From 1915 to 1919, the prominent Chicago surgeon Harry Haiselden electrified the nation by allowing, or speeding, the deaths of at least six infants he diagnosed as physically or mentally impaired. To promote his campaign to eliminate those infants that he termed hereditarily "unfit," he displayed the dying babies and their mothers to journalists and wrote a book about them that was serialized for Hearst newspapers. His campaign made front-page news for weeks at a time.
He also starred in a film dramatization of his cases, an hour-long commercial melodrama titled The Black Stork. In the film a man suffering from an unnamed inherited disease ignores graphic warnings from his doctor, played by Haiselden, and marries his sweetheart. Their baby is born "defective" and needs immediate surgery to save its life, but the doctor refuses to operate. After witnessing a horrific vision, revealed by God, of the child's future of misery and crime, the mother agrees to withhold treatment, and the baby's soul leaps into the arms of a waiting Jesus. The film was shown around the country in several editions from 1916 to at least 1928, and perhaps as late as 1942.
Many prominent Americans rallied to Haiselden's support, from leaders of the powerful eugenics movement to Helen Keller, the celebrated blind and deaf advocate for people with disabilities. Newspapers and magazines published the responses of hundreds of people from widely varied backgrounds to Haiselden's campaign, more than half of whom were quoted as endorsing his actions. Groups disproportionately represented among these supporters included people under thirty-five years of age, public health workers, nonspecialist physicians, lay women, socialists, and non-Catholic Democrats. However, advocates came from all walks of life, even a few Catholic clergymen.
Euthanasia and Eugenics
These events are important for more than simply their novelty and drama; they constitute a unique record documenting the nearly forgotten fact that Americans once died because their doctors judged them genetically unfit, and that such practices won extensive public support. The events also recover a crucial, defining moment in the history of euthanasia and in the relation between euthanasia and eugenics.
Until late in the nineteenth century, the term euthanasia meant "efforts to ease the sufferings of the dying without hastening their death," but it soon came to include both passive withholding of life-prolonging treatment and active mercy killing. The term eugenics was first popularized by Charles Darwin's cousin Sir Francis Galton in the 1880s. Galton defined it as "the science of improving human heredity." To improve heredity, eugenicists pursued a diverse range of activities, including statistically sophisticated analyses of human pedigrees, "better-baby contests" modeled after rural livestock shows, compulsory sterilization of criminals and the retarded, and selective ethnic restrictions on immigration.
Beginning in the 1880s, a few supporters of each movement linked them by urging that active or passive euthanasia be employed to end both the individual sufferings and the future reproduction of those judged to have heritable defects. Yet prior to Haiselden's crusade such ideas rarely won public endorsement from the leaders of either movement. Most eugenic leaders, such as Charles Davenport, Irving Fisher, and Karl Pearson, explicitly distinguished their support for selective breeding from their professed opposition to the death of those already born with defects.
Yet when Haiselden moved the issue from theory to practice, these same leaders proclaimed him a eugenic pioneer. His attention-getting actions were a calculated effort to radicalize the leaders of both eugenics and euthanasia, a strategy anarchists at the time popularized as "propaganda of the dead." By gaining extensive media coverage of his dramatic acts, Haiselden was able to shift the boundary of what was included in mainstream eugenics and successfully prod the official movement leaders to publicly accept euthanasia as a legitimate method of improving heredity.
Haiselden's actions blurred the boundaries between active and passive methods of euthanasia. In his first public case, he refused to perform a potentially life-saving operation, but did not hasten death. In subsequent cases, however, he prescribed high doses of narcotics with the dual purposes of speeding and easing death. He also performed lethal surgical operations, and fatally restarted a previously treated umbilical hemorrhage.
Journalism and film enabled Haiselden to reshape the relation between eugenics and euthanasia, but, ironically, mass culture also contributed to the almost total erasure of his crusade from later memory. Haiselden's efforts to publicize his actions provoked more opposition than did the deaths of his patients. Three government investigations upheld Haiselden's right not to treat the infants, but the Chicago Medical Society expelled him for publicizing his actions. Even professional leaders who supported eugenic euthanasia often opposed discussing the issue in the lay media.
