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Richard Feldman: What should we do with medical knowledge obtained through immoral means?

Richard Feldman

Eva Kor

Eva Kor, the prominent Hoosier Holocaust survivor died recently. Although diminutive in size, Eva was a strong, determined, and inspirational person who dedicated her life to expressing her personal messages concerning the Nazi’s unparalleled inhumanity and the arguably history’s most evil episode.

Eva survived the horrific experiments conducted on identical twins by Dr. Josef Mengele at Auschwitz. Twenty-three Nazi physicians faced charges at the Nuremberg trials, seven of whom were executed for their sadistic experiments, atrocities conducted on children and adults. These monstrous doctors disgraced their profession and their Hippocratic oaths. Their “medical” experiments punctuate Nazi Germany’s cruel, brutal, and ruthless obsession to “cleanse” the world of Jews and other groups they considered unworthy of living.

Holocaust survivor Eva Kor, (front middle) and her sister, Miriam (front right), at age 10, were the first twins liberated from Auschwitz concentration camps, Jan. 27, 1945.

What were these experiments conducted in total disregard for the subjects’ indescribable pain, mutilation, misery, and ultimately their survival?  And what do we do with this knowledge obtained through immoral means?

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Experiments were performed to discover how long downed pilots could survive frigid waters and how best to rewarm the victims. Many subjects died painfully with frozen extremities and hypothermia.

Simulated high-altitude experiments using decompression chambers were conducted to find the cause of high-altitude illness in pilots. Prisoners died of suffocation and others endured live brain dissections. 

Experiments studied how long it took subjects to die of dehydration when given seawater as their sole source of hydration.  In others, prisoners received medications to prevent hemorrhage and were subsequently subjected to extremity amputations without anesthesia.

The effectiveness of new sulfa antibiotics was tested on simulated battlefield wounds. Wounds were inflicted and then contaminated with virulent bacteria and added debris as the prisoners endured excruciating pain.

Racially-motivated eugenic experiments involved finding methods of mass sterilization of undesirables. Uteruses were injected with caustic substances and testicles irradiated with subsequent castration to examine the effects. Identical twin experiments sought to find ways to induce multiple births to further Aryan dominance. Others advanced Nazi racial superiority theories. Twin experiments also studied environmental verses genetic determinants in human physiology. Identical twins endured painful and debilitating bodily insults and then were killed and autopsied to see what comparable changes took place, controlled for genetic factors since the twins shared a common genome.

Virtually all the experiments were either pseudoscience or yielded worthless information. Some research was tainted by political interference and ideology, and others lacked scientific integrity. There was very little knowledge gained of enduring value. Possible exceptions were the understanding and treatment of hypothermia and high-altitude illnesses. All were obtained in an inhumane manner.

There has been a longstanding philosophical debate over what to do with this immorally-obtained medical knowledge. Some suggest that nothing should be used, and indeed some governmental agencies and journals have barred its use or acknowledgement in publications. Others believe that if the information has important medical benefit to mankind, it should be utilized.

A dominant position is that if the knowledge is of compelling medical benefit to humanity and not available from other sources, it should be used with explicit denouncement of the Nazi physicians and the unethical way it was obtained. I imagine if we could ask these unfortunate victims of the Nazi atrocities if the information from their suffering should be used to help others, they would give their blessings.

There was one definite positive result: The world medical-scientific community agreed to strict ethical standards for research involving human subjects.  These were based on principles formulated by the judges at the Nuremberg Trials and subsequently formalized by The Declaration of Helsinki.

May we never forget.

Richard Feldman, M.D., is a family physician and former Indiana state health commissioner.