December 9 marks the fiftieth anniversary of the beginning of the ‘Doctor’sTrial’, which followed the far more famous trial of the Nazi leadership at Nuremburg for ‘crimes against humanity’. Seven medical defendants received death sentences, and as the trial drew to a close, the prosecution’s two pri- mary medical expert witnesses summarised the ethi- cal arguments, the resulting principles serving as the basis of the Nuremburg Code.
Genocide,Webster’s Dictionary informs us, is ‘the deliberate and systematic destruction of a racial, political, or cultural group’. Australia would seem distant from such inhumanity, and indeed, on 11 December 1948 ratified the United Nations Conventionon the prevention and punishment of the crime of genocide. Therein lies a somewhat different definition: article II includes
any acts committed with intention to destroy, in whole or in part, a national, ethnical, racial or religious group such as: … e) forcibly transferring children of the group to another group.1
As the Human Rights Commission Inquiry into the Removal of Aboriginal Children has shown, Australia was in breach of the Convention for two decades.
In addition, real-time satellite telecasts from the Balkans and Central Africa inform us that genocide continues, and specialist programs for the treatment of Survivors of torture remind us that many have Come to Australia. Although it is the best documented, the Holocaust is neither the first nor the largest recorded genocide and, despite the Convention, it is far from the last. But it is a defining event of twentieth-century European history, born of enduring, virulent antisemitism, drawing sustenance
from European cultural traditions and nurtured by intellectual complicity.
The Holocaust also allows us the explore the roles and reactions of health professionals. In 1945,Allied medical personnel were among the first to enter camps filled with corpses and living skeletons, obliged to undertake public health roles of an extremely complex medical and political nature. Perhaps the best account is that of Marcus Smith, a young American who spent six weeks in Dachau fol- lowing liberation. He also described the malaria ‘research’ station where Professor Klaus Schilling, previously a member of the Malaria Commission of the League of Nations, experimented on prisoners.2 Concurrently, an Australian with the United Nations Relief and Rehabilitation Association (UNRRA), Raphael Cilento, was one of the first civilian doctors to enter Belsen. By contrast with Smith, Cilento had long experience in public health, and became Chief of UNRRA in the British Zone. Both witnessed the consequences of starvation, the ravages of typhus and the remarkable effectiveness of DDT.
Most doctors caught in the maelstrom of the Holocaust were consumed by it – but not all in silence. Consider the clinical accounts of starvation in the Warsaw ghetto population prior to the beginning of transportations to Treblinka in July 1942. Twentythree doctors, led by Israel Milejkowski, who was responsible for public health in the ghetto, continued their observations, measurements, autopsies and writing, despite suffering themselves from the conditions they were studying. Hunger disease, smuggled out and made public in Polish in 1946, is a remarkable scientific work, the more so as the authors had few illusions about their fate, as suggested by Milejowski’s concluding remarks:
A last few words to honor you, the Jewish doctors. What can I tell you, my beloved colleagues and companions in misery. You are part of all of us. Slavery, hunger, deportation, those death figures in our ghetto were also your legacy. And you by your work could give the henchmen the answer- “Non omnis moriar” – “I shall not wholly die” (p. xi)
3
Not all ghetto doctors perished. Adina Szwajer worked in the ghetto children’s hospital and as a courier for the Jewish armed resistance, escaping
just ahead of the ghetto uprising. Because of the profoundly conflicting roles that were thrust upon her (for instance, euthanasia of children awaiting deportation), Szwajger swore never to write again, and her account was to wait 50 years until she retired from paediatric practice:
somewhere underneath I thought that I had no right to carry out my profession. After all, one does not start one’s work as a doctor by leading people not to life but to death (p. 166).
4
Another ghetto survivor was Dr Abraham M’ajnryb, who ultimately practiced medicine in Australia. While Swajger was active in the resistance, Wajnryb considered his public health activities as such:
If we assume that the word ‘resistance’ includes all activities aimed at preserving the values which the enemy intends to destroy, then it is no exaggeration to say that the hospital was a bastion of resistance in the ghetto (p. 39).
5
Most Jewish doctors perished, and none survived the five death camps (all of which were in Poland). Some survived Auschwitz, which was both a death factory and a slave labour camp. Several wrote of their experiences soon after: Elie Cohen, Miklos Nyszli, Victor Frankl and Gisella Perl.6-9 In different ways, these doctors strove to reconcile their identity as doctors and as victims of a system in which logic and values were inverted or capricious.” That struggle was the more difficult because prominent among their persecutors were their professional colleagues. Indeed, Miklos Nyszli was chief forensic assistant to SS Dr.Josef Mengele, Auschwitz’s ‘angel of death’.
Nazi medicine would seem to bear little relation- ship to public health. However, there is a connec- tion, the 14fl3 program, which linked the T4 (euthanasia) program in Germany with the Nazi death factories. The T4 program coordinated the medical murder of psychiatric patients who were designated by physicians as ‘life unworthy of life’. Official support ceased in 1941, owing to pressure from within Germany, and the 14fl3 program relo- cated T4 personnel and technology, to facilitate the extermination of European Jewry in Poland.
