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
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.