To Use or Not to Use: the Ethical Dilemma Surrounding Nazi Human Experimentation

To Use or Not to Use

Hippocrates of Kos, often referred to as the “Father of Medicine,” once said: “[as] to diseases, make a habit of two things—to help, or at least to do no harm”.[footnoteRef:0] Here Hippocrates admonished his fellow physicians, aware of medicine’s limited capacity to cure and, thus, the temptation to turn to dangerous measures; he observed that to “experiment [is] treacherous”.[footnoteRef:1] This statement reached proportions beyond what Hippocrates contemplated in 1933, the year that marked the beginning of the Holocaust, a genocide in which Adolf Hitler’s Nazi Germany systematically murdered six million Jews, and took the lives of approximately twelve million people in total, within a span of twelve years.[footnoteRef:2]

By 1945, the Nazi regime had established 20,000 concentration camps, where those considered racially inferior were held prisoner. Not only were these prisoners discriminated against, torn from their homes, killed or worked to death, they were also used as test subjects. Nazi Germany was heir to an extremely radical approach to medicine, and saw an immense increase in forced, and often lethal, medical experiments and other types of exploitative and involuntary research. The Nazi physicians performed as many as thirty different types of experiments on more than twenty thousand prisoners, killing several thousand in the process.[footnoteRef:3] These experiments were separated into three categories: “experiments aimed at facilitating the survival of Axis military personnel…experiments aimed at developing treatment methods for injuries and illnesses which German military and occupation personnel encountered in the field… [and] experiments that sought to advance the racial and ideological tenets of the Nazi worldview”.[footnoteRef:4] These experiments have been universally recognized as barbaric, but the research has prompted an uncomfortable moral challenge within the scientific and medical communities: whether it is ever ethical to utilize data as abominable as that which was obtained during the Nazi medical experiments or not. [0: ] [1: ] [2: ] [3: ] [4: ]

On July 14, 1933, the Law for the Prevention of Offspring with Hereditary Diseases was enacted in Germany; the basic provisions of the law state that:

• Any person suffering from a hereditary disease may be rendered incapable of procreation by means of a surgical operation (sterilization), if the experience of medical science shows that it is highly probable that his descendants would suffer from some serious physical or mental hereditary defect.
• For the purposes of this law, any person will be considered as hereditarily diseased who is suffering from any one of the following diseases: congenital mental deficiency, schizophrenia, manic-depressive insanity, hereditary epilepsy, hereditary chorea, hereditary blindness, hereditary deafness, any severe hereditary deformity.
• Any person suffering from severe alcoholism may be also rendered incapable of procreation.[footnoteRef:5] [5:]

This law led to the sterilization of over 400,000 Germans and evoked a great interest in Nazi physicians with sterilization.[footnoteRef:6] If successful, sterilization could rid the world of those not belonging to the Aryan race and create a “pure” society, to the standards of Nazi Germany. This law was used by Nazi physicians to encourage the growth of the Aryan race via new and improved methods of sterilization. Among the physicians particularly motivated by this new law were two rival doctors, Professor Carl Clauberg and Dr. Horst Schumann, who both took up shop in Block 10, a cellblock at the Auschwitz Concentration Camp where women and men were used as experimental subjects for German doctors.[footnoteRef:7] With permission from an eager Heinrich Himmler, the two men began trials in 1942, and thus started a “macabre race between them to find the most effective method.”[footnoteRef:8] [6: ] [7: ] [8: ]

Block 10, commonly referred to as “Clauberg’s block,” was “created for him and his experimental efforts to perfect a cheap and effective method of mass sterilization.”[footnoteRef:9] Clauberg, a German gynecologist, spent the early stages of his career studying treatments to help infertile women conceive.[footnoteRef:10] However, after approaching Himmler and gaining his approval, he experimented with closing off the fallopian tubes by injecting a chemical substance into the cervix to cause sterility.[footnoteRef:11] He chose “married women between the ages of twenty and forty, preferably those who had previously borne children,” as his test subjects.[footnoteRef:12] He had experimented with a large variation substances, but kept the contents of such substances a secret, probably “intent upon protecting any medical discovery from research competitors.”[footnoteRef:13] The procedure caused acute pain and many women died from the surgery, while others were simply murdered so that Clauberg could study their organs.[footnoteRef:14] [9: ] [10: ] [11: ] [12: ] [13: ] [14: ]

