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Kennedy and Lennox on eugenics. The 1930s and 1940s were an especially turbulent period of history for the United States and the world, marked as it was by the Great Depression and World War II. First in 1936 and 1938, then on different occasions over subsequent years, Kennedy and Lennox each made known their own thinking about how “defective” individuals should be dealt with. Summarized here are some of these two neurologists’ most relevant and informative utterances on this subject, in which their arguments, supporting evidence, recommendations, and personal values are stated or implied.
Euthanasia. Lennox (WL) in an article (“Should They Live? Certain Economic Aspects of Medicine” ) published by the Phi Beta Kappa honor society’s journal American Scholar (AS) in 1938, and Kennedy (FK) first in an article (“Euthanasia: To Be or Not To Be” ) published by the popular weekly magazine Colliers in 1939 and then in a presentation (“The Problem of Social Control of the Congenital Defective: Education, Sterilization, Euthanasia”) made at a May 1941 American Psychiatric Association (APA) luncheon, both called for killing “defectives.”
WL: . . . the congenital idiots or monsters... What shall be done with these?... (Society) should eliminate . . . the idiots and monsters . . . The selection of the congenitally and hopelessly mindless for elimination would offer no more difficulties than their selection for lifelong incarceration. A court-appointed medical committee would be sufficient.(see Lennox reference below)
FK: What to do with the hopelessly unfit? . . . the place for euthanasia, I believe, is for the completely hopeless defective: nature’s mistake; something we hustle out of sight, which should never have been seen at all. These should be relieved of the burden of living . . . to allow them to continue such a living is sheer sentimentality, and cruel too; we deny them as much solace as we give our stricken horse. Here we may most kindly kill.(see Kennedy reference below)
The American Journal of Psychiatry (AJP) published Kennedy’s remarks in its July 1942 issue along with a lengthy, passionate rebuttal by the child psychiatrist Leo Kanner of Johns Hopkins. Kanner, who is credited with the classic description of infantile autism, challenged Kennedy’s view of the “feebleminded,” pleading in effect for a more sympathetic one. (see Kanner reference below) In the same issue, an editorial only a little shorter than Kennedy’s contribution summarized and assessed the two doctors’ respective arguments: (see Euthanasia citation below)
. . . the differences narrow down to a single point: for a specified group of defectives and under specified conditions Dr. Kennedy advocates euthanasia; Dr. Kanner opposes this procedure. Both writers are agreed as to the existence of the group in question and the hopelessness of their condition; one proposes a method of disposal which he believes would bring relief to all concerned, the other prefers to let the situation remain as it is... (Kennedy) offers strong arguments in support of his position. Dr. Kanner opposes this position but in his paper presents no arguments beyond the statement: “An idiotic child may have fond parents who want him alive.”
Euthanasia: “voluntary” versus “involuntary.” Although both wanted to legalize euthanasia for the “defectives” who could not give consent, Kennedy and Lennox differed on legalizing it for those seeking assistance in ending their own lives. Lennox was in favor, whereas Kennedy was outspoken in opposition on practical and philosophical grounds.
FK: . . . I have many instances in my own experience of seemingly fatally ill persons who for years after, lived useful lives... (B)esides, a civilization that deliberately shuts itself off from the bearing of pain and the presence of struggle and finally makes its bid for the softer life or death, is already slipping down the ways. To do this is a sign of degradation and defeat.3
Having been appointed the Euthanasia Society of America’s (ESA) founder as president only a month earlier, and with “a mercy death law” then under consideration by the New York state legislature, Kennedy appeared in the company of two others from the ESA on a program to “present the case for euthanasia—referred to in the official program as ‘the granting of peaceful death to incurable sufferers.’ ” As reported on February 14, 1939, this took place before “an overflow meeting of the Society of Medical Jurisprudence,” the NYT headlining the story, “Dr. Kennedy Gives Views: Euthanasia Needed Mainly For Defectives, Not For Easing Pain, He Declares.”
. . . the physician who was a “gentleman” was equipped to assist in a “necessary journey to death” . . . Then he turned to the “absurd and misplaced sentimental kindness” that seeks to preserve the life of a “person who is not a person.” ... “If the law sought to restrict euthanasia to those who could speak out for it, and thus overlooked those creatures who cannot speak,” Dr. Kennedy declared, “then, I say as Dickens did, ‘The law’s an ass.’ It’s time the law changed its mind.”
