When coercion in care makes Kilmeade’s “just kill ’em” thinkable

When coercion in care makes Kilmeade’s “just kill ’em” thinkable

 

Shannon Pagdon 

Content warnings: coercion, forced treatment, incarceration, institutionalization, eugenics, death, lethal injections, state violence, homelessness

 

On September 13, 2025, I returned from a trip to Berlin. On my first day there, I visited the Tiergartenstraße 4 memorial, the site where Nazi doctors planned Aktion T4, the forced sterilization and mass killing of people with psychiatric diagnoses and disabilities. The memorial’s stone panels, filled with archival documents, personal stories, art, and poems, are a powerful reminder of how far the rhetoric of dehumanization can go.

Back home, I read Brian Kilmeade’s words on Fox News: “Why not just give them involuntary lethal injections? Just kill ’em.” He has since apologized. But the damage is in the saying, and in the way his “apology” treated it as a slip of the tongue, as if suggesting state-sanctioned execution of homeless people were simply a bad joke. What was missing was recognition of the history he touched, the fear such words ignite, and the responsibility that comes with a national platform.

Kilmeade’s comment was meant as provocation. Yet it lands in a country where, every day, psychiatric patients are forcibly injected with medication against their will in the name of “treatment.” One is labeled execution, the other care. Both rest on the same premise: that some lives require force rather than consent. When we accept coercion as medicine, should we be surprised when the concept of lethal injection creeps into public imagination? How much of an extension of state power is this, really?

In most of medicine, refusal is respected. A cancer patient can deny chemotherapy, a person with kidney failure can forgo dialysis. Only in psychiatry is refusal rebranded as “lack of insight,” turning dissent into a symptom, autonomy into pathology. That logic not only makes coercion appear therapeutic, it fuels stigma and drives people away from care. It exists nowhere else in healthcare.

The danger is not only in the extremity of Kilmeade’s words. It is in the continuum they expose, from the increasingly normalized use of involuntary treatment, to the casual proposal of euthanasia, to the historical reality of Aktion T4. The memorial I walked through last week exists as a sobering reminder as to where such thinking and reasoning can lead.

Kilmeade’s words may sound extreme, but they grow from a soil we already live in. Every day in the United States, people labeled with psychiatric diagnoses are forced into hospitals, injected against their will, or placed under court orders that strip them of choice. These policies are framed as compassion, but their message is the same as Kilmeade’s “joke”: that some people’s lives can only be managed through force.

Politicians call these programs reforms. In New York City, Mayor Eric Adams has directed police and EMTs to sweep unhoused people into psychiatric wards, regardless of consent. In California, Governor Gavin Newsom’s CARE Courts threaten people with legal sanction if they resist treatment. These measures drain resources away from housing and voluntary supports, while deepening mistrust. They expand surveillance and control instead of dignity and care. Both frame these policies as compassionate. Both, in practice, normalize force over consent. Funding that could sustain voluntary supports is instead redirected to systems that deepen mistrust and reinforce the idea that people in distress are problems to be managed, not human beings in need of compassion and support. When even the Government Accountability Office admits that years of federal assessments have yielded “inconclusive results.” It should force all of us to ask why coercion remains the tool of choice in mental health policy. Mandates keep expanding, evidence does not.

And when commentators in mainstream outlets argue that the solution is more involuntary treatment, it shows just how normalized coercion has become. The evidence is weak. The outcomes are poor. What grows stronger is the stigma, and the idea that disabled people must be managed, not supported.

This push is not limited to politicians. In a recent New York Times opinion piece, a commentator went further, arguing that the answer to addiction and mental illness is to expand involuntary treatment. Essentially, to scale up the coercive strategies that already fail to build trust or long term well-being. When elite voices present force as a solution, it signals how deeply the logic of enforcement has entered mainstream debate.

Kilmeade’s words matter because they show how quickly rhetorical violence becomes thinkable. History teaches us that atrocities do not begin with action; they begin with imagination, with the suggestion that some lives are worth less, that their removal might even be merciful. That logic killed tens of thousands of disabled people in Germany. It should not be tolerated on American airwaves.

So what is to be done? First, media figures must be held accountable. A public platform is not a free pass to float genocide as a punchline. Networks must treat words like these not as ratings fodder but as ethical failures with real-world consequences. Second, we must invest deeply in supports that decades of disinvestment denied: permanent housing, robust voluntary services, peer-run alternatives, community care. These are proven to reduce homelessness and help people find support with dignity.

The plaques at Tiergartenstraße 4 are not just about history. They’re warnings for all of us. When a man on national television says “just kill ’em,” we can’t shrug it off as a bad joke. For those of us who have lived through psychiatric coercion, we know how easily words turn into practices, how quickly “care” becomes control. The answer is not more mandates or more force. The answer is solidarity: housing without conditions, peer-run spaces, communities that honor our autonomy. We survive by insisting that our lives have value, that our consent matters, and that history will not repeat if we refuse to let it.

ABOUT

Shannon Pagdon is a PhD student in social work at the University of Pittsburgh committed to advancing disability justice and rethinking coercion in mental health care. Shannon’s research and advocacy focuses on mental health policy, experiences labeled as psychosis, and the leadership of people with lived experience.

 

Support Disability Media and Culture

DONATE to the Disability Visibility Project®