DOMINIC LAWSON: Dreamy-eyed young woman whose photograph reminds us that the Nazis’ evil eugenics policy resonates with the most vulnerable in the NHS today

A dreamy-eyed young woman, smartly dressed from the lace collar down, gazes slightly away from the camera while standing in front of a picket fence. This is – or rather was – Ivy Angerer: one of many thousands of people with disabilities or mental problems murdered by the Nazis between 1939 and 1941 as part of a medical program known as ‘Aktion T4’.

This euthanasia scheme was organized under the auspices of the National Committee for Scientific Registration of Serious Hereditary Congenital Diseases.

What makes Ivy unusual is that she was born in this country (in 1911 at Hermitage Cottage, Broughty Ferry, near Dundee). And we know this largely because of research carried out over many years by Helen Atherton, 49, a registered nurse for people with learning disabilities who is now a lecturer at the School of Healthcare at the University of Leeds.

That research has revealed the details of 12 other British-born people who met their fate in the same way. Like Ivy, they were all from German or Austrian immigrant families who later returned to what became the Reich – mainly because of anti-German sentiment here or the threat of internment as ‘enemy aliens’ during the First World War.

The biographies and images of all these British-born victims are at the heart of an exhibition that opened last week at the London Metropolitan Archives and will then travel to other locations across the country.

I was invited to the launch, where Helen spoke with Dr. Paul Weindling, the leading British historian in this field (who has written several books, including From Clinic to Concentration Camp).

The exhibition is called ‘Finding Ivy: A Life Worthy Of Life’. Its title is a reference to the term used in Germany by the medical advocates of euthanasia (long before the Nazi government began Aktion T-4) for people like Ivy, ‘Lebensunwertes Leben’ – lives unworthy of life.

An account of Ivy’s early life says she was ‘hard-working and good at singing, but struggled with more academic subjects’.

She had what would now be termed a congenital disability, and in 1931 had been sent to the Am Steinhof psychiatric hospital in Vienna, where she was categorized as ‘a high-grade imbecile’ and worked in the laundry.

Nine years later, after Austria had become part of the Reich, Ivy, along with many others, was taken to a killing center in Hartheim, accompanied by nurses in special gray buses. Passengers were told they were being transferred to another clinic and would be required to shower upon arrival. These were the same as the ‘showers’ later used to murder millions of Jews: disguised gas chambers.

Ivy’s cause of death (at 29) was recorded as ‘liver atrophy’. Doctors would invariably produce such certificates. Although part of a coherent eugenics program, the authorities obviously did not want parents to know that their children had been murdered.

In fact, Aktion-T4 was suspended in 1941 after Catholic Bishop Clemens Von Galen boldly condemned it from his pulpit in Munster. Many of the clinicians involved then transferred their skills to Auschwitz and other extermination camps.

But this was not the death of medically sanctioned eugenics. Echoes of that continue today, here, within the NHS. This is Helen Atherton’s view, and not just hers.

She wrote to me: ‘Alarmingly, there is evidence that health professionals, like the Nazis, make subjective value-based judgments about an individual’s quality of life based solely on the label of learning disability.

‘In some cases this has led to life-saving treatment being refused. The misuse of Don Not Resuscitate Notices is probably the most obvious example.’

This became acute during the first wave of the Covid-19 pandemic, when the National Institute for Clinical Excellence (Nice) produced a ‘Clinical Frailty Scale’ to regulate treatment. It had nine categories and the guidance was to refuse life-saving medical treatment to all those in categories 7 to 9.

Category 7 was defined as follows: ‘Completely dependent on personal care, regardless of the cause (physical or cognitive). Still, they seem stable and not at high risk of dying.’

Action-T4 was suspended in 1941. But this was not the death of medically sanctioned eugenics, writes Dominic Lawson. Echoes of that continue today, here, within the NHS – which is a picture of Helen Atherton (pictured)

This would have defined my 28-year-old younger daughter, who has Down syndrome. She works part-time at the Grand Hotel, Brighton, and enjoys life immensely; but she is completely dependent on others, in the sense that she could not live alone without a full-time carer.

Yet in March 2020 she was written off as not deserving of life-saving treatment if she contracted Covid-19, simply because of her learning disabilities.

After an outcry, Nice changed its guidelines. Yet there is a widespread belief in the medical profession that my daughter’s existence is an aberration in itself. Shortly after Domenica was born, the first pediatrician we saw said, ‘You didn’t need to have this baby, you know.’ This was a subtle reference to the prenatal tests used to detect Down syndrome.

Officially, the decision on whether to terminate such pregnancies rests solely with the parents-to-be. But those who say they want to keep their child all too often come under insidious and sometimes open pressure from doctors to terminate such pregnancies – even up to the moment of natural birth.

Many women have confirmed this – and this does not only apply to Down syndrome. Paralympic champion Tanni Grey-Thompson, who has spina bifida, revealed that it was in the face of much medical discouragement that she herself had a child: ‘The first thing I was offered at my first scan was a dismissal because “people like you shouldn’t have kids” I was told,” she said.

When I wrote about my daughter’s birth in 1995, the country’s then favorite former nurse, Claire Rayner, declared that the Lawsons had acted selfishly because of the ‘cost to society’ of people like Domenica.

This was precisely the argument used to justify the Aktion-T4 program.

Amazingly, Rayner was at the time patron of the Down’s Syndrome Association. Still, she was shocked when the association asked her to resign.

I suspect that her astonishment was due to the fact that her view was widespread in medical circles.

And it is to that extent encapsulated in our abortion law: the limit for termination is 24 weeks (marking of viability, more or less). However, if there is ‘a substantial risk of serious disability’, the unborn child can be eliminated at any time.

This exemption is based on the false rationale that such people, if born, ‘cannot lead meaningful lives’ – as described by the legislation’s intellectual progenitor, the late Baroness (Mary) Warnock. It has even been used, extraordinarily, as a cause of third-trimester terminations of cleft palate babies.

Now former cabinet minister Sir Liam Fox plans to bring an amendment to the Criminal Justice Bill which would end the exception to the 24-week rule for Down syndrome: in other words, they would have the same protection under the law as anyone else.

Helen Atherton cited this now topical issue in her speech launching the Finding Ivy exhibition. Not unreasonably, since they are linked by eugenic theory and practice. And when I looked at the picture of Ivy, I also saw my daughter, Domenica.