“Lebensunwertes Leben” is a chilling German phrase that means “life unworthy of life.” It was coined in 1920 by German professors Karl Binding and Alfred Hoche, who thought that people with congenital, mental or developmental disabilities only burdened their families and the state. Hoche described such people as “human ballast” and “empty shells of human beings.” 

That argument was the seed that grew into the horrific fruit of the Holocaust. Before the Nazis built Auschwitz or perfected the gas chamber, there was Knauer, a baby born blind, missing a leg and part of an arm, and labeled an “idiot.” When a family member requested a “mercy killing” for Knauer, Hitler and his personal physician, Karl Brandt, directed doctors at the University of Leipzig to end Knauer’s life.

From 1939 to 1945, at least 5,000 other children would be killed in German hospitals. From killing children, the Nazi euthanasia program accelerated to killing adults, then prisoners, and finally Jews. Mass genocide was simply the logical conclusion following the premise that some human lives are unworthy of life.

Curing by Killing

Imagine living in such a barbaric society. The awful reality is that we already do. In the United States, somewhere between 67% and 85% of babies diagnosed with Down syndrome are aborted. Babies with anencephaly and spina bifida face a similar fate (83% and 63%, respectively).

In our “civilized” society, it is simply assumed that a prenatal diagnosis of lethal, life-limiting or severely debilitating disorders justifies abortion. The medical euphemism used to describe those babies and their conditions is “incompatible with life”—America’s version of lebensunwertes leben.

How do doctors sworn to preserve life do the opposite? According to Dr. Robert Jay Lifton, who personally interviewed German physicians involved in mass killings, the fundamental shift happened when doctors convinced themselves that killing was healing.

Similarly, we live in a society that deems the murder of unborn babies to be medical care. In 2017, CBS News tweeted: “Iceland is on pace to virtually eliminate Down syndrome through abortion.” In 2019, a UK woman confessed, “I aborted my disabled baby girl after [the] 20-week scan to free her from a life of pain and suffering.” It sounds more civilized to reframe personal convenience as compassion, but killing babies with disabilities is not curing. “Woe to those who call evil good and good evil” (Isaiah 5:20). 

‘Wonderful Are Your Works’

A society shaped by atheistic materialism and Darwinian evolution can never account for the worth of persons with disabilities—because such a society does not account for God. Christians, however, are compelled to protect and care for babies with disabilities simply because they are humans made in the image of God.

For me, this issue transcends statistics or abstract moral dilemmas. I am the proud father of twin sons whose lives, some think, would not be worth living. They were born with a condition called nemaline myopathy, which causes extreme muscle weakness. One passed away at the age of 3; the other is now 8. Caring for such weak and dependent children has deepened my understanding of the image of God.

Because of my sons’ condition, I’ve wrestled with whether they could pray as the psalmist: “I praise you, for I am fearfully and wonderfully made. Wonderful are your works” (Psalm 139:14). Or does their disability make them defective? It’s one thing for armchair philosophers to contemplate such questions, but for wheelchair sufferers like my son, these questions are personal. 

Image of God

In Scripture, the first sanction against murder is explicitly grounded in the fact that “God made man in his own image” (Genesis 9:6). But what is the image of God? Is it human intellect, our moral reasoning, our relational capacity, or our physical ability to have dominion over animals and plants? If any of these apply, some people might possess more or less of the image of God than others. Then would some humans have more of a right to life than others?

Peter Singer, professor of bioethics at Princeton, believes that the value of human life depends on functions like rationality and autonomy. He argues that disabled infants lack these characteristics. “Killing them, therefore, cannot be equated with killing normal human beings or any other self-aware beings.” In Singer’s world, the most vulnerable among us are the most expendable.

But according to Scripture, the image of God is not merely something humans bear or possess; it is what we are as humans. The Dutch theologian Herman Bavinck said, “The essence of human nature is its being [created in] the image of God.” That is, to be human is to be in God’s image.

Our appearances, capabilities and experiences vary, but the one thing each one of us shares in common is our humanness. Again, Bavinck asserts that “the doctrine of human creation in the image of God extends to every stage of a person’s development. Nothing in a human being is excluded from the image of God. While all creatures display vestiges of God, only a human being bears the image of God. And he or she is such totally—in soul and body, in all his faculties and powers, in all conditions and relations.”

The most critical distortion to the image of God is not disability but sin. And even though Adam’s sin skewed the image of God in humanity, it did not erase it. Neither could sin thwart God’s purpose to fill the earth with humans made in His image. While the first man failed to image His glory—and we all too have fallen short of His glory—Christ is the perfect “image of the invisible God” (Colossians 1:15). Fully God and fully man, Christ came as the perfect human, and died for our sins so that we could be redeemed and begin being conformed to His image (Romans 8:29; 2 Corinthians 3:18). So, for Christians, humanness means even more—not only in imaging our God but also His Son.

That is gloriously true for my son and for all children with disabilities or life-limiting conditions, whether born or unborn. Christ is the image of God, and in Him, we who were made in God’s image, and have sinned, are invited into redemption. To judge any human as unworthy of life is to defame the image of our God and His Son. To put them to death—even in the name of mercy or medicine—is to desecrate the glory of Christ.