| More

Pertinent Today: What Contemporary Lessons Should be Taught by Studying Physician Participation in the Holocaust?

Views: 246 Downloads: 55
Mark A. Levine, Matthew K. Wynia, Meleah Himber, William S. Silvers

Abstract


The participation of physicians in the atrocities of the Holocaust exposed vulnerabilities in medicine’s moral commitment to patients’ best interests that every health professional should recognize. Teaching about this history is challenging, as it is extremely complex and there are no common standards for what basic historical facts students in health professions training programs should learn. Nor is there guidance on how these historical facts can or should be related to contemporary ethical issues facing health professionals. To address these problems, we propose a set of core historical facts about health professional involvement in the Holocaust that every student in a health professional training program should learn. We then identify three ethical lessons from the Holocaust that are pertinent today as physicians struggle to maintain their moral compass and earn the trust of patients and the public: 1) The lesson of commitment to science; maintaining balance between reason and skepticism in the search for truth, (2) The lesson of clinical detachment; maintaining balance between necessary professional distance with a commitment to humanism and intimacy with patients, and 3) The lesson of competing loyalties; maintaining balance in upholding medicine’s multiple responsibilities, including to individual patients and the larger community. Embedding these facts and lessons into the education of health professionals is challenging yet critically important. Today’s physicians struggle with some of the same ethical tensions as did German physicians in the Nazi era, albeit in a much-attenuated fashion. Awareness of these tensions and taking active measures to maintain them in balance are necessary components of humanistic health care, which should be an integral part of health professional training programs.

Keywords


Holocaust; medical ethics; health professional education; trust; scientific method; competing loyalties; professional detachment

Full Text:

PDF

References


Anti-defamation League. “Why We Need Legislation to Ensure the Holocaust is Taught in Schools.” https://www.adl.org/blog/why-we-need-legislation-to-ensure-the-holocaust-is-taught-in-schools.

Baron, Jeremy Hugh. “Genocidal Doctors.” Journal of the Royal Society of Medicine 92, no. 11 (1999): 590-593.

Baron, Richard J., and Adam J. Berinsky. “Mistrust in Science – A Threat to the Patient–Physician Relationship.” New England Journal of Medicine 381, no. 2 (2019): 182-185.

Beecher, Henry K. “Ethics and Clinical Research.” New England Journal of Medicine 274, no. 24 (1966): 1354-1360.

Blendon, Robert J., John M. Benson, and Joachim O. Hero. “Public Trust in Physicians – U.S. Medicine in International Perspective.” New England Journal of Medicine 371, no. 17 (2014): 1570-1572.

British Medical Association. Medicine Betrayed: The Participation of Doctors in Human Rights Abuses. London, UK; Atlantic Highlands, NJ: Zed Books, 1992.

Caplan, Arthur L. When Medicine Went Mad: Bioethics and The Holocaust. Contemporary Issues in Biomedicine, Ethics, and Society. Totowa, NJ: Humana Press, 1992.

Casey, Nicholas. “Trading Lifesaving Treatment for Maduro Votes.” New York Times, March 17, 2019. https://www.nytimes.com/2019/03/17/world/americas/venezuela-cuban-doctors.html.

Conference on Jewish Material Claims against Germany. “New Survey by Claims Conference Finds Significant Lack of Holocaust Knowledge in the United States.” http://www.claimscon.org/study/.

Cook, John, and Stephan Lewandowski. “Rational Irrationality: Modeling Climate Change Belief Polarization Using Bayesian Networks.” Topics in Cognitive Science 8, no. 1 (2016): 160-179.

Funk, Cary, Meg Hefferon, Brian Kennedy, and Courtney Johnson. “Trust and Mistrust in Americans’ Views of Scientific Experts.” Pew Research Center. https://www.pewresearch.org/science/2019/08/02/trust-and-mistrust-in-americans-views-of-scientific-experts/.

Godfrey-Smith, Peter. Theory and Reality: An Introduction to the Philosophy of Science. Chicago: University of Chicago Press, 2003.

Halperin, Edward C. “The Rise and Fall of the American Jewish Hospital.” Academic Medicine 87, no. 5 (2012): 610-614.

