Trump to People with Disabilities: "Just Die."

 In The Politics of Autism, I discuss the issue's role in presidential campaigns.   In this campaign, a number of posts have discussed Trump's support for the discredited notion that vaccines cause autism.  He also has a bad record on disability issues more generally. 

At TIME, Fred Trump recalls his uncle Donald at an Oval Office meeting on disabilities:

He sounded interested and even concerned. I thought he had been touched by what the doctor and advocates in the meeting had just shared about their journey with their patients and their own family members. But I was wrong.

“Those people . . . ” Donald said, trailing off. “The shape they’re in, all the expenses, maybe those kinds of people should just die.”

I truly did not know what to say. He was talking about expenses. We were talking about human lives. For Donald, I think it really was about the expenses, even though we were there to talk about efficiencies, smarter investments, and human dignity.

Fred Trump also recalls an earlier conversation about raising money for his severely disabled son.

I got him up to speed on what Eric had told me. I said I’d heard the fund for William was running low, and unfortunately, the expenses certainly were not easing up as our son got older. In fact, with inflation and other pressures, the needs were greater than they’d been. “We’re getting some blowback from Maryanne and Elizabeth and Ann Marie. We may need your help with this. Eric wanted me to give you a call.”

Donald took a second as if he was thinking about the whole situation.

“I don’t know,” he finally said, letting out a sigh. “He doesn’t recognize you. Maybe you should just let him die and move down to Florida.”

Euthanasia and Autism

 In The Politics of Autism, I write about the dangers of eugenics and euthanasia. 

\An earlier post described euthanasia in the Netherlands. Some autistic people there have undergone euthanasia because they said they could not lead normal lives.  At NRO, Wesley Smith discusses an AP story on the study:

I never understand why people are surprised by these kinds of horror stories. Once a society decides that killing is an acceptable answer to suffering, what constitutes suffering sufficient to be made dead becomes highly elastic and stretches over time. This can even include loneliness, as I have written about before. The story describes the phenomenon:

Many of the patients cited different combinations of mental problems, physical ailments, diseases or aging-related difficulties as reasons for seeking euthanasia. Thirty included being lonely as one the causes of their unbearable pain. Eight said the only causes of their suffering were factors linked to their intellectual disability or autism — social isolation, a lack of coping strategies or an inability to adjust their thinking.

The unintended cruelty of euthanasia is becoming increasingly clear:

Dr. Bram Sizoo, a Dutch psychiatrist, was disturbed that young people with autism viewed euthanasia as a viable solution.

“Some of them are almost excited at the prospect of death,” Sizoo said. “They think this will be the end of their problems and the end of their family’s problems.” . . .

Tim Stainton, director of the Canadian Institute for Inclusion and Citizenship at the University of British Columbia, wonders if the same thing is happening in Canada, which arguably has the world’s most permissive euthanasia laws and which doesn’t keep the kinds of records that the Netherlands does.

“Helping people with autism and intellectual disabilities to die is essentially eugenics,” Stainton said.

Indeed. Now, add in the prospect of organ harvesting as a benefit to society and the acute danger to the vulnerable who can come — or be made — to think that their deaths will have greater value than their lives comes vividly into focus.

Autism and Euthanasia in the Netherlands

 In The Politics of Autism, I write about the dangers of eugenics and euthanasia. 

Irene Tuffrey-Wijne and colleagues have an article at BJPsych Open:Euthanasia and physician-assisted suicide in people with intellectual disabilities and/or autism spectrum disorders: investigation of 39 Dutch case reports (2012–2021)

Abstract

Background

Euthanasia review committees (Regionale Toetsingscommissies Euthanasie, RTE) scrutinise all Dutch cases of euthanasia and physician-assisted suicide (EAS) to review whether six legal ‘due care’ criteria are met, including ‘unbearable suffering without prospect of improvement’. There are significant complexities and ethical dilemmas if EAS requests are made by people with intellectual disabilities or autism spectrum disorders (ASD).

Aims

To describe the characteristics and circumstances of people with intellectual disabilities and/or ASD who were granted their EAS request; investigate the main causes of suffering that led to the EAS request; and examine physicians’ response to the request.

Method

The online RTE database of 927 EAS case reports (2012–2021) was searched for patients with intellectual disabilities and/or ASD (n = 39). Inductive thematic content analysis was performed on these case reports, using the framework method.

Results

Factors directly associated with intellectual disability and/or ASD were the sole cause of suffering described in 21% of cases and a major contributing factor in a further 42% of cases. Reasons for the EAS request included social isolation and loneliness (77%), lack of resilience or coping strategies (56%), lack of flexibility (rigid thinking or difficulty adapting to change) (44%) and oversensitivity to stimuli (26%). In one-third of cases, physicians noted there was ‘no prospect of improvement’ as ASD and intellectual disability are not treatable.

