The Nazi experiments and data
It’s been 75 years since the liberation of Auschwitz, the largest of the concentration camps and extermination centres. In Auschwitz and other camps across Germany, Poland and France, some of the most harrowing human experiments were conducted.
Inmates were subject to 26 different types of experiments ranging from surgical mutilation to phosgene gas exposure, to experiments on the “feasibility of bone, muscle, and joint transplants the post-mortem examination of skeletons and brains to assess the effects of starvation; the efficacy of surgical techniques for sterilizing women; and the impact of stress and starvation on ovulation, menstruation, and cancerous growths in the reproductive organs of women.”
How the experiments were conducted was brutal and immoral for more than one particular reason. First, physicians thought it acceptable to experiment on particular groups of people which they saw as inferior in society and hypothesised different in biology to themselves. Some commentators argue that the Nazi physicians were ‘not manipulated by Nazi doctrine but had already, from the beginning of the century, been committed to hygienic theories’.
Secondly, though not surprising after reading the first, no information on the experiments themselves was given. The concentration camp victims were subjects to be dispensed with at any time and at the whim of those in authority. The physician Dr Sigmund Racher who conducted one of the most notorious experiments, the effects of high altitude on human survival asks in a letter addressed to Heinrich Himmler, the second most powerful man in the Third Reich, to dispense with “two or three professional criminals” to be used in his experiments. This is because Racher writes “such experiments on human beings are very dangerous and nobody is volunteering”. Dr Rudolf Brandt, on behalf of Himmer, replies: “I can inform you that prisoners will, of course, be gladly made available for the high flight researches...I want to use the opportunity to extend to you my cordial wishes on the birth of your son.”
In the opening statement of the Doctors’ Trial, Chief of Counsel Brigadier General Telford Taylor charged defendants “with murders, tortures, and other atrocities committed in the name of medical science. The victims of these crimes are numbers in the hundreds of thousands. A handful only are still alive; a few of the survivors will appear in this courtroom. But most of these miserable victims were slaughtered outright or died in the course of the tortures to which they were subjected. For the most part they are nameless dead. To their murderers, these wretched people were not individuals at all. They came in wholesome lots and were treated worse than animals.” The criminal proceedings started in December 1946 and ended in August 1947. 16 of the 23 defendants (a mix of German physicians and administrators) were found guilty. Seven were sentenced to death.
In the same August, the Nuremberg Code was introduced. The first of the ten principles in the 1947 Nuremberg code reads: “The voluntary consent of the human subject is absolutely essential… before the acceptance of an affirmative decision by the experimental subject, there should be made known to him the nature, duration, and purpose of the experiment; the method and means by which it is to be conducted; all inconveniences and hazards reasonably to be expected; and the effects upon his health or person, which may possibly come from his participation in the experiment.” [emphasis added] The Universal Declaration of Human Rights (UNHR) goes beyond asserting the right to life of each individual (Article 1). In Article 5, we read that, “no one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment”.
The Nuremberg Code and the UNHR are only two of the several legislations which now govern medical research and good medical practice. They also serve to make up for research dating back to before the Nazi experiments which we consider as highly unethical and, in several ways, discriminatory. Sex workers, the terminally ill and mentally infirm were over the years also used as research participants in various experiments.
There is one aspect which the Nuremberg Code or subsequent legislations have not considered. What do we do with the data that was obtained from the Nazi Experiments and any other experiment which is highly unethical and infringes human rights? Should we take a consequentialist approach and argue that the end justifies the means, that the pain inflicted on the few but benefitting the many is, therefore, somehow, ethically justified? This debate intensified at the beginning of the last decade with the publication of hypothermia studies that were built on similar studies conducted in Nazi camps. Physicians and scientists were using data obtained by the Nazi physicians as a source and background for their research.
I suggest it’s Robert Pozos, a hypothermia expert, who clearly sets out the conflict I have just mentioned. He sets out this example in a chapter titled ‘Scientific Inquiry and Ethics. The Dachau Data’ in Arthur Caplan’s ‘When medicine went mad: bioethics and the holocaust.’
“A drug dealer whose profession has resulted in the death of individuals, the breakup of families, and the dehumanisation of individuals gives a large sum of money to a local charity for the expressed purpose of helping the poor and feeding the homeless. Should the charity accept the money knowing full well the source of those funds? In essence, the question is not whether the money is tainted. Some would argue that it would be better to feed the homeless, even though the source of funds was unethical. Otherwise would say that it would be better not to accept the money since it is tainted and no matter how great the good it could produce; its evil genesis would always outweigh any potential benefits.”
As we see, there is still a conflict between medicine, law and ethics which remains largely unresolved. The various legislation and guidelines we now have in place set out principles and regulate procedures are, unfortunately, always reactive in nature. They are introduced after the harm is already inflicted. By no means do I mean that participating in a research study is unsafe. With research ethics committee approval necessary for the conduct of clinical research, the rights and protection of patients’ participants in trials are always safeguarded.
What I am here referring to is the lack of thorough legislation which provides advice and safeguards the data obtained from genetic testing, for example. There is also a lack of clarity as to what to do with incidental findings that scientists come across when conducting research. This is why we need legislation to be proactive rather than reactive.
Legislation governing research and the increasing number of patient groups who have an interest in research confirms that these human experiments will never take place again. However, their abominable nature will always lurk in the shadows and echo in any discussion into new research and trials.