Professional Ethics Tinged By The Holocaust

A Ghanaian medical student at Emory University in Atlanta, Pierre Ankomah had a Jewish roommate with whom he’d often discuss how their profession “seriously erred” during the years of the Holocaust, how doctors and nurses were complicit in mass murder.

They spent many hours “questioning why people were able to, en masse, buy into the hideous ideas that were perpetrated by the Nazis,” he says. “Why were there such few and muted voices of dissent?”

This year some of Ankomah’s questions were answered — in the death camps of Poland and sites of mass malpractice in Germany.

Along with other future members of the medical profession, he visited the venues of the Final Solution as part of a program sponsored by New York’s Museum of Jewish Heritage – A Living Memorial to the Holocaust to teach young professionals the moral lessons offered by the Shoah. The museum recently featured those lessons in the exhibit, “Creating the Master Race,” on loan from the U.S. Holocaust Memorial Museum in Washington.

The Fellowships at Auschwitz for the Study of Professional Ethics (FASPE) has similar European missions for law, journalism and seminary students. FASPE (mjhnyc.org/faspe) will hold its annual alumni reunion symposium at the museum on Jan. 15-16. A separate new program for students and teachers based in Houston’s Texas Medical Center, the Center for Medicine after the Holocaust (CMATH), has a similar itinerary and similar goal.

Both programs take small groups to Holocaust-related sites in Poland and Germany — places where doctors and nurses and other people in the “healing” professions — played a major role in state-sponsored killings from 1933 to 1945.

In each case, the participants imagine themselves as potential collaborators in Nazi Germany, making connections between the Nazi-era physicians’ moral quandaries and the ethical questions students will face when they enter their profession full time.

A medical student from the States stands in a crematorium at Auschwitz. Rendered silent by the mass murders that had taken place there some seven decades earlier, he later asks himself, “How am I like the Nazi doctors?”

A nursing student from the U.S. considers her peers who had supported the genocidal goals of National Socialism. “I could have been the one doing it,” she thinks.

“I could see,” Ankomah told The Jewish Week in an e-mail interview, “that we are not too many turns away from replicating some of the nightmares of the past.”

“Members of the professions — lawyers, doctors, business executives, among others in Nazi Germany — played an instrumental role in the design and implementation of the Holocaust and in failing to halt the complete breakdown of societal mores,” the introduction to the FASPE catalog states. “Through setting broad agendas and implementing national policies, professionals set the tone for how a country and its citizens deal with ‘small,’ day-to-day issues. In dealing with the day-to-day issues, the professionals set the tone for broader agendas and set the stage for how larger policies are implemented.”

Both programs offer meetings with historians, Holocaust survivors and Righteous Gentiles, emphasizing contemporary insights on the Shoah experience.

Of the scores of people who have taken part so far in these programs, only a few are Jewish.

“It’s not a Jewish issue,” David Marwell, director of the Museum of Jewish Heritage, says of the universal lessons that FASPE teaches. “It’s not a Jewish program.”

Both programs recognize the pedagogic advantage of taking participants to Europe, where the Holocaust and murder of millions of other innocent people took place. “There’s something about the power of place,” Marwell says. “It’s a significantly different impact to be at the [historical] places as you study about them,” says Thorin Tritter, a historian who serves as FASPE director.

Neither program offers specific ethical advise on specific issues to its participants. FASPE, Marwell says, stresses that an individual patient is the pre-eminent responsibility of a physician, and that a patient is entitled to “informed consent” in choosing his or her treatment.

Similarly, CMATH approaches the topic in broad terms. “We encourage [students] to ask questions … challenge authority,” says Dr. Sheldon Rubenfeld, a Houston endocrinologist who was inspired to form CMATH (medicineaftertheholocaust.org). Under the auspices of the organization he has coordinated a lecture series, an exhibit at Houston’s Holocaust Museum and a series of university courses — after accompanying a March of the Living visit to Poland 15 years ago. He says he says he stood in Auschwitz where Dr. Josef Mengele, the sadistic “Angel of Death” had stood while deciding which of the Jews pushed out of cattle cars would live and which would die, and asked himself, “What was a doctor doing on the ramps of Auschwitz?”

The trip sharpened his interest in medical ethics, a field that has received more prominence internationally in the last decade, he says.

While the New York and Houston programs are the only known ones that educate future members of the medical profession with such annual visits to Europe’s World War II killing fields, other institutions sponsor occasional activities that deal with the ethical issues raised by the behavior of doctors and their allies during the Third Reich. A British university has sponsored shorter missions to Auschwitz, and the World Organization of General Practice sponsored sessions at its European conference on “The Continuing Legacy of Medicine of the Third Reich” and “Lessons of the Holocaust.”

“The ethical [lessons] that can be drawn are pretty clear,” Marwell says.

The goal of the FASPE curriculum for medical students — designed by faculty at the Yale School of Medicine — is to “provide insights that will help them tackle problems of moral reasoning in their future careers,” according to the program’s mission statement.

If, as attorneys say, good cases make bad law, bad medical practice teaches good lessons.

The doctors who aided and enabled the Nazis’ racist policies — in the name of eugenics, the Nazi-endorsed study of heredity — provide the strongest example imaginable of people abandoning their morality and professional ethics, leaders of FASPE and CMATH agree.

While the CMATH curriculum includes references to such examples of American malpractice as compulsory sterilization in some parts of this country a century ago and the Tuskegee syphilis experiment conducted on poor blacks in rural Alabama between 1932 and 1972, its emphasis is on Nazi Germany.

“The medical profession played a central role in planning and implementing the genocidal murder of more than six million Jews,” Rubenfeld wrote in an article, “Healing by Killing,” in the Houston Medicine journal. “Hundreds of physicians willingly participated in all of these genocidal activities.

“Physicians in Nazi Germany betrayed the Hippocratic Oath, the ethical bedrock of the medical profession for more than 2,000 years, when they chose knowledge over wisdom, the state over the individual, a führer over God, and personal gain over professional ethics,” he wrote.

Germany, for years the cultural and scientific center of Europe, held the position in medicine that the U.S., arguably, holds now. “German biomedical science was the most advanced in the world during the first three decades of the twentieth century,” Dr. Rubenfeld wrote in “Medicine after the Holocaust,” a publication he edited. “America’s circumstances today are eerily similar to those of Germany in the early 1930s. American biomedical science is now the most advanced in the world.”

“It is natural for physicians (and future physicians) to try to find some fundamental difference between themselves and Nazi doctors — to distance themselves as far as they can from the perpetrators of such heinous crimes,” one FASPE participant wrote afterwards. “But to do so misses the point.”

“It’s a normal thing,” says Marwell, for the participants in the programs “to place themselves in [the collaborating doctors’] shoes.”

“The FASPE experience will continue to live with me until the end of my life, and the numerous lessons taught implicitly and explicitly throughout our discussions will serve to guide my clinical practice as a physician,” wrote one participant in last year’s program, after he set foot in an Auschwitz gas chamber. “Now that I have had the unique opportunity to walk out of that crematorium … I hope to use my expanded knowledge and improved emotional awareness to guide my future doctor-patient relationships.

The experience, he wrote, “will shape both the quality of their lives and, importantly, the quality of their deaths.”

“I finished the program equipped with a mental toughness and a desire to continue examining similarly difficult [moral and ethical] questions from as humane a perspective as possible,” Ankomah says. “I think I am much more on the lookout for incarnations of themes such as dehumanization, subservience to authority and pseudo-scientific rationales that resulted in the establishment of the euthanasia programs and the death camps of the Holocaust.”