While this may not have been the first articulation of this principle of self-determination, it was and remains the most famous. It seems flawed only in one respect. The medical experiments that were the subject of this trial were so barbaric that no coherent ethical or legal theory could ever sanction the experiments themselves let alone provide support for anyone to consent to them. Moreover, the judges at Nuremberg never addressed the murder of well over 100,000 individuals with disabilities. This may be because the American experience in the first half of the twentieth century was marked by the banishment of tens of thousands of individuals with disabilities to public institutions through state statutes that exceeded in viciousness the Jim Crow segregation statutes of the South.
Individuals can decide that their lives no longer have meaning.
This flows irrevocably from the definition of incompetence. We need to, however, recognize that many individuals will need assistance in decision making and that much resistance will arise from challenging accepted, indeed cherished, notions in the field of law, medicine and ethics. Opposition will mount not only in the field of developmental disabilities but also in the field of aging where the numbers will be much greater in the next thirty years and the competition for limited resources will make today's discussion even more critical. We need to adopt a set of short and long term strategies We have to reject the very idea of incompetence. This means, among other things, a thorough re-examination of what currently passes for human services.