The Central Role of Neuroscientists Under National Socialism

Tatu L, Bogousslavsky J (eds): War Neurology. Front Neurol Neurosci. Basel, Karger, 2016, vol 38, pp 168–183 (DOI: 10.1159/000442682)

The Central Role of Neuroscientists under National Socialism

Lawrence A. Zeidman Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, Ill. , USA

Abstract vating factors for collaborating neuroscientists. Some Neuroscientists played central roles in the victimization German and Austrian neuroscientists tried to resist Nazi of colleagues and their patients during the era of Nation- policies, although much more passively than their col- al Socialism from 1933 to 1945. After helping dismiss leagues in German-occupied countries. French, Dutch, Jewish and nonideologically aligned colleagues, Ger- Norwegian, and Danish neuroscientists actively resisted man neuroscientists were among the physicians and re- the Nazification of their profession from the beginning searchers who joined the Nazi Party and affiliated groups and helped to save some patients and colleagues, at in record numbers. Forced sterilization and then so-called great personal risk. Many German, Austrian, Czech, and ‘euthanasia’ of neurological and psychiatric patients Polish neurologists were murdered in the Holocaust, and were planned and executed by prominent German and hundreds of thousands of neurological and psychiatric Austrian neuroscientists. Other neuroscientists collabo- patients were sterilized or murdered in just 12 years. The rated indirectly by using patients for unethical experi- Nazis used the ‘successful’ techniques developed in the mentation to discover the cause of multiple sclerosis or ‘euthanasia’ programs to carry out the mass murder of to try to induce epileptic convulsions in a hypoxic state. millions in the Holocaust. Today’s neuroscientists are ob- Some merely used neuropathological material from mur- ligated to learn of the ethical violations of their predeces- dered patients for publications in scientific journals. In sors 70–80 years ago. No law will prevent abandonment the totalitarian state, research funding and academic ad- of the basic principles of ethical patient care and profes- vancement were awarded to physicians engaged in eu- sionalism that can occur in any totalitarian state, but neu- genics research. Opportunism and ideologically tainted roscientists can possibly prevent it. science without regard to medical ethics were the moti- © 2016 S. Karger AG, Basel Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 6/22/2016 1:04:37 PM Introduction and Brief Historiography

In the past 25 years, there has been a small but ac- celerating number of critical articles dealing with neuroscience1 under National Socialism (Na- zism) in Europe from 1933 to 1945. Several books on Nazi medicine and eugenics policies in general were published in the late 1980s or 1990s [1– 7] , but these primarily discussed the unethical brain research carried out by neuroscientists Ju- lius Hallervorden (1882–1965) (fig. 1 ) and Carl Schneider (1891–1946) and did not comprehen- sively evaluate the roles of neuroscientists as part of the larger context. Actually, neuroscientists played central roles in Nazi medicine, since Nazi eugenics policies such as forced sterilization and so-called ‘euthanasia’ primarily targeted neuro- Fig. 1. Julius Hallervorden, unknown year. Reprinted logic and psychiatric (neuropsychiatric) patients with permission of the Archiv der Max Planck Society, [8]. The emerging body of work on Nazi medi- Berlin-Dahlem. cine in general, spurred by debates in the 1980s, and the discovery of Hallervorden’s brain collec- tion in the early 1980s [9] were motivating factors gap between the initial criticism in 1949 by neu- for the late Tübingen Emeritus Professor of Neu- rologist Leo Alexander (1905–1985) of the un- ropathology Jürgen Peiffer (1922–2006) to au- ethical activities of Hallervorden [16] and Georg thor a number of works mainly in German on the Schaltenbrand (1897–1979) in the Nazi era [17] involvement of neuroscientists in the Nazi period and the works of neuroscientists in the 1990s. Even [10–14] . Peiffer’s work was aided by the sudden as late as 1974, the major German scientific insti- availability of 30,000 ‘euthanasia’ victim files kept tute, the Max Planck Society (MPG – Max-Planck- by the former East German secret service and Gesellschaft ), a successor agency to the Kaiser-Wil- state archives after Germany’s 1990 reunification helm Institute (KWI), obtained a court injunction [15] . The availability of this new documentary in- to prevent publication of an article about Nazi eu- formation was paramount, given that many of the thanasia and neurological research at the KWI, collaborating neuroscientists destroyed incrimi- calling the attempt ‘slanderous’ [18] despite Ale- nating files after the war or that such files were xander’s earlier reports and works from the 1940s. destroyed during Allied bombing [12] . Many years later, in 2001, after an independent in- It was likely the attempted whitewashing of vestigation, the MPG president finally and formal- German neuroscience, fear of Nestbeschmutzung ly apologized for his society’s collaboration with (fouling one’s own nest), and avoidance of con- the Nazi euthanasia programs [19] . fronting the past [15] that caused a four-decade Montreal child neurologist Michael Shevell also published a number of works in the 1990s critically appraising academic neuroscience in 1 By convenience, many of the neurologists, neuropsychia- the Nazi era. After Shevell published landmark trists, neuropathologists, and basic neuroscience researchers in this paper are referred to as ‘neuroscientists’, though that studies on Hallervorden [20] and Schaltenbrand term did not emerge until the early 1960s. [21], as well as an analysis of Alexander’s role in

