When Medicine Went Mad

Contemporary Issues in Biomedicine, Ethics, and Society

When Medicine Went Mad: Bioethics and the Holocaust, edited by Arthur L. Caplan, 1992

Compelled Compassion: Government Intervention in the Treatment of Critically III Newborns, edited by Arthur L. Caplan, Robert H. Blank, and Janna C. Merrick, 1992

New Harvest: Transplanting Body Parts and Reaping the Benefits, edited by C. Don Keyes, 1991

Aging and Ethics, edited by Nancy S.Jecker, 1991 Beyond BabyM: Ethical Issues in New Reproductive Techniques,

edited by Dianne M. Bartels, Reinhard Priester, Dorothy E. Vawter, and Arthur L. Caplan, 1989

Reproductive Laws for the 1990s, edited by Sherrill Cohen and Nadine Taub, 1989

The Nature of Clinical Ethics, edited by Barry Hoffmaster, Benjamin Freedman, and Gwen Fraser, 1988

What Is a Person?, edited by Michael F. Goodman, 1988 Advocacy in Health Care, edited by Joan H. Marks, 1986 Which Babies Shall Live?, edited by Thomas H. Murray

and Arthur L. Caplan, 1985 Alzheimer's Dementia: Dilemmas in Clinical Research,

edited by Vijaya L. Melnick and Nancy N. Dubler, 1985 Feeling Good and Doing Better, edited by Thomas H.

Murray, Willard Gaylin, and Ruth Macklin, 1984 Ethics and Animals, edited by Harlan B. Miller and William H.

Williams, 1983 Profits and Professions, edited by Wade L. Robison,

Michael S. Pritchard, and Joseph Ellin, 1983 Visions of Women, edited by Linda A. Bell, 1983 Medical Genetics Casebook, by Colleen Clements, 1982 Who Decides?, edited by Nora K. Bell, 1982 The Custom-Made Child?, edited by Helen B. Holmes,

Betty B. Hoskins, and Michael Gross, 1980 Birth Control and Controlling Birth: Women-Centered Perspectives,

edited by Helen B. Holmes, Betty B. Hoskins, and Michael Gross, 1980

When Medicine Went Mad

Bioethics and the Holocaust

Edited by

Arthur L. Caplan

Center for Biomedical Ethics, University of Minnesota, Minneapolis, Minnesota

Springer Science+Business Media, LLC

portions of the paper by George Annas have been published in

GeorgeJ . Annas and Michael A. Grodin, editors, The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation, Oxford University Press, NY, 1992.

© 1992 by Springer Science+Business Media New York Originally published by The Humana Press Inc. in 1992 Softcover reprint of the hardcover 1 st edition 1992

All rights reserved

The opinions expressed in this book are solely those of the authors. Springer Science+ Business Media, LLC assumes no liability for those opinions.

No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise without written permission from the Publisher.

Library of Congress Cataloging in Publication Oata

Main entry under title: When medicine went mad : bioethics and the holocaust I edited by

Arthur L. Caplan. p. cm. - (Contemporary issues in biomedicine, ethics, and

society) Includes bibliographical references (p. ) and index. ISBN 978-1-4612-6751-5 ISBN 978-1-4612-0413-8 (eBook) DOl 10.1007/978-1-4612-0413-8 1. Human experimentation in medicine-Germany. 2. Medical ethics.

3. World War, 1939-1945-Atrocities. I. Caplan, Arthur L. II. Series. R853.H8W54 1992 174'.28--dc20 92-11687

CIP

Preface

During the past decade, I have had the opportunity of editing and writing many books. None was more difficult to conceive, create, and bring to press than this one.

This book represents the culmination of a long­standing, self-imposed obligation. In 1976, Peter Steinfels, who now reports on religion for The New York Times, was a senior colleague of mine at the Hastings Center, the nation's preeminent think tank on issues in bioethics. He had the idea of holding a conference to discuss the implications of the Holocaust for bioethics. Even though I had only recently taken a part time position at the Center, I did not hesitate to let Peter know that I thought his idea was a bad one. I could not see any reason for spending even a day exploring the ethical legacy of a historical event that was so obviously immoral and wrong. What learning or insight could possibly emerge from a discussion of the ethics of genocide, torture, and murder?

