The influences of social Darwinism on medical ethics must be examined carefully because Western society is currently enamoured by many of these same beliefs. They are not labelled as such, and are often promoted independently. But the ideas themselves are there and already impacting current thinking within medical ethics and bioethics.

Any attempt to draw connections between the Nazi Holocaust and contemporary bioethical debate must be done carefully. Too often connections are made that are tenuous at best, and completely wrong at worst [7]. Some claim it is impossible to draw any meaningful lessons from what was basically an "irrational lust for murder" [8]. Any mention of the Holocaust can raise so many emotions that rational discussion becomes difficult [9]. Some are offended that anything today could be compared to the Holocaust since it is viewed as the icon of absolute evil. Yet similarities do exist between some of the practices carried out by the Nazis and practices currently being debated. Some emphasise these similarities while others focus on the differences to avoid any connection. The claim is often made that "then is not now, and there is not here, and they are not us" [10]. The assumption is that we could never do what they did.

Yet they were people like us. Part of the internal anguish in examining the Holocaust comes from wondering whether we actually could do what they did. Some claim the Nazis were completely psychopathic. Others disagree, like Elie Wiesel who wrote that, "They did not think that what they were doing was wrong. They were convinced that what they did was good" [11]. They thought they were doing what was best for humanity, or at least for their Volk. Then and now, the same questions were asked. "Who shall live and who shall die? And, Who belongs to the community entitled to our protection? Then and now, the subject at hand is killing, and letting die, and helping to die, and using the dead" [12]. Then and now, similar arguments based on similar worldviews were used to justify controversial practices.

Dónal P O'Mathúna

https://pmc.ncbi.nlm.nih.gov/articles/PMC1484488/