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Front Neurol Neurosci. Basel, Karger, 2016, vol 38, pp 168–183 (DOI: 10.1159/000442682) Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 6/22/2016 1:04:37 PM US Army medical reports [22] and the Nurem- tance of the Nazis and the ramifications of perse- berg Code [23] , he highlighted how academic cution of ‘non-Aryan’ (mainly Jewish) neurosci- neuroscientists were heavily implicated in Nazi entists. crimes. Neuroscientists played crucial unprofes- sional and unethical roles in the process that be- gan with the ‘de-Judification’ of German medi- The Nazification of German Neuroscience cine (the wholesale removal of Jewish doctors and researchers) and ended in the mass murder of By 1945, over 41,000 German doctors (45–50%) millions [24] . However, neuroscience was not had become Nationalsozialistische Deutsche Ar- merely a ‘microcosm’ [24] of Nazi medicine; it beiterpartei (NSDAP, the National Socialist Ger- was the central specialty in planning, enforcing, man Workers’ Party, or the Nazi Party) members and profiting from Nazi eugenics policies. In the [36, 37], 26% joined the Sturmabteilung (SA, 2000s, Shevell further helped to elucidate the role Storm troopers, or the Nazi ‘brown shirts’), and of neuroscientist Heinrich Gross (1915–2005) in 7% joined the most exclusive and fanatical Nazi Nazi activities [25] and helped to dismantle the group, the Schutzstaffel (SS, the Nazi black shirts, Hallervorden-Spatz Disease (HSD) eponym in a paramilitary organization) [37] . It is uncertain 2003 in favor of pantothenate kinase-associated how many of the 41,000 Nazi doctors were neu- neurodegeneration [26] . Zeidman et al. in 2012 roscientists [38], but this group and the neurosci- demonstrated the dramatic drop in the unquali- entists who joined the SA or SS comprised the fied usage of the HSD eponym from the 1990s to most basic category of collaborators. The fact that the 2000s [27] , largely because of Shevell’s and nearly half of doctors supported their criminal others’ work. government, or at least joined its ranks to protect For better organization and discussion of the themselves and their careers, facilitated the un- central roles of neuroscientists in Nazi eugenics ethical Nazi eugenics programs. As part of the programs, the neuroscientists will be divided into larger process of Gleichschaltung, or coordina- collaborators, resistors, and victims; however, tion of thought and ideology, all public and pri- these categories overlap significantly. For in- vate life was brought under totalitarian control in stance, the ‘banality of evil’ [28] among collabora- Nazi Germany. The medical profession under- tors was sometimes combined with the ‘ordinar- went Gleichschaltung , in which all medical asso- iness of good’ [29] more typically seen among ciations coalesced under the aegis of the Nazi resistors. Kondziella originally used this categori- Physician’s League, which ensured Nazi ideology zation for neuroscientists in 2009 [30] , adopting was implemented at every level [36] . the technique used by Holocaust historian Raul Not only Gleichschaltung of neuroscience but Hilberg (1926–2007), who separated groups in- also the ‘de-Jewification’ of the profession was re- volved in the destruction of European Jewry into quired to facilitate the sterilization, murder, and perpetrators, victims, and bystanders [31] . This subsequent neurological research in the Nazi era approach was later used for a comprehensive dis- [8, 24, 34, 39]. Consistent with the anti-Semitism cussion of neuroscientist collaborators [32] , resis- entrenched in German neurology that had long tors [33] , and victims [34] and of Scandinavian pre-dated but that escalated during the Nazi re- neuroscientists of all categories [35] . Throughout gime, many Nazi and SA neuroscientists eagerly this chapter, there will be an attempt to explain helped expel Jewish colleagues from academic po- how some German and Austrian neuroscientists sitions and insurance panels. Within 5 years, Jew- abandoned their humanity and ethics. Also in- ish doctors even in private practice were de-li- cluded will be an overview of neuroscientist resis- censed and reduced to mere ‘Jewish sick treaters’,

