In 1930, the Nazi psychiatrist Ernst Rüdin called for the extension of medical killing to “prevent a crisis in social care.” At that point, he assured his audience, “I personally should not care to consider any coercive measures”—only counselling to encourage sterilizations of those deemed “unfit” and beyond medical help. But Rüdin would later go on to oversee not only sterilizations, but also the mass killing of psychiatric patients under the Nazi regime.

OK, I lied. The first statement I quoted, about expanding euthanasia to “prevent a crisis in social care,” was made not by Rüdin in 1930—but by the president of Belgium’s largest health-insurance fund a few weeks ago. Comparing today’s push for “assisted dying” to Nazi eugenics may seem like another shallow reductio ad Hitlerum. But the value of the comparison isn’t to claim we are on a slippery slope to the full suite of Nazi horrors. The question, rather, is why we are seeing the soft return of outlooks and policies that led to such monstrous results in the 20th century. What their reemergence shows is that we never overcame the contradictions to which the Nazis were responding in the most brutal imaginable way. Because we are still living in the same modern world, riven by the same contradictions, the horrifying solutions proffered by the Third Reich haven’t truly gone away.

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