Conclusions

Examination of societal support for suffering associated with lifelong disability, and debates around the acceptability of these factors as reasons for granting EAS, are of international importance.

More on Asperger and Nazism

In The Politics of Autism, I write about the dangers of eugenics and euthanasia.

In A Different Key, John Donvan and Caren Zucker found that Dr. Hans Asperger worked with Nazis in Austria.  We are now learning more details. 

Herwig Czech has an article at Molecular Biology titled "Hans Asperger, National Socialism, and “Race Hygiene” in Nazi-era Vienna." The abstract:

Background

Hans Asperger (1906–1980) first designated a group of children with distinct psychological characteristics as ‘autistic psychopaths’ in 1938, several years before Leo Kanner’s famous 1943 paper on autism. In 1944, Asperger published a comprehensive study on the topic (submitted to Vienna University in 1942 as his postdoctoral thesis), which would only find international acknowledgement in the 1980s. From then on, the eponym ‘Asperger’s syndrome’ increasingly gained currency in recognition of his outstanding contribution to the conceptualization of the condition. At the time, the fact that Asperger had spent pivotal years of his career in Nazi Vienna caused some controversy regarding his potential ties to National Socialism and its race hygiene policies. Documentary evidence was scarce, however, and over time a narrative of Asperger as an active opponent of National Socialism took hold. The main goal of this paper is to re-evaluate this narrative, which is based to a large extent on statements made by Asperger himself and on a small segment of his published work.

Methods

Drawing on a vast array of contemporary publications and previously unexplored archival documents (including Asperger’s personnel files and the clinical assessments he wrote on his patients), this paper offers a critical examination of Asperger’s life, politics, and career before and during the Nazi period in Austria.

Results

Asperger managed to accommodate himself to the Nazi regime and was rewarded for his affirmations of loyalty with career opportunities. He joined several organizations affiliated with the NSDAP (although not the Nazi party itself), publicly legitimized race hygiene policies including forced sterilizations and, on several occasions, actively cooperated with the child ‘euthanasia’ program. The language he employed to diagnose his patients was often remarkably harsh (even in comparison with assessments written by the staff at Vienna’s notorious Spiegelgrund ‘euthanasia’ institution), belying the notion that he tried to protect the children under his care by embellishing their diagnoses.

Conclusion

The narrative of Asperger as a principled opponent of National Socialism and a courageous defender of his patients against Nazi ‘euthanasia’ and other race hygiene measures does not hold up in the face of the historical evidence. What emerges is a much more problematic role played by this pioneer of autism research. Future use of the eponym should reflect the troubling context of its origins in Nazi-era Vienna.

Dr. Hans Asperger's Nazi Connection

In The Politics of Autism, I write about the dangers of eugenics and euthanasia.

In A Different Key, John Donvan and Caren Zucker found that Dr. Hans Asperger worked with Nazis in Austria.  We are now learning more details.

Edith Sheffer writes at The New York Times:

Child “euthanasia” was the Reich’s first program of mass extermination, begun by Hitler in July 1939 to get rid of children regarded as a drain on the state and a danger to its gene pool. Most of the victims were physically healthy, neither suffering nor terminally ill. They were simply deemed to have physical, mental or behavioral defects.

At least 5,000 children perished in around 37 “special wards.” Am Spiegelgrund, in Vienna, was one of the deadliest. Killings were done in the youths’ own beds, as nurses issued overdoses of sedatives until the children grew ill and died, usually of pneumonia.

Asperger worked closely with the top figures in Vienna’s euthanasia program, including Erwin Jekelius, the director of Am Spiegelgrund, who was engaged to Hitler’s sister. My archival research, along with that of other scholars of euthanasia like Herwig Czech, the author of a forthcoming paper on this subject in the journal Molecular Autism, show that Asperger recommended the transfer of children to Spiegelgrund. Dozens of them were killed there.

One of his patients, 5-year-old Elisabeth Schreiber, could speak only one word, “mama.” A nurse reported that she was “very affectionate” and, “if treated strictly, cries and hugs the nurse.” Elisabeth was killed, and her brain kept in a collection of over 400 children’s brains for research in Spiegelgrund’s cellar.

Professor Sheffer is the author of the forthcoming book  Asperger’s Children: The Origins of Autism in Nazi Vienna.

Republican Platform on Autism and Disability

In The Politics of Autism, I discuss the issue's role in presidential campaigns.  