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Front Neurol Neurosci. Basel, Karger, 2016, vol 38, pp 168–183 (DOI: 10.1159/000442682) Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 6/22/2016 1:04:37 PM restricted to seeing only Jewish patients or work- seminars for SS doctors about the heredity of neu- ing at Jewish hospitals [34] . The mass expulsion or rological diseases and the physicians’ duty to pro- general professional marginalization of 6,000– tect German racial purity. He even advocated ex- 8,000 Jewish doctors from Germany [40] , includ- panding the sterilization law to other neurologi- ing up to one-third of Austro-German neurosci- cal diseases not explicit in the law. Birkmayer entists [8] , had two primary effects: (1) opportu- took part in the ‘de-Jewification’ of the Viennese nistic ‘Aryan’ neuroscientists filled the vacated neurology clinic and helped to install loyal Nazi positions and helped implement eugenics policies colleagues. Birkmayer’s SS career ended in 1939 on neuropsychiatric patients [24, 39, 41], and (2) in an ironic scandal when his ‘non-Aryan origin’ Jewish neuroscientists, not believed to be ideologi- was revealed (he had a Jewish grandmother). He cally synchronized with Nazi policies, could not was allowed to resign from the SS to save face, was resist eugenics measures on patients [40] . The Na- allowed to remain at the neurology clinic, and was zis eventually wanted to eliminate the Jewish ‘par- even promoted to senior assistant. Eventually, he asite’ from Germany to protect the German gene was dismissed from the NSDAP in 1943. After the pool. Jewish doctors were antithetical to this geno- war, Birkmayer circulated stories about helping cidal goal because they preserved Jewish life [40] . Jewish colleagues as well as being involved in the An illustrative example of self-admitted Nazi resistance, and he was eventually denazified in the collaboration was that of German neurologist and late 1940s. In a 1964 letter, Birkmayer admitted to geneticist Peter Becker (1908–2000), describer of having made a ‘mistake’ with his Nazi beliefs but Becker muscular dystrophy and Becker myotonia. still advocated voluntary sterilization of patients Becker later admitted SA membership and be- with hereditary diseases. In 1961, Birkmayer co- came an SA Obertruppführer (sergeant). Addi- discovered that levodopa therapy was extremely tionally, he became a Nazi party member. Becker effective in Parkinsonism. He also conducted early stated that ‘Since dismissal from the SA would work on combining carbidopa with levodopa to have made completion of training and a teach- increase its efficacy in the late 1960s and helped ing career impossible, I must confess to being an design the first selective monoamine oxidase-B in- opportunist in that respect’ [42]. Typical Persil- hibitor, L-deprenyl (Selegiline), for Parkinsonism scheine (whitewash certificates) [43] in Becker’s in the mid-1970s. He founded the Birkmayer Insti- post-war denazification file include attestations tute for Parkinsonism Therapy in Vienna [39] . that Becker was not a ‘Nazi activist or propagan- Was Birkmayer just a misguided youth? Why dist’ [42]. At the very least, Becker was a Mitläufer should neurologists of today care? Only because (fellow traveler) [43] , a member of the anonymous so many neuroscientists supported the Nazis ranks of German physicians who opportunistically were eugenics policies so vigorously implement- participated in the regime, more for professional ed. Overall, at least 30 Austrian neuroscientists advancement than for ideological reasons [42] . eagerly collaborated with the regime in various The Austrian neurologist Walter Birkmayer capacities [44] . (1910–1996) was also opportunistic but was more ideologically committed than Becker. During the 1930s, Birkmayer was an illegal member of four Forced Sterilization: A ‘Legal’ but Unethical terrorist groups (the NSDAP and its subsidiary Measure against Neuropsychiatric Patients groups were illegal in Austria prior to 1938): the Hitler Youth (1931), the SA (1932–36), the Many ‘Aryan’ neuroscientists who kept positions NSDAP, and the SS. He was promoted to SS-Un- or obtained vacated positions from dismissed tersturmführer (lieutenant) and spoke at evening colleagues helped to enforce the Nazi forced ster-

