Medicine and Medical Ethics in Nazi Germany: Origins, Practices, Legacies (review)

That many men and women in the biomedical sciences forged careers at the expense of those in their "care" is a subject that continues to defy comprehension. The essays gathered in Francis R. Nicosia and Jonathan Huener's edited volume seek to further demystify this aspect of the Holocaust. Based on lectures given at the 2000 Miller Symposium at the University of Vermont, these essays summarize past arguments and chart a course for future investigation. They explore the intersection of racial politics and medical ethics to evaluate, among other things, the influence of the global eugenics movement on German race hygiene, the complex victimization of patients and wards of the state, medical experimentation inside and outside the camps, as well as the myriad institutions (concentration camps, children's hospitals, state asylums, research centers) involved.

The introduction argues for the reappraisal of the notion that 1945 marked an end to eugenic thinking. It also highlights the importance of the global context in connecting Nazi eugenics to the worldwide movement in the early part of this past century. It raises issues hotly debated in recent years, such as how ordinary citizens became embroiled in the police, legal, medical, and welfare enforcement of all manner of social and racial policies. Most important, it broadens the definition of perpetration by emphasizing the role of educated professionals and the careerism that lay at the heart of their research.

Garland E. Allen, a biologist by training, examines American eugenicists' support for their German colleagues and the conditions that led to sterilization on a mass scale in both countries (but with very different outcomes). Allen brings to light how eugenic discourses have functioned on the world stage, thereby developing a base with which to compare the lingering effects of eugenic impulses after the Second World War. This focus is not entirely new, and in recent years historians of eugenics have emphasized the need to view population policy advocates, birth controllers, and racial hygienists as part of an international movement that at times has transcended national concerns. Both the United States and Germany witnessed labor unrest, social strife, and attacks against the welfare state in the 1920s, but the course navigated in each context played a significant role in the implementation and realization of eugenic practices (to say nothing of political outcomes on a large scale). Although both nations toyed with similar notions, Allen suggests that the core differences are worthy of reexamination not as part of a study culminating in Nazi abuses but for how the two nations invested biomedical science with common social imperatives.

The remaining essays recast the issue of legitimacy within the German national context and in light of recent preoccupation with the role of the professions in supporting the NS state. Robert N. Proctor, Henry Friedlander, Michael H. Kater, and Michael Burleigh all raise new issues for consideration and focus on the reasons preventing a contemporary reckoning with certain aspects of Nazi crimes.

In his article on the Nazi war on tobacco, Proctor condenses some of his arguments on the relationship among racial hygiene, bodily purity, and National Socialist public health campaigns, providing an intriguing look at the medicalization of smoking, smokers, and addiction. Drawing from his earlier work on cancer research, Proctor questions why contemporary health care activists and medical practitioners aren't familiar with the Nazi origins of the public health fight that presaged much of the current antismoking campaigns. Through the use of intriguing examples of medico-moralizing in which tobacco use is characterized first as "lung masturbation" and "dry drunkenness," and later related to Jewish degeneracy, Proctor outlines the Nazi correlation of decadence, modernity, and racial decline. Despite propaganda cautioning Germans against the pitfalls of smoking, tobacco use actually increased until the hardship of fighting a losing war forced rationing of resources...