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Of course, Darwinism was only one manifestation of a wider intellectual shift that gave birth and succor to euthanasia. Dowbiggin is especially good at tracing the connections between euthanasia and the larger intellectual picture in vignettes of many leading figures in the euthanasia movement. Most early leaders were either secular progressives or Unitarians. Charles Francis Potter, who organized the Euthanasia Society of America (ESA) in 1938, was a former Unitarian minister who after leaving Unitarianism founded the Humanist Society of New York. In addition to the many humanists and Unitarians supporting the ESA, Potter gained the endorsement of a few prominent liberal religious leaders, including Harry Emerson Fosdick and Rabbi Sidney Goldstein.
For these progressives, the euthanasia movement was part of a larger campaign to replace traditional Judeo-Christian morality. Along with euthanasia, most of them also promoted birth control, abortion, and eugenics. Dowbiggin points out that their concern for individual freedoms (some were ACLU members, for example) was often vitiated by the paternalism inherent in their technocratic ideals. Thus many euthanasia advocates affirmed the propriety of involuntary euthanasia for those whose lives were deemed not worth living, not only for the sake of the suffering individual, but also because these "defectives" were perceived as a burden to society. Crass economic arguments for ending human lives that consumed precious resources without contributing anything to society were not at all uncommon in euthanasia literature. 1
The backlash against the Nazi euthanasia program together with the conservative political and moral atmosphere in the 1950s caused the euthanasia movement to flounder in both the United States and Britain, but it revived with the advent of Sixties-style liberalism. In the 1950s the Anglican minister Joseph Fletcher, famous for promoting situation ethics, heralded a new approach to euthanasia that would become prominent in the 1960s and thereafter. He abandoned eugenics considerations and stressed personal autonomy. Individual choice would not only become the slogan of abortion advocates, but would also dominate pro-euthanasia literature.
Of course, medical advances have also played a significant role in the vicissitudes of the euthanasia movement. Improvements in health and hygiene have extended life expectancy but have also thereby increased the numbers of people dying of protracted, painful terminal illnesses, such as cancer. However, the argument that compassion for these suffering individuals requires the legalization of voluntary euthanasia was partly undercut by advances in palliative medicine. Even the Catholic Church, the staunchest foe of euthanasia, accepted the doctrine of "double effect," which acknowledges that it is permissible for physicians to administer pain-killers, even if this unintentionally speeds the death of the patient.
By the 1960s, life-support systems that kept people's bodies functioning even without brain function led many to conclude that individuals needed protection against a too-vigorous medical establishment, leading to the popularization of the Living Will, an advance directive to terminate life-support systems in cases where recovery seems hopeless. The euthanasia movement preyed on these fears, and most Americans and Britons came to accept the necessity of passive euthanasia, i.e., withdrawing life support from patients without prospect of recovery. Nevertheless, most remained either opposed to or at least uneasy about legalizing active euthanasia.
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