Extract Not only is the article by David Reardon and associates1 flawed . . . but the authors, particularly the lead author, have a specific and known political bias against abortion rights. . . By publishing an article that does not adhere to high standards, we feel that CMAJ has done a disservice to our field, not to mention women and their families across the nation.
Abstract Between 1939 and 1945, 180,000 psychiatric patients were killed in Nazi Germany. This paper opens with a brief discussion of the reasons for addressing this issue today; it is followed by the details of the so-called euthanasia program that entailed killing of patients by gas in special hospitals in the years 1939-1941, and in psychiatric hospitals in the years 1942-1945. In this latter period, patients were killed with lethal injections and through the introduction of a starvation diet. The fate of the Jewish patients and forced laborers, as well as the experiments conducted on the patients, are mentioned. Finally, some thoughts are presented to answer the question of why this could have happened. To me, the giving up of individual responsibility in an authoritarian system leads to the loss of the individual conscience and soul, including those of a psychiatrist.
Cranach MV. The Killing of Psychiatric Patients in Nazi-Germany between 1939-1945. Israeli J Psych & Related Sciences. 2003;40(1):8-18
A presentation by the same title with a similar abstract was presented at a meeting of the Israel Psychiatric Association, Jerusalem, 6th of December 2001.
Extract Apparently Dr. Carlos Del Campo (Can Med Assoc J 1984; 130: 361, 362, 366) consulted only a small portion of the literature in concluding that it shows “no evidence that a continued unwanted pregnancy will endanger the mother’s mental health”. He ignored the Aberdeen study, . . .Dr. Del Campo was very selective in examining the work done in Czechoslovakia. . . the conclusion to be drawn from these studies is that termination of an unwanted pregnancy is likely to be beneficial to a woman’s mental health if it is her choice to exercise this option, whereas mandatory motherhood is likely to be harmful to her mental health. This conclusion is consistent with my clinical experience of 20 years in working with couples and families, as it is with that of many other family psychiatrists.
Extract . . . A common error made by physicians is that they assume a responsibility that is not theirs. When a healthy woman becomes pregnant it is her responsibility and it is certainly not the duty of the physician to terminate the pregnancy. . . . .
. . . If it is a depression one has to treat the depression, not the pregnancy. We are using the wrong diagnosis to escape from a difficult decision. To justify an abortion one must be sure that health will be permanently damaged, as in a patient with chronic nephritis or one at risk of heart failure. . . .
. . . .The lack of guiding principles has created a very disturbing situation. A most disturbing thought is that those who are unwanted can be disposed of. This happened to the Jews in Nazi Germany and it happens in all totalitarian states. . . .Throughout history, people were first dehumanized, not regarded as people, then used or killed. . .
. . . Physicians’ attention must be focused on preventing the occurrence of those situations in which abortion may be justifiable. . . The Oath of Hippocrates should serve as a means of drawing the members of the medical profession together irrespective of religious or philosophical differences. As it is now, we are the passive onlookers of a debate between fanatically rigid groups.
Extract . . . the term unwanted pregnancy . . . I use . . . simply to denote a pregnancy in a patient who does not want a baby. . . If he is implying that some of these patients use pregnancy as a club with which to beat their parents over the head, I would certainly agree. . .The “wilful exposure to unwanted pregnancy” syndrome certainly must be one of psychodynamic origin. . . . when are our psychiatric colleagues going to come forward with positive, practical steps to help alleviate it?
Extract The Act does not give Dr. Hughes the right to castigate those psychiatrists who, acting “in good faith,” are seriously in doubt as to whether an abortion is justified, and for good reasons know that support and treatment would be at least as effective as abortion in dealing with the problem be it-social or medical. They have ample clinical evidence- to support the ” good faith ” of their decisions . . .. It would be of great interest to see- what factual evidence could be produced to support the many decisions to abort under the present Act.
Extract That the W.H.O. includes such a phrase [“well-being”] in their definition of mental health does not give it legal validity. Neither does it give it medical sanction, for W.H.O. definitions are notoriously unstable and liable to change, as is evidenced by those on alcoholism and drug addiction. There is no agreement on a definition of ” mental health ” in spite of national associations, institutes, and research funds devoted to its cause.
Extract It has gradually dawned upon the politicians that a doctor might have objections, and at a very late stage a ” conscience clause” has been included, but only against strong opposition. . . . The clause allows for objection on moral or religious grounds, but how does the doctor stand if he objects on clinical grounds ? As a psychiatrist, patients are referred to me for termination of pregnancy, usually the sole grounds for referral being that the patient is depressed as a result of having an unwanted pregnancy. Many psychiatrists consider that there are no, or virtually no, psychiatric grounds for termination of pregnancy, but how will the psychiatrist stand when the new Bill becomes law ? If he does not consider that there are adequate clinical grounds for termination of pregnancy, is he liable to be sued for negligence? The situation must have no parallel in the whole of the history of medicine, and clarification of the doctor’s position is, in my opinion, urgently needed.
Stanley W. (Correspondence) Abortion Bill. Br Med Journal. 1967 Apr 22;2(5546):247.
Extract . . . What to do with the hopelessly unfit? I had thought at a younger time of my life that the legalizing of euthanasia . . . Now my face is set against the legalization of euthanasia for any person, who, having been well, has at last become ill . . . But I am in favor of euthanasia for those hopeless ones who should never have been born-Nature’s mistakes.
. . . should the social organism grow up and forward to the desire to relieve decently from living the utterly unfit, sterilize the less unfit, and educate the still less unfit-then the Law must also grow, along with the amplitude of our new ideas for a wiser and better world, and fit the growing organism easily and well; and thereafter civilization will pass on and on in beauty.