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5 The Ethics of Evil: The Challenge and the Lessons of Nazi Medical Experiments Arthur L. Caplan Taking the Nazis’ Ethical Arguments Seriously Most histories of medical ethics locate the origins of bioethics in the ashes of the German concentration camps. The Nuremberg Code is frequently held up in courses and textbooks on medical ethics as the “constitution” of human subjects research. But very little is said about the actual experiments that generated this document. And even less is said about the moral rationales those involved in the horri¤c research gave in their defense. Why? One reason is that the events of the Holocaust are so horrid that they speak for themselves. What more is there to say about mass murder and barbaric experimentation except that it was unethical? Another is that many scholars have dismissed the research done in the camps as worthless. Those involved in conducting it have been dismissed as lunatics and crackpots. What point is there is discussing the ethics of research that is nothing more than torture disguised as science (Berger 1990)? Yet another reason for the failure to grapple with Nazi moral rationales is that there has been a tradition of trying to offer psychological explanations for the behavior of those involved in the killing, so that moral explanations seem unnecessary . Those who went to work at the gas chambers and dissection rooms did so through adaptations of personality and character that make their conduct understandable but make it dif¤cult to hold them morally accountable for their conduct (Lifton 1986; Browning 1993). And there is always the fear that to talk of the ethics of the research done in the camps is to lend barbarism a convenient disguise. It is simply wrong to look at the ethical justi¤cations for what was done because it confers a false acceptability on what was manifestly wrong. Perhaps the most important reason for the absence of commentary on the ethics of the research done in the camps is that such questions open a door that few bioethicists wish to enter. If moral justi¤cations can be given for why someone deemed mass murder appropriate in the name of public health or thought that it was right to freeze hapless men and women to death or decompress them or infect them with lethal doses of typhus—then to put the question plainly— what good is ethics? Debunking the Myths of Incompetence, Madness, and Coercion It is comforting to believe that health care professionals from the nation that was, at the time, the world’s leader in medicine, who had pledged an oath to “do no harm,” could not conduct brutal, often lethal, experiments upon innocent persons in concentration camps. It is comforting to think that it is not possible to defend in moral terms wound research on the living. It is comforting to think that anyone who espouses racist, eugenic ideas cannot be a competent, introspective physician or scientist. Nazi medical crimes show that each of these beliefs is false (Caplan 2004). It is often believed that only madmen, charlatans, and incompetents among doctors, scientists, public health of¤cials, and nurses could possibly have associated with those who ran the Nazi party. Among those who did their “research” in Auschwitz, Dachau, and other camps, some had obvious psychological problems , were lesser scienti¤c lights, or both (Lifton 1986). But there were also well-trained, reputable, and competent physicians and scientists who were also ardent Nazis. Some conducted experiments in the camps. Human experimentation in the camps was not conducted only by those who were mentally unstable or on the periphery of science. Not all who engaged in experimentation or murder were inept (Kater 1990; Proctor 1992; Caplan 1992, 2004). Placing all of the physicians, health professionals, and scientists who took part in the crimes of the Holocaust on the periphery of medicine and science allows another myth to ®ourish—that medicine and science went “mad” when Hitler took control of Germany. Competent and internationally renowned physicians and scientists could not willingly have had anything to do with Nazism. However, the actions as well as the beliefs of German physicians and scientists under Nazism stand in glaring contrast to this myth (Proctor 1988; Kater 1989). Once identi¤ed, the myths of incompetence and madness make absolutely no sense. How could ®akes, crackpots, and incompetents have been the only ones supporting Nazism? Could the Nazis have had any chance of carrying out genocide on a staggering, monumental scale...

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