Ethical considerations in the use of Pernkopf's Atlas of Anatomy: A surgical case study

Yee, A., Zubovic, E, and others
Surgery May 2019Volume 165, Issue 5, Pages 860–867

Abstract

The use of Eduard Pernkopf's anatomic atlas presents ethical challenges for modern surgery concerning the use of data resulting from abusive scientific work. In the 1980s and 1990s, historic investigations revealed that Pernkopf was an active National Socialist (Nazi) functionary at the University of Vienna and that among the bodies depicted in the atlas were those of Nazi victims. Since then, discussions persist concerning the ethicality of the continued use of the atlas, because some surgeons still rely on information from this anatomic resource for procedural planning. The ethical implications relevant to the use of this atlas in the care of surgical patients have not been discussed in detail. Based on a recapitulation of the main arguments from the historic controversy surrounding the use of Pernkopf's atlas, this study presents an actual patient case to illustrate some of the ethical considerations relevant to the decision of whether to use the atlas in surgery. This investigation aims to provide a historic and ethical framework for questions concerning the use of the Pernkopf atlas in the management of anatomically complex and difficult surgical cases, with special attention to implications for medical ethics drawn from Jewish law.

The info is here.

The Nuremberg Code 70 Years Later

Jonathan D. Moreno, Ulf Schmidt, and Steve Joffe
JAMA. Published online August 17, 2017.

Seventy years ago, on August 20, 1947, the International Medical Tribunal in Nuremberg, Germany, delivered its verdict in the trial of 23 doctors and bureaucrats accused of war crimes and crimes against humanity for their roles in cruel and often lethal concentration camp medical experiments. As part of its judgment, the court articulated a 10-point set of rules for the conduct of human experiments that has come to be known as the Nuremberg Code. Among other requirements, the code called for the “voluntary consent” of the human research subject, an assessment of risks and benefits, and assurances of competent investigators. These concepts have become an important reference point for the ethical conduct of medical research. Yet, there has in the past been considerable debate among scholars about the code’s authorship, scope, and legal standing in both civilian and military science. Nonetheless, the Nuremberg Code has undoubtedly been a milestone in the history of biomedical research ethics.1- 3

Writings on medical ethics, laws, and regulations in a number of jurisdictions and countries, including a detailed and sophisticated set of guidelines from the Reich Ministry of the Interior in 1931, set the stage for the code. The same focus on voluntariness and risk that characterizes the code also suffuses these guidelines. What distinguishes the code is its context. As lead prosecutor Telford Taylor emphasized, although the Doctors’ Trial was at its heart a murder trial, it clearly implicated the ethical practices of medical experimenters and, by extension, the medical profession’s relationship to the state understood as an organized community living under a particular political structure. The embrace of Nazi ideology by German physicians, and the subsequent participation of some of their most distinguished leaders in the camp experiments, demonstrates the importance of professional independence from and resistance to the ideological and geopolitical ambitions of the authoritarian state.

The article is here.

Where did Nazi doctors learn their ethics? From a textbook

Michael Cook
BioEdge.org
Originally posted April 29, 2017

German medicine under Hitler resulted in so many horrors – eugenics, human experimentation, forced sterilization, involuntary euthanasia, mass murder – that there is a temptation to say that “Nazi doctors had no ethics”.

However, according to an article in the Annals of Internal Medicine by Florian Bruns and Tessa Chelouche (from Germany and Israel respectively), this was not the case at all. In fact, medical ethics was an important part of the medical curriculum between 1939 and 1945. Nazi officials established lectureships in every medical school in Germany for a subject called “Medical Law and Professional Studies” (MLPS).

There was no lack of ethics. It was just the wrong kind of ethics.

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It is important to realize that ethical reasoning can be corrupted and that teaching ethics is, in itself, no guarantee of the moral integrity of physicians.

The article is here.

Swastikas, Slurs and Torment in Town’s Schools

By Benjamin Weiser
The New York Times
Originally published November 7, 2013

Here is an excerpt:

“There are anti-Semitic incidents that have occurred that we need to address,” John Boyle, Crispell Middle School’s principal, said in a deposition in April.

In 2011, when one parent complained about continued harassment of her daughter and another Jewish girl, Pine Bush’s superintendent from 2008 to 2013, Philip G. Steinberg, wrote in an email, “I have said I will meet with your daughters and I will, but your expectations for changing inbred prejudice may be a bit unrealistic.”

Mr. Steinberg, who, along with two other administrators named as defendants, is Jewish, described the lawsuit in recent interviews as a “money grab.” He contended that the plaintiffs had “embellished” some allegations.

The entire story is here.

Hitler's Philosophers, By Yvonne Sherratt

This book tells the disturbing and important story of how major thinkers abetted genocide

By John Gray - Book Review
The Independent
Originally published February 23, 2013


The only German philosophy professor who actively resisted the Nazis is nowadays virtually unknown. Though one or two scholarly monographs have appeared on him, Kurt Huber will not be found on any university syllabus. The silence that has swallowed his name and his works is almost as complete as that which followed when, after being stripped of his university post and doctoral degree by a Nazi People's Court, he was executed by guillotine in July 1943 for writing a pamphlet against National Socialism as a member of the White Rose resistance group.

A conservative Catholic who produced a classic study of Leibniz and made important contributions to aesthetics and musicology, Huber is today not much more than a footnote in history. When Yvonne Sherratt writes, "Huber's intellectual prowess remains as quiet in the Western world as it was under Hitler", she hardly exaggerates.

In contrast, some active collaborators with the Nazis feature among the most celebrated names of post-war philosophy. Serving the Nazis for a time as a university rector, Martin Heidegger cut off relations with Edmund Husserl, the Jewish philosopher who had secured his professorship, removing the dedication to Husserl from Being and Time (Heidegger's principal work) and failing either to visit his mentor when he was dying or attend his funeral in 1938. As a result of the intellectual campaign waged by his former student and lover Hannah Arendt, and support form prominent figures such as Jean-Paul Sartre, Heidegger succeeded in becoming one of the most influential of late 20th-century philosophers.

The entire review is here.