GOP Platform:

We reaffirm the Constitution’s fundamental principles: limited government, separation of powers, individual liberty, and the rule of law. We denounce bigotry, racism, anti-Semitism, ethnic prejudice, and religious intolerance. Therefore, we oppose discrimination based on race, sex, religion, creed, disability, or national origin and support statutes to end such discrimination.
...

We support the appointment of judges who respect traditional family values and the sanctity of innocent human life. We oppose the non-consensual withholding or withdrawal of care or treatment, including food and water, from individuals with disabilities, newborns, the elderly, or the infirm, just as we oppose euthanasia and assisted suicide.

...
We call on Congress to ban sex-selection abortions and abortions based on disabilities --discrimination in its most lethal form. 

..,.  

[The] Workplace Innovation and Opportunity Act — modernizing workforce programs, repealing mandates, and advancing employment for persons with disabilities — is now law. 

... 

American medicine is poised to enter a new era of technological advance. Federal and private investment in basic and applied biomedical research holds enormous promise, especially with diseases and disorders like autism, Alzheimer’s, and Parkinson’s. 

...  

Under the last two Republican presidents, landmark civil rights legislation affirmed the inherent rights of persons with disabilities. Republicans want to support those rights by guaranteeing access to education and the tools necessary to compete in the mainstream of society. This is not just a moral obligation to our fellow Americans with disabilities. It is our duty to our country’s future to tap this vast pool of talented individuals who want to work and contribute to the common good. For that reason, Republican leadership led to enactment of the ABLE Act (Achieving a Better Life Experience) and the Steve Gleason Act. The former, for the first time, lets people with disabilities maintain access to services while saving to develop assets. The latter, bearing the name of the former NFL player with ALS, provides access to speech-generating devices. In addition, our Workforce Innovation and Opportunity Act will make it easier for students with disabilities to pursue competitive employment. 

Persons with disabilities are nearly twiceas likely to be self-employed as the general population. To encourage their entrepreneurship, it makes sense to include them in the Small Business Administration’s 8(a) certification program, which opens up federal contracting for emerging businesses. Any restructuring of the tax code should consider ways in which companies can benefit from the talent and energy of their disabled employees.

The Individuals with Disabilities Education Act (IDEA) has opened up unprecedented opportunities for many students. Congressional Republicans will lead in its reauthorization, as well as renewal of the Higher Education Act, which can offer students with disabilities increased access to the general curriculum. Our TIME Act (Transition to Integrated and Meaningful Employment) will modernize the Fair Labor Standards Act to encourage competitive employment for persons with disabilities. We affirm our support for its goal of minimizing the separation of children with disabilities from their peers. We endorse efforts like Employment First that replace dependency with jobs in the mainstream of the American workforce.

We oppose the non-consensual withholding of care or treatment from people with disabilities, including newborns, the elderly, and infirm, just as we oppose euthanasia and assisted suicide, which endanger especially those on the margins of society. We urge the Drug Enforcement Administration to restore its ban on the use of controlled substances for physician-assisted suicide. 

...
Precisely because we take our country’s treaty obligations seriously, we oppose ratification of international agreements whose long-range implications are ominous or unclear. We do not support the U.N. Convention on Women’s Rights, the Convention on the Rights of the Child, the Convention on the Rights of Persons with Disabilities, and the U.N. Arms Trade Treaty, as well as various declarations from the U.N. Conference on Environment and Development.

Euthanasia and Autism in Europe

In The Politics of Autism, I write about the dangers of eugenics and euthanasia.

At The Washington Post, Charles Lane writes of an autistic Dutch psychiatric patient Dutch psychiatric patient known as 2014-77.  Despite his doctor's qualms, he requested and got a fatal dose of drugs.

Thus did a man in his 30s whose only diagnosis was autism become one of 110 people to be euthanized for mental disorders in the Netherlands between 2011 and 2014. That’s the rough equivalent of 2,000 people in the United States.
...

According to an analysis of 66 of the 110 cases from 2011 to 2014, by psychiatrist Scott Kim of the National Institutes of Health and two colleagues, Dutch psychiatric patients were often euthanized despite disagreement among consulting physicians as to whether they met legal criteria. In 37 cases, patients refused possibly beneficial treatment, and doctors proceeded anyway.
...

Among the obvious risks, Columbia University psychiatrist Paul S. Appelbaum writes in a companion article to Kim’s, is “inducing hopelessness among other individuals with similar conditions and removing pressure for an improvement in psychiatric and social services.”

“Will psychiatrists conclude from the legalization of assisted death that it is acceptable to give up on treating some patients?” Appelbaum asks.

Some doctors already have. In 2009, a 37-year-old Belgian woman became distraught after a romantic breakup and began seeking a doctor to euthanize her, per that country’s law, which is similar to Holland’s.

