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Doctor discusses Shoah’s legacy for medical ethics

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Nazi physician Carl Clauberg, left, who performed medical experiments on prisoners USHMM PHOTO
Nazi physician Carl Clauberg, left, who performed medical experiments on prisoners USHMM PHOTO

It’s inconceivable to think that physicians could transform from healers into killers, said Dr. Raul Artal at a Holocaust Education Week event geared mainly for medical professionals.

But, he noted, German doctors and other medical personnel took part in large-scale concentration camp experiments concerning  malnutrition, and the infection of man-made wounds to test antibiotics, among other topics of investigation.

As well, he said, during World War II, more than six million Jews were selected and killed; 400,000 German patients were selected and sterilized; 5,000 German children selected and euthanized; and 200,000 German adults selected and euthanized. Only 15 per cent of patients in German mental hospitals at the start of the war survived. Thousands of German doctors were involved, Artal said.

The California-based professor and chairman emeritus of Saint Louis University’s department of obstetrics, gynecology and women’s health, spoke Nov. 4 about Medical Ethics and the Holocaust: A Legacy for Today, at Mount Sinai Hospital, as part of Toronto’s 35th annual Holocaust Education Week.

Artal, who is a champion of Houston’s Center of Medicine After the Holocaust, teaching internationally about medical ethics lessons from the Holocaust, also spoke the preceding night at Reena in a more personal vein.

At Mount Sinai, he also touched on his own experience when he spoke briefly about his birth in 1943 in Bersad, a German Romanian concentration camp in Transnistria.

Artal noted that he was born with what would later be described as an extremely low Apgar score. “Don’t predict anything based on Apgar scores,” he cautioned.

He also said he was lucky not to be born in a camp like Auschwitz, where babies with Aryan features were given up for adoption, and those with non-Aryan features were sent to the gas chambers.

Addressing directly the relevance of his lecture topic, Artal asked, “What is the lesson today, when technology exists to modify genes and create ‘perfect’ babies?”

He believes that genome technology “should be used only for modifying genes that lead to disease, not to attain better babies,” he said.

Biomedical ethics have evolved over time, and will continue to be an essential component of medical education, he added. Future issues will depend on medical advances in technology and other factors including disease knowledge, the national health care delivery system, and “our collective conscience.”

Medical ethics is not a list of rules, Artal said, but rather “a matter of continual thought and evolution.”

Current principles include respecting patient autonomy, promoting the well-being of patients, and causing no harm or injury, Artal said.

He explained that medical ethics was consistent until the mid- to late 1800s, when Charles Darwin proposed the idea of natural selection, Darwin’s cousin Francis Galton coined the term “eugenics,” and Friedrich Nietzsche said that God is dead, and that “the sick man is a parasite of society.”

During the Third Reich, Artal said, there was a slippery slope that started with 1933 laws permitting involuntary sterilization of people with conditions ranging from blindness or deafness to schizophrenia, and those from “undesired races.” Eventually, this led to the Final Solution, and later to a coverup of what happened, Artal added.

Of 23 medical doctors tried at Nuremberg following the war, seven were acquitted, seven received death sentences, and the remainder received prison sentences ranging from 10 years to life.

The 10-point Nuremberg code developed at the trial deals with medical research, and states, among other things, that voluntary consent of the human subject is essential. As well, Artal added, the subject should be at liberty to bring the experiment to an end, and experiments should avoid all unnecessary physical and mental suffering.