Medicine and Medical Ethics in Nazi Germany: Origins, Practices, Legacies

http://jama.ama-assn.org/issues/current/ffull/jbk1120-4.html

Medicine and Medical Ethics in Nazi Germany: Origins, Practices, Legacies

edited by Francis R. Nicosia and Jonathan Huener (symposium, University of Vermont, April 2000), 160 pp, with illus, $59.95 ISBN 1-57181-386-1, paper, $19.95, ISBN 1-57181-387-X, New York, NY, Berghahn Books, 2002.

Reviewed by Hannah S. Decker, PhD

This is an engrossing book. While the story of Nazi crimes against humanity and the role of physicians in them are broadly known, the essays in Nicosia and Huener's short book bring a specificity and analysis that is profoundly disturbing.

German doctors were unusually supportive of the Hitler regime and Nazi racial ideology. Forty-five percent joined the Nazi party, 33% joined the Nazi Physicians' League, 26% were members of the SA (stormtroopers), and 7% joined the elite and comparatively small Schutzstaffel (SS). Physicians outranked in representation every other professional group except in the SS (there, lawyers had them beat).

German doctors had many avenues for professional betterment under the Nazis. Many German physicians, suffering economically when Hitler came to power, lent their support to get rid of Jewish competitors and then took their jobs. Physicians who supervised the sterilization (often unknown) of 400 000 German adults and deaths of 100 000 "lives not worth living"disabled children and adults in state hospitalshad a better chance of a higher civil service rank and more pay. This was falsely dubbed a euthanasia program. Voluntarily, physicians slowly starved their patients and then overdosed them on medication. This often led to a pneumonia, so the physicians could send home notices of "natural death."

But it was in the human experiments at the death camps that physicians could reap perhaps their greatest rewards. Here was a gold mine of opportunity: innumerable men and women who could be used for "research." On the basis of this "research," physicians published papers in prestigious journals, sent home specimens that could be used by their mentors in Germany, or completed a thesis that would enable them to teach at a university. It was even possible for an SS physician at a camp to get an inmate doctor to write a paper that he then submitted under his own name.

After the Second World War, most doctors quietly returned to their practices and jobs and almost nothing was said about their ethically compromising activities. Important German and Austrian scientific institutesthe Max Planck Institute being a foremost exampletook a long time to acknowledge officially the crimes of Nazi medicine and admit they were still using specimens from death camp inmates.

Yet Nazi Germany was full of paradox. It was under the Nazis that the world's most aggressive crusade against smoking took place. In some measure this was linked to Hitler's personal aversion to smoking, but this was not the main impetus. The antismoking campaign was an important aspect of the racial ideology of Nazism. Tobacco was seen as sapping the strength of the German people, whose bodies had to be pure if they were to establish Aryan supremacy over other countries and people.

Sadly, the German physicians' cooperation with the Hitler regime had some roots in our country. Nazi physicians were educated and supported in their unethical or even criminal activities partly by the eugenics movement that was influential in the United States in the 1920s and 1930s, before and at the time Hitler took power. As one contributor writes, "Eugenicists argued that many social problems could be eliminated by discouraging or preventing the reproduction of individuals deemed genetically unfit (negative eugenics), while desirable social traits could be increased by encouraging reproduction among those deemed most genetically fit (positive genetics)." Wealthy families in this country, such as the Harrimans and the Rockefellers, funded eugenic research and educational programs, and prominent scholars lent their endorsement. The results were that 30 state legislatures adopted their arguments and passed sterilization laws. Congress instituted antiimmigration laws to keep out "undesirable" people. The Nazis pointed to these measures to substantiate their own policies for "racial hygiene."

This book is morally challenging to all physicians. How easy it is to shed the Hippocratic Oath for professional and economic gain! We are also left with a difficult question: how do we monitor genetic research today? Valuable genetic research, with its promise of preventing and curing disease, must not be misused by a new eugenics.

AUTHOR/ARTICLE INFORMATION

Hannah S. Decker, PhD
University of Houston
Houston, Texas

 

More info on Eugenics:

Biography of Harry H. Laughlin

Laughlin's Eugenical Sterilization in the United States established him as an expert on the topic. His model sterilization laws were used by many of the more than 30 states that passed sterilization laws. Germany's 1933 sterilization laws were also modeled after Laughlin's. Laughlin's immigration studies, which seemed to support the idea that recent immigrants from Southern and Eastern Europe had a higher percentage of "socially inadequate" persons than other immigrants, led to the highly restrictive immigration quota system of 1924 which favored immigrants from Northern Europe. As is evident in the Laughlin Collection, Dr. Laughlin also devoted considerable time and effort developing his ideas for a common world government.

Harry Laughlin's Model Law

Laughlin published a copy of his "Model Eugenical Sterilization Law," a law which was carefully crafted to be both constitutional and heavily used. A state law derived from his model was passed by the state of Virginia in 1924, and found constitutional by the U.S. Supreme Court in the highly flawed case of Buck v. Bell in 1927. The ruling greatly increased the passing of sterilization laws and the use of eugenic sterilization through the period of the second World War. State sterilization programs resulted in the sterilization of over 64,000 mentally ill and developmentally disabled patients by the time they went into general disuse in the mid-1960s.

Laughlin would later go on to be a principle founder of the Pioneer Fund, and received an honorary degree by the University of Heidelberg in 1936 for his work behalf of the "science of racial cleansing." The Nazi German state would sterilize many hundreds of thousands of people under their own sterilization laws. Laughlin was himself an epileptic, suitable for sterilization under his own law.

PS. ANyone know about the Third International Congress of Eugenics held in New York 1932? I´ve read the purpose of the evnt would have been to call for the sterilization of fourteen million Americans... ANyone read if this was being planned???! ( have not found data to confirm this in the net myself).