In Nazi Germany, the concept of the “ideal citizen” was used to define who could and could not be a member of the German “Volk”. Ideas of purity, white supremacy and intellectual superiority created the concept of the Aryan race. In today’s society, science is viewed as the supreme authority in decision-making. If science deems something to be true, it must be so. This is a dangerous attitude as it provides no room to question why or how conclusions are drawn. Governments and leaders use this conceptualization of science and society’s unquestioning acceptance to their advantage. This is especially evident in Nazi Germany. The discriminatory and exclusionary policies used by the Nazi regime with the end goal of creating a perfect society were grounded in the scientific discoveries of the time. This, in turn, worked to create the social context necessary for exclusionary principles of citizenship to flourish, allowing ideas of Nazism to be grounded in both widespread medical and social principles. The government subsidized certain forms of scientific discovery and spread propaganda for this very purpose. The medicalization of regime priorities through science in Nazi Germany created the basis for inclusion and exclusion of certain individuals in regards to their citizenship.
The Medicalization of Citizenship in Germany
The idea that race and genetic factors define a person’s worth is not unique to Nazi Germany. The German eugenics movement was rooted in the longstanding social ideas that were quite present throughout the Weimar Republic as well. Following World War I, the discontent among the people led to a deep-seated unrest on the basis of German productivity.1 The eugenics movement is rooted in philosophical, sociopolitical, and cultural phenomena which were not unique to Germany. In Germany, these conditions combined to create a structure in which social aspects of the eugenics movement and genetic biology evolved simultaneously. Prior to the rise of the Third Reich, ideas of Nordic superiority were present throughout the European continent, stemming from the romanticism of the North in the early nineteenth century.2
The background behind the creation of the German Volk is important in understanding the conceptualizations of citizenship. The Nazi society was one of exclusion and “othering”. Individuals were not excluded based on certain characteristics but rather excluded because of the characteristics they lacked. Unless an individual could meet the criteria of the “master race”, they were excluded and just simply categorized as “other.”
Given this method for exclusion, the medicalization of citizenship was necessary to create justifications for why certain people could be excluded or treated differently. Policies in Nazi Germany were made for the sake of the people’s collective good, but only certain people. Because there was no one thing the government could point to when excluding someone, medical justifications and practices were created that provided basis for exclusion. It is important to note that these characteristics are applicable for the forced sterilization movement, which was sanctioned by law. Following this, and throughout the forced euthanasia movement, societal acceptance was often abandoned, and medicine was no longer a justifying factor. In regards to sterilization, however the idea of excluding people based on characteristics they do possess, as opposed to excluding them based on characteristics they do not possess, holds much more legitimacy.
The Evolution of Medical Practices
It is clear that medical norms will evolve with the discovery of new and better practices, and that these breakthroughs may even completely negate past discoveries. This phenomenon demonstrates why it is necessary to be skeptical of scientific discovery, as there are always new breakthroughs which better create better understandings. The Nazi regime, however, used this idea to their advantage. The Third Reich ushered in a new era of scientific discovery. New and monumental breakthroughs were constantly made which continually justified the exclusionary policies of the Nazi government.
Many practices which were practiced in the Weimar Republic were no longer deemed medically sound by the doctors of the Third Reich. This was interesting in that many of the doctors remained constant between the two regimes, but the social context in which they were forced to operate changed completely. They gave up their agency for the sake of their jobs, and sometimes their lives.3 A case study by M. Hau outlined how Dr. Walhter Jaensch’s research shifted from the Weimar Republic to the Third Reich. Prior to 1933, Dr. Jaensch’s research was focused on improving the people’s productivity following World War 1. He received funding to research the importance of mental and physical health in children. The Weimar Republic was very focused on an individual’s contribution to society, and he became the prime researcher in combatting diseases that prevented this. This research put him in a position to be very effective for the Nazi agenda. He reinvented this field along the lines of race, as he was forced to integrate the ideas of Nazi eugenics into his research in order to remain relevant.4 This case study provides a prime example of the subjectivity of medicine. Prior to the rise of the Third Reich, Jaensch focused on productivity and combatting mental illnesses which inhibited this productivity. In Nazi Germany, he became a key figure in the eugenics movement. His diagnoses defined an individual’s role in society based on their productivity. Individuals were only valued as citizens if they were productive.