Fortunately, wiser heads, namely Daniel Callahan and Willard Gaylin, prevailed, and Peter put together his meeting. No conference has had as profound an impact on me as that one did.

Soon after the half-day conference began, the scholars who were present, including Telford Taylor and Lucy Dawidowicz, made it clear that medicine and science had played crucial roles both in the fostering ofN azi ideology and in implementing the Final Solution. Moreover, it became clear that many of the physicians, public health officials, and scientists who had been involved with the Nazi movement felt no remorse over their activities. They believed they had acted ethically in setting out to sterilize and destroy Jews, Gypsies, homosexuals, and other groups perceived as threats to the racial health of the German nation.

v

VI Preface

That conference forced me to confront a number of extremely disturbing questions. How could the biomedical establishment of the most sophisticated, technologically advanced nation of its day become so enmeshed with a racist and vile ideology? How could it be that so many doctors and scientists could find moral justifications for their horrible crimes? And, why was it that my own field of bioethics had paid so little attention to the obvious dilemma raised by the reality that Nazi doctors and scientists had grounded their actions in moral language and ethical justifications? If the Holocaust could be defended on ethical grounds then what use is bioethics?

It took more than a decade but, through the efforts of many courageous and generous people, I was able to organize a conference on May 17-19,1989 at the University of Min­nesota to examine the meaning ofthe Holoca ust for Bioethics. The articles collected in this volume represent the results of that meeting.

I am not sure that the authors have answered all of the questions that have troubled me about the need to reconcile my own work in bioethics with the role of biomedicine in the Holocaust. But I am quite certain that this collection of papers goes some way to filling what has been a huge and inexcusable gap in the literature of bioethics.

The organization of this conference and the produc­tion of a set of papers on bioethics and the Holocaust was a very, very difficult task. It was next to impossible to find a source offunding for the meeting. Few foundations or donors wanted their name associated with the subject. I would like to extend my deepest appreciation to the Otto Bremer Foun­dation of St. Paul, Minnesota, the Minneapolis Federation for Jewish Service, the Okinow Foundation, Lieberman Enterprises, Richard and Judith Spiegel, and the College of Liberal Arts, the Medical School, and the Hospital and Clinic of the University of Minnesota for their willingness to sup­port the conference that led to this book. A special debt of

Preface VH

gratitude must be extended to Edwin C. (Jack) Whitehead. When it seemed as if the subject matter ofbioethics and the Holocaust would prove too controversial for funders he stepped forward and asked his foundation to provide the funds necessary to make this conference happen. Jack Whitehead died early in 1992. I would like to think that he would have taken great pride in seeing this book in print.

Others who played crucial roles in both the conference and the subsequent creation of this book were David Brown, MD, Dean of the University of Minnesota Medical School, who was unstinting in his support, Rabbi Irvin Wise, Morton Ryweck, Louis Newman, John Lavine, Geri Joseph, Bart Galle, Ellen Green, MD, Msgr. James Habiger, Gary J. Stem, and Paul Sand. Robert Pozos, Gisela Konopka, Robert Berger, MD, Charles Carroll, David Lieberman, Robert Proctor, Sam Lieberman, Beth Virnig, and Nancy Segal each played crucial roles in advancing my own thinking about this most difficult subject.

Two of my colleagues here at the Center for Biomedi­cal Ethics at the University of Minnesota, Diane Bartels and Dorothy Vawter, provided important support and intellec­tual advice and assistance. Toni Knezevich, William Sucha, Patty Vogt, Barbara Higgins, and Lisa Siewart worked long and hard on both the conference and the book. Candace Holmbo went above and beyond the call of duty to make sure that the book became a reality.

