Analyzing Nursing as a Dispositif : Healing and Devastation in the Name of Biopower. A Historical, Biopolitical Analysis of Psychiatric Nursing Care under the Nazi Regime, 1933-1945
Creators: name: Foth, Thomas
Publisher: name: Université d'Ottawa / University of Ottawa
Year: 2011
Subjects: Nazi-Nursing
killings of patients
Euthanasia
Actor Network Theory
Psychiatric practice
Nazism
Psychiatry
Germany
Fascism

description: Under the Nazi regime in Germany (1933-1945) a calculated killing of chronic “mentally ill” patients took place that was part of a large biopolitical program using well-established, contemporary scientific standards on the understanding of eugenics. Nearly 300,000 patients were assassinated during this period. Nurses executed this program through their everyday practice. However, suspicions have been raised that psychiatric patients were already assassinated before and after the Nazi regime, suggesting that the motives for these killings must be investigated within psychiatric practice itself. My research aims to highlight the mechanisms and scientific discourses in place that allowed nurses to perceive patients as unworthy of life, and thus able to be killed. Using Foucauldian concepts of “biopower” and “State racism,” this discourse analysis is carried out on several levels. First, it analyzes nursing notes in one specific patient record and interprets them in relation to the kinds of scientific discourses that are identified, for example, in nursing journals between 1900 and 1945. Second, it argues that records are not static but rather produce certain effects; they are “performative” because they are active agents. Psychiatry, with its need to make patients completely visible and its desire to maintain its dominance in the psychiatric field, requires the utilization of writing in order to register everything that happens to individuals, everything they do and everything they talk about. Furthermore, writing enables nurses to pass along information from the “bottom-up,” and written documents allow all information to be accessible at any time. It is a method of centralizing information and of coordinating different levels within disciplinary systems. By following this approach it is possible to demonstrate that the production of meaning within nurses’ notes is not based on the intentionality of the writer but rather depends on discursive patterns constructed by contemporary scientific discourses. Using a form of “institutional ethnography,” the study analyzes documents as “inscriptions” that actively interven in interactions in institutions and that create a specific reality on their own accord. The question is not whether the reality represented within the documents is true, but rather how documents worked in institutions and what their effects were. Third, the study demonstrates how nurses were actively involved in the construction of patients’ identities and how these “documentary identities” led to the death of thousands of humans whose lives were considered to be “unworthy lives.” Documents are able to constitute the identities of psychiatric patients and, conversely, are able to deconstruct them. The result of de-subjectification was that “zones for the unliving” existed in psychiatric hospitals long before the Nazi regime and within these zones, patients were exposed to an increased risk of death. An analysis of the nursing notes highlights that nurses played a decisive role in constructing these “zones” and had an important strategic function in them. Psychiatric hospitals became spaces where patients were reduced to a “bare life;” these spaces were comparable with the concentration camps of the Holocaust. This analysis enables the integration of nursing practices under National Socialism into the history of modernity. Nursing under Nazism was not simply a relapse into barbarism; Nazi exclusionary practices were extreme variants of scientific, social, and political exclusionary practices that were already in place. Different types of power are identifiable in the Nazi regime, even those that Foucault called “technologies of the self” were demonstrated, for example, by the denunciation of “disabled persons” by nurses. Nurses themselves were able to employ techniques of power in the Nazi regime.