[Bonhoeffer's position on sterilization of the mentally ill].

unlabelledKarl Bonhoeffer was head of the psychiatric department of the Charité University Hospital from 1912 to 1938 and in 1923 expressed his expert opinion for the Prussian Provincial Health Council regarding the demand of the Saxon physician Gustav Boeters for the implementation of a sterilization law. Bonhoeffer wrote that eugenic sterilization cannot be successful because only obvious bearers of severe forms of mental illness can be registered but not the carriers of hereditary illness factors if they only lead to mildly expressed forms of illness or even if the carriers remain without symptoms. However, after the adoption of the "law for the prevention of offspring with hereditary diseases" in 1933 Bonhoeffer gave courses on hereditary health issues supporting the execution of the law. How should this change be understood going from a scientifically critical position against eugenically preventive sterilization of the mentally ill to acting as an expert advocate in discussions about hereditary health and thereby as a seeming protagonist, a coperpetrator and forerunner of National Socialist health policy? To understand this it seems necessary to consider the situation of that time which was increasingly dominated by a biologically and socially oriented medicine in connection with the eugenic movement. Then the effects and motives of Bonhoeffer's position toward sterilization will be questioned. Effects can be seen on the one hand in that the leading authority of the discipline apparently supported the execution of the law by giving courses on the subject and as an expert advocate and by that eliminating doubts in the justification of the law. On the other hand Bonhoeffer's "restrictive statements about eugenic sterilization…were used to support argumentation and precedence cases as a basis for cautious indications". It remains a fact that his expert judgments more frequently than not saved some mentally ill persons from sterilization but nonetheless demanded this of others. QUESTIONS: 1. Did Bonhoeffer accept eugenic sterilization as justified in cases of unequivocally inherited defects in mentally ill patients? 2. Why did Bonhoeffer not boycott the law in his realm of influence or make this rejection public by resignation? The answers will try to create an understanding for the behavior of an influential person, now seen as controversial, within the context of his time in order to sensitize those of us born later for the present effects in our own times.