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Front Neurol Neurosci. Basel, Karger, 2016, vol 38, pp 168–183 (DOI: 10.1159/000442682) Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 6/22/2016 1:04:37 PM Fig. 2. Hans Berger, unknown year. Reprinted with permission of the De- partment of Neurology and Rehabili- tation, University of Illinois at Chica- go, Chicago, Ill., USA.

ilization policy. Collaboration with the Nazi ster- vere hearing loss, chronic alcoholism, pre-senile ilization policy was legal and was not unique to or senile dementia, encephalitis, poliomyelitis, Germany, but it was unethical on multiple levels ‘therapy-resistant paralysis’ (refractory neuro- and was carried out on a much grander scale syphilis, presumed to have a genetic predisposi- there than anywhere else [45] . Even prior to the tion), multiple sclerosis (MS), or Parkinson’s dis- Nazi era, some of the leading international neu- ease [20, 24, 49]. Doctors were required to report rologists of the 19th and 20th Centuries, such as any genetic illnesses known to them (except in W.G. Lennox (1884–1960), R.F. Kennedy (1884– women over 45) and could be fined a fee of 150 1952) [46] , Gabriel Anton (1858–1933) [47] , Reichsmark for failing to do so. Pediatricians, Herman Lundborg (1868–1943) [35] , and Au- psychiatrists, and neurologists were most in- guste Forel (1848–1931) [48] , were outspoken volved in reporting such patients to the genetic eugenicists. Thus, it was not surprising that neu- health courts. The mortality rate from forced rological and psychiatric diseases were propelled sterilization was 0.5%, for a total of 2,000 patients to the top of the sterilization list in Nazi Ger- dead from these procedures [49] . many. Hans Berger (1873–1941) (fig. 2 ) was Neuro- The Nazi government passed the compulsory psychiatry Director at the University of Jena, sterilization program into law in July 1933. By and in 1924, he discovered the human EEG. In this new law, an individual could be forcibly ster- 1931, he first documented alpha (the Berger ilized if, according to an Erbgesundheitsgericht (a rhythm) and beta waves in EEG. Berger’s EEG genetic health court), he or she suffered from the discoveries were groundbreaking, but he collab- following conditions: ‘congenital feebleminded- orated with Nazi sterilization. He was an Erbge- ness’, schizophrenia, hereditary epilepsy (these sundheitsobergericht (EGOG, the Appellate Ge- three comprised 81–97% of patients), bipolar netic Health Court) expert and took part in the disorder, Huntington’s disease, major brain mal- rejection of at least six appeals. Berger quit the formations, congenital blindness, congenital se- EGOG following mandatory university retire-