Finally, I must single out for special thanks two exceptional people who stuck with me throughout the creation ofthis book. My father, Sidney, who was among the American troops who liberated the Dachau concentration camp. It was very difficult for him to listen to discussions and debates about the use of data from Nazi medical experiments con­ducted in the camps, but he never wavered in his support for my belief that the subject had to be examined. And my wife Janet who saw me become at various times agitated, angry, and distraught as I tried to work with the contributors to this

Vlll Preface

volume, think through my own thoughts and feelings about the topics addressed in this book and respond to those who argued that the project should not be done because it touched on subjects that ought to remain taboo. From the time I first decided to do something about the obligation I felt to examine the legacy of the Holocaust for bioethics right up to the appearance of this book she has been my most acute critic while also remaining an unwavering source of support.

Arthur L. Caplan

Contents

v Preface xii Contributors

Testimonies

3 Nazi Experiments as Viewed by a Survivor of Mengele's Experiments

Eva Mozes Kor

9 A Profile of Nazi Medicine: The Nazi Doctor-His Methods and Goals

Sara Seiler Vigorito

15 The Meaning of the Holocaust for Bioethics_ Gisela Konopka

Medicine, Bioethics, and Nazism 23 Nazi Biomedical Policies

Robert N. Proctor

43 Eugenics: The Science and Religion of the Nazis Renno Muller-Hill

53 How Did Medicine Go So Wrong? Arthur L. Caplan

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x Contents

The Use of Infonnation from Nazi "Experiments" The Case of Hypothennia

95 Scientific Inquiry and Ethics: The Dachau Data Robert s. Pozos

109 Nazi Science: Comments on the Validation of the Dachau Human Hypothermia Experiments

Robert L. Berger

135 The Dachau Hypothermia Study: An Ethical and Scientific Commentary

Jay Katz and Robert S. Pozos

141 Moral Analysis and the Use of Nazi Experimental Results

Benjamin Freedman

155 Can Scientists Use Information Derived from the Concentration Camps? Ancient Answers to New Questions

Velvl W. Greene

Medical Killing and Euthanasia: Then and Now

173 Which Way Down the Slippery Slope? Nazi Medical Killing and Euthanasia Today

Ruth Macklin

201 The Contemporary Euthanasia Movement and the Nazi Euthanasia Program: Are There Meaningful Similarities?

Ronald E. Cranford

211 The Way They Were, The Way We Are Richard John Neuhaus

Contents

The Abuse of Medicine and the Legacy of the Holocaust

233 Abuse ofHwnan Beings for the Sake of Science Jay Katz

271 "Medspeak" for Murder:

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The Nazi Experience and the Culture of Medicine William E. Seidelman

281 Twin Research at Auschwitz-Birkenau: Implications for the Use of Nazi Data Today

Nancy L. Segal

301 The Human Genome Project in Perspective: Confronting Our Past To Protect Our Future

George J. Annas

321 Bibliography 331 Notes and References 355 Index

Contributors

GEORGE J. ANNAS • Boston University, Boston, MA ROBERT L. BERGER • Harvard Medical School, Brookline, MA ARTHUR L. CAPLAN • University of Minnesota, Minneapolis,

MN RONALD CRANFORD • Hempin County Medical Center,

Minneapolis, MN BENJAMIN FREEDMAN • McGill University, Montreal, Que­

bec, Canada VELVL GREENE • Ben Gurion University Medical School,

Beersheva, Israel JAY KATZ • Yale Law School, New Haven, CT GISELA KONOPKA • Minneapolis, MN EVA MOZES KOR • C.A.N.D.L.E.S ., Terre Haute, IN RUTH MACKLIN • Albert Einstein College of Medicine,

Bronx, NY BENNO MULLER-HILL • University of Cologne, Cologne, F RG RICHARD JOHN NEUHAUS • New York, NY ROBERT S. Pozos • Naval Health Research Center, San

Diego, CA ROBERT N. PROCTOR • Pennsylvania State University,

University Park, P A NANCY SEGAL • California State University, Fullerton, CA WILLIAM SEIDELMAN • North Hamilton Community Health

Center, Hamilton, Canada SARA VIGORITO • C.A.N.D.L.E.S., Cleveland Heights, OH

xu