Bioethics and the Holocaust: A Comprehensive Study in How the Holocaust Continues to Shape the Ethics of Health, Medicine and Human Rights

Foreword
Preface
Contents
1 The Question of Relevance
	1.1 Would That the Holocaust Was Irrelevant
	1.2 The Curse of Abiding Relevance
	1.3 Science in the Service of Ideology, In the Service of Politics
	1.4 Medicine in Extremis: Then and Now
	1.5 Heroism and Self-sacrifice
	1.6 Maintaining Dignity and Professionalism
	References
2 Teaching Medical Ethics in Nazi Germany: Debunking the Myth that the Nazi Physicians Abandoned Their Ethics
	2.1 Introduction
	2.2 The Development of the Course
	2.3 Hierarchy in the Medical Profession: Physicians as Health-Leaders
	2.4 Obedience to Authority—The “Banality of Evil”
	2.5 The Physician as Caretaker of the Race
	2.6 Hippocrates in Nazi Medicine
	2.7 Bad Genes
	2.8 Antisemitism in the Medical Profession
	2.9 Selection and Sterilization
	2.10 Positive Eugenics
	2.11 The Ethics of Medical Gender Policies
		2.11.1 Abortion
	2.12 Confidentiality
	2.13 “Euthanasia”—The Connection to the Final Solution
	2.14 Conclusion
	References
3 The Role of Professions in a State: The Effects of the Nazi Experience on Health Care Professionalism
	3.1 Organizing Medical Work: Consumerism, Professionalism, or Statism
		3.1.1 Introduction
		3.1.2 Professionalism is a Choice
		3.1.3 Defining Professionalism
		3.1.4 Why Choose Professionalism in Health Care?
		3.1.5 Options Other Than Professionalism
		3.1.6 Ancient Arguments About the Ethics of Health Care
		3.1.7 Early Development of Modern Professionalism
	3.2 Nazi Statist Professionalism and Race-Based Medical Ethics
		3.2.1 German Medicine’s Embrace of a Pure Statist Approach
	3.3 Medicine’s Response to the Nazi Challenges to Professional Ethics
		3.3.1 Western Medical Professions’ Reaction to the Holocaust
		3.3.2 The 1947 Nuremberg Code and the Declaration of Geneva as Promissory Notes
		3.3.3 The 1947 Declaration of Geneva
		3.3.4 Broken Promises, Scandals, and Reform
	3.4 Concluding Reflections
	References
4 The Physician’s Role: Patient v. Population
	4.1 Introduction
	4.2 The Rise of the Eugenics Movement
	4.3 Eugenic Medicine: From Theory to Practice
	4.4 Population health : Examples in Modern Medicine
	4.5 The Role of Informed Consent in Eugenics and Population health
	4.6 Conclusion
	References
5 The Transformation of Physicians from Healers to Killers: The Role of Psychiatry
	5.1 Introduction
	5.2 The Paradigm Shifts
	5.3 Dehumanization and Degradation
	5.4 Psychiatry Timeline—Kraepelin to Rüdin
	5.5 Sterilization Was not Enough
	5.6 The Importance of Eugenics for the War Machine
		5.6.1 Euthanasia Decree: From Eugenics to Euthanasia
		5.6.2 Aktion T4
		5.6.3 Mechanisms of Death
		5.6.4 Continued Psychiatric Leadership
	5.7 Resistance
	5.8 Summary
	References
6 The Physician at War
	6.1 Introduction
	6.2 The Military Physician
	6.3 The Problem of Dual Loyalty
		6.3.1 Historical Examples
	6.4 An Ethical Analysis of Military Medicine
	6.5 Dual Loyalty in Non-military Settings
	6.6 Conclusion
	References
7 Medicalization of Social Policies: Defining Health, Defining Illness
	7.1 Introduction
	7.2 Medicalization and the Volkskörper
		7.2.1 Regulating the Deviant (Social) Body
		7.2.2 Gemeinnutz Geht Vor Eigennutz: Medicalized Government Assistance
		7.2.3 Medicalizing Citizenship
	7.3 Medicalization Today
		7.3.1 Medical Disqualification of Deviant Behavior
		7.3.2 Government Assistance and the Medicalization of Benefits
		7.3.3 Policing Medicalized Borders and Regulating Immigration
	7.4 Conclusion
	References
8 Bioethics and the Krankenmorde: Disability and Diversity
	8.1 Introduction
	8.2 “Life Unworthy of Living”
