On October 25, 1946, twenty-three Nazi doctors stood trial for ‘crimes against humanity’. Out of the twenty-three physicians, sixteen were found guilty and seven were sent to their deaths by execution (Lifton 10). The crimes for which they were held responsible were that of true evil and disregard for basic human rights. Under their care, innocent men, women, and children were used as human guinea pigs in experiments involving but not limited to: sterilization, malaria, high altitude and freezing experiments where women were used to performing “rewarming”, hepatitis, mustard gas, bone, muscle and nerve regeneration as well as bone transplantation experiments to which limbs were transferred from one person to the next (Reamey). During the War Crimes trials in Nuremberg, Germany, all of the Nazi physicians failed to see the wrong in the atrocities they had aided in. The words of Dr. Fritz Klein, a Nazi physician, perfectly illustrate his logic,
“Of course I am a doctor and I want to preserve life. And out of respect for human life, I would remove a gangrenous appendix from a diseased body. The Jew is the gangrenous appendix in the body of mankind” (Colaianni).
Several of the accused had argued that their experiments differed little from pre-war ones and that there was no law that differentiated between legal and illegal experiments. As a result, following the close of the Nuremberg Trials in 1947, two American doctors by the names of Leo Alexander and Andrew Ivy submitted six points to the Council for War Crimes, defining legitimate medical research. The trial verdict adopted these points and added an additional four. These ten points constituted the Nuremberg Code. Although it was not incorporated directly into American or German law, the Nuremberg Code is the basis for the Code of Federal Regulations which are the regulations issued by the United States Department of Health and Human Services, governing federally funded research in the United States (Lifton 281).In addition, the Nuremberg code has also been incorporated into the law of individual states such as California, and other countries. (“U.S”) These monsters of men often called the ‘doctors from hell’, performed the unspeakable (Spitz 12). In doing so, they uncovered a need for a change in the way medical practices were conducted and provided just cause to make it happen. Through the Nuremberg Code, the relationship between physician and patient drastically changed, taking the power away from the once, ‘all mighty’ physician and giving it back to the patient. Modern medical practice is centered on the patient, their needs and concerns, quite opposite of that of the Nazi doctor’s bedside manner. Modern medical experiments are offered to willing subjects who receive payment for their participation, unlike the brutal and unforgiving treatment of those during World War II. Without the conviction of the infamous Nazi doctors and the development of the Nuremberg Code, modern medicine would not be the same.
More than 7% of all German physicians became members of the Nazi SS during World War II. In doing so, these doctors willingly participated in genocide, something that should have been antithetical to the values of their chosen profession. (Colaianni) The value of physicians to the Nazi regime is clear: their support gave scientific legitimacy to the principles of eugenics on which the Nazis built their racial policy and rationalized murder under the logic of medical necessity. In Anschutz and Birkenau, Dr. Josef Mangele’s job was to stand at the train tracks where the soon to be prisoners of the infamous death camps, would face him. With a quick point of his finger, left or right, he chose the fate of innocent men, women, children and even infants in their mother’s arms. Often referred to as ‘The Angel of Death’, Dr. Mengele aided in killing the 1.5 million children sent to the gas chambers during the Holocaust. In Birkenau, Mengele was said to hold ‘games of death’ on Jewish holidays. On the Friday before the Jewish New Year festival in 1944, he sent 328 children to their deaths in the gas chambers. It is said that he hung a batten between two goal posts of a football pitch and those approximately 1,000 children who were not the required height were sent to the gas chamber. (Posner 54) Along with the death selections, Mengele was the head of medical staff, responsible for using all physicians under his authority to help him carry out his atrocities.