The T4 program and forced sterilisation were pre- sented to the German public through sophisticated propaganda as issues of social or public health. Malthusian images were conjured of a nation sapped financially and morally by a rising tide of imbeciles, cretins and the socially and morally corrupt. These concerns were not initiated by the Nazis; they had been around a long time, and not only in Germany. However, radical biological solutions to social (and later, racial) so-called problems required that these be framed as such, and that the solutions bear the imprimatur of learned disciplines, particularly
genetics, medicine, psychiatry and public health. Indeed, the greater responsibility lies at the level of ideas rather than in the brutal acts of men such as Mengele. Medical professionals as a group were early and eager supporters of national socialism, providing critical support and legitimacy to Nazi eugenic and racial policy.’’
William Seldeman, Professor in the Department of Family and Community Medicine and the University of Toronto, has pointed out that doctors
in Nazi Germany appeared to have little difficulty accommodating to a system of fundamentally dis- torted values.12However, he asks whether they were any different from doctors elsewhere, or doctors today, suggesting that physicians ‘need to ask them- selves if they are any less fallible, any less vulnerable, any wiser, any stronger?’ (p. 9). Such questions should alert us to the perils of forgetting. As genocide evolves, some health professionals continue to be involved as perpetrators, and as after the Second
World War, many will seek later to return to their healing and caring roles. There is nothing in the nature of health education or practice that confers immunity. The medical education of the doctors, whether they were perpetrators, victims or bystanders, could not have prepared them for what they encountered. And despite our knowledge of what has and what is happening, the situation is little changed.
Australian health professionals are probably more likely than ever to find themselves working among refugee populations overseas and with survivors in Australia. Genocide was and is a major public health issue, which should be reflected in educational curricula. Workers should be equipped with more than clinical skills and moral outrage. They should be provided with an understanding of the precursors, processes and consequences of genocide, the literature about which is now vast. They should also be informed about the ways in which their chosen pro- fessions may have been implicated in past genocides.
Public health professionals should take a lead as educators in this field. Over the last eight years, several Australian health professionals have attended the annualJanuary course for genocide educators at Yad Vashem in Jerusalem, coordinated through the Australian Centre for Comparative Genocide Studies at Macquarie University. All have been powerfully challenged by it. I believe that it is time to make genocide studies available within public health curricula in Australia. In doing so, we may prove the truth of Dr Milejowski’s attestation-non omnis moriar.
Ernest Hunter
Northern ClinicalSchool University of Queensland, Cairns
References
- Chalk F, Jonassohn K The history and sociology of genocide: analyses and case studies. New Haven: Yale University Press, 1990.
- Smith MJ. Dachau: the harrowing of hell. Albany: State University of New York, 1995 [1972].
- Winick M,editor. Hunger disease : studies by the Jewlsh physicians in the Warsaw ghetto. Trans. Osnos M. New York Wiley, 1979.
- Szwajger AB. I remember nothing more: the Warsaw Children Hospital and the Jewish resistance. Trans. Stok T, Stok D. New
York: Simon and Schuster, 1990. - Wajnryb A. Memoirs of a doctor from the Wilno ghetto. Trans. Konsman E, Wajynryb A. Sydney; Centre for Comparative
Genocide Studies, Macquarie University, 1979. - Cohen E A. Human behaviour in the concentration camp. Trans. Braaksma HM. London: Free Association Books, 1988
[1952]. - Nyiszli M. Awchwitz: A doctor’s eye-witness account. Trans. Kremer T, Seaver R. London: Grafton Books, 1973 (1946)
- Frankl VE. Man’s search for meaning. New York: Washington Square Press, 1984 (1946).
- Perl G. I was a doctor in Auschwitz. New York International Universities Press, 1948.
- Hunter E. At the healer’s limits: three medical sumivors of Auschwitz. Sydney: Centre for Comparative Genocide
Studies, Macquarie University. In press. - Hunter EM. The snake on the caduceus: dimension of medical and psychiatric responsibility in the Third Reich.
Aust N Z J Psychiatary 1993;27:149-56. - Seidelman WE. Whither Nuremburg? Medicine’s continuing Nazi
h i t a g e . Toronto: Royal Canadian Institute, University of Toronto, 1994.
https://journals.sagepub.com/doi/10.3109/00048679309072134
Annihilating Difference: The Anthropology of Genocide
Scientific Racism in Service of the Reich: German Anthropologists in the Nazi Era
Gretchen E Schafft
Annihilating Difference: The Anthropology of Genocide, 117-136, 2002
BACKGROUND
Almost sixty years after the invasion of Poland by the Nazis in World War II, an old man stands shaking by his door, afraid to meet the anthropologists who have come to talk to him. He says he does not have anything to tell; he was sick, in the hospital at the time. Another villager is nothesitant and tells of the time of the Nazi occupation of Poland when anthropologists came into the town under SS guard, gave the townspeople a time to appear at the priest’s house, and examined them from head to foot.(Few Jews remained in the villages by that time, having been moved to collection points and ghettoes.) Some were given German passports and told to appear for induction and transport to the Russian Front. Others were told to appear for delousing and assignment to labor battalions in Germany. Others escaped to the south and joined the resistance, or were shot attempting to do so. The few people who can remember this time complete a record that at last is being pieced together. They are the living memory of a period almost forgotten in anthropology’s professional history.