Shifts in Attitudes Towards Abortion
The shift demonstrates the role the government plays in defining medicine and the social conventions associated with a breakthrough or field of discovery. Jaensch is only one researcher, and his work provided the foundation for an entire eugenics movement. The shift in abortion science charted a similar course. Prior to 1930, abortion was widely available in Germany and was becoming increasingly accepted. In Nazi Germany, the medical and social conceptualizations of abortion caused this attitude to change completely. The idea of the German citizen is intertwined with this shift. While abortion was viewed as a crime against the German people, it was simultaneously employed as a tool to prevent certain people from reproducing. With the rise of the Third Reich, all research and documentation on abortion including sex education material, papers, and books were destroyed. The narrative surrounding abortion became one of danger- not only to the individual woman but to the collective. The practice damaged the continued creation of the German Volk.5 While it became increasingly illegal for women to obtain abortions, forced sterilization and selective abortion became more prevalent practices perpetuated against those who were not viewed as a part of the German Volk because of any sort of medical abnormality. Between 1934 and 1945, approximately 400,000 coerced sterilizations and abortions were performed in Nazi Germany in accordance with the “Act for the Prevention of Children with Hereditary Diseases.”6 Conceptualizations of citizenship are evident in the practice of abortion in Nazi Germany. The state viewed them as dangerous and harmful to both the individual and the society for those who were valued, but used them to forcefully prevent reproduction among those who were not valued in the society.
Shifts in the Field of Neurology
Similarly, the field of neurology witnessed a drastic shift in the rise of the Nazi regime. While many scientists willingly adapted their research to fit with Nazi ideology, many neurologists did not. The non-compliant researchers were driven out of the field, and those who remained operated under the control of the government. A symbiotic relationship was created; researchers kept their jobs if their findings fit with government priorities. They were given significant resources to conduct research on neurology, as long as the findings were Nazi approved. As mentioned in regards to abortion, the sterilization of individuals with hereditary diseases was very widespread. This included those with epilepsy. The true purpose of the eugenics movement was not, however to eliminate the people with certain characteristics, i.e. epilepsy. The purpose was to eliminate those who did not have the characteristics worthy of German citizenship. This concept was difficult to codify, thus researchers created a way to associate the excluded individuals with the negative traits that warranted sterilization. The Kaiser Wilhelm Institute in Berlin became widely involved with this movement by expanding the definition of Epilepsy through falsified research and the murder of patients under the guise of research.7 The expansion of Epilepsy allowed doctors to diagnose and sterilize a wider variety of people in a way which was viewed as medically sound and lawful.
Medicine and the Perpetuation of Social Norms
The idea of citizenship in Nazi Germany was one which emphasized the collective German identity. Public health and sacrifice for the greater good were the main priorities of the state. These completely overshadowed individual freedoms and liberties. The goal was to create a healthy and unified German society with a strong sense of both nationalism and militarism. In the context of Germany’s defeat in World War I, these priorities address the fears and concerns present among the German people.
The case study of Walther Jaensch provides just one example of how drastic the shift in thinking was from the Weimar Republic to the Third Reic8h. The eugenics movement had to be integrated into society in a way which seemed natural and correct. In marking those who underwent these procedures as feeble-minded or unhuman, the ideas of eugenics became acceptable. A high school biology textbook demonstrated an example of propaganda for the eugenics movement and sterilization which read, “an easy surgical procedure, a humane means by which the nation can be protected from boundless misery.”9 Campaigns such as this one were present in textbooks, films, pamphlets, and posters and minimized the importance of individual rights in the context of the greater good. The portrayal of certain individuals as inhuman facilitated their exclusion from society and led to the widespread acceptance of the eugenics movement and the idea of the ideal citizen.
The government also played on the perceived objectivity of science in creating the idea of the perfect citizen. Researchers and the government built a sort of symbiotic relationship which allowed them to further the racial agenda on both fronts. Institutions such as the Kaiser Wilhelm Institute would legitimize the Nazi agenda through scientific discovery in return for generous funding. This would advance not only the personnel at research institutes but also create a scientific backing for the policies promoted by the government. Human heredity was viewed as an economic resource as opposed to an issue of individual freedom.
