Medicine after the Holocaust Previously published by Sheldon Rubenfeld: Could It Be My Thyroid? Medicine after the Holocaust From the Master Race to the Human Genome and Beyond Edited by Sheldon Rubenfeld In Conjunction with the Holocaust Museum Houston medicine after the holocaust Copyright © Sheldon Rubenfeld, 2010 Softcover reprint of the hardcover 1st edition 2010 978-0-230-61894-7 All rights reserved. First published in 2010 by PALGRAVE MACMILLAN® in the United States - a division of St. Martin’s Press LLC, 175 Fifth Avenue, New York, NY 10010. Where this book is distributed in the UK, Europe and the rest of the World, this is by Palgrave Macmillan, a division of Macmillan Publishers Limited, registered in England, company number 785998, of Houndmills, Basingstoke, Hampshire RG21 6XS. Palgrave Macmillan is the global academic imprint of the above companies and has companies and representatives throughout the world. Palgrave® and Macmillan® are registered trademarks in the United States, the United Kingdom, Europe and other countries. ISBN: 978–0–230–62192–3 (paperback) ISBN 978-0-230-62192-3 ISBN 978-0-230-10229-3 (eBook) DOI 10.1057/9780230102293 Library of Congress Cataloging-in-Publication Data is available from the Library of Congress. Design by Integra Software Services First edition: January 2010 10987654321 Permissions Portions of Chapter 7, “Genetic and Eugenics,” are from A Passion for DNA: Genes, Genomes and Society, pp. 3–5, 179–208, 209–222, by James D. Watson, Cold Spring Harbor Laboratory Press 2000. c James. D. Watson. Reprinted with permission of James D. Watson. Chapter 5, “Mad, Bad, or Evil: How Physicians Healers Turn to Torture and Murder” was discussed and published in “Physicians and Torture: Lessons from the Nazi Doc- tors,” by Michael A. Grodin and George Annas, International Review of the Red Cross, Volume 89, Issue 867, September 2007, pp. 635–654. c International Commit- tee of the Red Cross 2007. Reprinted with the permission of Cambridge University Press. Chapter 9, “The Legacy of the Nuremberg Doctors’ Trial to American Bioethics and Human Rights,” is adapted and updated from the final chapter of American Bioethics: Crossing Human Rights and Health Law Boundaries , pp. 159–166, by George Annas, by permission of Oxford University Press, Inc. 2004. Excerpt from “Little Gidding” in FOUR QUARTETS, copyright 1942 by T.S. Eliot and renewed 1970 by Esme Valerie Eliot, reprinted with permission of Houghton Mifflin Harcourt Publishing Company. Excerpt from “Little Gidding” in Four Quartets by T.S. Eliot reprinted with permission of Faber and Faber Ltd. Figure 5.1. The Defendants’ Box at the Doctors’ Trial; Figure 5.2. Adolf Hitler as the Physician to the German People; Figure 5.3. “You Are Sharing the Load!”; Figure 10.1. Glass Man; and Figure 10.2. Maimed soldiers in Plötzensee near Berlin, summer 1916 are reprinted courtesy of the United States Holocaust Memorial Museum. The photograph on the cover is reprinted courtesy of the Holocaust Museum Houston. This page intentionally left blank Contents List of Tables and Figures ix List of Contributors xi Acknowledgments xv Foreword: This Past Must Not Be Prologue xix Francis S. Collins Introduction 1 Sheldon Rubenfeld Part 1 Eugenics, Euthanasia, Extermination 9 1 When Evil was Good and Good Evil: Remembrances of Nuremberg 11 Edmund D. Pellegrino 2 Medicine during the Nazi Period: Historical Facts and Some Implications for Teaching Medical Ethics and Professionalism 17 Volker Roelcke 3 Academic Medicine during the Nazi Period: The Implications for Creating Awareness of Professional Responsibility Today 29 William Seidelman 4 Misconceptions of “Race” as a Biological Category: Then and Now 37 Theresa M. Duello 5 Mad, Bad, or Evil: How Physician Healers Turn to Torture and Murder 49 Michael A. Grodin 6 Genetic Diversity Has Prevailed, Not the Master Race 67 Ferid Murad Part 2 Medicine after the Holocaust 69 7 Genetics and Eugenics: A Personal Odyssey 71 James D. Watson viii C ONTENTS 8 The Stain of Silence: Nazi Ethics and Bioethics 83 Arthur L. Caplan 9 The Legacy of the Nuremberg Doctors’ Trial to American Bioethics and Human Rights 93 George J. Annas 10 A More Perfect Human: The Promise and the Peril of Modern Science 107 Leon R. Kass 11 What Does “Medicine after the Holocaust” Have to Do with Aid in Dying? 123 Kathryn L. Tucker 12 Is Physician-Assisted Suicide Ever Permissible? 