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Front Neurol Neurosci. Basel, Karger, 2016, vol 38, pp 168–183 (DOI: 10.1159/000442682) Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 6/22/2016 1:04:37 PM ment in 1938, but when asked to return in 1941, sane … only 3% of the insane in the next genera- he readily answered, ‘I am very happy to con- tion could be eliminated by sterilizing the insane tinue my work […] at the EGOG …’. However, of the present generation … This was exactly the Berger did not resume his EGOG position and view taken several years before, namely in 1935, committed suicide shortly thereafter. Berger had by a committee of the American Neurological As- earlier participated in the committee discussing sociation’ [45] . On a larger scale, sterilization can his possible successors and approved its selec- be seen as the first step along the slippery slope tion. The committee excluded candidates with leading to patient murder [52] . Even without con- a ‘liberal-passive’ attitude towards eugenics and sidering links to the Holocaust, the sterilization favored neuroscientist Berthold Kihn (1895– program’s mortality rate [49] did not prevent 1964), an ‘ideologically, professionally and po- many German neuroscientists from placing the litically reliable man’ because of his ‘hereditary- genetic ‘health’ of the German people over the pathological work’ and ‘commitment to the health of their patients. Thus, despite the ‘legality’ EGOG’. Although Berger was not a Nazi or an SS of Nazi sterilization, it was unethical, even by the member, he became a ‘Supporting Member’ of standards of the era. the SS (Förderndes Mitglied). Being a Förderndes Mitglied provided ‘sufficient protection against Nazi harassment’. At the very least, Berger seems ‘The Needle Belongs in the Hands of the to have been a eugenicist and was likely ideo- Doctor’ [52] : Killing the Neuropsychiatrically logically indoctrinated by Nazism on some levels Ill [45] . Rudolf Lemke (1906–1957), Berger’s assistant, Neuroscientists such as Max de Crinis (1889– was an EGOG assessor and was co-responsible 1945), Carl Schneider, and Hans Heinze (1895– with Berger for at least 25 cases of forced steriliza- 1983) were instrumental in planning and execut- tion. The topic of Lemke’s 1935 inaugural lecture ing the next step on the slope to the Holocaust, was ‘The evaluation of the feebleminded at the the mass murder of ‘useless eaters’ in Germany, Erbgesundheitsgericht’ [45] . Lemke’s glowing Ber- the various covert programs comprising ‘eutha- ger tribute [50] , without any mention of his or his nasia’ [53]. Child euthanasia, adult euthanasia mentor’s active involvement in Nazi programs, (‘ Aktion T4’ – named for the headquarters at is exemplary of post-war whitewashing. Lemke Tiergartenstrasse 4 in Berlin) and ‘wild euthana- likely did not want to implicate himself in Nazi sia’, led to the mass murder of roughly 275,000 activities by exposing Berger’s involvement in his neuropsychiatric patients ( table 1 ) by gassing, biography because Lemke was likely complicit in starvation, lethal injection, or other means such even more sterilization decisions than Berger and as hypothermia [16, 52] and were the direct pre- was a Nazi member himself [51] . cedents for wholesale genocide in the Holocaust Even compared with programs in other coun- [16, 52]. These programs were never legalized, de- tries, the Nazi sterilization program was more spite a drafted 1940 law [54] ; they were autho- ‘successful’ than those in other countries such as rized only by Hitler’s special decree backdated to the US; 30,000 were sterilized in 29 US states from coincide with the German invasion of Poland in 1907 to 1939 vs 400,000 in Nazi Germany in just September 1939 [54] . Hitler rationalized that 12 years [49] . The Nazi sterilization program was there would be less resistance from the Church if irresponsible and short-sighted. Alexander stated mass execution of neuropsychiatric patients oc- that ‘it had been realized since shortly before the curred during wartime [53] . Also, there would be war that most insane do not descend from the in- massive cost savings and vacating of hospital beds

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Adult ‘euthanasia’ criteria Child ‘euthanasia’ criteria

Physicians were asked to report the following types of Physicians and midwifes were required to neuropsychiatric patients, primarily if rendered incapable of report all infants and children below age 3* work, but also for racial reasons: with the following disorders: Patients institutionalized more than 5 years Idiocy and mongolism** (especially with blindness and deafness) Patients with the following conditions if they were unable to do Microcephaly more than routine labor: schizophrenia, epilepsy, senile diseases, therapy-resistant (progressive) paralysis and other forms of syphilis, encephalitis, Huntington’s disease and other terminal neurological illnesses, and every type of feeblemindedness Patients committed as criminally insane Severe or progressive hydrocephalus Patients without German citizenship All deformities, especially missing limbs or severely defective head or vertebral closure (spina bifida) Patients not of ‘Germanic or related blood’ [Negro, Negro hybrid, Paralysis, including Little’s disease (spastic Gypsy, Gypsy hybrid, Jew, or Jewish hybrid (Mischling) of first (two diplegia, a form of cerebral palsy) grandparents) or second (one grandparent) degree]

