the lessonaesculapius.the doctor

Doctors and Nazis

Civilized peoples intuitively have the values; to extend compassion and accept the responsibility to keep all of the people safe from disease, predators and hunger . Demonstrably included are the children, the elderly and the less abled; even the stupid or venal.  Mature and civilized societies, no matter material achievements remain respectful of the mysteries of life. They don't get lost in smugness and hubris. Civilized societies promote community and don't celebrate alienation through jingoism or promotion of divisions. Civilized societies don't promote cruelty,  no matter the target.

I have always held an interest in social issues, history and politics. In the late 1990s. When I began this particular treatise I was struggling with the ethical challenges presented by the intrusion of corporate interests into the patient physician interface.

I had become fearful of the rise to political power by the coalition of politicians with roots in the reconstructionist movement of the John Birch Society, the radical Rand style "libertarian" and  evangelical Christian political ideologies. Observing the resultant concentration of power in supra national business interests blending with government processes led to my revisiting the history of the rise of fascism in 20th Century Europe. I was expecting to find characters from Metropolis malignantly manipulating an innocent "volk" and a naive' intelligentsia.

What I found was horrifying. I discovered that among the educated in Germany the professions represented the highest percentage of participation in the Nazi Party, in particular the doctors. Having always believed in the power of the Hippocratic tradition I was stunned. The horror of the atrocities is shattering; but more disturbing is the ease with which I can understand how it came about.

Into the years of my childhood any physician expecting to be accepted as optimally educated was compelled to have some education in the medical universities of Germany and Austria. Germany was a world center of medical research and innovation well into the 20th Century. Indeed classes in German language were highly recommended for my college pre-medical course. No group of people was more esteemed than the academics, the philosophers and the doctors.

Inspired by the American Eugenics movement and funded in large part by the John D. Rockefeller Jr. foundation, It was the doctors, not fringe "quacks" but the academic establishment, who led the way to the philosophic rationale for so called "racial hygiene" policies. Many of the German doctors of the pre war medical establishment came to  participate as perpetrators of torture and murder. "The needle belongs in the hand of the doctor." --- Viktor Brack.

I do not believe the Holocaust could have happened without the collaboration of the doctors. 

We ponder the universal question; "How could it happen"?

Following the ending of World War I punitive reparations and annexing of land were imposed on Germany. This was accompanied and followed by great political and economic upheaval. Shame and humiliation; the literature is replete with accounts. To mention two men, Freud became deeply depressed and developed his Death Wish theories. Adolph Hitler described his profoundly personal experiences of the mortification of all of the Germanic peoples. Two men struggling with the same emotions.

It surely cannot be surprising that there is a thirst for order, an organizing view of mankind that could repair the crushed spirits among a people suffering with the loss of an entire generation of young men as well as physical devastations in war. An articulate ruler with a reparative philosophy and the power to apply it was longed for. The doctors provided the reparative philosophy and the judges provided the articulate Hitler the absolute power to apply it.

In the thirties the German people had universal access to medical care by way of a half century of national insurance.  A warning sign, to my eye, is that the elite of the physicians were increasingly found away from the bedside in the academic centers. Direct care regressed to the responsibility of significantly less educated and sophisticated practitioners. There are references to the encouragement of "volk medicine."   Most of the more educated and sophisticated physicians left the bedside.

This pseudo-scientific philosophy was eugenics, races arranged in a hierarchy according to worth, the "Nordic" at the highest level and thus most entitled. Failures in war and its consequences were from contamination (disease) of the racial stock. The academic medical establishment enthusiastically embraced, indeed from the very beginning contributed to, development of the theories and the programs for implementation of  " cures," the killing.

Killing became medical treatment.

They had become deluded by perceived mastery of the tools of science and ennobling ideals of serving a more expansive good, a magnificent master, their nation and their race. Compensation included celebrity and positions of high esteem within the government. Distance from the bedside of the objects of their programs made easy the retreat from ethical responsibilities. Particular individuals faded and into insignificance. 

These government "scientists" judged an excessively permissive and compassionate attitude toward the congenitally defective and the mentally ill was destructive to the "Nordic races." As a remedy they developed  a program of propaganda promoting euthanasia to the people in town halls, film, radio and other media. Children deemed afflicted were the first to be systematically murdered. Then of course came the adults, and the so-called sexually perverse, and the Jews and the Communists and the Gypsies and Slavs etc. They were obsessed with the fear of contaminating disease. Long after it was clear that Germany had lost the war the crematoria ran full force.

The need for charity toward the unfortunate was suppressed.  Indeed when rays of understanding broke through guilt was projected; the victims blamed for their misfortunes. When one's gaze rests on one's human image and suffering is reflected; the eyes must be disabled or the mirror must be broken. Even so, human caring is difficult to kill. Some working at the torture and killing struggled with emergence of empathy for the victimized. Records are replete with their strivings and efforts they pursued to blind and numb themselves in order to "courageously" serve the higher purpose. Sadly the U. S. medical establishment raised little outcry as information regarding the application of the Nuremberg laws, even the exclusion of the Jewish doctors.

I recommend the works of Jay Lifton The Nazi Doctors and Stephen Glass Life Unworthy of Living for further reading

In adolescence I can recall my confusion over the largess of the Marshal Plan after having been emotionally whipped to a frenzy of hatred for the Japanese and Germans during the active war. However the triumphant Allies at the ending of that World War II may represent the apex of our surviving Western civility. They recognized reason in minimizing the humiliation suffered by the defeated nations and the material devastation. Compassion was chosen rather than imposition of punitive deprivations and stigma; lest they become embedded as a historical view to endure for centuries. Of course there were instances of exceptions, breaches in the fine line between accountability and trivialization of evil and through denial.

The legal community did make a major contribution at The Nuremberg trials placing accountability in the individual holding direct power and actions not to be excused on the basis of government command. That is atrocities were not excused on the grounds of "events of wars." Unfortunately the arrangement with the Japanese doctors was dissimilar, a pact with the Devil. --- Remission from prosecution in exchange for research data obtained through torture and abuse of prisoners of war. Read Hastings Institute Critique of Nuremberg.

Applying data obtained through torture is as without value to science as when applied to military intelligence.  I take pride in my American Psychiatric Association for vigorously renouncing the Mengele twin research data in early 1970s when it was discovered to have found its way into the academic literature.

I am not certain how its creation evolved, but I am disturbed and subtly offended by this bas relief above the Butler Street entrance to Grady Hospital.  It is of course aesthetically ugly but it is the display of hubris that is disturbing.




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Revised October 2008