The idea of “feeblemindedness” was used as a basis for many decisions made. It allowed for the government to make decisions on an individual’s behalf because their mental ability was called into question. Feeblemindedness was never defined and became a catch-all for the exclusion of unwanted individuals. Feeblemindedness overruled issues of legality, as the diagnosis was highly elastic and granted the government decision-making power over an individual. The passage of the 1933 compulsory sterilization law allowed for individuals diagnosed with feeblemindedness and other diseases to be sterilized against their will. Other diagnoses were used similarly, including those of schizophrenia and manic depression.10 The widespread acceptance of the forced sterilization movement set the stage for the forced euthanasia movement which followed. Germany is the only country in which the eugenics movement evolved to such extreme measures. While many countries implemented sterilization, none other than Germany moved to forced euthanasia. Sofair and Kaldijian outline the role of medical professionals in this shift. While Hitler and the economic crisis impacted the German eugenics movement, much of it stemmed from the participation of scientists. As opposed to the involuntary sterilization movement, the involuntary euthanasia movement was never sanctioned by law and occurred in secret, which required support from doctors and professionals who implemented it.11 Ideas of exclusion and public health became so deeply engrained in society that the lives of unwanted individuals were sacrificed for the sake of Nazi policies. With the help of physicians, even this extreme of a measure was made medically possible, both physically and societally.
The ideal citizen in Nazi Germany possessed a certain set of very distinct characteristics. All those who did not possess these characteristics were excluded. Rooted in the economic instability and eugenic ideals of the Weimar Republic, Nazi leaders were able to utilize a form of biopower to control who was allowed to consider themselves German. The success of these policies stemmed from the total control the regime had over all aspects of society. In controlling societal norms and beliefs from the bottom up, German citizens were taught principles of exclusion and citizenship which fit with the Nazi agenda. At the same time, eugenic ideals began to infiltrate the medical field, which led to a seemingly objective source corroborating the legitimacy of Nazi policies. Medicalization played the largest role in the exclusion of certain individuals as medical diagnoses legitimized exclusion on the basis of a physical or mental shortcoming which negatively affects the health of the society as a whole. Emphasis placed on the collective good allowed for individual liberties to be disregarded in those who were not considered citizens or contributing members of society in the eyes of the government.
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1 Timm, A. “Nazi Bevölkerungspolitik, Health, and the Family.” In The Politics of Fertility in Twentieth Century Berlin. Cambridge University Press (2010): 123-25.
2 Wessel, M., The Concept of the “Nordic Race” in German and Nordic Racial-Theoretical research in the 1920s. NordEuropa Forum (2016): 29-49.
3 Haque, Omar S., Julian DeFritas, Ivana Viani, Bradley Niederschulte, and Harold Bursztajn. “Why did so many German doctors join the Nazi Party early?” International Journal of Law and Psychiatry 35 (2010): 473-79.
4 Hau M. Constitutional Therapy and Clinical Racial Hygiene in Weimar and Nazi Germany. In Journal of the History of Medicine and Allied Sciences 71:2 (2016): 115-143.
5 David, HP; Fleischhacker, J; Hohn, C. Abortion and Eugenics in Nazi Germany. In Population and Development Review 14 (1988): 81-112.
6 Link, G. Coercive Eugenic Sterilization and Abortion in Nazi Germany. In Geburtshilfe un Frauenheilkunde 59 (1999): 416-424.
7 Martin M, Fangerau H, Karenberg A, German Neurology and the ‘Third Reich’. In European Neurology 76. (2016): 234-243
8 Hau M. Constitutional Therapy and Clinical Racial Hygiene in Weimar and Nazi Germany. In Journal of the History of Medicine and Allied Sciences 71:2 (2016): 115-143.
9 Bachrach, S. In the Name of Public Health- Nazi Racial Hygiene. In New England Journal of Medicine 351 (2004): 417-420.
10 Bachrach, S. In the Name of Public Health- Nazi Racial Hygiene. In New England Journal of Medicine 351 (2004): 417-420.
11 Sofair, AN; Kaldijian, LC. Eugenic sterilization and a qualified Nazi analogy: The United States and Germany, 1930-1945. In Annals of Internal Medicine 132 (2000): 312-319.