Apologising for Nazi medicine: a constructive starting point

Abstract

At long last: in May 2012 the German Medical Association (GMA) has apologised for medical atrocities under National Socialism (appendix). Although overdue, the apology is necessary and highly commendable, not least as survivors of medical atrocities and persecution are still living. German medicine between 1933 and 1945 saw a colossal breach of the ethics of patient care: doctors initiated and implemented an estimated 350,000 coerced sterilisations and 260,000 killings of mentally ill and disabled patients, and an unknown number of coerced human experiments, taking well over a thousand research subjects to the point of death. Doctors conducted selections for slave labour or death at Auschwitz, and took part in the development and use of killing methods, as poison gas, fatal injections, starvation diets and electrocution. Tens of thousands of bodies of the executed were delivered to German medical institutes, so that teaching and research in some departments routinely used bodies of Nazi victims until at least 1990 and in some cases for longer. This year's German Medical Assembly has opened a new chapter in the German medical profession's engagement with the Nazi past. What has already become known as the "Nürnberg Declaration 2012" goes beyond all declarations to date regarding medicine during National Socialism. It expresses understanding of how physicians took a major role in atrocities under National Socialism, as well as a long overdue official apology. Its full significance will become apparent with further disclosures following the clear words of the German profession. For an apology needs to be informed by full disclosure of evidence for which the apology is being rendered. It has taken 33 years for the German Medical Association to hold its annual assembly in Nürnberg since it last met there, in a city which is historically associated both with Nazism and especially with Nazi medicine. It was here that the in 1935 the Nürnberg Racial Laws were proclaimed, here that the Nazi Party rallies were held, and at the Doctors Trial of 1946/47 the grim details of crimes against humanity were laid bare. Whether one is a vistor to Nürnberg or a resident, no one can escape its history. Although the process of coming to terms with the past, has not always been easy, the city of Nuremberg has found various ways of engaging with its Nazi past as with museums and a human rights award. The Nürnberg Group of the IPPNW (International Physicians for the Prevention of Nuclear War) organised the international congresses on "Medicine and

Hunger Strikers: Ethical and Legal Dimensions of Medical Complicity in Torture at Guantanamo Bay

“…Recall the very slow drumbeat of history after World War II: the final judgment at the Nuremberg Medical Trials, issued April 1949, 96 the Declaration of Geneva, adopted in 1948 by the newly formed World Medical Association and last revised in 2006, 97 and the Nuremberg Declaration of the German Medical Assembly in 2012. 98 These three documents over a 60 year period demonstrate progress but also the ponderous pace at which the medical community has responded to its own extraordinary transgressions. This saga continues to haunt all health professionals throughout the world.…”

Contributory factors to the evolution of the concept and practice of informed consent in clinical research: A narrative review

“…The horrific experiments perpetrated by Nazi doctors between 1933 and 1945 on concentration camps prisoners are well-known, including surgical and radiation sterilization as well as drug trials, often to test treatments for diseases with which the victims had been deliberately infected [ 19 , 20 ]. While consent was not sought from these victims, a distinction must be drawn between these atrocities, and paternalism.…”

Human Subjects Research after the Holocaust

“…I also sought to bring the findings and conclusions to the attention of colleagues and medical students and to encourage (together with other colleagues) medical institutions and professional organizations to confront their Nazi past (e.g., Kolb et al 2012). I found that the decades of refusal by both individual physicians and medical organizations to confront this past, to acknowledge extreme forms of wrongdoing, and to investigate their origins, were an extreme expression of a broader tendency in the profession not to admit mistakes and not to investigate the genesis and mechanisms of malpractice as described, for example, by David Rothman (2000a).…”