Bioethics Discussion Blog: Medical Ethics in the Nazi Era: “Medicine Gone Bad”?

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Sunday, April 03, 2005

Medical Ethics in the Nazi Era: “Medicine Gone Bad”?

When one thinks about medical ethics back in the early 1940s, one of the first examples that come to mind is the behavior of Nazi physicians and scientists. We readily conclude that this period in Germany clearly demonstrated the unethics of medicine as practiced by those physicians and scientists and that whatever science and medicine which came out of Germany at that time, because of the unjust and murderous treatment of many peoples, was bad science and bad medicine. Robert N. Proctor writing in the Perspectives in Biology and Medicine, Spring 2000 p. 335 “NAZI SCIENCE AND NAZI MEDICAL ETHICS:SOME MYTHS AND MISCONCEPTIONS”
and which can be obtained through this link in pdf format presents a view which, while not ignoring the horrific behaviors and results, points out that we shouldn’t jump to the conclusion that there was nothing more to the story of the Nazi medicine/science era than “medicine gone mad”. To view a different perspective of this era than what you and I usually hold, reading Proctor’s article is worthwhile. Here is an excerpt from the conclusion:


“My point is not to rescue the honor of medicine in its darkest hour, but
rather to stress its subtlety and complexity. The history of medicine in this
period is a history of both forcible sterilization and herbal remedies; we
cannot forget the crimes of a Karl Brandt or a Hermann Voss, but we
also should not forget that the SS built the world’s largest botanical medical
garden in Dachau, or that German nutritionists mandated the production
of whole-grain bread. Fascist physicians willfully murdered their
handicapped patients, but organic farming and species protection were
also going concerns. The question is not one of balance, but of the proper
understanding of origins, context, continuities, and contradictions. It is
part of the horror of this period, that such an “advanced” technological
society could fall so far into butchery and barbarism.

I do not believe there is an inherently totalitarian tendency in modern
science, but I do think it is important to recognize that, just as the routine
practice of science is not incompatible with the routine exercise of cruelty,
so the dictatorial and murderous aspirations of fascism were not necessar-
ily at odds with the promotion of cutting edge science and progressive public
health—at least for certain elements of the population. The exclusive
focus on the heinous aspects of Nazi medical practice makes it easy for us
to relegate the events of this era to the monstrous or otherworldly, but
there is more to the story than 'medicine gone mad.' The Nazi campaign
against carcinogenic food dyes, the world-class asbestos and tobacco epidemiology,
and much else as well, are all in some sense as fascist as the yellow
stars and the death camps. There is sometimes white in black, and
black in white; appreciating some of these subtler speckles and shadings
may open our eyes to new kinds of continuities binding the past to the present.
It may also help us better see how fascism triumphed in the first place.”

2 Comments:

At Monday, April 04, 2005 5:16:00 AM, Blogger james gaulte said...

I could not get the link to the reference to work.And from your quote I could not really grasp what the author's point(s) might be.I did grasp the points made by Robert Jay Lifton in "The Nazi Doctors, Medical Killing and the Psychology of genocide", two of which were.The Medical killing was the extreme but perhaps logical progression of the "ethic" that the German physician was the physician of the state (the collective) and not the individual and that the individual must be sacrificed for the good of the Volk. And the system was structured to diffuse individual responsiblity (just cogs in the machinery)

 
At Monday, April 04, 2005 3:11:00 PM, Blogger Maurice Bernstein, M.D. said...

James, I am sorry for your problem with the link but I just realized today that one must be on a server which will authorize you receiving the text of the article. For example, a university server through a university library authorization. If you are able, go to a local university library and try it there. The address of the article is:
http://muse.jhu.edu/journals/perspectives_in_biology_and_medicine/v043/43.3proctor.html
What I think what Proctor is saying is that, though he found vast inhumanity and wrong in what the Nazi's did, there was still some spots or dots of good science in all that bad. The examples he gives is the identification and campaign against carcinogenic food dyes and the epidemiologic identification of asbestos and tobacco as harmful, long before these revelations were made in other countries. ..Maurice.

 

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