignorant.

  10. #10 Art
    September 15, 2009

    My interpretation is that many conspiracy theorists have no real experience or exposure to real evil, extreme abuses of power and have never been in a situation where justice or freedom was of existential importance. That while they see themselves as guardians of freedom and justice their actions are functionally more akin to an allergy where a naive immune defense system overreacts to slight insults. An overreaction that debilitates and can destroy the body. Or the political body of a nation.

    Talking with such people it strikes me that they have a very naive and juvenile understanding of totalitarian power and evil in general. To them they are something you can fight with a gun. They fail to understand that they can pervade a society that is frightened. That abuse of power comes more often from weakness, insecurity and paranoia than strength and confidence.

    They misunderstand the T-4 program. They imagine that Hitler came to power using guns when in fact he gained power by catering to German insecurity by offering power and control by way of will and purity. Which is where we get into eugenics and the idea that if the society could be cleansed of its diseased portions through the application of will and discipline that Germany could regain power.

    The elimination of the communists and Jews and deformed was part of and training for the use of power that would counter the humiliation and shame of the defeats of WW1 and the weaknesses prior. Through purity, will and rejection of weakness the battered, and humiliated German people would rise up and dominate their persecutors.

    It was the shame of their own weakness that allowed them to murder. The T-4 program was the equivalent of the sociopath’s mutilation of small animals. Mental practice in cruelty, the use of violence and suppression of feeling that would allow the slaughter that would come. A way to overcome the fear and shame.

    Not understanding that evil comes from weakness and shame they mistake the normal above board, mature, and confident functions of matching resources to need, at some level services are always rationed, with placating an internal sense of shame and humiliation by scapegoating a minority and elimination it. Never having gone without they mistake moderate taxation with deprivation and normal bounding of freedom with slavery.

    Never having seen a mountain they imagine every mole hill is a mountain and themselves as great mountaineers. Never having been in a serious fight they imagine a bloody nose is a mortal wound.

  11. #11 PalMD
    September 15, 2009

    @Geoff
    I mostly agree with you. A single-payer system never should have been taken off the table.

    : )

  12. #12 perceval
    September 15, 2009

    In that context, it is interesting that the churches actually stood up for the rights of the mentally ill and disabled, including Cardinal von Galen, and this had at least some effect on the administration’s policies. (Ian Kershaw has more details IIRC). To their eternal shame, the churches never showed similar support for the homosexuals, socialists, and Jews.

  13. #13 Orac
    September 15, 2009

    In that context, it is interesting that the churches actually stood up for the rights of the mentally ill and disabled, including Cardinal von Galen, and this had at least some effect on the administration’s policies. (Ian Kershaw has more details IIRC).

    I’m reading Richard J. Evans’ three-part series on the history of the Third Reich. In the third book, he discusses von Galen at length. It just goes to show that even a totalitarian dictatorship cannot entirely ignore the will of the people. It is also one of the times when the Church actually did stand up for what was right, even at the risk of its priests being jailed and worse.

  14. #14 KristinMH
    September 15, 2009

    To their eternal shame, the churches never showed similar support for the homosexuals, socialists, and Jews.

    There was a great book written about ten years ago called “Hitler’s Pope” which went pretty in depth into this. It was eye-opening to me – having grown up a touchy-feely social gospel Catholic, I wasn’t really aware of the anti-modernist, anti-humanist tradition of the church. The Pope didn’t speak out for the gays, Jews, or socialists, because the Catholic church was against homosexuality and socialism and not too warm on Jews either.

    But to answer Pal’s question, no, I don’t think the people who are conflating mass murder with end of life planning understand what real evil is. I think they’re like children over-dramatizing themselves, working themselves up about how oppressed they are so they can feel like heroes. If health care reform is like mass murder, then being an ass at a town hall is exactly like being part of the French resistance.

    And if to do this they have to dredge up a disgusting and evil act from the past and smear a good man (Obama) with it, so what?

  15. #15 Julie, RN
    September 15, 2009

    IIRC, a relative of Hitler’s was killed for being “feebleminded”. She was a distant cousin and older than him. If he knew about it, he wasn’t concerned. As for conflating Nazi policy with the current debate, that’s classic conservative mindset: things aren’t just bad, they are REALLY bad. No room for nuance or relativity here. It’s a curious psychological characteristic: all or none.

  16. #16 Denice Walter
    September 15, 2009

    If you think back to last year: similar confabulation and riotous behavior emerged in response to Obama during the campaign and during the economic catastrophes(beginning one year ago today-Sept. 15 -and around the “bottom” of March 9).Each time,he spoke to clear up mythological beliefs -“putting out fires”- only to have them spring up again,in a new area.Last week, Geithner said of the crisis, (paraphrase):”We needed to act quickly to prevent further damage to the system. Our opponents wanted *no* action.Can you imagine the result if we had done *that*?” – During the Depression, FDR spoke frequently(“Fireside Chats”) to quell fears and inform the public about his actions to deal with the crisis.(According to my relatives -mostly business people and supporters- that president was similarly smeared as a “socialist” and worse).I think we need a continued effort by the president to educate the public and counter misinformation and fear-mongering (I know, I know,Fox will call it “re-education”, like they do in *camps*)Seriously.A therapeutic program to keep people informed and dealing with their unfounded fears. Television-side chats.

  17. #17 felixma
    September 15, 2009

    atheists caused 911 – treat them accordingly

    you have forfeit your life

    http://www.sotoman.info/freethinking/index.php?topic=1198.0

  18. #18 MonkeyPox
    September 15, 2009

    The above insanity was brought to you by Dave Mabus, a shit-eating ass-monkey hate monger who is so insecure about his own faith that he thinks one person’s atheism is actually worth murder. Nice, Dave. Keep it up until the feds or the psychiatrists lock you up.

  19. #19 terrifiedtabetic
    September 15, 2009

    Yo, Christofascist, get your own fucking blog.

  20. #20 Igor
    September 15, 2009

    Oh no, it’s Mr. Mabus, run for the foxholes.

  21. #21 J Todd DeShong
    September 16, 2009

    What is really sad is that people like Limbaugh, Glenn Beck, Hannity, Coulter, Sarah Palin are repsonsible for inciting the masses. What’s worse, is that the masses are so easily incited by such obvious liars!
    I am amazed that people are so opposed to healthcare for all!
    I am a 45 year old man without insurance. I went back to graduate school for two years and kept my $500/month COBRA insurance as long as I could. Now I am working in a hospital lab, using my degree, but am working as a PRN currently which is not a position with insurance benefits.
    I am one example of millions of people in this country without health insurance that gets overlooked in the lies and deception and worry about covering illegal aliens.
    JTD

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