“They were surrounded by a group of SS men and women, who amused themselves by giving these helpless creatures a taste of hell, after which death was a welcome friend…They were beaten with clubs and whips, torn by dogs, dragged around by their hair and kicked in the stomach with heavy German boots. Then, when they collapsed, they were thrown into the crematory – alive.” – Dr. Gisella Perl, a Jewish inmate, on the treatment of pregnant women in Auschwitz. “Our whole being concentrated on Mengele’s hands. Those hands had the power to condemn us to immediate execution or to prolong our miserable life by a few days.” (Reamey)
In her essay, A long Shadow: Nazi doctors, moral vulnerability and contemporary medical culture, Alessandra Colaianni, a medical student studying at John Hopkins University in Baltimore, writes about a doctors ‘license to sin’. ‘Physicians and even medical students are allowed to perform actions that, in other contexts, are taboo. This begins early in medical school: in pursuit of scientific knowledge, I and two classmates dissected the cadaver of a 98-year-old woman, cutting her muscles apart with scalpels and cleaving her bones with a saw. Forcing an intubation tube down an unconscious person’s throat, removing a dead person’s heart and placing it in a live person’s chest, drilling holes in someone’s skull. These actions are allowed when they are performed by physicians but are the stuff of horror films and criminal cases when non-licensed personnel attempts them. Physicians make high-stakes life and death decisions that outsiders are not allowed to make; for example, in evaluating which patients to recommend for a transplant operation when limited donor organs are available. These extra rights and responsibilities are carefully meted out through rigorous training and licensing procedures, but they may also lead physicians to arrogance or a belief that they are above the law. This ‘license to sin’ is not confined to the hospital. As of 2007, 38 states allowed the death penalty and of those, 17 required and 18 permitted the presence of a physician during executions (Colaianni). The ‘license to sin’ was critical to the Nazi regime. By having a doctor make every decision that sent an innocent person to death, murder became a medical procedure. Actions that were unacceptable for a state to undertake became acceptable if a physician did them. In the ‘euthanasia’ program, three junior physicians marked brief questionnaires about mentally handicapped individuals with a red ‘+’ (for death) and a ‘–‘ (for life). In this way, murder was systematized, ‘mediatized’ and sanctioned. To the physicians who volunteered for these tasks, whether they should be allowed to condemn someone to death seemed not to be the question: they were already permitted to do things ordinary citizens could not do, and selections were one more special responsibility. Such actions performed by medical doctors transitioned the physician into a terrorist. A healer, into a murderer and a trusted professional into a criminal. Although these actions were one in which the Nazi doctors could be held accountable, the question of right practice for human experimentation gave little ground for prosecutors to stand on during the Nuremberg Trials.
Along with death selections, Dr. Mengele especially took an interest in twins. He believed they held the key to eugenics. These twins were selected from the ‘sorting’ at the train tracks, taken to special barracks, given extra food and warm clothing. They were treated exceptionally well and cared for personally by Dr. Mengele. He measured every limb of their body, took their height and weight, eye and hair color, skin samples, anything he could use to compare to the other twins’ anatomy. Then when the time was right, he would conduct experiments such as removing lymphoid in one twin and injecting both twins with Tuberculosis or Malaria. Without any kind of antibiotic, he would observe the effects and the disease process as they suffered a slow and painful death, observing the differences in the disease process with and without lymphoid. Some twins were inflicted with wounds in which glass and sawdust were rubbed into and sowed back up to induce the infliction of gangrene. One twin would be given an herbal supplement while the other twin was not, in order to compare the differences in the infection’s process. In other cases, blue dye was injected directly into the subject’s pupils in hopes to find a way to change brown eyes to blue, the desired eye color for racial supremacy. (Reamey)
Along with children, Dr. Mengele was responsible, along with others in performing unspeakable human experiments on men and women, all with no intention of their subjects living, nor with any concern for their being. All experiments were performed without anesthetic, proper medical attention or consent of the ‘patient’. In one of the most traitorous experiments, subject’s limbs were cut off and preserved in a bin of ice water to await transplantation to another un-consenting subject. High altitude experiments, where subjects were put in pressure chambers to simulate jumping out of an airplane at different altitudes to measure the body’s reaction. Almost all of the subjects who were selected to participate in the high altitude experiments died during them. SS physicians conducted freezing experiments, where subjects were forced to remove their clothing and sit in tanks of ice water until hypothermia set in, in which case women were used to ‘rewarm’ the subjects by laying naked next to and on top of them. In some cases, women were forced to have intercourse with the men to evaluate how quickly the body warms when stimulated (Spitz 212). All of these experiments were planned, conducted and performed forcibly by Nazi physicians.
During the Nuremberg Trials, the doctors defended their actions by explaining that they had acted as a ‘biological soldier’ (Colaianni). They claimed that everything they had done was in the best interest of Germany and all Germans in general. That it was their job to rid the nation of the ‘life unworthy of life’, the ‘useless eaters’ that was the Jewish race (Mostert). They explained that there was not much difference between their experiments and earlier ones both in the United States and Germany and that there was no law that differentiated an acceptable experiment from an unacceptable one. Although torture and genocide were far from the context of the Hippocratic Oath, the prosecutors had a hard time finding ground to stand on when it came to the matter of the provisions for human experimentation. Dr. Leo Alexander and Dr. Andrew Ivy, two of the men who helped prosecute the Nazi Doctors in the Nuremberg Trials decided to change that. In December 1947 their six points for medical human experimentation was adopted by the Council for War Crimes and an additional four points were added. The Nuremberg Code, as they fittingly called it, set out basic standards for that of medical experimentation on humans by which modern laws have been conceived. The Nuremberg Code set out these ten requirements:
- The voluntary consent of the human subject is absolutely essential.
