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that people give some states a negative value - that is, they
indicate that they would prefer to be dead than to survive in
that condition. Apparently, the life of the elderly woman described
by Sir Gustav Nossal was, in the opinion of the matron
of the nursing home, the doctor, and the relatives, not worth
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living. If we can set criteria for deciding who is to be allowed
to die and who is to be given treatment, then why should it be
wrong to set criteria, perhaps the same criteria, for deciding
who should be killed?
So it is not the attitude that some lives are not worth living
that marks out the Nazis from normal people who do not commit
mass murder. What then is it? Is it that they went beyond
passive euthanasia, and practised active euthanasia? Many,
like Lorber, worry about the power that a program of active
euthanasia could place in the hands of an unscrupulous government.
This worry is not negligible, but should not be
exaggerated. Unscrupulous governments already have within
their power more plausible means of getting rid of their opponents
than euthanasia administered by doctors on medical
grounds. 'Suicides' can be arranged. 'Accidents' can occur. If
necessary, assassins can be hired. Our best defence against such
possibilities is to do everything possible to keep our government
democratic, open, and in the hands of people who would not
seriously wish to kill their opponents. Once the wish is serious
enough, governments will find a way, whether euthanasia is
legal or not.
In fact the Nazis did not have a euthanasia program, in the
proper sense of the word. Their so-called euthanasia program
was not motivated by concern for the suffering of those killed.
If it had been, why would the Nazis have kept their operations
secret, deceived relatives about the cause of death ofthose killed,
and exempted from the program certain privileged classes, such
as veterans of the armed services, or relatives of the euthanasia
staff? Nazi 'euthanasia' was never voluntary, and often was
involuntary rather than non-voluntary. 'Doing away with useless
mouths' - a phrase used by those in charge - gives a better
idea ofthe objectives of the program than 'mercy-killing'. Both
racial origin and ability to work were among the factors considered
in the selection of patients to be killed. It was the Nazi
belief in the importance of maintaining a pure Aryan Yolk - a
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Practical Ethics
somewhat mystical entity that was thought of as more important
than mere individuals lives - that made both the so-called euthanasia
program and later the entire holocaust possible. Proposals
for the legalisation of euthanasia, in contrast, are based
on respect for autonomy and the goal of avoiding pointless
suffering.
This essential difference in the aims of Nazi 'euthanasia' and
modem proposals may be granted, but the slippery slope argument
could still be defended as a way of suggesting that the
present strict rule against the direct killing of innocent human
beings serves a useful purpose. However arbitrary and unjustifiable
the distinctions between human and non-human, fetus
and infant, killing and allowing to die may be, the rule against
direct killing of innocent humans at least marks a workable line.
The distinction between an infant whose life may be worth
living, and one whose life definitely is not, is much more difficult
to draw. Perhaps people who see that certain kinds of human
beings are killed in certain circumstances may go on to conclude
that it is not wrong to kill others not very different from the
first kind. So will the boundary of acceptable killing be pushed
gradually back? In the absence of any logical stopping place,
will the outcome be the loss of all respect for human life?
If our laws were altered so that anyone could carry out an
act of euthanasia, the absence of a clear line between those who
might justifiably be killed and those who might not would pose
a real danger; but that is not what advocates of euthanasia
propose. If acts of euthanasia could only be carried out by a
member of the medical profession, with the concurrence of a
second doctor, it is not likely that the propensity to kill would
spread unchecked throughout the community. Doctors already
have a good deal of power over life and death, through their
ability to withhold treatment. There has been no suggestion that
doctors who begin by allowing severely disabled infants to die
from pneumonia will move on to withhold antibiotics from
racial minorities or political extremists. In fact legalising eu-
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thanasia might well act as a check on the power of doctors since
it would bring into the open and under the scrutiny of another
doctor what some doctors now do on their own initiative and
in secret.
There is, anyway, little historical evidence to suggest that a
permissive attitude towards the killing of one category of human
beings leads to a breakdown of restrictions against killing other
humans. Ancient Greeks regularly killed or exposed infants, but
appear to have been at least as scrupulous about taking the lives
of their fellow-citizens as medieval Christians or modem Americans.
In traditional Eskimo societies it was the custom for a
man to kill his elderly parents, but the murder of a normal
healthy adult was almost unheard of. I mention these practices
not to suggest that they should be imitated, but only to indicate
that lines can be drawn at places different from where we now
draw them. If these societies could separate human beings into
different categories without transferring their attitudes from one
group to another, we with our more sophisticated legal systems
and greater medical knowledge should be able to do the same.