Kater, Michael H. “Professionalization and Socialization of Physicians in Wilhelmine and Weimar Germany.” Journal of Contemporary History 20, no. 4 (1985): 677-701.

Kater, Michael H. Doctors under Hitler. Chapel Hill and London: The University of North Carolina Press, 1989.

Light, Donald W. “Values and Structure in the German Health Care Systems.” The Milbank Memorial Fund Quarterly. Health and Society 63, no. 4 (1985): 615-647.

Lifton, Robert J. The Nazi Doctors: Medical Killing and the Psychology of Genocide. New York: Basic Books, 2000.

Mackowiak, Philip A., Donna Parker, and Lindsay D. Croft. “The Case for Medical History in Physicians’ Education: A Survey of What Physicians and Physicians-in-Training Think.” The American Journal of Medicine 130, no. 4 (2017): 494-497.

Montross, Christine. Body of Work: Meditations on Mortality from the Human Anatomy Lab. New York: Penguin Press, 2007.

Neumann, Melanie, Friedrich Edelhäuser, Diethard Tauschel, Martin R. Fischer, Markus Wirtz, Christiane Woopen, Aviad Haramati, and Christian Scheffer. “Empathy Decline and Its Reasons: A Systematic Review of Studies with Medical Students and Residents.” Academic Medicine 86, no. 8 (2011): 996-1009.

Okrent, Daniel. The Guarded Gate: Bigotry, Eugenics, and the Law that Kept Two Generations of Jews, Italians, and Other European Immigrants out of America. New York: Scribner, 2019.

Proctor, Robert N. Racial Hygiene: Medicine under the Nazis. Cambridge, MA: Harvard University Press, 1988.

Project of the ABIM Foundation, ACP-ASIM Foundation, and European Federation of Internal Medicine. “Medical Professionalism in the New Millennium: A Physician Charter.” Annals of Internal Medicine 136 no. 3 (5, 2002): 243-246.

Rao, Vijaya, and Glenn Flores. “Why Aren’t There More African-American Physicians? A Qualitative Study and Exploratory Inquiry of African-American Students’ Perspectives on Careers in Medicine.” Journal of the National Medical Association 99, no. 9 (2007): 986-993.

Royal College of Physicians. “Doctors in Society. Medical Professionalism in a Changing World.” Clinical Medicine 5, no. 6 – Supplement 1 (2005): S5-S40.

Sidel, Victor W. “The Social Responsibilities of Health Professionals. Lessons from Their Role in Nazi Germany.” Journal of the American Medical Association 276, no. 20 (1996): 1679-1681.

Torcello, Lawrence. “The Ethics of Belief, Cognition, and Climate Change Pseudoskepticism: Implications for Public Discourse.” Topics in Cognitive Science 8, no. 1 (2016): 19-48.

United States Holocaust Memorial Museum. “Deadly Medicine: Creating the Master Race.” https://www.ushmm.org/information/exhibitions/traveling-exhibitions/deadly-medicine.

Washington, Harriet A. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. New York: Doubleday, 2006.

Weindling, Paul. Health, Race, and German Politics between National Unification and Nazism, 1870-1945. Cambridge; New York: Cambridge University Press, 1989.

Whitman, James Q. Hitler’s American Model: The United States and the Making of Nazi Race Law. Princeton, NJ: Princeton University Press, 2017.

Wynia, Matthew K., William S. Silvers, and Jeremy A. Lazarus. “How Do U.S. and Canadian Medical Schools Teach About the Role of Physicians in the Holocaust?” Academic Medicine 90, no. 6 (2015): 699-700.

Wynia, Matthew K., and Alan L. Wells. “Light from the Flames of Hell: Remembrance and Lessons of the Holocaust for Today’s Medical Profession.” Israeli Medical Association Journal 9 (2007): 186-188.

Zimmerman, Frederick J., and Nathaniel W. Anderson. “Trends in Health Equity in the United States by Race/Ethnicity, Sex, and Income, 1993-2017.” Journal of the American Medical Association Network Open 2, no. 6 (2019): e196386-e196386.


Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 Mark A. Levine, Matthew K. Wynia, Meleah Himber, William S. Silvers

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.