Stephen Unwin: Uncomfortable lessons from history and today

We are horrified by Nazi atrocities but did the beliefs that led to them really disappear after the war and do they persist today? How can we tackle them? asks Stephen Unwin.

Nazi eugenics poster from the 1930s declaring: “Healthy parents, healthy children!” - Wellcome Collection

Eugenics was created in London and enthusiastically nurtured in America and Scandinavia, but it was in Nazi Germany that it found its most appalling realisation.

The persecution, forced sterilisation and murder of as many as 275,000 “useless eaters” is one of the most overlooked chapters in the whole ghastly history of the Third Reich.

We must be careful not to draw simplistic parallels between the grotesque cruelties of the Third Reich and the very real but much more nuanced injustices faced by disabled people today. However, certain lessons can, I think, be drawn.

Support by progressives

The first is the way this barbarism was supported by lawyers, professors and other respected professionals.

We can easily dismiss eugenics as pseudoscience but that was not how it seemed at the time, with many people – including a large number of progressives – wanting to improve the health, happiness and prosperity of “the race”.

In other words, the motivation behind this campaign was not confined to Nazi Germany but was evident in advanced societies around the world.
It is an uncomfortable truth that eugenics was not discredited in 1945, and many of its core beliefs endured. William Beveridge, the founder of the welfare state, was a committed eugenicist.

The long-stay hospitals that were the destiny of so many learning-disabled people in postwar Britain and America treated learning disability as a medical issue and were often appallingly managed, resulting in dehumanising, regimented and squalid living conditions.

While the worst of these were eventually closed down in the 1970s and 1980s, hardly a week goes by without new accounts of neglect, abuse and cruelty, and the dreadful roll call of places such as Winterbourne View, Muckamore Abbey, Whorlton Hall and so many others should make us consider whether we have moved beyond the mentality that enabled the Nazi Aktion T4, the systematic murder of people with disabilities.

Furthermore, the appalling catalogue of bullying, violence and murder of learning-disabled people in Katherine Quarmby’s book Scapegoat suggests we live in a society that all too readily devalues the disabled and regards them as fair game.

An example of support for this barbarism might be philosopher Peter Singer’s statement in 1979 that “killing a disabled infant is not morally equivalent to killing a person. Very often it is not wrong at all.”

This was based on his views on the relative capacities of animals: “If we compare a severely defective human infant with a nonhuman animal, a dog or a pig, for example, we will often find the nonhuman to have superior capacities, both actual and potential, for rationality, self-consciousness, communication and everything else that can plausibly be considered morally significant.”

Another example is evolutionary biologist Richard Dawkins who, in 2020, tweeted: “It’s one thing to deplore eugenics on ideological, political, moral grounds. It’s quite another to conclude that it wouldn’t work in practice. Of course, it would. It works for cows, horses, pigs, dogs & roses. Why on earth wouldn’t it work for humans?”

The fact that the breeding of physical characteristics in animals and plants is quite different from ensuring intellectual capacity in human beings is one objection; another is that eugenics has been tried and made absolutely no difference.

It is astonishing that such eminent figures have spread such pernicious nonsense.

We also have to recognise just how deeply rooted the prejudice against disabled people is, and not just among some look-at-me intellectuals. The fact that some parents internalised the views of their child’s worthlessness during the eugenic period shows just how pervasive this can be.

T4 enjoyed popular support and that should give us pause. Germany had an advanced society with an enviable reputation for medicine and social care yet its population had absorbed a culture of contempt to such an extent that it allowed these things to happen.

Medical values

The programme was carried out by medical professionals, from nurses and doctors right up to the most senior academics and experienced physicians of the time, and in hospitals and other clinical settings, which offers us the second lesson.

We rightly praise the NHS and entrust our bodies to the expert care of its staff, but medical professionals are no more immune to prejudice, often unconscious, than the rest of us.

The fact that learning disabled people suffered disproportionately in the pandemic for reasons unconnected to their condition should make us question medicine’s hierarchy of values.

Especially worrying was the National Institute for Health and Care Excellence’s early triage advice which identified learning disability as an underlying health condition. This was quickly changed when it was pointed out that a learning disability was not an illness, but it is troubling that it was issued in the first place.

In thinking about T4, we need to explore the extent to which our own society regards the disabled as in some sense dispensable.