135 Wesley J. Smith 13 Cinematic Perspectives on Euthanasia and Assisted Suicide 153 Glen O. Gabbard 14 Science, Medicine, and Religion in and after the Holocaust 163 John M. Haas 15 Why Science and Religion Need to Cooperate to Prevent a Recurrence of the Holocaust 171 Irving Greenberg 16 The Status of the Relationship between the Citizen and the Government 181 Ward Connerly 17 From Nuremberg to the Human Genome: The Rights of Human Research Participants 185 Henry T. Greely 18 Medical Professionalism: Lessons from the Holocaust 201 Jordan J. Cohen 19 Assessing Risk in Patient Care 209 George Paul Noon 20 Jewish Medical Ethics and Risky Treatments 213 Avraham Steinberg Afterword 221 Michael E. DeBakey Appendix A: Additional Information 225 Index 227 List of Tables and Figures Tables 5.1 The Formation of a Torturer 57 5.2 Why Physicians are Vulnerable to Becoming Perpetrators 58 13.1 Films from 1970 to 2006 Showing Variations of Euthanasia 155 18.1 Physician Charter: Responsibilities of Individual Physicians 202 18.2 Contrasting Terms: Professionalism and Commercialism 203 Figures 5.1 The Defendants’ Box at the Doctors’ Trial 50 5.2 Adolf Hitler as the Physician to the German People 54 5.3 “You are sharing the load!” 60 10.1 Glass Man 109 10.2 Maimed soldiers in Plötzensee near Berlin, summer 1916 111 This page intentionally left blank List of Contributors George J. Annas, J.D., M.P.H., is the Edward R. Utley Professor and Chair, Depart- ment of Health Law, Bioethics & Human Rights, Boston University School of Public Health, and professor in the Boston University School of Medicine and School of Law. He is the cofounder of Global Lawyers and Physicians and a member of the Institute of Medicine and the Committee on Human Rights of the National Academies. Professor Annas is the author or editor of 17 books on health law and bioethics. Michael E. DeBakey, M.D., a pioneer in the field of cardiovascular surgery, was chancellor emeritus of Baylor College of Medicine. Dr. DeBakey also developed the concept of mobile army surgical hospitals (MASH) and was a driving force behind the development of the Veterans Administration Medical Center System and the National Library of Medicine. Dr. DeBakey received numerous medical awards, including the Presidential Medal of Freedom with Distinction, the Albert Lasker Award for Clinical Research, and the Congressional Gold Medal. Arthur L. Caplan, Ph.D., is the Emmanuel and Robert Hart Professor of Bioethics and chair of the Department of Medical Ethics at the University of Pennsylvania. Dr. Caplan is the author or editor of 25 books, including When Medicine Went Mad: Bioethics and the Holocaust, and more than 500 papers in refereed journals of medicine, science, philosophy, bioethics, and health policy. Jordan J. Cohen, M.D., is president emeritus of the Association of American Medical Colleges and professor of medicine and public health at George Washington University. Dr. Cohen has held many leadership positions in academic medicine, and he is also chairman of the Arnold P.Gold Foundation, which advances humanism in medicine through innovations in medical education. Francis S. Collins, M.D., Ph.D., is director of the National Institutes of Health and the former director of the National Human Genome Research Institute at the National Institutes of Health, where he led the successful effort to complete the Human Genome Project. In recognition of his contributions to genetic research, Dr. Collins received the Presidential Medal of Freedom, the nation’s highest civil award. Ward Connerly is chief executive officer of Connerly & Associates, Inc., and the founder and president of the American Civil Rights Institute. Mr. Connerly stimu- lated the University of California to end the use of race as a means for admission in xii L IST OF C ONTRIBUTORS 1995 and has led campaigns in several states to require equal treatment under the law for all residents in public education, public employment, and public contracting. Theresa M. Duello, Ph.D., is the assistant director of the Diversity Initiatives Endocrinology-Reproductive Physiology Program and associate professor in the Department of Obstetrics and Gynecology at the University of Wisconsin-Madison. She teaches medical school and undergraduate courses on health disparities with an emphasis on the need for medical history to inform the training of future health professionals. Glen O. Gabbard, M.D., is the Brown Foundation Chair of Psychoanalysis, pro- fessor of psychiatry, and director of the Baylor Psychiatry Clinic at Baylor College of Medicine. He has published over 290 scientific papers and book chapters and authored or edited 23 books, including Psychodynamic Psychiatry in Clinical Practice and Psychiatry and the Cinema. Henry T. Greely, J.D., is the Deane F. and Kate Edelman Johnson Professor of Law and professor (by courtesy) of genetics at Stanford University. He is also the director of both the law school’s Center for Law and the Biosciences and the Stanford Center for Biomedical Ethics Program in Neuroethics. Professor Greely specializes in the implications of new biomedical technologies, especially those related to genetics, neuroscience, and stem cells. Irving Greenberg, Ph.D., is an ordained Orthodox rabbi and scholar who has been a seminal thinker in confronting the Holocaust as a historical transforming event. A pioneer in Holocaust education, theology, and in Jewish-Christian dialogue, Rabbi Greenberg has published numerous articles and monographs on Jewish thought and religion and was one of the founding figures of the United States Holocaust Memorial Museum.