Paul Etkind has prepared a summary of our May 6, 2018,
meeting. As you may recall, the theme of the meeting was Holocaust
Remembrance and the talks by our three guests outlined the role of
German physicians in the Holocaust. Our thanks to Paul for
arranging the meeting and for his summary.
Examining the Role of German Physicians in the Holocaust
Paul Etkind
The Sunapee-Kearsarge Jewish Community held its annual Spring
meeting on May 6 and focused on the Shoah. The title of the
presentation and subsequent discussion was “From the Hippocratic
Oath to Active Participation in the Death Camps: Examining the
Role of German Physicians in the Holocaust.” Leading this
presentation were Rabbi Edward Boraz, who is celebrating his
twentieth year as Director of Hillel at Dartmouth College as well
as the Rabbi for Congregation Kol Ha’Emek, the Upper Valley Jewish
Community; Dr. James Bernat, an Emeritus Professor or Neurology
and emeritus Professor of Medicine at the Geisel School of
Medicine at Dartmouth; and Dr. Donald Kollisch, an Associate
Professor of Medicine and an Associate Professor of Community and
Family Medicine at the Geisel School of Medicine at Dartmouth. The
three developed this material for a six-week medical ethics
elective course for medical students. They wanted to explore the
question of how could educated and trained German physicians
forsake their professional vows to initially abet eugenics, then
euthanasia, and then extermination? How might current medical
students develop a sense of awareness to realize when/if they
might be headed down a similar path that is contrary to the ethics
of their profession?
Rabbi Boraz began the discussion with a review of the legal
framework that the Nazi government built over time that culminated
in human experimentation and extermination in camps especially
designed for such purposes. The first law passed, in April 1933,
was entitled Law for the Restoration of the Professional Civil
Service. It began with an innocuous, and reasonable, mission: to
restore a national civil service in which people could be denied
that status or could be dismissed if they did not have the
required or customary educational background to do the job.
However, it then went on to say people could be dismissed for lack
of other qualifications. These other qualifications included not
being Aryan or those whose political activities offered no
assurance they would fully support the State.
In July 1933, the Law for Prevention of Offspring with Hereditary
Diseases was passed. This eugenics law allowed the State, with a
court order, to surgically sterilize an individual if there was a
high likelihood of his/her offspring will suffer serious physical
or mental defects of a hereditary nature. If the courts approved,
then sterilization could proceed even if the subject of the court
order objected to it. Rabbi Boraz cautioned the audience to not
assume a sense of moral superiority regarding eugenics, because
the United States had numerous similar laws on the books at that
time.
Two more laws were passed in September 1935 that furthered the
legal basis for The Final Solution. The first was the Reich
Citizenship Law, which says anyone enjoying the protection of the
German Reich had specific obligations as a result. It defined a
Reich citizen as on who is of German or related blood and proves
by his conduct that he is willing and able to faithfully serve the
German people and the Reich. The other law passed on that date was
Law for Protection of German Blood and German Honor. The preamble
states the law was passed because the Reichstag was moved by the
understanding that purity of German blood is the essential
condition for the continued existence of the German people and was
inspired by the inflexible determination to ensure the existence
of the German nation for all time. The law forbade marriages
between Jews and German citizens and allowed such marriages that
occurred prior to the law’s passage to be annulled. Extra-marital
affairs between Jews and German citizens were forbidden. Jews were
forbidden to employ female subjects of the Reich under the age of
45 years as household help. Finally, Jews were forbidden to fly
the Reich or national flag or display Reich colors. Cynically, the
law said Jews were protected by law to fly the Jewish colors.
Dr. Bernat then continued the presentation with a discussion of
how the German medical profession adopted and supported the Nazi
government’s philosophy of Aryan racial superiority. The German
medical society agreed that it is the role of physicians to assure
the health of Society, so the conditions necessary for societal
health as outlined by these laws demanded the support of
physicians and their professional organizations. Dr. Bernat
pointed out that, in many societies including the US, there is a
dynamic tension between the rights of individuals and the rights
of Society. What is good for the individual might not be good for
the group, and vice versa. In the Third Reich, the medical
professions adopted the government’s view that what is right for
Society is the primary concern. Thus, services for Jews and other
marginalized populations were no longer considered to be very
important. Why expend the resources of those contributing to
Society on those who only drain Society of its vigor?
Dr. Bernat recounted the research of a colleague who, in the
1980s, followed up with interviews of German physicians who had
worked in the extermination camps. Some had great regrets over
their actions, but most felt that they were doing their duty as
their government and profession had expected of them.
Dr. Kollisch summarized the two previous presentations and then
spoke briefly about the students who have taken this course. His
main point was that these legal and cultural frameworks that
promote marginalization may not be recognized for what they are
doing or are capable of fostering until it is too late. They were
developed incrementally so that, by the times the worst outcomes
were in place, they seemed more normal and fewer questioned them.
He also spoke of the students who have taken this course over the
past three years. Most students take electives that offer concrete
skills (eg, patient interviews) so only approximately 9 or so
students have taken this each year. Interestingly, few Jewish
students have enrolled. He did not know why that was so. Are
Jewish students that aware of the Holocaust that they don’t feel
such a course is the best use of their time? Students who have
taken the course have expressed gratitude for the content of the
information and discussions, and how it has sharpened their
awareness of ethical issues in their chosen profession.
The actions of German medicine and physicians are a
little-investigated aspect of the Holocaust and the audience
showed as much with their frequent “Oh’s” and amazed facial
expressions. Even with so little data available, the
findings of these three teachers were provocative and filled with
lessons for today.