Adapted from Friedlander [84] and Proctor [52]. * Later children older than 3 were included and even teenagers, en- compassing all handicapped minors and infants. ** Mongolism is an outdated and offensive term for Down syndrome (trisomy 21).

for wounded soldiers. By 1941, the T4 planners Nazi leaders deluded the German people into had exterminated 70,273 patients [54] . The kill- supporting the humane and economical premises ings ended at this point on an official scale follow- of ‘euthanasia’ with propaganda throughout the ing Church protests, and gassing equipment and 1930s, culminating in the 1941 film Ich klage an personnel were transferred to the East for use in (I Accuse). This film was about a young MS pa- the ‘Final Solution’. However, ‘wild euthanasia’ tient who wanted ‘voluntary’ euthanasia because continued until 1945 as a decentralized process at of her crippling ‘incurable’ disease [56]; this eu- individual asylums. The zeal of neuroscientist phemized voluntary mercy-death was far from killers is tragically demonstrated by the contin- the actual involuntary merciless execution of the ued murder of patients in Bavaria after the war neuropsychiatrically ill. Academic neuroscien- had officially ended, not to cease until American tists had also become indoctrinated that chroni- soldiers interceded with their weapons drawn cally ‘incurable’ patients deserved no autonomy [55] . Notably, Hitler had rejected an offer from or dignity and that murdering them was justifi- two Catholic bishops to take over the costs of care able. Although neuroscientists such as Forel [48] for these patients, suggesting against an econom- had advocated for euthanasia as early as the late ic explanation for ‘euthanasia’ and favoring racial 19th century, the 1920 book by neuropsychiatrist hygiene as the true motivation [15] . Alfred Hoche (1856–1944) and lawyer Karl Bin- ding (1841–1920), Die Freigabe der Vernichtung

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Front Neurol Neurosci. Basel, Karger, 2016, vol 38, pp 168–183 (DOI: 10.1159/000442682) Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 6/22/2016 1:04:37 PM Berthold Ostertag (1895–1975), who was operat- ing on a special decree to collect all malformed fetus and child brains for research [12] . Neurosci- entist Willibald Scholz (1889–1971; for whom Scholz type (juvenile) metachromatic leukodys- trophy is named) published at least 11 papers based on 194 victims’ brains analyzed at the Ger- man Research Institute for Psychiatry in Munich under the ‘euthanasia’ programs [12] . In Munich as in Berlin, the transportation of brains was likely based on the neuropathologists’ specialized research interests. Whereas Hallervorden predomi- nantly examined cases of cerebellar atrophy, multiple and diffuse scleroses, status marmoratus, and Huntington’s chorea, Scholz primarily examined cases of Little’s disease, psychoses, and senile dementia [12] . Neuropathological work was not the only neuroscientific research done exploiting the ‘euthanasia’ victims. At Würzburg University, Schalten- brand conducted human experiments, without patient or family consent, to determine whether MS had a possible viral etiology. He performed Fig. 3. Hans Nachtsheim, around 1945–1950. Reprinted intra-cisternal injections of cerebrospinal fluid with permission of the Archiv der Max Planck Society, Berlin-Dahlem. from known MS patients into monkeys and then from the monkeys into 45 neuropsychiatric patients from the mental institute in Werneck; this experiment resulted in at least two deaths [21] . murdered patients [12]. Hugo Spatz (1888–1969), Schaltenbrand was an SA storm trooper in 1934 Hallervorden’s friend and Brain Research Direc- but resigned from the SA in 1936, then joining the tor at the KWI, also took part in dissecting at least Nazi Party. His motivation seems to have been 105 ‘euthanasia’ brains, further lending weight to opportunistic, and he was indoctrinated to be- the argument to rename HSD to pantothenate ki- lieve that the patients upon whom he was experi- nase-associated neurodegeneration [27]. At least menting were verblödete Menschen , or ‘mentally 37 scientific publications resulted from 170 cases deficient’, individuals not deserving the same investigated by neuropathologists [12] . In addi- rights as others. Schaltenbrand published his re- tion, at least 34 publications were authored by sults in 1943, expressing a hope to expand the ex- neuroscientist Heinrich Gross (1915–2005) based periment, an objective that was foiled secondary on brains from the 772 murdered children from to the war [21] . the Am Spiegelgrund Kinderfachabteilung in Vi- Hans Nachtsheim (1890–1979) ( fig. 3 ), a ge- enna [25] . neticist interested in epilepsy, became a director At least one publication resulted from the at the KWI for Anthropology, Human Heredity, exploitation of 106 brains from Berlin’s Wie- and Eugenics in Berlin in 1941. He desired to sengrund Kinderfachabteilung by neuroscientist prove that a hereditary epileptic would have sei-

