By Hedy S. Wald

“Medicine was used for villainous ends during the Holocaust.  The Holocaust was an enormous trauma inflicted on human dignity and the human person; medicine was implicated in crimes against humanity.”  His Eminence Daniel Cardinal DiNardo, Archbishop of Galveston-Houston.¹

January 27 is International Holocaust Remembrance Day, a day designated by the United Nations General Assembly resolution 60/7 in 2005 after a special session marking the 60^th anniversary of the liberation of the Nazi concentration camps and the end of the Holocaust.²  In the words of Secretary General Ban-Ki Moon (2008), “The International Day in memory of the victims of the Holocaust is a day on which we must reassert our commitment to human rights… We must also go beyond remembrance, and make sure that new generations know this history.  We must apply the lessons of the Holocaust to today’s world.”²

Indeed.  A recent medical humanities article (co-authored with my colleagues Drs. Rubenfeld and Fins)¹ was a resounding call for teaching lessons of the Holocaust within medical education.  We joined others in the medical education/bioethics community calling for a curriculum that would create space for a mix of reflective practice and historical awareness to grapple with the medical profession’s central role in “using science to help legitimize persecution, murder and ultimately genocide.”³

“Almost every aspect of contemporary medical ethics is influenced by the history of physician involvement in the Holocaust,” Wynia and colleagues wrote.¹  The United States Holocaust Memorial Museum’s (USHMM) “Deadly Medicine: Creating the Master Race” exhibit³ documents the moral failures of individual physicians and the medical establishment during the Third Reich including participation in horrific experimentation and medicalized genocide.  My daughter, a pediatrics resident at the time, and I visited that exhibit in 2012 and in our photo essay about this experience, confronted how healers became killers,⁴ how traditional Hippocratic virtues morphed into unspeakable evil.¹  As my colleagues and I have written about the process of confronting this history, “it begins with a difficult realization: the doctors perpetuating the Holocaust were much like us, academic physicians who were the best and the brightest of their day.  Nazi physicians, idealistic in a perverse way, earnestly believed they were doing the right thing.”¹   “With the help of physicians and medically trained geneticists and anthropologists, the Nazis developed racial health policies that started with the mass sterilization of ‘hereditarily diseased’ persons and ended with the near annihilation of European Jewry.”³  With the help of a profession sworn to “do no harm.”

Education about the role of the medical profession during the Holocaust has thus been termed a “moral imperative,” ^1,5 ideally contributing to the process of establishing a virtuous professional identity, a learner’s sense of meaning and purpose, awareness of risks of abuse of power, and helping to foster emotional and ethical resilience.¹  Can we thus help “immunize our learners and perhaps society from a tragic recurrence”?¹  Lessons learned from the Nazi doctors can help serve as a “ warning beacon”¹ as learners as well as seasoned clinicians and researchers face contemporary and future fundamental relevant dilemmas such as prejudice, assisted reproduction and suicide, resource allocation, obtaining valid informed consent, use of “big data,” and challenges of genomics and technology expansion.⁵  Holocaust and Medicine curricula within undergraduate and graduate medical education and for continuing medical education (see http://www.mimeh.org/ and http://www.medicineaftertheholocaust.org/ for online curriculum modules and webinars) as a pre-emptive educational approach can “bring a powerful perspective to such dimensions as ethical decision making, empathy, values clarification, and resiliency in medicine and, more broadly, to the formation of humanistic, ethically responsible health care practitioners.”⁵  A recent #bioethx social media Twitterchat for which I served as guest co-host (with Dr. A. Fernandes in April, 2016) provided an innovative educational platform for participants on the topic of “Medicine and the Holocaust in Medical Education” with reflection-inviting questions, engaged dialogue, and published references (http://bit.ly/2kk7FIJ).

Let us pledge this January 27, as compassionate, humanistic healthcare practitioners, to “Never Forget.”

Hedy S. Wald, PhD is a Clinical Associate Professor of Family Medicine at the Warren Alpert Medical School of Brown University where she directs the reflective writing curriculum in the Family Medicine Clerkship and was honored with the Dean’s Excellence in Teaching Award.

References

1. Wald HS, Rubenfeld S, Fins JJ. (2016). The Holocaust as End Stage Disease: Medical Education as a Moral Imperative. Hektoen International, A Journal of Medical Humanities. http://www.hektoeninternational.org/index.php?option=com_content&view=article&id=2036
2. International Holocaust Remembrance Day. https://en.wikipedia.org/wiki/International_Holocaust_Remembrance_Day
   Accessed January 25, 2017.
3. United States Holocaust Memorial Museum. Deadly Medicine: Creating the Master Race. https://www.ushmm.org/information/exhibitions/traveling-exhibitions/deadly-medicine
   Accessed January 25, 2017.
4. Wald HS, Weiner CL. (2009). Deadly medicine: creating the master race – A visit to the US. Holocaust Memorial Museum exhibit at the UN. Ars Medica. 5(2):48-57.
5. Reis SP, Wald HS. (2015). Contemplating medicine during the Third Reich: scaffolding professional identity formation for medical students. Acad. Med. 90(6): 770-3.