Professional Documents
Culture Documents
Joseph R. Fitchett
Joseph.fitchett@doctors.org.uk
Context
The genocidal atrocities committed by the Nazis, mainly directed at millions of Jews
throughout Europe, are of an unparalleled evil. Deeply disturbing for the medical
profession is the role that doctors played up until the end of the Second World War,
euthanasia. The following article provides an overview of the political climate at the
time, the eugenics movement worldwide in the 1930s and the unsettling past, only 65
years ago.
“For ever let this place be a cry of despair and a warning to humanity where the Nazis
murdered about one and a half million men, women and children, mainly Jews from
Historical Background
Following defeat of the First World War in 1918, the recently united Germany was left
isolated and facing severe sanctions. Germany signed the Treaty of Versailles and as a
consequence lost over 10 per cent of its territory, all overseas colonies, set to pay
crippling sanctions, prohibited to annex neighbouring states and had the size of its army
greatly capped. The Weimar Republic, a liberal democracy, was instilled in 1919 to
govern Germany. It was difficult, however, to reach a single party majority with its
near impossible in its early years to control left and right wing extremism, attempted
coup d’états, rampant inflation and economic meltdown. Despite the “Golden Era” from
the mid-1920s, political instability within Germany and the crisis of the Great
Socialist German Worker’s Party (the Nazi Party) with many Germans still humiliated
by the terms of the Treaty of Versailles. The Nazi Party, promoting German
nationalism, was racist, anti-communist and anti-capitalist, with its leader Adolf Hitler
Paul von Hindenburg appointed the increasingly popular Adolf Hitler as Chancellor for
dismantling restrictions of power and expanding his command and German territory,
The eugenics movement of the early 20th Century was not a phenomenon exclusive to
Nazi Germany. The aim was to improve the human species by controlling birth and
offspring. Compulsory sterilization was a key mechanism to reach this end. Eugenics
inevitably raises concerns violating human rights, namely the right to life, privacy and
freedom from discrimination, however it was at the time justified in both utilitarian and
Darwinian terms. Controversy over eugenics and the Nazi desire for “racial hygiene”
and extermination of certain distinct population groups is highlighted by the fact that
other countries applied eugenic policies to differing degrees. The United States of
America, Britain, Sweden, Belgium, Canada, Australia and others enforced, in different
degrees, compulsory sterilization based on criteria such as mental health, social class,
sexuality, and crime. It was in this controversial climate that the Nazi Party began
outlining its increasingly severe interpretations of the eugenic movement of the 1930s
Hitler increasingly began to see society as a “biological organism” and became fixated
began to carry more importance than the “individual benefit” and economic
involuntary euthanasia was initially confined to the asylums but soon expanded into
hospital practice. The next step, genocide, is extreme but was central to the “racial
hygiene” sought by the Nazi Party [2]. The spectrum from compulsory sterilization to
Third Reich. Supervised by doctors, they are a chilling reminder to those in the
Enforced scientific experimentation by the Nazis is shocking simply in its nature and
compounded by the fact that doctors, respected as protectors of life, carried out the
research in labour and concentration camps. Experiments included genetics,
and high altitudes), infectious diseases and pharmacology. Many experiments were done
in the aim of understanding the conditions a soldier may encounter during the Second
World War. Freezing experiments for the Luftwaffe (Nazi air force) would therefore
bath, which they could succumb to. Further experiments for pilot survival included
analysing the effects of drinking seawater. Some prisoners were subjected to mustard
deliberately infected with malaria. Dr Josef Mengele, a physician and Schutzstaffel (SS)
officer, was the notorious medical officer at Auschwitz and chief medical officer at
treated his subjects well. However, from around 3,000 twins only 52 are known to have
survived Auschwitz [3]. Mengele was even referred to as the “White Angel” as he
inspected the new arrivals to Auschwitz and Birkenau concentration camps, directing
them either to the right or to the left, indicating their immediate fate: hard labour or the
gas chambers.
Following the end of the war, the allies (France, the United States of America, the Soviet
Union and the United Kingdom) put on trial suspected war criminals. Political
differences between the allies at the end of the Second World War resulted in diplomatic
difficulties over continuing to use the International Military Tribunal that had operated
in 1945-46. Instead, 12 trials were held before United States military courts in the city of
Nuremberg in the American-occupied zone. The Doctors’ Trial, December 1946 to
August 1947, brought 23 defendants to trial facing accusations on four charges, namely
1) Conspiracy to commit war crimes and crimes against humanity, 2) War crimes, such
Prosecutors concentrated on the experimentation within the camps and seven were
acquitted, seven sentenced to the death penalty (including Karl Brandt, Hitler’s personal
physician) and the remaining nine received sentences of imprisonment. The trial led to
the Nuremberg Code – a set of biomedical research ethics principles addressing non-
that the “voluntary consent of the human subject is absolutely essential” [4]. The impact
of the Nuremberg Code on medical ethics can be felt to this day with subsequent
statements such as the 1964 Declaration of Helsinki [5] and 1978 Declaration of Alma
Ata [6] emphasising ethical principles for human experimentation and promoting health
Reflections
The Auschwitz camp complex, including the Birkenau extermination centre, stands
almost impossible to comprehend how such atrocities could take place. The fact that
human beings are capable of the most inhumane of thoughts and actions is unsettling.
Patients trust their doctors and healthcare professionals often at times of great despair.
treat and care for, and must respect their patients’ autonomy, always seek their consent
and do them no harm. Through experimentation, hard labour and murder, the
prisoners in the Nazi concentration camps were dehumanised and subjected to the
gravest violations of their human rights. The presence of a medical professional can
often be seen to justify a procedure, particularly relevant to this day with accusations of
and never treating them merely as a means to an end are two of the most important
principles we must all actively promote throughout our lives to safeguard humanity.
“A destruction, an annihilation that only man can provoke, only man can prevent”
1
Biddiss M. Disease and dictatorship: the case of Hitler’s Third Reich. Journal of the
1995
3
Lagnado LM, Dekel SC. Children of the Flames. Penguin, 1991
4
The Nuremberg Code. Trials of War Criminals before the Nuremberg Military Tribunals under
Control Council Law No.10, Vol.2, pp.181-2. US Government Printing Office. Washington
DC, 1949
5
World Medical Association. Declaration of Helsinki – Ethical principles for medical research
Press, 1992
9
Special Issue on the Nuremberg Doctors’ Trial. British Medical Journal. 7 December
1996
10
Proctor RN. Racial Hygiene. Harvard University Press, 1988
11
Weindling P. Health, Race, and German Politics, 1870-1945. Cambridge University Press,
1989