China's Orphanages and Death
by Walter Reich
On rare occasions, historical parallels of contemporary events are so sharp that they pierce decades of time to penetrate our minds and skewer our souls. Accusations of the deaths, by deliberate neglect, of disabled children in Chinese orphanages, made by a credible human rights organization [Human Rights Watch], summon up memories of the deaths, by both deliberate neglect and direct killing, of disabled children in Nazi German institutions. Those memories impose on us a powerful obligation to respond to the accusations against the Chinese orphanages by calling for an international investigation--and, if the accusations are confirmed, to take decisive action to end the medicalized killing of helpless innocents.
Human Rights Watch has reported that a majority of children, who entered a Shanghai orphanage in the late 1980s and early 1990s died within a year; that this high death rate was typical of orphanages throughout China, and that it was a result of a policy, euphemistically called `summary resolution,' which selected children for death by starvation, sometimes aided by the administration of sedating drugs. These deaths, the report noted, were attributed to such causes as `congenital malformations of the brain' and `mental deficiency.'
Critics have cited a number of reasons for the deliberate starving of these Chinese children. Many of the children admitted to the orphanages were abandoned because they were born disabled. In a country that has an official policy limiting families to one child, some couples abandon disabled children so that they can try again for a healthy child; others may do so to shift to the state a caretaking burden they are unable to bear.
In the Chinese orphanages, according to these critics, it is these disabled children who tend to be subjected to `summary resolution'--deliberately starved, not treated when they develop easily treatable medical conditions, sometimes medicated to keep them quiet as they starve, and confined to `dying rooms.' Chinese orphanages realize significant income from adoptions of healthy babies by childless Western couples; disabled babies are not only unlikely candidates for adoption but also no less burdensome for their institutional caretakers than they would have been for the parents who abandoned them.
The parallels with the treatment of disabled children in German institutions during the Nazi era are haunting. Although the vast bulk of Nazi killing was, of course, eventually focused on Jews and became what we now know as the Holocaust, it was heralded, before the start of the Second World War, by the systematic, government-sponsored killing of children and adults who were disabled--a practice that continued after the war began. The killing methods, especially in the cases of children, often involved starvation and the administration of lethal doses of medications. In the cases of disabled adults, direct killing using gas was common--a method that, once refined, was used on a mass scale against Jews after the German armies rolled into Poland.
* The German killing of disabled children and adults was justified on the grounds that these persons constituted `life unworthy of life.' After 1934, mental hospitals were urged to neglect their patients. In 1935, Hitler was confident that a war would require healthy people, and that during a war it would be possible to easily eliminate the `incurably ill.'
* According to the reports provided by Human Rights Watch, the starved children in the Chinese orphanages look very much like the starved children in the German `Children's Specialty Institutions'; the Chinese institutions, too, administer sedatives to some children selected for death; they, too, use false diagnoses as coverups; they, too, cremate the remains of starved children; and they, too, employ physicians, many of whom probably tell themselves that the children dying under their care would have died anyway, and in any case are useless eaters in a country challenged by scarce resources.
* It should be clear; even if the existence of the `dying rooms' in Chinese orphanages were confirmed, it would not amount to the Holocaust, or even a semblance of it. Unlike Nazi Germany, China has not developed a systematic racial ideology, particularly one that requires all members of certain groups to be killed because of ethnic origin. Chinese leaders, as contemptuous of human rights as they have been, have not promulgated any such ideology; nor is it known that they have promulgated national or regional programs aimed at killing disabled children.
* But if the report by Human Rights Watch is correct, it seems clear that the general circumstances in China, including the lack of individual human rights, have enabled at least some Chinese orphanages to engage secretly in practices that parallel some of the practices, particularly death by starvation, that were carried out by Nazi Germany against disabled children and adults.
* If the Human Rights Watch report can be verified by international inspections, the parallels between the Chinese orphanages and the Nazi programs to kill disabled children are alarming. These parallels remind us that human beings, including physicians and other caregivers, are extraordinarily vulnerable to inhuman acts and extraordinarily capable of justifying their behavior on what they see as rational grounds. And they remind us that countries in which democratic institutions are forcibly forbidden and human rights systematically quashed are ones in which human life becomes, quite simply, expendable.
* The experience of the Holocaust, and the world's silence in response to it, have taught us that we must never shut our ears to reports of evil acts. We must investigate such reports and respond vigorously if they are confirmed. We have an obligation to do that--to ourselves, to the most defenseless of our fellow human beings, and to memory.
Dr. Walter Reich, a physician who is the director of the U.S. Holocaust Memorial Museum and the chairman of the Committee on Human Rights of the American Psychiatric Association. Dr. Reich draws chilling parallels between the practices that have been observed in China and the horrors of the Holocaust.