Good Lives
Jan Grue on what disability reveals about human flourishing
Reviewed:
The Question of Unworthy Life: Eugenics and Germany’s Twentieth Century by Dagmar Herzog. Princeton University Press, 2024
The Life Worth Living: Disability, Pain, and Morality by Joel Michael Reynolds. University of Minnesota Press, 2022
The Art of Flourishing: Conversations on Disability, edited by Liz Bowen, Joel Michael Reynolds, Rosemarie Garland-Thomson, and Erik Parens. Oxford University Press, 2025
At the Nuremberg Medical Trials, Karl Brandt, Hitler’s personal physician, testified about his involvement in what he referred to as “the Leipzig case.” The parents of a child born with several disabilities wanted to have it killed. Since the director of their local hospital had rebuffed them, they had petitioned the Führer’s chancellery directly. As it happened, the Führer wanted a solution to the so-called euthanasia question, and so Brandt was directed to review the case and make it an exemplar. He found, as he put it, no reason to let the child live.
The child, eventually identified as a boy named Gerhard Kretschmar, became the first known victim of the T4 program, which killed nearly 300,000 disabled people between 1939 and 1945. While public protests led to an official suspension of the program in 1941, T4 continued its practices unofficially, the “wild” phase of its “euthanasia” lasting until the end of the war. Even in the postwar years, there was a “crushing breadth of popular support for the perpetrators, and ongoing shaming of the victims and their families,” writes historian Dagmar Herzog in The Question of Unworthy Life. Beyond Brandt, who was convicted of crimes against humanity at Nuremberg and executed in 1948, very few physicians were held accountable, while people with disabilities kept being marginalized, confined to underfunded and short-staffed institutions. Not infrequently, ex-Nazi employees were “hired back as nurses and wardens.” Disabled people “were not viewed by their fellow citizens as fully human,” writes Herzog, “and their lives, bodies, and souls were not treated as of equal value.”
Much about the medical murders was known from the beginning; more was uncovered after the end of the war. Yet the revelations about the T4 program failed to banish one of its core assumptions: that some disabilities inherently make life not worth living. Is it an overstatement to say that echoes of that sentiment persist today? I don’t think so. One doesn’t need to look too closely to see traces of T4 in tech’s transhumanist ambitions to overcome human frailty and bodily vulnerability once and for all.
Take Nucleus Genomics. Financed in part by Peter Thiel’s Founders Fund, the company—which ran a major ad campaign last year using taglines like “IQ is 50% genetic”—offers screening of up to twenty IVF embryos with the promise of evading undesirable “genetic conditions and traits,” among them somatic disorders like Huntington’s, caused by single-gene mutations, as well as much more loosely defined conditions like ADHD, insomnia, alcoholism, and anxiety. The pitch is that prospective parents can have their “best baby,” which in turn presupposes that such a thing exists.
This new eugenics is depressingly similar to its antecedents in its rejection of the body, and the granularity of embodied life, in favor of a narrow, singular vision of the life of the mind. Intelligence, narrowly defined, reigns supreme; bodily variation, like a clunky bit of code, is a problem in need of debugging. Unlike its forebears, though, the new order appears willing to let some of the would-be outcasts into the club—so long as they prove useful. Certain forms of neurodiversity have even been embraced, recast not as hindrances but superpowers, the mark of the mythical “10x” engineer who churns out work an order of magnitude more productively than “normal” workers. For tech moguls like Elon Musk and Alex Karp of Palantir, a hint of autism is perfectly acceptable, even desirable, if it strengthens the bottom line. According to Karp, only two kinds of people will succeed in the AI era: trade workers and the neurodivergent. Within the vastly diverse minority of disabled people, it has long been possible to discern the subgroup of the “able-disabled,” the people who gain some degree of social acceptance by living up to productivity norms and demonstrating their economic utility, often at a high human cost.
According to this familiar logic, the disabled remainder might well be better off dead. In Jojo Moyes’s bestselling novel Me Before You (2012), a rich, highly privileged quadriplegic man insists that he is nevertheless deprived of everything that makes life good, including the possibility of working, and must therefore kill himself. He does, and the story frames this as a happy ending. In 2021, Canada enacted laws that made nonterminal disabilities a sufficient, legitimate reason for physician-assisted suicide. And in one of the baldest statements of the cost-benefit approach, President Trump, after a meeting with disability advocates during his first term, allegedly said that, with the expenses involved, “those kinds of people”—referring to disabled people who required strict care and frequent hospital trips—“should just die.”
Haven’t we made some progress, though? I’ve been hearing language like Trump’s less often since I became a tenured professor, or for that matter since I got married and became a father. It seems I’m no longer being challenged, however implicitly, to prove that my life is worth living. Perhaps I’m passing as one of the able-disabled. Perhaps I’m now spending more time in the company of people who have lived long enough to think twice about what sort of experiences might really make you wish you were dead. And perhaps, following decades of activism, there has been a cultural shift in what “disability” signifies. From the 1960s onwards, American activists drew inspiration from and aligned with the civil rights movement to position disability as a minority identity. In the United Kingdom in the 1970s, the “social model” explained the marginalization of disabled people as a form of political and economic oppression driven by industrial capitalism and the privileging of interchangeable workers’ bodies. In both cases, disability was reconfigured from an individual medical problem to a phenomenon with social, cultural, and historical aspects: as a binary category of exclusion imposed on the range of natural human variation. The year I was born, 1981, happened to be the United Nations’ International Year of Disabled Persons. In the decades since, anti-discrimination laws have been implemented across the world.
It can be hard to reconcile this cheerful story of social progress with the sudden, baleful resurgence of eugenic ideology. But eugenics arose, in part, as a progressive project aimed at bettering the human condition, and even modern, progressive disability policies have partly been motivated by the idea that disability can somehow be “solved.” Some forms of the social model took the position that once political and economic oppression were eliminated, full equality would be achieved; the UN Convention on the Rights of Persons with Disabilities similarly advances the goal of “full and equal participation.” Like any grand ideal, these bear an equally grand potential for disappointment. All utopias, Fredric Jameson once observed, are defined by what they exclude, and disability’s utopian scenarios are no exception: they leave no room for the people who cannot live up to a particular standard, whether defined by productivity norms or some more humane understanding of lives well lived. The persistence of this gap in our thinking suggests there are still fundamental philosophical questions to be answered about how we view such people. Why we can only conceive of certain lives as problems to be remedied? Why, in short, does disability remain synonymous with deficit?
Read the whole essay on BR’s website.