Promoters of the new mass media had their own reasons for repressing coverage of Haiselden's crusade. While his motion picture sought to make those he considered defective look repulsive, many viewers instead interpreted such scenes as making the film itself disgusting and upsetting. Even critics who lavishly praised his ideas found his graphic depictions of disease aesthetically unacceptable. Such responses were one important reason films about euthanasia and eugenics were often banned. The Black Stork helped provoke, and became one of the first casualties of, a movement to censor films for their aesthetic content. By the 1920s film censors went far beyond policing sexual morality to undertake a form of aesthetic censorship, much of it aimed at eliminating unpleasant medical topics from theaters.
Professional secrecy, combined with the growth of aesthetic censorship, drastically curtailed coverage of Haiselden's activities. In 1918 Haiselden's last reported euthanasia case received only a single column-inch in the Chicago Tribune, a paper that had supported him editorially and given front-page coverage to all of his previous cases. The media's preoccupation with novelty and impatience with complex issues clearly played a role in this change, as did Haiselden's death in 1919 from a brain hemorrhage at the age of forty-eight. But the sudden silence also reflected the conclusion by both medical and media leaders that eugenic euthanasia was unfit to discuss in public. The swiftness of Haiselden's rise and fall resulted from a complex struggle to shape the mass media's attitudes toward—and redefinitions of—eugenics and euthanasia.
Since 1919 the relationship between euthanasia and eugenics has been debated periodically. Although Haiselden's pioneering example was almost completely forgotten, each time it reemerged it was treated as a novel issue, stripped of its historical context. In the United States and Great Britain, the debate begun by Haiselden over the relation between eugenics and euthanasia revived in the mid-1930s. At the same time, Germany launched the covert "T-4" program to kill people with hereditary diseases, a crucial early step in the Nazi quest for "racial hygiene." The techniques and justifications for killing Germans diagnosed with hereditary disease provided a model for the subsequent attempt to exterminate whole populations diagnosed as racially diseased.
With the defeat of Nazism and the consequent postwar revulsion against genocide, public discussion of euthanasia and its relation to the treatment of impaired newborns was again repressed. In the early 1970s, the debate resurfaced when articles in two major American and British medical journals favorably reported cases of selective nontreatment. Nevertheless, it was not until the 1982 "Baby Doe" case in Indiana, followed by "Baby Jane Doe" in New York State a year later, that the subject once again aroused the degree of media attention occasioned by Haiselden's crusade. In response, the federal government tried to prevent hospitals from selectively withholding treatment, arguing such actions violated the 1973 ban on discrimination against people with disabilities. However, the Supreme Court held that antidiscrimination law could not compel treatment of an infant if the parents objected. Meanwhile, Congress defined withholding medically indicated treatment as a form of child neglect. That law favors treatment but allows for medical discretion by making an exception for treatments a doctor considers futile or cruel. Conflicts still occur when doctors and parents disagree over whether treatments for specific infants with disabilities should be considered cruel or futile.
Understanding this history makes it possible to compare both the similarities and the differences between the past and the present. Concerns persist that voluntary euthanasia for the painfully ill will lead to involuntary killing of the unwanted. Such "slippery-slope" arguments claim that no clear lines can be drawn between the diseased and the out-cast, the dying and the living, the voluntary and the coerced, the passive and the active, the intended and the inadvertent, the authorized and the unauthorized. Haiselden's example shows that these concerns are neither hypothetical nor limited to Nazi Germany. Americans died in the name of eugenics, often in cases where there were no absolute or completely objective boundaries between sound medical practice and murder. But that history does not mean that all forms of euthanasia are a prelude to genocide. Meaningful distinctions, such as those between the sick and the unwanted, are not logically impossible. However, they require sound ethical judgment and moral consensus, not solely technical expertise.
Haiselden's use of the mass media also provides intriguing parallels with the actions of Michigan pathologist Jack Kevorkian, who began publicly assisting the suicides of seriously ill adults in 1990. Both men depended on media coverage for their influence, and both were eventually marginalized as publicity hounds. But each showed that a single provocateur could stretch the boundaries of national debate on euthanasia by making formerly extreme positions seem more mainstream in comparison to their actions.
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