Monday, May 09, 2005

Retired Doc's suggestion for Medical Curriculum,Part 9, The Nazi transformation for Healing to Killing,

Media coverage of the 60th anniversary of the end of world war II has focused on various events including the anniversary of the liberation of Auschwitz (Jan 27,1945). A few blogs ago I wrote about the transformation of a lay person into a physician. The anniveraries highlighted this year made me think of another transformation; the transforming of more than a few German physicians into mass murderers. Some teaching time needs to be spent to make medical students aware of the major role that doctors played in state sponsored killing of unbelievable magnitude and genocide. Robert Jay Lifton's " The Nazi Doctors-Medical Killing and the Psychology of Genocide" would be a good reference source.It available on Amazon.com
(also the AMA has teamed with the US Holocaust Memorial Museum to sponsor a series of lectures.)
Students will learn of the major role doctors played at Auschwitz and of the progression from the compulsory sterilization movement (to rid the German nation of inferior(Jewish) blood) to the children's "euthanasia" program to the T4 program which focused on killing adult patients judged"not fit to live" providing the preliminary "learning curve" of perfecting the mass killing techniques later used in the camps. Lifton explains how the T4 program involved "virtually the entire German psychiatric community and the related portions of the general medical community" It was not just a few psychopaths.The processes became bureaucratized and participants could think of themselves as just "cogs" and maybe thereby lessen guilt.
It still seems inconceivable that there could have been this transformation of many physicians from healers to killers. Dr. Lifton discusses factors involved in the specificity of the Jewish genocide and provides material that might help illuminate broader questions of life and death and state control that are of enduring interest to physicians including the sacrifice of the individual to the state.The malignant racism and Anti-Semitism cannot be over emphasized but medical students need to know there were also large killing programs managed by physicians that murdered non-Jewish German children and adults who were labelled a burden to society.
The philosophical underpinnings of the "nazification of the medical profession" is discussed by Lifton. The influential manual of Rudolf Ramm proposed that physicians be the "Physicians to the Volk". The physician was to be concerned with the health of the Volk and was to overcome the old individualistic principle of the right to one's own body and the embrace the duty to be healthy and the physician duty was to the collectivity.The physician was the cultivator of the genes.National socialism was thought of as an "applied biology".Physicians were to be the technicians and engineers of the pseudoscience of race hygiene.
Some of the factors leading to the transformation from healing to killing emphazied by Lifton are:the acceptance of the notion that the state was the patient and not the individual human being,the belief or rationalization that the physician was just a cog in a machine and not to blame and that they were powerless to stop the evil because the orders came from someone else and ultimately the Fuhrer.
How all the medical ideals were betrayed and physicians became key players in unprecedented horror, murder and torture should be worth a few hours of instruction and discussion among medical students.

1 comment:

A MD said...

NEJM paper by Eli Weisel, Nobel laureate and Holocaust survivor.