Colombo, November 16:

Hitler’s extermination project, the infamous “Holocaust” in which six million Jews and other non-Aryan races were killed in Nazi concentration camps during World War II, has prompted the world medical fraternity to study in-depth, the phenomenon of “medical atrocities”.

To prevent such atrocities from taking place now and in the future, the British medical journal Lancet has instituted an international  Commission to study the atrocities committed by German doctors and scientists during the Holocaust.

“Confronting what happened to medicine in this period is crucial to recognise and modify similar tendencies today and guide and inform the ethical practice of medicine.”

“For decades there has been a refusal by the medical community to engage with such a past, and as a consequence, long-standing myths about the relationship between the Nazi regime and medicine have prevailed,” Lancet said announcing the formation of the Commission in its website dated November 8.

The first myth is that only a few fanatical physicians committed medical atrocities, and all other German and Austrian physicians and medical scientists were coerced into it by the Nazi regime. The other myth is that science in Nazi-ruled Europe was “pseudoscience” invalid for post-war medical science.

These myths have to be shattered through a proper inquiry, Lancet said.

In its view, there was extensive cooperation of many German and Austrian physicians and medical organisations with the health and population policies of the Nazi regime. Since not much was done after the war to find out and punish those complicit in these activities, many of them retained their positions and advanced their careers.

“One of the core questions of relevance today is what are the conditions under which physicians and scientists, despite existing bioethical regulations, are prepared to harm patients or do research on patients to “devalue social groups and populations”, Lancet said.

The persecuted included Jews, Sinti and Roma peoples, gays, psychiatric patients, and many others fell under this category.

The Commission’s second objective will be to identify areas vulnerable to abuse of power and unethical actions in present-day medical practice, research, and health policies, and to make recommendations for moral and conscience development, policy, and education to prevent future abuse of power by health professionals and scientists, Lancet said.

The inquiry commission will inquire into the supposed value of genetic endowment of populations which should be treated as a “public health issue”.  There are exclusionary ethics that do not respect all groups. Physicians are tempted or pressured to accept these notions by those in power or who provide financial resources.

Another area of inquiry is medical scientists’ lobbying for deregulated spaces of research and the conditions, justifications, and implications of practising diverging ethical standards in different populations.

The commission will evaluate existing medical curricula and propose educational approaches that promote ethical conduct, compassionate identity formation, and moral development, Lancet said.

“Our work in the coming two years should complement knowledge aimed at practical application in clinical contexts, medical research, and health policies,” the journal added.

The commission is diverse in composition. The 20 commissioners are: Tessa Chelouche, Herwig Czech, Sabine Hildebrandt (Co-Chair), Astrid Ley, Etienne Lepicard, Esteban González-López, Miriam Offer, Avi Ohry, Shmuel Reis (Co-Chair), Volker Roelcke (Co-Chair), Maike Rotzoll, Carola Sachse, Hans-Walter Schmuhl, Sari Siegel, Michal Simunek, Amir Teicher, Kamila Uzarczyk, Anna von Villiez, Hedy Wald, and Matthew Wynia.

Weindling’s Study

Paul Weindling, Anna von Villiez, Aleksandra Loewenau, and Nichola Farron have done work on the victims of unethical human experiments and coerced research under Nazi rule.

They say that experiments on humans were more extensive than often assumed, with a minimum of 15,750 documented victims.

The authors consulted the International Tracing Service at Bad Arolsen, the United States Holocaust Memorial Museum and the Yad Vashem archives, court records in war crimes proceedings, and oral history collections notably the Holocaust Foundation

Experiments began in the 1930s and rapidly increased from 1942, reaching a high point in 1943 and sustained until the end of the war. Many survived the war with severe injuries. The victims came from diverse nationalities with Poles (Jews and Roman Catholics) as the largest national cohort.

During the Nuremberg medical trial of 1946-47 it was stated that 90% of all medical research under Nazi rule was criminal. But the sample presented was partial.

The authors reconstructed the life histories of the total population of all Nazi research victims. This allowed one to place the survivors within a wider context.

Records showed how a single person could be the victim of research on multiple occasions. Polish Catholic priest Fr. Leon Micha?owski, was subjected to malaria in August 1942 and then to freezing experiments in October 1942. Some experiments were taken to the point of death.

The experiments were part of mainstream German medical research, and were not pseudoscience. Prestigious research institutions such as the Kaiser Wilhelm Society and funding agencies such as the German Research Fund were involved. It has been argued more recently, that some experiments were cutting-edge science.

Some experiments were sponsored by German pharmaceutical companies but more detailed research would be necessary on this.  The extent of involvement of German pharmaceutical companies like that of IG-Farben (using the branded product names of ‘Bayer’, ‘Hoechst’ and ‘Behringwerke’) is contentious.

Victims were a highly international group. But the largest national groups were the Poles, both Roman Catholics and Jews. There were smaller national groups, such as the Swiss, British and Irish.

The victims included a Swiss conscientious objector who was used for malaria experiments at Dachau. British commandos captured in Norway were used for amphetamine experiments.  Amphetamine is a central nervous system stimulant that is used in the treatment of attention deficit.

Statistics on gender indicate a 2:1 proportion with a preponderance of males. This is because more men than women were held in concentration camps. In the case of sterilisation experiments at  Auschwitz and in concentration camps in Greece large numbers of women were used. Children were often victims of experiments in psychiatric clinics.

Towards the end of the war, in Auschwitz, Roma and Jewish children were targeted for research by Josef Rudolf Mengele who was a German Schutzstaffel (SS) officer and physician nicknamed the “Angel of Death”.

The statistics show that age distribution was the same in the case of  men and women. While there was a very wide age spectrum, the peak comprised victims born in 1921, who were in their early twenties at the time of the experiments. Batches of Jewish children were dispatched for hepatitis and tuberculosis research.

As regards ethnicity, of the confirmed victims numbering 15,754, Jews were 20% (3098), Roma and Sinti 2% (335) and unknown or  others  were       78% (12,321). Large-scale anthropological investigations were conducted on Roma and Sinti, numbering at least another  21,498 persons.

The Sinti are a subgroup of Romani people who are found mostly in Germany, France and Italy and Central Europe, numbering some 200,000 people. They were traditionally itinerant.

The largest series of experiments was on infectious diseases. Malaria research at Dachau between 1942 and 1945 had 1091 confirmed victims. After infection, different combinations of drugs were tested.

Nearly a quarter of confirmed victims were either killed to obtain   organs for research, or they died as a result of experiments taking the research subject to the point of death. The experiments on freezing and low pressure at Dachau was notorious. Euthanasia killings and executions were sources of bodies for research.

The survivors were often seriously disabled and handicapped for the remainder of their lives. The experiments gained in numbers with the war and the implementation of the Holocaust. They were sustained at a high level of intensity despite imminent defeat, the authors point out.

References:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00157-4/fulltext#back-bib4

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822534/