How can it be that physicians and nurses worked actively in collaboration with government leaders to sterilize and kill “undesirables” during the Nazi era? How did these health care professionals come to subordinate their obligation to individual patients to a perceived obligation to the state-as-patient? What were the intertwined ideological and scientific origins of “racial hygiene”? And what lessons might we draw for contemporary medicine and society?
These questions that will confront visitors to “Deadly Medicine: Creating the Master Race,” an exhibition by the United States Holocaust Memorial Museum that opens April 14 at the Countway Library. Harvard Medical School has partnered with the museum to bring the exhibition and its provocative questions to health care professionals in training, including students of medicine, nursing, law and public health, as well as their faculties, staff members and the public. To inspire and lead debate, the museum and HMS will sponsor related public forums and events on campus and across Boston.
Few adults are ignorant of the virulent anti-Semitism of the Third Reich and the Nazis’ attempted annihilation of Europe’s Jews. Most are familiar with the horrors of medical experimentation attached to the concentration camps, and the name Josef Mengele remains a notorious synonym for monster-physician. What far fewer people know is that, in the Nazi era, the medical profession and its opinion elites played a central role in conceiving and promoting the concept of “racial hygiene,” which became the ideological foundation for Hitler’s efforts to purify the German nation. Indeed, a symbiotic relationship existed between medical professional elites and the Nazi regime: Nazi policies supported public health measures that many physicians already had come to embrace years before, while the profession’s imprimatur and active involvement became the literal means of effecting Hitler’s plans.
For example, in addition to eliminating “non-Aryans”—Jews, Gypsies and others who differed from Nazi stereotypes of the ideal German—it was seen as important for the health of the nation to eradicate “feeblemindedness,” physical deformity, alcoholism, blindness and deafness. More than 400,000 German men and women were sterilized, many through orders issued by “heredity health courts” comprising geneticists, physicians and anthropologists, who offered a patina of respectability to the unconscionable process. Likewise, convinced that maintaining “non-productive” members of society within institutions at government expense was a waste of resources, Hitler instituted a secret, so-called euthanasia program that some physicians and nurses helped implement. More than 200,000 Germans, including 5,000 children, were killed between 1935 and 1945. These murders of German citizens began before and continued during the Holocaust.
Of course, not all health care professionals supported racial hygiene policies, the ideology of genetic determinism, or programs of sterilization and euthanasia. “Deadly Medicine” creates an opportunity to reflect not only on the social, political and economic determinants of these events, but also on the moral choices that individual professionals face today on a range of issues.
Visiting the exhibition and its website (www.ushmm.org/deadlymedicineboston) and participating in related forums will prompt more questions than answers. We hope that people will not view the Nazi story as an aberration of the deep past, far removed from contemporary circumstances, an impossibility anywhere else. Nazi physicians believed they were acting in the people’s interest, on behalf of public health; they were blind to their own excesses. Most people are, including, and perhaps especially, esteemed professionals. Therefore, the exhibition should remind us to remain alert to our inherent biases and the possibility of committing or participating in wrongful acts that we haven’t recognized as wrong.
On the other hand, it can be easy to over-generalize and make simplistic comparisons to modern health policies. For example, the very use of the term “euthanasia” could introduce confusion, leading some people to mistakenly equate the current ethical framework in the United States for making decisions about the use of sustaining technologies near the end of life with the Nazi program of systematized murder. Careful analysis of similarities and differences between contemporary events and Nazi policies can head off overly broad generalizations and the demagoguery that could result from them. We hope that “Deadly Medicine” will foster such insight through critical analysis, self-reflection and humility.
Guest essay by Mildred Solomon and Scott Podolsky
Solomon is an associate clinical professor of medical ethics in the departments of Global Health and Social Medicine (GHSM) at HMS and of Anesthesia at Children’s Hospital Boston, and director of the Fellowship in Medical Ethics within the HMS Division of Medical Ethics. Podolsky is an assistant professor of social medicine in GHSM and director of the Center for the History of Medicine at Countway Library. The opinions expressed are those of the authors and not necessarily those of Harvard Medical School, its affiliated institutions or Harvard University.
