A new book has just been published,titled "Bioethics and the Holocaust: A Comprehensive Study in How the Holocaust Continues to Shape the Ethics of Health, Medicine and Human Rights." It is a free download from the Maimonides Institute for Medicine Ethics & The Holocaust.
Chapter Two, "Teaching Medical Ethics in Nazi Germany: Debunking the Myth that the Nazi Physicians Abandoned Their Ethics," by Tessa Chelouche is mind-blowing.
Believe it or not, Nazi Germany was in the forefront of publishing a guide for medical ethics. medical ethics manual, Medical Jurisprudence and Rules of the Medical Profession,was written by Dr. Rudolf Ramm. In its own sick and twisted way, it created an ethics system that in some ways resembles the one used by doctors worldwide - but it was steeped in Nazi racial ideology.
The uncomfortable reality is that the physicians who executed these crimes were of the conviction that their actions were morally and scientifically right (Caplan 2010). These were not incompetent, insane physicians from the fringes of the profession. Many were distinguished, experienced professionals from mainstream German medicine, which was considered to be the most progressive of the time (Aly et al. 1994; Weiss 2005). The German physicians were not coerced to join the Nazi Party, but did so on their own initiative and in greater numbers than any other free profession (Kater 1989). Among them were university professors and experienced physicians who, like Rudolf Ramm, took it upon themselves to inculcate future generations of physicians precisely due to the fact that they believed that what they were practicing and preaching was ethically and morally right (Bruns and Chelouche 2017). In Ramm’s words: “So this book should be a companion and a guide to the student of medicine and to the young physician for his established goal and an adviser to the young person in his choice of profession.”
...Nazi Germany became the first country in the world to hold mandatory ethics classes in medical schools.
Antisemitism was an inherent feature of Nazi medical ideology. One of the first steps taken in the newly formed Nazi regime was the removal of Jews from medical practice, both academic and clinical. In reading the textbook we realize the extent to which the Nazi physicians internalized and embraced antisemitism as inherent to, and acceptable with, medical and ethical norms. Ramm praises the new antisemitic directives: “One of the first measures of the National Socialist Physicians leadership was the cleansing of the profession of politically unreliable and racially foreign elements, so long as the medical benefit for the Volk population was not endangered” “Cleansing the profession” refers to the expulsion of the Jewish physicians from medicine in 1938, whose licenses were revoked and who were no longer considered doctors, but rather healers permitted to treat only fellow Jews. “One can however today already grasp the blessings which are important to life and to our Volk in the offices of the states that have emerged after the forceful expulsion of the Jews from the profession” He rationalizes the self-righteous persecution and marginalization of Jewish physicians: “It was the Jew who forced some German doctors into a crass materialistic employment of professionally unworthy methods of competition; the Jew who endangered the German Volk, and the one who through extension of his souls-poisoning ideas, enabled the destruction of germinating life while generating the impression, through his methods of advertising in wide circles of the population, that he was indispensable as a medical researcher and medical practitioner…Today no full-blooded German would allow himself to be treated by a Jewish doctor”. Although these passages read as blatant racist propaganda, they are in essence what was deemed morally right to teach medical students in Nazi Germany.
The chapter goes on to discuss sterilization, eugenics and euthanasia as all being placed in an ethical framework.
Ramm's medical ethics manual created a framework that was 'ethical" in the sense that it had an ethical basis - the importance of the Volk and the nation, ensuring that the most fit people would lead the nation in the future. Those who would be deleterious towards that goal should be marginalized and ultimately eliminated. It is monstrous, but it is a self-consistent ethical framework that appealed to the medical professionals in Germany of the day.
The conclusion includes:
[E]thics instruction does not ensure future virtuous medical practice. In addition, the existence of codes and directives and in this case, ethical textbooks, does not assure moral integrity. In fact, Ramm’s work shows us just how training and education can be used deleteriously.
If we expand a little beyond the medical profession, this is exactly what we are seeing today. So called "human rights" groups, taking the mantle of the highest ethical arbiters as medical professionals have been, have created their own self-consistent definition of morality that just happens to be twisted against today's Jews. They created brand new definitions of "apartheid" and "persecution" and "colonialism" that have been custom built to apply only to Israeli Jews, or terms like "indigenous" that have been interpreted deliberately to exclude Jews.
The insidiousness of their methodology is that they are not just spreading hate. They are teaching their ethical framework as if it is the only ethical system that exists.
Within that framework, it is impossible to defend Israel (as well as the traditional family, religion, and a host of other issues.)
This chapter is meant to teach doctors that they cannot assume that their ethical training makes them immune to doing immoral things in service of the prevailing standards and mores. But others who claim to have the moral high ground should read this as well.
Bioethics and human rights both became much more prominent as a response to the Holocaust. This book reminds us that adhering to an ethical framework is not enough: sometimes the framework itself can justify even the most heinous crimes.
(h/t Jay L)