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Front Neurol Neurosci. Basel, Karger, 2016, vol 38, pp 168–183 (DOI: 10.1159/000442682) Downloaded by: Univ. of California Santa Barbara 128.111.121.42 - 6/22/2016 1:04:37 PM est academic German and Austrian neuroscientists conceived and planned the covert unmerci- ful ‘euthanasia’ programs along with Hitler’s henchmen and were largely responsible for the murder of 275,000 neuropsychiatric patients. Ar- guably and indirectly, they are culpable of the genocide of millions in the Holocaust, since the ‘euthanasia’ programs were the proving ground for ‘efficient’ mass murder. These programs pro- duced immense suffering by patients and their families, not only from the killing, but also from the massive deception of this ‘ill-kept secret’ [15] . Admitting guilt and fearing prosecution, some of the worst perpetrator neuroscientists, such as Schneider [18, 80] and De Crinis [81] , committed suicide at the end of the war. Others, such as Hallervorden, never expressed repentance and tried to deny any involvement in Nazi crimes when it became clear that the international neurological community did not ap- prove [27] . The indirect support of ‘euthanasia’ by neuroscientists like Hallervorden became a primary motivating factor in the killing by the Nazis. The eager participation by opportunistic neuroscientists like Hallervorden, Ostertag, Fig. 5. Adolf Wallenberg (1862–1949), unknown year. Re- Scholz, and others was due to a program that ‘… printed with permission of the Department of Neurology circumvented what would otherwise have meant and Rehabilitation, University of Illinois at Chicago, Chi- cago, Ill., USA. Wallenberg, the famous neuroscientist decades of troublesome procedure’ [18] . Ethically who described Wallenberg syndrome, was a refugee conceived scientific research takes significant from Nazi Europe (Danzig) who eventually immigrated time to plan and implement, but when a plethora to Illinois to live with his daughter. of scientific material became available to neuroscientists in the Nazi era, they seized the opportunity without considering the consequences. While it’s more clear in an extreme case like that of lar to those faced today: competition for research Hallervorden, the actions of the ‘neurologic court funding and academic promotion, pressure to of opinion’ [82] toward eponymous collaborating publish papers, pressure to care for patients eco- neurologists such as Becker, Berger, or Scholz or nomically, and determination of the most hu- those without a syndrome named after them, mane way to treat the chronically or terminally ill. such as Birkmayer, are likely to be more equivo- However, science and medicine without con- cal. One possible response is changing a prize science can lead down a pernicious pathway to- named for a collaborator to a victim’s name in- ward ideological or opportunistic support of a stead, as was done by the German Neurological state that devalues patient care for racial, political, and Stroke Societies; the ‘Hugo Spatz Prize’ was or economic reasons. Some of the best and bright- renamed the ‘Adolf Wallenberg Prize’ [83] ( fig. 5 ).

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Lawrence A. Zeidman, MD Department of Neurology and Rehabilitation (M/C 796) Neuropsychiatric Institute University of Illinois at Chicago (UIC) 912 S. Wood Street, Chicago, IL 60612–7330 (USA)

E-Mail lzeidm1 @ uic.edu

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