The experiment was done to me in Auschwitz, Block 10. The experiment was done on my uterus. I was given shots in my uterus and as a result of that I was fainting from severe pain for a year and a half. [Years later,] Professor Hirsh from the hospital in Tzrifin examined me and said that my uterus became as a uterus of a 4-year-old child and that my ovaries shrank. (Ms. A, Age 83)[footnoteRef:15] [15: ]

Schumann differed from Clauberg in that his qualifications for experimentation were “more political than medical,” as his medical experience consisted of selecting prisoners to be sent to euthanasia centers.[footnoteRef:16] With no training as a radiologist, he used extremely high doses of radiation in a careless, hit-and-miss manner, followed by operations. From this, his victims obtained deep burns to the sexual organs, severe burns, and many deaths.[footnoteRef:17] In the end, they butchered hundreds of Auschwitz prisoners in a large series of experiments. The experiments “were encouraged officially as a direct expression of racial theory and policy.”[footnoteRef:18] [16: ] [17: ] [18: ]

The sense that “Germany was losing the medical war meant pressure for systematic experiments,” so some Nazi doctors justified their actions by declaring their experiments were explicitly conducted for the war effort.[footnoteRef:19] These experiments were primarily conducted at Dachau concentration camp under the control of Dr. Sigmund Rascher, an “ambitious experimentalist keen to become an academic high-flier” who conducted deadly experiments on humans for the wartime effort.[footnoteRef:20] Rascher decided, for the benefit of the German Air Force, to investigate the limits of human endurance and existence at extremely high altitudes. He designed experiments to duplicate the conditions that a German pilot might encounter in combat. Using a mobile aviation pressure chamber provided to Rascher by Luftwaffe, victims were subject to rapidly fluctuating altitudes, reaching up to 68,900 feet, and then free falling completely.[footnoteRef:21] The reports on these experiment demonstrate complete disregard for human life and callousness to suffering and pain. Records reveal at one and the same time the medical results of the experiments and the degradation of the physicians who performed them. The first report by Rascher to Himmler was made in April 1942 and contains a description of the effects of the low-pressure chamber on a 37-year-old Jew: [19: ] [20: ] [21: ]

The third experiment of this type took such an extraordinary course that I called an SS physician of the camp as witness, since I had worked on these experiments all by myself. It was a continuous experiment without oxygen at a height of 12 kilometers conducted on a 37-year-old Jew in good general condition. Breathing continued up to 30 minutes. After 4 minutes the experimental subject began to perspire, and wiggle his head; after 5 minutes cramps occured; between 6 and 10 minutes breathing increased in speed and the experimental subject became unconscious; from 11 to 30 minutes breathing slowed down to three breaths per minute, finally stopping altogether… About ½ hour after breathing had stopped, dissection was started.[footnoteRef:22] [22: ]

He explained how the heart was still beating for a majority of the dissection, stating that:
One hour after breathing had stopped, the spinal marrow was completely severed and the brain removed. Thereupon, the action of the auricle of the heart stopped for 40 seconds. It then renewed its action, coming to a complete standstill 8 minutes later.[footnoteRef:23] [23: ]

Despite this failure, Rascher was upbeat, telling Himmler that he foresaw “entirely new perspectives for aviation.”[footnoteRef:24] It is estimated that 540 prisoners were subject to these experiments, and that between 30 and 80 died as a result.[footnoteRef:25] [24: ] [25: ]

Immediately following the conclusion of his high-altitude experiments, Rascher conducted a second set of experiments that proved to be even more deadly. He sought out to discover means to prevent hypothermia and the most effective method of rewarming German pilots who had to parachute into the North Sea.[footnoteRef:26] His research was conducted in two parts: first, to establish the amount of time it would take to lower the body temperature to death, and second, how to best resuscitate the frozen victim. The experiments involved being forced to sit in water tanks of three to seven degrees celcius from 80 minutes to three hours.[footnoteRef:27] At the first of the Nuremberg Trials, Leo Michalowski, a Polish priest, recounted his horrific experience at Dachau: [26: ] [27: ]

I was undressed and two medical apparati, whose nature I cannot give in detail, were tied to my body. Two wired were introduced into my rectum, and affixed to my body with scotch tape. I was then dressed in a flyer’s uniform, flyer’s boots, and a safety life-saving belt. I was then dropped in the water in which ice blocks were floating. I was conscious for one hour during which I was at first given a cigarette, and some rum… Shortly afterwards I lost consciousness. But I remember that at this time, my legs and arms were absolutely like frozen iron, and that cold sweat came down from my forehead.[footnoteRef:28] [28: ]