The woman, Tine Nys, had a history of mental illness, including a teenage suicide attempt, but had more recently been doing well. In February 2010, however, she received a new diagnosis of autism and, two months later, a lethal injection. Her two surviving sisters have recently come forward to denounce the administering physician’s “nonchalant” attitude.

Autism, Eugenics, and Euthanasia

In The Politics of Autism, I write about the dangers of eugenic solutions.

At The Independent, Mathieu Vaillancourt writes of forbidding autistic people to donate to sperm banks.

The other problem is the whole concept of eugenics behind this. It's indeed true that autism is a complex and umbrella-like condition which may seems scary at first glance. Many with autism face massive challenges - but others who have dyslexia, autism (or any other neurological disorder) are able to have great, fulfilling lives and possess a sense of responsibility, loyalty and precision that lots of people would do anything to have. To label people with dyslexia or Asperger Syndrome as impure makes this look like a dodgy remake of an era not so long ago, when some governments wanted a ''purer'' race and sought to sterilize people against their will, or even ''euthanize'' them.

He is not exaggerating.  In Buck v. Bell (274 US 200), the US Supreme Court upheld involuntary sterilization. Writing for the majority, Justice Oliver Wendell Holmes declared:

It is better for all the world if, instead of waiting to execute degenerate offspring for crime or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes. Jacobson v. Massachusetts, 197 U.S. 11. Three generations of imbeciles are enough.

And "respectable" thought leaders wanted to go even farther, to the killing of defectives.   A 1942 debate in the American Journal of Psychiatry focused on on whether the government should eliminate the  "feebleminded." Neurologist Foster Kennedy argued in the affirmative.Leo Kanner, who would soon publish the landmark article launching the study of aut ism, argued against killing.  An anonymous editorial sided with Kennedy’s position.

This debate was hardly a "one-off."

Consider William G. Lennox.  He was not some random nut, but a distinguished neurologist who did important work on epilepsy.  (To this day, the American Epilepsy Society bestows an annual William G. Lennox Award.)  In an article in autumn 1938 issue of The American Scholar, the official publication of Phi Beta Kappa, Dr. Lennox wrote of people "confined in institutions where they are never seen by the public."

They are the congenital idiots or monsters, the result of some slip of the hand of Him who made them; lumps of matter in human form but without human mind. What should be done with these? Of many defectives it can be said that human judgment is subject to error and that cures sometimes occur when least expected, but for this lowest group there can be no such plea. A clockcase without works can never tell time. Physicians are bound by inherited ethical standards and the motto "They shall not die." Raymond Pearl, the biologist, has this to say:

These unfit organisms are kept alive by the rest of society for no realistically demonstrable reason other than that they were once born, and by being born, somehow placed upon the rest of mankind what has gradually come to be regarded as a permanently binding obligation to see that they do not die. It is difficult to convince a biologist that a social philosophy will endure for any great length of time that deliberately and complacently loads upon the already weary backs of the able and fit an evergrowing burden. . . . No species or variety of plant or animal has long survived that was intrinsically incapable of making its own living. There is somewhere a biological limit to altruism, even for man.3

"Very well for another person's child," says the objector, "but what if it's your own? " Memory flicks past rows of writhing, incontinent, vacant-eyed, speechless bodies, distressing to the point of nausea, and I answer "I should rather see a child of mine in its coffin."

Dr. Lennox proposed actual death panels:

Decisions involving life and death are, however, reached daily by legal processes. 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. Laws would of course need to be revised, and prior to this public opinion would need to be awakened. The essential prerequisite to human progress in any field is willingness to face realities and to work out fundamental rather than temporary solutions of problems.

Autism and Euthanasia

In The Politics of Autism, I discuss the dangers to the lives of autistic people. Alex Schadenberg writes at LifeNews:

The British Medical Journal (BMJ) will publish a “study” on July 27, 2015 examining 100 requests for euthanasia for psychiatric reasons in Belgium. Link to the early release of the study. 

Four of the six authors of the study are connected to the euthanasia clinic in Belgium.
...
The “study” examines 100 consecutive requests for euthanasia at a psychiatric out-patient clinic between October 2007 and December 2011. The analysis of the data closed in December 2012. The data states:

• 77 euthanasia requests were woman, 23 were men,
• 48 of the requests were approved and 35 died by euthanasia,
• 1 died by palliative sedation (sedation with withdrawal of water),
• the average age was 47,
• 58 were depressed, 50 had a personality disorder,
• 12 were autistic, (I have an autistic son), 13 had post traumatic stress, 11 had anxiety disorder, 10 had an eating disorder, etc