	8.3 Compulsory Sterilization
	8.4 Children’s “Euthanasia”
	8.5 Murder of Asylum Patients in Eastern Occupied Territories
	8.6 Aktion T4 and Sonderbehandlung 14f13
	8.7 De-Centralised “Euthanasia” and Aktion Brandt
	8.8 Krankenmorde Memory, Meaning and Bioethics
	8.9 Disability and Bioethics
	8.10 COVID-19 and the Allocation of Health Resources
	8.11 Conclusion
	References
9 Race, Eugenics, and the Holocaust
	9.1 Introduction
	9.2 What Was “Race” then and What is It Now?
		9.2.1 Before the War
		9.2.2 During the War: Race Under Hitler’s Regime
		9.2.3 After the War: The United Nations’ Statement on Race
		9.2.4 After the War: Race in Contemporary Bioethics
	9.3 What Was Eugenics, and What is It Now?
		9.3.1 Before the War: American and British Eugenics
		9.3.2 During the War: German Eugenics
		9.3.3 After the War: UNESCO and Eugenics
		9.3.4 After the War: Eugenics in Modern Bioethics
	References
10 Physician-Assisted Suicide, Euthanasia, and Bioethics in Nazi and Contemporary Cinema
	10.1 Introduction
		10.1.1 Terminology
		10.1.2 Euthanasia During the Third Reich
		10.1.3 Euthanasia in the Contemporary Western World
		10.1.4 Why Film?
	10.2 Medical Films Under National Socialism
	10.3 Euthanasia in Ich klage an and in Contemporary Cinema
		10.3.1 Cinematic Justifications of Physician-Assisted Suicide and/or Euthanasia
	10.4 Discussion
		10.4.1 The Medical Profession’s Ethic
		10.4.2 Lives Not Worthy to Be Lived
	10.5 Conclusion
	References
11 Godwin’s Law and the Limits of Bioethics and Holocaust Studies
	11.1 Introduction
	11.2 Godwin’s Law and Bad Logic
	11.3 Godwin’s Law, Ethics, and Historical Reflection
	References
12 From the Nuremberg “Doctors’ Trial” to the “Nuremberg Code”
	12.1 Introduction
	12.2 Misconceptions
	12.3 The Nuremberg Medical Trial Agenda to Create a Code of Ethics
	12.4 The Victim’s Voice
	12.5 From Ethical Debate to the Final Declaration
	12.6 Publicizing the Guidelines
	References
13 The Holocaust as an Inflection Point in the Development of Research Ethics
	13.1 Introduction
	13.2 History of Research Ethics Pre-World War II
		13.2.1 German Research Ethics
	13.3 Doctors’ Trial and the Publication of the Nuremberg Code
	13.4 Codification of Ethics Post Nuremberg
		13.4.1 Declaration of Helsinki
		13.4.2 Belmont Report
		13.4.3 Federal Policy for the Protection of Human Subjects
		13.4.4 International Ethical Guidelines for Biomedical Research Involving Human Subjects
	13.5 Key Issues
		13.5.1 Informed Consent
		13.5.2 Lack of Adequate Definitions
	13.6 Current Debate
		13.6.1 What Makes Human Subject Research Ethical?
		13.6.2 Reevaluation of Research Ethics: How Can Codes of Ethics Be Standardized and Enforced?
	13.7 From Codification to Moral Professionalism: Teaching Bioethics and the Holocaust
	References
14 The Rights and Responsibilities of the Physician to Uphold Bioethical Values in Society
	14.1 Introduction: Are Bioethical Values “In Society” or “Of Society?”
	14.2 The Person and the Goods of Medicine: Definitions
		14.2.1 The Person Matters
		14.2.2 Philosophical Anthropology: The Ethical Implications of Personalism and Materialism
		14.2.3 Conscience and Moral Decision Making
		14.2.4 Rights, Responsibilities, and the Goods of Medicine
	14.3 Professional Hierarchies: Then and Now
		14.3.1 Hierarchy in Healthcare
		14.3.2 National Socialism and the Medical Hierarchy
	14.4 Conscience, Conscientious Objection (CO), and Ethical Diversity
	14.5 Remembrance as Both Atonement and Advocacy
	References
15 Bioethics and the Holocaust in a Multicultural Context
	15.1 Introduction
	15.2 Diversity and Interfaith Interaction Before the Holocaust
		15.2.1 Diversity as a Human Right
		15.2.2 The Beginnings of Modern Interfaith Interaction
	15.3 The Rejection of Multiculturalism Under the Nazi Regime
		15.3.1 The Exploitation of Apologetic Sermons
	15.4 Rights and Interfaith Interaction After the Holocaust
		15.4.1 Post-Holocaust Human Rights and Bioethics
		15.4.2 Holocaust and the Modern Way of Interfaith Interaction and Dialogue
		15.4.3 Holocaust and a New Interfaith Awakening as It Relates to Bioethical Issues
	15.5 The Importance of Diversity and Interfaith Initiatives in Education
		15.5.1 The Holocaust as a Case Study
		15.5.2 The Holocaust and the Head, Heart, Hand Educational Model Part One
		15.5.3 The Holocaust and the Head, Heart, Hand Educational Model Part Two
		15.5.4 The Holocaust and the Head, Heart, Hand Educational Model Part Three
	15.6 Outlook
	References
16 Medicine, the Holocaust, and Human Dignity: Lessons from Human Rights
	16.1 Introduction
	16.2 Making Sense of Human Dignity
	16.3 Human Dignity, Bioethics, and the Holocaust
	16.4 The Holocaust and Non-ideal Theory in Bioethics
	16.5 The Usefulness of Human Dignity
	References
17 The Goals of Medicine in a Post-Holocaust Society
	17.1 Introduction
	17.2 The Medical Profession in Nazi Germany
		17.2.1 Labeling and Othering
		17.2.2 Medicalization and Dehumanization
		17.2.3 Politicization, Utilitarianism and Caring for the Volk
	17.3 Medicine in a Post-Holocaust Society
		17.3.1 Lessons from the Holocaust
		17.3.2 Medicine: Its Power and Privilege
		17.3.3 Responsibility of Medicine to Society
	17.4 Morality and Medicine After the Holocaust
		17.4.1 Rehumanizing the Patient
		17.4.2 Rehumanizing the Physician
	17.5 Conclusion
	References
Index