A few days later, Bernard Sachs, a past president of the ANA, responded to his “good friend” Kennedy in a letter to the NYT, summing up, “Irrespective of religious doctrines or sanctions, it is the solemn duty of the physician to prolong life, not to end it.” After another few days, the NYT printed a letter from the Cornell professor restating his support for euthanasia “for creatures born defective” and opposition to it “for those persons who, having been well, are ill,” and making clear these opinions were “entirely personal,” not “to be construed as the policy of the Euthanasia Society of America.” The next week, only a month after assuming the position, Kennedy resigned the ESA presidency.
Euthanasia: “active” versus “passive.” Like Malthus more than a century before, Lennox advocated a “non-interventional” approach to lifethreatening infectious illnesses for overpopulated countries to reduce their overall numbers. He also called for the same “non-interventional” approach, or what has been labeled “passive” euthanasia, for “defective” individuals overcrowding asylums and placing an economic burden on society. WL:
. . . until wealth could be increased or birthrates reduced, medicine in the Orient should abandon attempts to wholesale prevention of infection... There is not the same disproportion between population and material resources in America as in the Orient but if we are far-sighted we shall begin to do something about that portion of our population which is a heavy and permanent liability... Should the lives of incurables in institutions be prolonged by prophylactic injections against typhoid fever, scarlet fever and diphtheria? The death-rate in institutions from communicable diseases is decreasing and consequently the need for more institutions is increasing. To these facts medical superintendents point with pride and taxpayers with anxiety....
Labels. Kennedy and Lennox referred to those they recommended for euthanasia variously as “idiots,” “imbeciles,” and “morons,” terms that, although offensive in modern usage, were accepted scientific labels at the time. In making their cases, Kennedy and Lennox did not limit themselves to the standard medical lexicon when speaking of “defectives” though. Kennedy, for example, labeled them “Nature’s mistakes.” Lennox reached further for images to characterize them. This former medical missionary, who went to medical school after he was turned down for theology school, saw them not as products of “Nature” but rather as the Creator’s mistakes (“the result of some slip of the hand of Him who made them, lumps of matter in human form but without human mind”). In Lennox’s view, they were, or may as well have been, inanimate, “clock case(s) without works,” which, of course, “can never tell time.” If animate, they might have “human form,” but they reminded Lennox more of the cattle he had tended as a ranch hand in his youth.
WL: As an inexperienced “hand” on a huge southwestern cattle range it used to be my job at round-up time to work on “the drag,” keeping the worn-out cows and little dogies from falling behind the herd, while the experienced cowboys rode at the head, skillfully “pointing” the wild-footed steers toward their destination. Physicians, as a class, work only on the drag— trying to keep the physically and mentally unfit in the procession...
Kennedy and Lennox saw Medicine as a player on the larger world stage, further subordinating the individual’s interests to what they perceived as the greater good. Lennox, for example, expounded on Medicine’s geopolitical possibilities, unselfconsciously suggesting not only that “birth-planning” might operate to avoid international conflict, especially between East and West, but also that “this principle of limiting certain races through limitation of offspring might be applied intranationally as well as internationally.” After opining in the fall of 1938 that “Germany in time might have solved her Jewish problems in this way,” he went on to hint that targeting of groups within the overall population might be desirable in the United States because a “solvent society must say how many and what sort are to be born”.
The views expressed by Drs. Kennedy and Lennox on eugenics were not novel nor truly exceptional among their peers and contemporaries generally. After Galton’s coinage of the term eugenics in 1883, many people of note involved themselves as active proponents of this developing “science,” if it can fairly be called such, and the movement it spawned. When Kennedy and Lennox took up the cause, though, both it and they were in their sixth decade. In the United States, enthusiasm for eugenics was by then cresting and would decline further as details of what transpired in Europe under the Nazis emerged.
Lennox WG. Should they live? Certain economic aspects of medicine. Am Scholar 1938;7:454–466, 509.
Kennedy F. The problem of social control of the congenital defective: education, sterilization, euthanasia. Am J Psychiatry 1942;99:13–16
Kanner L. Exoneration of the feebleminded. Am J Psychiatry 1942;99: 17–22.
Euthanasia. Am J Psychiatry 1942,99:141–143.
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