Abstract
ing representatives of the medical association and medical specialist bodies, as well as with the considerable participation of eminent representatives of university medicine and renowned biomedical research facilities,” the group said in the declaration. “We acknowledge the substantial responsibility of doctors for the medical crimes committed under the Nazi regime and regard these events as a warning for the present and the future.” One of the legacies of the Doctors Trial is the Nuremberg Code, which defines core principles for rights of participants in medical research, such as voluntary consent and the absence of coercion (http://tinyurl.com/794hahy). During the trial, attorneys for the defense had argued that their experiments were not unlike previous studies by researchers in the United States, France, Great Britain, and other countries. Concerns raised during the trial led to the development of the code, described by the United States Holocaust Memorial Museum as “a landmark document on medical ethics” (http://tinyurl.com/7fdsjql). The German Medical Association’s declaration acknowledged that the “human rights violations perpetrated in the name of medicine under the Nazi regime continue to have repercussions to this day and raise questions concerning the way in which physicians perceive themselves, their professional behavior, and medical ethics.” Of the many lessons to be learned from distortions of medical practice that occurred during the Nazi era, among the most important is understanding the human motivations that led physicians to subordinate the needs of individual patients to the demands of the government. “The German physicians believed they were behaving morally and following the dictates of the Hippocratic Oath by transforming the doctorpatient relationship into a new relationship in which the state became the doctor and the German people became the ‘patient,’ or the volk,” said Sheldon Rubenfeld, MD, clinical professor of medicine at Baylor College of Medicine and president of the Center for Medicine After the Holocaust, in Houston, in an e-mail. Thus, by this reasoning, German physicians rationalized eugenic sterilization, euthanasia, and, ultimately, elimination of Jewish, black, homosexual, Roma, and other “genetically inferior” individuals as treatment of their “patient,” the volk, said Rubenfeld. Another rationale for their actions resonated among the public. “The economic advantages of eliminating expensive utilizers of health care resources were also widely touted and readily accepted by a receptive citizenry during a worldwide depression,” he said.
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