Rascher would then use different methods to try and warm up the prisoners, at first by drugs, massages, and electric blankets, but mainly by sandwiching the unconscious men between two nude women, often forcing the women to copulate with his body.[footnoteRef:29] Rascher and other Nazi doctors conducted many more experiments for the wartime effort, and some out of mere curiosity, such as investigating the immunization of malaria, typhus, and hepatitis, experimenting on twins to show their genetic make-up, and testing blood coagulation, abusing more than twenty thousand prisoners in all.[footnoteRef:30] [29: ] [30: ]

There may never be a “right” answer as to whether the data obtained by Nazi doctors should be used or not, but there are countless arguments both for and against the data’s use. The first major argument for using the Nazi’s research is largely based on utility; if the data exists, and it could help people to understand their disease or to carry out activities more safely, perhaps scientists should use it to better the lives of humankind. Dr. John Hayward, a hypothermia expect at the University of Victoria in British Columbia, stated, "I don't want to have to use this data, but there is no other and will be no other in an ethical world.”[footnoteRef:31] In addition, Dr. Robert Pozos, founder of the University of Minnesota's Hypothermia Laboratory, spent several years in the early 1980s doing hypothermia tests on volunteers, utilizing Nazi data because he never allowed their body temperature to go below 95 degrees fahrenheit (the temperature at which hypothermia begins to occur). Contrarily, Rascher’s victims reached temperatures below 80 degrees fahrenheit.[footnoteRef:32] These results cannot and will not be reproduced, but they can be used to benefit the medical world today. As stated by a survivor of Mengele’s experiments: [31: ] [32: ]

It appears that, at least in some cases, there was an attempt to induce illness by injecting bacteria and then an attempt to cure these illnesses, that is to say, we served as laboratory animals in the hands of the criminal, Mengele, and this type of research should of course be made available to the world.[footnoteRef:33] [33: ]

People also argue that not using the data may suggest that the victims died for no reason and their suffering meant nothing. Velve Greene, a Jewish professor of medicine, said that the data obtained by Nazi doctors should be “exhumed, printed, and disseminated to every medical school in the world” and taught to the students “not during a special course in ethics or history,” but as a part of the core medical curriculum. Greene believes that the students and the doctors and the residents know that “this was not ancient history or an episode from a horror movie where the actors get up after filming and prepare for another role. It was real. It happened yesterday.” She stresses that “[the Nazis] tried to burn the bodies and to suppress the data. We must not finish the job for them.”[footnoteRef:34]

Many maintain that publishing the data would not only serve as evidence that these monstrosities occured but would also help to prevent them from ever happening again. Dr. Howard M. Spiro, the founding section chief of gastroenterology in the Department of Internal Medicine at Yale, claimed that “the best argument I've heard for preserving the Nazi data is to keep evidence that those experiments were carried out. As long as the data are available, evidence that at least some people did some bad things in Nazi Germany cannot be denied.”[footnoteRef:35] By using the data, some feel that we are paying a justice to the victims. This is best stated by Lucien Ballin, member of a military intelligence assault force that helped unearth Nazi medical-experiments data. She said that "the suffering is done. Let someone benefit from all the pain."[footnoteRef:36] [34: ] [35: ] [36: ]

Many researchers believe that there is no reason not to use the data, since the data itself did not do the experimentation, it was merely the product. Along these same lines, some scientists believe that it may be more unethical to not use the data that could save someone's life.[footnoteRef:37] Bioethicist Dr. Benjamin Freedman believed it serves no purpose to science to ignore what could potentially help people. “We are talking of the use of the data, not participation in these heinous studies, not replication of atrocities,'' he said. ''The wrongs perpetrated were monstrous; those wrongs are over and done. How could the provenance of the data serve to prohibit their use?''[footnoteRef:38] [37: ] [38: ]