- The experiment should be such as to yield fruitful results for the good of society, unprocurable by other methods or means of study, and not random and unnecessary in nature.
- The experiment should be so designed and based on the results of animal experimentation and a knowledge of the natural history of the disease or other problem under study, that the anticipated results will justify the performance of the experiment.
- The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.
- No experiment should be conducted, where there is an apriori reason to believe that death or disabling injury will occur; except, perhaps, in those experiments where the experimental physicians also serve as subjects.
- The degree of risk to be taken should never exceed that determined by the humanitarian importance of the problem to be solved by the experiment.
- Proper preparations should be made and adequate facilities provided to protect the experimental subject against even remote possibilities of injury, disability, or death.
- The experiment should be conducted only by scientifically qualified persons. The highest degree of skill and care should be required through all stages of the experiment of those who conduct or engage in the experiment.
- During the course of the experiment, the human subject should be at liberty to bring the experiment to an end, if he has reached the physical or mental state, where continuation of the experiment seemed to him to be impossible.
- During the course of the experiment, the scientist in charge must be prepared to terminate the experiment at any stage, if he has probable cause to believe, in the exercise of the good faith, superior skill and careful judgment required of him, that a continuation of the experiment is likely to result in injury, disability, or death to the experimental subject (“U.S.”).
Nazi doctors conducted as many as 30 different types of experiments on concentration-camp inmates. They performed these studies without the consent of the victims, who suffered indescribable pain, mutilation, permanent disability, or in many cases death as a result. Although the Nuremberg Code was never actually put into law in either America nor Germany, the Nuremberg Code is the basis for the Code of Federal Regulations which are the regulations issued by the United States Department of Health and Human Services, governing federally funded research in the United States. It is from the lessons learned through the horrors of medical experiments during the Holocaust that America has built the modern medical culture that is practiced today. Due to the Nazi doctor’s trials and the formation of the Nuremberg Code, modern medical experiments are based on paid participation and are conducted in hospitals or medical facilities where subjects are given room and board, fed and monitored before and after their procedure or tests to ensure medical safety and competency (“U.S.”). The Nuremberg Code changed the way physicians and patients interacted. It took the power away from the medical professionals and gave it to the patient, allowing them to be in control of their medical treatment and if they so choose, a medical experiment. The Code shed new light on the importance of humanity and mercy on those entrusted to the care of a physician. It turned the patient into the boss and the physician into the servant, quite the opposite of Nazi, Germany during WWII.
The atrocities of the Nazi doctors who participated in the human experiments during the Holocaust indeed cast a long shadow. A shadow that the world has used to shield the patient’s rights and vitality from that of the sins of the Nazi doctors. Through these dark and satanic events, American has learned from the mistakes and misconduct of the Holocaust and used it to constitute a foundation of new medical ethics and practices. Without the doctor’s trial, Leo Alexander, Andrew Ivy and all of the Holocaust survivors who shared their experiences, America may never have constituted regulations for human experimentation.
“We have to go into the despair and go beyond it, by working and doing for somebody else, by using it for something else.” Elie Wiesel, a Holocaust survivor. (Wiesel 36)
- Colaianni, Alessandra. “A Long Shadow: Nazi Doctors, Moral Vulnerability and Contemporary Medical Culture.” Journal Of Medical Ethics 38.7 (2012): 435-438. –Academic Search Elite. Web. 22 Nov. 2014.
- Lifton RJ. The Nazi Doctors: Medical Killing and the Psychology of Genocide. New York, NY: Basic Books, 2000.
- Mostert, Mark P. “Useless Eaters: Disability as Genocidal Marker In Nazi Germany.” Journal Of Special Education 36.3 (2002): 155. Academic Search Elite. Web. 22 Nov. 2014.
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- Reamey, Annie S. Gisella Perl:Angel and Abortionist in the Auschwitz Death Camp. N.p., 2006. Web. 22 Nov. 2014.
- Spitz, Vivien. Doctors from Hell. Boulder, CO: Sentient Publications, 2005. Print.
- Tuffs, Annette. “Nazi War Crimes and Medicine 50 Years On.” Lancet 348.9036 (1996): 1234. Academic Search Elite. Web. 22 Nov. 2014.
- U.S. Department of Health & Human Services. U.S. Department of Health & Human Services, 7 Nov. 2005. Web. 22 Nov. 2014.
- United States Holocaust Memorial Museum. “Introduction to the Holocaust.” Holocaust Encyclopedia. http://www.ushmm.org/wlc/en/article.php?ModuleId=10005143. Web. Nov. 2014.
- Wiesel, Elie. Night. New York: Hill and Wang, 2008. Print.