It came as no surprise when the Netherlands became the first country in the world to legalize assisted suicide and voluntary euthanasia. In mid-April, that country's senate voted to pass into law a bill that had been approved by its lower house of parliament last fall.

The Dutch had been accelerating toward this dark goal for several decades, doing in the shadows what they longed to do in the full light of day. Now they have their wish.

Those of us who watch with horror the seemingly inevitable advance of the culture of death across Europe and America can at least bring good out of evil by learning a lesson from this sorry chapter.

We have a tendency in our assessment of evil to believe that only obvious monsters commit great crimes. This tendency manifests itself quite clearly in public debates where the only example of evil anyone can recall is that of Hitler. We imagine that perpetrators of such large-scale evil would be as easy to spot as a hell-bent ghoul in full Nazi regalia.

There is a problem with this mode of argument, which the late Leo Strauss called the reductio ad Hitlerum. So few of us know what went on in the Third Reich, and how it was actually accomplished, that we have no way of comparing our own situation to that of the Germans in the first half of the 20th century. Ironically, the true lessons of Nazi Germany are lost on the Netherlands even though the Netherlands was lost to the invading Nazis in 1940.

As evidence of the Netherlands’ amnesia, hear the words of Dutch health minister Els Borst reassuring legislators that the law legalizing assisted suicide and euthanasia could not be abused by doctors: “There are sufficient measures to eliminate those concerns.” Assisted suicide, so she told the lawmakers, will remain a last resort, an option only available to those facing endless suffering.

Careful Killings

Well, now, let's go back a few decades. We hear a lot about the evils of German concentration camps — and rightly so, for they were hideous manifestations of the near-bottomless human reservoir of innovative cruelty. But how many of us are aware of the Nazis’ euthanasia program, and how it came about? Ms. Borst?

In Germany, a journal founded by the highly respected German zoologist Ernst Haeckel, Das monistische Jahrhundert, published in 1913 the first sustained arguments supporting euthanasia. This respectable public debate helped pave the way for the even more influential euthanasia tract published in 1920 by Karl Binding and Alfred Hoche. The title Binding and Hoche chose speaks for itself: Permission for the Destruction of Life Unworthy of Life.

This popular tract had a popular effect. It facilitated the easy acceptance of the Nazi euthanasia program Aktion T-4, which, at five German locations, dispatched between 120,000 and 275,000 mental patients, physically disabled persons, incurables and other “undesirables.” These patients were not eliminated by cackling, sadistic members of the SS, but by a vast and complex network of very ordinary doctors and nurses. Good and loyal bureaucrats, they filled out minutely detailed forms in triplicate, generally doing their best to treat patients to be euthanized with the utmost concern and gentleness — and all in the name of compassion.

We imagine that perpetrators of such large-scale evil would be as easy to spot as a hell-bent ghoul in full Nazi regalia.

As with many of the euthanasia programs being floated today — such as the one just ratified by the Dutch — the Nazi system incorporated many layers of checks and double-checks. It began as an immense federation of careful compassion, set up to ensure that no one who was curable or who still had a reasonable prospect for a pleasant existence would be inadvertently terminated.

But, alas, even the most carefully guarded boundaries somehow proved permeable to excess “compassion.” In 1943, for example, Hadamar, one of the five killing stations, began to euthanize children — not merely the disabled or retarded, but also members of asylums, juvenile homes and orphanages. Of course, troublemakers were included, too, as were children of mixed races and those with significant childhood acne.

What are the lessons for the Dutch from the German experience?

Harmful Healthcare

First, the Aktion T-4 euthanasia program was carried out by professional, competent, well-educated doctors and nurses. These doctors made their diagnoses in accordance with the medical histories of each patient under consideration, and the decision to euthanize was carried out only after several doctors had officially concurred.

Second, when the Aktion T-4 program was discontinued due to public outcry (yes, public opinion actually did count in Nazi Germany), doctors themselves continued the program without benefit of official sanction and apparatus, making decisions on their own about which patients to euthanize. The practice of euthanasia, once it was accepted as a part of the art of medicine, continued its forward motion, and was administered with a far freer hand.

Third, the Dutch no doubt believe that, unlike the Nazis, the Netherlands’ euthanasia and assisted-suicide program will apply only to willing participants. Yet, in the 1990 Remmelink Study, undertaken in the Netherlands to determine the number of cases of euthanasia being done in defiance of the law, it was found that at least 2,300 cases of requested euthanasia occurred per year, as well as 400 cases of assisted suicide.

Even more startling, the study showed there were at least 1,000 cases of involuntary euthanasia each year — that is, cases where doctors eliminated patients without the patient's explicit request.

If a little over a decade ago Dutch doctors were happy to break the law in order to euthanize patients, how is it that the recent legislation de-criminalizing euthanasia will make them more cautious about administering it? If 27% of the decisions to terminate the life of a patient occurred without the patient's’ explicit consent in 1990, what reason is there to expect that doctors who have been killing for years with the fear that they might be prosecuted will now, with legalization, suddenly break such habits?

Sadly, the Dutch have learned nothing from their own history, let alone that of Nazi Germany. They have asked for and received “Permission for the Destruction of Life Unworthy of Life.”

What about us? There is every indication that Americans are following the same path marked off by the Germans and the Dutch. Pro-euthanasia societies, those denizens of despair, have already won in Oregon and they're moving fast in on other states every day.

It's our hope against their hopelessness.

Will we stand by and watch as our nation falls, one state at a time, into this dark corner of the culture of death? Or will we let this historic moment spur us to fight for life with new intensity and resolve?

Ben Wiker teaches classics at Franciscan University of Steubenville, Ohio