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A HISTORICAL ACCOUNT OF MEDICINE'S DESCENT INTO DARKNESS

Shevell, Michael MD

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Dr. Shevell is Associate Professor in the Departments of Neurology, Neurosurgery and Pediatrics at McGill University in Montreal, Quebec.

Deadly Medicine: Creating the Monster Race Edited by Susan Bachrach and Dieter Kuntz

226 Pages • University of North Carolina Press 2004

Stripped of its veneer of science and technology, medicine strives to alleviate and minimize disease and suffering without inflicting additional harm. Although the actual interventions used and the approach taken may change through the acquisition of new knowledge, the core remains unaltered. This statement is true of every historical epoch save one, Nazi Germany. During the Third Reich, a thus far unique confluence of scientific thought and political context interacted synergistically to corrupt and distort medicine's purpose with horrific results.

Based on a current (April 2004–October 2005) exhibit at the United States Holocaust Memorial Museum in Washington, DC, Deadly Medicine: Creating the Master Race–edited by Susan Bachrach and Dieter Kuntz – details this corruption and distortion in medicine's darkest hours.

Seven essays written by distinguished scholars in the field provide an overview of medicine's descent into darkness and the actions undertaken by physicians. The unique feature and strength of this book is that each of these chapters is lavishly illustrated by reproductions of primary archival materials that emphasize the points made in the text. Propaganda material, scientific and medical documents, physical settings and instruments used in sterilization and involuntary euthanasia, photographs of perpetrators and, more important, photographs of victims and their personal effects render the horrors real, making a vivid and lasting impression on the reader. The illustrations – predominantly photographs – are well chosen.

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BIOLOGICAL ASPECTS, NAZI PHILOSOPHY

Figure. Reviewer Dr....
Figure. Reviewer Dr....
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The introductory essay by Susan Bachrach and the essay by Sheila Faith Weiss on pre-1933 German Eugenics highlight the biological aspects of Nazi philosophy. With racial restoration a central feature of a political philosophy and culture, presumed biological threats to overall racial health were envisioned and biological remedies were proposed. Racial policies were framed as “public health” measures emphasizing “scientific” principles of population management. A central, indeed invariable, role for heredity was purported on the flimsiest of evidence and social problems were re-cast as biology. Concurrent with this was a reformulation of individual value in terms of economic productivity, idealized physical traits, and arbitrary cultural standards.

Daniel Kevles's essay on International Eugenics highlights the worldwide reach and influence of eugenic thought. It was the political context of Nazi Germany with its systematic devaluation of both individual autonomy and intrinsic worth within the framework of harsh oppression that permitted the implementation of biological theory into practice.

The essays – by Gisele Bock, “Nazi Sterilization and Reproductive Policy;” Benoit Massin, “Science of Race;” and Michael Burleigh, “Nazi Euthanasia Program” – document the implementation of these policies with the cooperation of medical practitioners. The key element was a focus shift in emphasis in medical practice from the individual to the collectivity (Volkskörper), which emphasized biological regeneration through incrementally more brutal programs that made acts of public policy what had been private matters, including reproduction, marriage, and health care.

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INVOLUNTARY EUTHANASIA

Burleigh's essay together with that of Henry Friedlander – “From Euthanasia to the Final Solution” – documents the horrific details of programs for children as well as adults: involuntary euthanasia for the physically and mentally handicapped that would lend both personnel and techniques to the Holocaust of European Jewry.

The euthanasia programs were carried out in existing healthcare facilities by trusted physicians who carried out mass murder on an assembly line. The physicians were convinced they were practicing acceptable medicine. Before long physicians served on the arrival ramps of death camps to affect a process of “life or death” selection based on potential productivity.

Neurologists will feel a particular connection with the topic matter of this book. This comes with the sad realization that it was the patients we care for who were particular early targets of Nazi racial policies: the retarded; those with epileptic seizures, psychosis, or dementia; or the physically disabled. This would be a fair sized segment of our clinic population – the patients we see every day in practicing neurology.

It is disturbing to think that our predecessors during the Third Reich did not see it possible to act collectively and protect patients from harm. Awareness of this dark era in medicine's history should help us avoid such grave errors now and into the future.

©2005 American Academy of Neurology

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