Questions regarding the Nazi medical experimental data's validity, and the ethics in regard to using the data, present a very large problem. Many researchers consider the data to be ruined due to the way it was obtained. They believe that the data was not properly recorded, that the Nazis didn’t carry out the tests in a sufficient way to use the data, and in order for an experiment to be done correctly, it has to be able to be repeated.[footnoteRef:39] The terrible experiments by the Nazi's would be near impossible to replicate, especially considering the state the patients were in.[footnoteRef:40] Dr. Robert Berger of Harvard Medical School criticized the validity of the hypothermia experiments done at Dachau, stating that the “study has all the ingredients of a scientific fraud, and rejection of the data on purely scientific grounds is inevitable. They cannot advance science or save human lives.”[footnoteRef:41] He calls attention to Rascher’s lack of regard for important variables such as age, nutrition levels, and the numbers of subjects who underwent immersion while naked, clothed, conscious, or anesthetized. Rascher also failed to state the endpoints of the experiment: “time spent in the bath, specific body temperature, subject's clinical condition, death, and the like.”[footnoteRef:42] Though this scrutiny is not limited to the hypothermia tests. Researchers also question many chemical tests, claiming that the Nazis changed the data to make it more appealing, did not correctly check the height and weight of the victims, and did not have clear ways to measure their results.[footnoteRef:43] [39: ] [40: ] [41: ] [42: ] [43: ]

The best argument to be held about the validity of the experiments is that the victims did not accurately portray the population.[footnoteRef:44] All of the victims came from certain racial or social groups, they were almost always malnourished and usually sick.[footnoteRef:45] Undoubtedly, not all racial and social groups are the same, so the results obtained from the tests conducted cannot be expected to apply to everyone. In addition, malnourished or sick people do not have the same capabilities as a healthy person and thus cannot endure diseases and temperature changes in the way that a healthy person can. All of this makes it extremely difficult to take the Nazi data seriously. The data might be utterly worthless to the normal population. [44: ] [45: ]

Perhaps the most difficult question to answer is surrounding the ethics of using the data. The methods of the Nazi doctors were inarguably barbarous, involving the torture and death of human beings. There is a talmudic agade: Tov she-barofim le-gehinom—“the best doctors are destined for hell”—that many apply to the Nazi doctors.[footnoteRef:46] Elie Wiesel, Holocaust survivor and Nobel Laureate, wrote: [46: ]

“Who or what is to blame for the creation of the assassins in white coats?... it was the sense of reality that was missing. In their eyes, the victims did not belong to humankind; they were abstractions. The Nazi doctors were able to manipulate their bodies, play with their brains, mutilate their future without remorse; they tortured them in a thousand ways before putting an end to their lives.”[footnoteRef:47] [47: ]

The data obtained from these experiments should be reason enough to know that the methods and data are unethical and corrupt. For example, Dr. Hans Eppinger, Jr. conducted tests on the potability of sea water on 90 Gypsy prisoners:

The subjects were given unaltered sea water and sea water whose taste was camouflaged as their sole source of fluid. Eppinger's infamous "Berka" method was devised to test whether such liquids given as the only supply of fluid could cause severe physical disturbance or death within six to twelve days. The Gypsies became so profoundly dehydrated that they were seen licking the floors after they were mopped just to get a drop of water.[footnoteRef:48] [48: ]

In addition, using this data would be setting a pattern for other unethical studies. Many fear that by using this data, science is being made more important than human life. Eva Mozes Kor, a survivor of Dr. Josef Mengele's twins experiments at Auschwitz, said that:
To declare the use of the Nazi data ethical, as some of the American scientists and doctors advocate, would open a Pandora's box and could become an excuse for any of the Ayatollahs, Kadafis, Stroessners, and Mengeles of the world to create similar circumstances whereby anyone could be used as their guinea pig.[footnoteRef:49] [49: ]

By doing this, others would be more inclined to do unethical experiments as well, and would be given the impression that these inhumane experiments can in fact be useful.[footnoteRef:50] [50: ]

The Hippocratic Oath is among the most important parts of the medical profession. As a part of this oath, doctors must swear to “use treatment to help the sick according to [the doctor’s] ability and judgement, but never with a view of injury or wrongdoing.”[footnoteRef:51] Hence, these Nazi doctors violated their vow to the medical profession. Therefore the data, like the experiments, should be left in the past. The data was not found in an ethical manner, it is not necessarily valid, and the tests are for the most part outdated. Kor summarizes the argument in one statement: [51: ]

Today some doctors want to use the only things left by these victims. They are like vultures waiting for the corpses to cool so they could devour every consumable part. To use the Nazi data is obscene and sick. One can always rationalize that it would save human lives; the question should be asked, at what cost?[footnoteRef:52] [52:]

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