Alfred Erich Hoche (1865-1943) was a German psychiatrist active in the late nineteenth and early twentieth centuries. He is remembered mainly for his writings on eugenics and euthanasia, but also for his work on the classification of mental illnesses.
He studied in Berlin and Heidelberg, qualified as a psychiatrist in 1890 and, from 1902, directed the psychiatric clinic in Freiburg im Breisgau. He firmly opposed the theories of Sigmund Freud and also published poetry under the pseudonym Alfred Erich. After the National Socialists came to power he gave up his post in Freiburg. Following the loss of his only son in 1915 he grew increasingly withdrawn and melancholic, and his death in 1943 was probably a suicide.
In a book written with the jurist Karl Binding and published in 1920, he argued that the killing of patients he considered 'mentally dead' could be permitted, especially those who had been so since birth or early childhood. His arguments combined social and financial utility, and the Nazi T-4 euthanasia programme drew on similar ideas. Hoche privately criticised that programme when it affected one of his own relatives.
Today his case is studied as an example of how medical reasoning can slide into justifications of violence. Some authors have compared his arguments with those of the philosopher Peter Singer.
Key ideas
- Classification of mental illness. His work on how to order psychiatric disorders was highly influential in his time.
- Life unworthy of life. The concept that gives the title to his work with Binding: the idea that certain lives lack value and could be ended.
- Social utility as a criterion. He judged patients by their contribution to society and the state, and by their financial burden.
- Opposition to psychoanalysis. He openly rejected Freud's theories.
Curiosities
Experiments on guillotined bodies
Hoche described how he posed as an assistant to join an autopsy and study the effects of electricity on the nervous system. Later, with special permission from the prosecutor, he experimented on bodies of guillotined prisoners within two minutes of execution.
A poet under a pseudonym
Alongside his clinical work, he published poetry under the name Alfred Erich.
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