Ryan Breeden writes: In March 2018, members of Germany’s far-right Alternative für Deutschland (AfD) presented a formal ‘inquiry’ about the number of migrant families producing children with severe disabilities based on the alleged prevalence of incestuous marriages. The reaction to this almost word-for-word reworking of older antisemitic tropes about Jews and disability provoked swift public backlash, but as Dagmar Herzog shows in a sweeping and unsettling new study, The Question of Unworthy Life, such language is part of a long and resilient grammar.
A leading scholar of modern European history, Herzog is well-known for her incisive work on religion, sexuality, psychoanalysis and the politics of memory in Germany and beyond. In this book, she traces the evolution of the category of ‘unworthy life’ in Germany from the late nineteenth century through Nazi racial hygiene programmes, to the postwar reckoning (or lack thereof), and into contemporary struggles over disability rights. The book’s title nods to the infamous 1920 treatise by Karl Binding and Alfred Hoche, Die Freigabe der Vernichtung lebensunwerten Lebens (Permission to Annihilate Life Unworthy of Life), which provided intellectual scaffolding for the Nazi ‘euthanasia’ program (Herzog is careful to always put the programme in quotations to highlight that there was nothing humane about it) that murdered 300,000 people with disabilities and sterilised a further 400,000.
The book is structured around key moments in Germany’s eugenic history, beginning with the late nineteenth century rise of institutionalisation and pedagogical debates over ‘incurability’. Herzog excavates early Protestant and Catholic charity work, showing how religious institutions wavered between paternalistic care and complicity in the state’s biopolitical ambitions, forming what she calls a kind of ‘theo-biopolitics’ where issues of biological health and disease became bound up with notions of guilt and sin. From there, she moves to the Nazi era, detailing the T4 programme that trained personnel who would later operate the death camps of Operation Reinhard and detailing the ways in which Protestant leaders, rather than resisting, often sought ways to reconcile their faith with the regime’s policies.
This conceptual scaffolding lingered, often intact, long after 1945. In West Germany, postwar courts rejected compensation claims for victims of forced sterilisation. Some of the very doctors who had gassed disabled children in clinics returned to public life as misunderstood humanitarians. In the East, the commitment to antifascism and ‘socialist humanism’ oof the communist party (SED or Socialist Unity Party) proved hollow when it came to protecting its most vulnerable citizens who were unable to contribute to the ‘workers’ state’. While resources were directed towards integrating those deemed ‘developable’ or capable of work, the most severely disabled were systematically neglected, warehoused in appalling conditions and hidden from view.
Yet the book is not merely a catalogue of neglect and cruelty. Throughout, Herzog traces a number of what she calls ‘radical un-dehumanizers’ – individuals who strove to make a case for the rights of people with the most significant intellectual and physical disabilities. In West Germany, she highlights figures like the journalist and historian Ernst Klee, whose writings and TV documentaries helped reorient the terms of debate on Germany’s Nazi past, and the radical special education teachers Wolfgang Jantzen and Georg Feuser. In East Germany too there was resistance to the dominant state ideology of ‘socialist humanism’. After taking over the Katharinenhof in Großhennersdorf in Saxony in 1971, the paediatrician couple Dr Jürgen and Dr Uta Trogisch pioneered new models of care that emphasised relative independence in fundamental areas such as eating, dressing, and social integration, but more importantly, redefined what constituted achievement. Likewise, in a remarkable 1981 essay, activists Wolf Späte and Thomas Thom placed the attitudes and actions towards individuals with disabilities at the core of socialist ethics. ‘The orientation toward satisfying social needs,’ they wrote, ‘is something we consider so extraordinarily important because it is in personal devotion to the intellectually disabled that our true degree of humanity is expressed.’
If Herzog’s history is deeply embedded in the German context, its resonance today is disturbingly global. Forced sterilisation policies remain in force in dozens of countries across the globe, including at least twelve in the EU. Recent policy proposals in Europe and North America, such as the expansion of physician-assisted suicide laws to include non-terminal conditions (for example chronic disabilities, psychiatric illnesses), have provoked a strong backlash from the disability community. In my own country of Canada, for example, the Medical Assistance in Dying (MaiD) programme, first introduced in 2016 as a compassionate response to terminal illness, has gradually expanded into a euthanasia regime where Canadians with disabilities and mental illness – especially those living in poverty – are choosing death in the face of a gutted welfare state. Numerous disability rights organisations, as well as the UN, have argued that this effectively resurrects the old eugenic argument that some lives are too burdensome to sustain.
Perhaps nowhere is this more true than in the case of immigration. Across much of the world, migrants with disabilities or chronic illnesses face systematic barriers to entry, residency, and asylum, often couched in the administrative language of ‘burden-sharing’ or ‘national capacity’. In Germany, disabled migrants must find employment to receive government health insurance or else seek out costly private options that often do not cover ‘pre-existing conditions’. In Australia, migrants are routinely refused visas on the basis of their medical needs in to curb public spending and ‘protect’ its health care system. Even the language which insists that migrants must ‘integrate’ often rests on normative assumptions about productivity and cognitive capacity.
Meanwhile, a resurgent global far right is rehabilitating the language of eugenics and race science for the digital age. As a Guardian report recently revealed, Silicon Valley-funded Substacks cultivate what its founders call ‘legitimacy by association’ – luring sympathetic academics into the orbit of white nationalist ideology. Their goal, openly stated, is to translate discredited nineteenth century racial science into twenty-first century immigration policy, feeding talking points to far-right politicians across Europe, including the AfD in Germany. This sort of ideology has found champions in figures like Elon Musk and even Donald Trump. Indeed Trump has repeatedly spoken about he and his supporters’ ‘good genes’ in contrast to the ‘bad genes’ and ‘poisoned blood’ of undocumented immigrants, and expressed disdain for disabled people, including reportedly telling a relative with a disabled son: ‘maybe you just let him die.’ The second Trump administration’s cuts to Medicaid, special education, and disability housing should be seen this light.
In the end, the question Herzog forces us to ask is not whether we are repeating history. The democracies of the twenty-first century are not Weimar Germany, and neoliberal biopolitics is not Nazism. She rightly acknowledges the important legal and cultural transformations – the work of disability rights activists, advocates, scholars – that have occurred in the last half-century, including the recognition of disability rights in Germany’s Basic Law and the ratification of the UN Convention on the Rights of Persons with Disabilities. But her work suggests that the moral compromises that facilitated Nazi ‘euthanasia’ were not sui generis. They grew from assumptions about life’s value that remain perilously close to the surface: that some lives are ‘better’ than others. Herzog’s achievement is to show how easily the boundaries of moral concern can be drawn too narrowly – and how fiercely they must be contested, again and again.
Dagmar Herzog’s The Question of Unworthy Life: Eugenics and Germany’s Twentieth Century is published by Princeton University Press.
13/6/2025