A price on everything

Third, we should examine how a cost-benefit analysis was used to vindicate the murders. For, although irrational hatred no doubt fuelled this assault, it was given social and political justification by a calculation that set expenditure on such people against their productivity and concluded that they were a net loss.

While most disabled people are quite capable of working and many are eager to do so, a minority are not. People such as my profoundly learning-disabled son, Joey, will never hold down a job or pay tax, and will require frankly expensive care throughout his life.

As a parent, I have often been made all too aware of the costs incurred and am reliably informed that the first question asked when local authorities (under dreadful financial pressures) consider an application for support is about the costs.

T4 shows in the most vivid way imaginable that the moment an individual’s fundamental rights are subjected to a simple financial evaluation is the moment the gates of hell open wide.

Courageous opposition

The final lesson that can be drawn from T4, however, is more positive and more energising, albeit tinged with tragedy and dreadful pain. It can be found in the extraordinarily courageous opposition that took shape and, astonishingly, managed to stop the programme.

This was partly possible because (unlike the Jewish or Romany experience) it wasn’t entire families that were destined for slaughter. The opposition – from a handful of brave, fiercely determined relatives with a few influential and largely Catholic churchmen – is a remarkable story of courage and principle that is not widely known.

Today, we still see families heroically battling against many injustices. These range from the endless, bureaucratic tedium of fighting local authorities for basic support to the powerful crusades for justice led by the grieving families of too many disabled people who have died entirely preventable deaths, often in the hands of badly trained and managed staff.

The fact that mothers such as Sara Ryan, whose son Connor Sparrowhawk drowned in a bath in an NHS assessment and treatment unit in 2013, were vilified and blamed by the authorities shows that the days of gaslighting are hardly behind us.

What these committed campaigners also show, however, is just how powerful family voices can be, especially when allied with the lived experience of the learning disabled themselves.

When authorities are confronted by the passionate rage of real families suffering genuine injustice, they do, eventually, have to acknowledge their shortcomings. They are certainly forced to face up to the consequences of their actions.

Poster from London’s Eugenics Society in the 1930s gives an unambiguous message – Wellcome Collection

Never again

So what do we need to do to ensure that T4 can never be repeated? How will we know when its lessons have been learned and we can put it behind us?
I suspect three things are needed. The first is cultural: above all, the understanding that having a disabled family member – especially one with learning disabilities – isn’t the worst thing imaginable.

But health professionals still talk about the “risks” of having a child with Down syndrome, and hateful terms like “idiot”, “imbecile”, “retard” and “moron” remain in common parlance.

Language and representation need to change radically if the disabled, especially (though not exclusively) those like my son who find it very difficult to speak up for themselves, are to be granted the dignity, respect and affection that they so deserve.

Then, we need to stop assessing people by their productivity and earning abilities, and create a new sense of community and belonging. That will require a reshaping of our entire system of values, wherein we stop regarding intellectual achievement as the single most important quality a human being can have.

From Plato to this day, philosophers have struggled with the problem of “idiocy”, with a deep anxiety about whether people with limited rational capacity, and certainly those lacking speech, can be admitted into the category of human.

In my experience, however, learning disabilities has the effect of turning the assumptions of classical thought on its head and insisting that the best definition of a human is the product of two human parents and nothing to do with intellectual ability, speech or rational powers.

As Hamlet put it, we need to learn there are more things in heaven and earth than are dreamt of in our philosophy, and the time has come to rethink some of our most cherished prejudices.

Finally, in more practical if equally ambitious terms, I think we need to develop nothing less than a new social contract to ensure our fellow humans are not only protected but also given the best that society can offer them.

The extraordinary achievements of medicine mean that far more disabled infants survive, which is welcome. But, if people are to have a decent, happy life, we need a new understanding of our shared experiences and responsibilities. Profound disabilities can be found in any family, class, educational background and ethnicity, and need to be accepted as fundamental.

As Rosemarie Garland-Thomson shrewdly observed: “What we call disability is perhaps the essential characteristic of being human.”

The challenge is clear, but who is prepared to take the lead?

A longer version of this article appeared in Byline Times:

Stephen Unwin is author of the play All our Children, about the Nazi genocide of disabled people, and father of Joey, a young man with severe learning disabilities

Further reading
Shapland S. When mass murder was social policy. Community Living. 2020; 33(3):30