Offline: Holocaust education—a medical imperative

Abstract

As school students in England in the 1970s, we were taught the bare facts of the Holocaust. And that is where we left it. A fact of history, a fact certainly to be remembered, yet a fact that seemed very distant from contemporary times. But last week, the Ontario Medical Association, together with Doctors Against Racism and Anti-Semitism, held a webinar to discuss the case for teaching the Holocaust in medical schools. The meeting was led by Dr Frank Sommers, a professor of psychiatry at the University of Toronto. Born in Budapest in 1943, Dr Sommers' extended family died in Nazi concentration camps. The webinar also heard evidence from bioethicist Dr Sheena Eagan and Professor Sheldon Rubenfeld, founder of the Center for Medicine after the Holocaust. Here are five reasons why the Holocaust should be considered a core subject for medicine today. First, doctors were centrally complicit in the Holocaust. Their collusion was such an extreme perversion of a physician's professional ethics that this very fact must be part of the repertoire of knowledge for every prospective doctor. Medicine drove the incremental advance towards genocide. The idea of life unworthy of life. Compulsory sterilisation. The euthanasia programme. And eventually genocide itself. A killing project led by doctors. Second, out of the Holocaust came the ethical foundation for medical research today—the Nuremberg Code. The Doctors' Trial at Nuremberg, beginning on Dec 9, 1946, lasted 130 days. 20 doctors and three bureaucrats. Experiments of torture, atrocity, and murder. The goal: to find methods to produce death, not healing. The Nuremberg Code was an integral part of the final legal judgment. The nature of human experimentation was at the heart of the trial. For the first time, the Nuremberg Code set out the principles of research ethics. The Nuremberg Code defines fundamental human rights for all research participants. One cannot begin to understand the moral basis of medical research in the 21st century without understanding the Nuremberg Code. And one cannot understand the Nuremberg Code without understanding the Holocaust. Third, teaching the Holocaust provides an opportunity for medicine to play its part in fighting anti-Semitism. Racism, including anti-Jewish hatred, is a public health issue. Teaching the Holocaust would be a significant act of resistance by the medical profession. Fourth, including the Holocaust in the medical curriculum would provide an opportunity to reflect on the role of the doctor in society. The idea of medical professionalism is based on a moral contract between the doctor and the individual patient in society. But for Nazi doctors during the Holocaust, individuals had no meaning whatsoever. The underlying idea of Nazism was that society was an organic entity where the individual was subordinated to the body politic. The doctor's duty was to serve the body politic, not the individual. Teaching the Holocaust would be a starting point for reflecting on the meaning of science, service, and human dignity in medicine—indeed, the very meaning of a profession. Finally, teaching the Holocaust would emphasise two vital principles in medicine. First, that the value of every human life is infinite. Second, our shared fate. As Robert J Lifton has argued, “We have a sense of kinship with every other self on the planet because we recognise that we all may go down together if we don't pull together to survive.” Genocide. The climate crisis. Nuclear war. COVID-19. These are the shared threats we face together. Teaching the Holocaust would foster that sense of kinship. In Auschwitz: A Doctor's Eyewitness Account, Miklós Nyiszli wrote that “it was absolutely necessary to forget...if we wanted to keep from going mad”. An understandable sentiment. By contrast, the philosopher Avishai Margalit has proposed the notion of an ethics of memory. In his book of the same name, Margalit asks whether there is an obligation to remember. And if so, what is the nature of that obligation? He distinguishes between common memory—the aggregate of individual memories—and shared memory, a community of memory that demands action. “Even the project of remembering the gloomiest of memories is a hopeful project”, Margalit wrote. And, “a proper community of memory may help shape a nation”. Teaching the Holocaust in medicine might possibly do much more. It might just be a contribution to protecting all the peoples of the world from atrocities impossible to imagine.