The fact that German and, to a lesser extent, Austrian anthropologists were involved in the Holocaust as perpetrators, from its beginning to its conclusion, has never been fully acknowledged nor discussed by American anthropologists. 1 The role that American funding played in developing the Nazi ideology of race has also not been told. The information has been available, although not easy to access. Records of these anthropologists‘ theoretical and empirical studies, as well as their activities as trainers of SS doctors, members of racial courts, collectors of data from concentration camp medical experiments, and certifiers of racial identities have been“ cleansed.“ Documents that should be available in archival files are missing The biographies of many perpetrators include a cover story for the years 1933 through 1945.’The archives of the Rockefeller Foundation, which supported Ger-man anthropologists in their racial research, are also mysteriously missing important research plans and reports.
THE NUREMBERG CODE
1. The voluntary consent of the human subject is absolutely essential.
This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, over-reaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved, as to enable him to make an understanding and enlightened decision. This latter element requires that, before the acceptance of an affirmative decision by the experimental subject, there should be made known to him the nature, duration, and purpose of the experiment; the method and means by which it is to be conducted; all inconveniences and hazards reasonably to be expected; and the effects upon his health or person, which may possibly come from his participation in the experiment.
The duty and responsibility for ascertaining the quality of the consent rests upon each individual who initiates, directs or engages in the experiment. It is a personal duty and responsibility which may not be delegated to another with impunity.
2. The experiment should be such as to yield fruitful results for the good of society, unprocurable by other methods or means of study, and not random and unnecessary in nature.
3. The experiment should be so designed and based on the results of animal experimentation and a knowledge of the natural history of the disease or other problem under study, that the anticipated results will justify the performance of the experiment.
4. The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.
5. No experiment should be conducted, where there is an a priori reason to believe that death or disabling injury will occur; except, perhaps, in those experiments where the experimental physicians also serve as subjects.
6. The degree of risk to be taken should never exceed that determined by the humanitarian importance of the problem to be solved by the experiment.
7. Proper preparations should be made and adequate facilities provided to protect the experimental subject against even remote possibilities of injury, disability, or death.
8. The experiment should be conducted only by scientifically qualified persons. The highest degree of skill and care should be required through all stages of the experiment of those who conduct or engage in the experiment.
9. During the course of the experiment, the human subject should be at liberty to bring the experiment to an end, if he has reached the physical or mental state, where continuation of the experiment seemed to him to be impossible.
10. During the course of the experiment, the scientist in charge must be prepared to terminate the experiment at any stage, if he has probable cause to believe, in the exercise of the good faith, superior skill and careful judgement required of him, that a continuation of the experiment is likely to result in injury, disability, or death to the experimental subject.
[„Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law No. 10“, Vol. 2, pp. 181-182. Washington, D.C.: U.S. Government Printing Office, 1949.]
When a team of health activists from an NGO specializing in women’s health called Sama visited Khammam on an exploration mission in March 2010, they were told that up to 120 girls had side effects such as epileptic seizures, severe abdominal pain, headaches and mood swings. The Sama report also said that there had been cases of early onset of menstruation after vaccination, heavy bleeding and severe menstrual cramps in many students. The standing committee attracted the responsible state governments for the shabby investigation of these deaths. It said it was worrying to note that „all seven deaths without in-depth investigations were collectively dismissed as not related to vaccinations… the speculative causes were suicides, accidental drowning in the well (why not suicide?), malaria, viral infections, subarachnoid bleeding (without autopsy) Etc.“
The committee said that in connection with the death of girls who are classified as suicide, the role of the „HPV vaccine as a possible, if not probable cause of suicidal thoughts“ cannot be excluded.
It was said that an American NGO – Program for Appropriate Technology in Health (PATH) – carried out the studies.
https://economictimes.indiatimes.com/topic/program-for-appropriate-technology-in-health
NUREMBERG AND TUSKEGEE: LESSONS FOR CONTEMPORARY AMERICAN MEDICINE
David M. Pressel, MD, PhD Wilmington, Delaware
The activities of German doctors during the Naziregime are well known and documented. They include efforts at eugenic sterilization and euthanasia, gruesome medical experimentation, and contributions to genocide. The German medical profession embraced the Nazi ideology of racial superiority. Nazi doctors enthusiasticaly perverted traditional medical mores of viewing each patient as awful individual towards a misguided sense of protecting the racial wellbeing of the nation from the perceived threat of certain groups of people. Similarly, some 20th-century American physicians engaged inactivities prompted by a-misguided sense of patients worth as individuals. This essay will examine the ethical problems of Nazi medicine and ethical missteps in the United States in the context of challenges forcontemporaryphysicians,particularlythewayinwhichwe refertoourpatients.(JNatlMedAssoc.203;95:1216-125.)
JULIMINATION 
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