Editorial

The Editors of Perspectives in Biology and Medicine are honored to present in this issue the texts of eight lectures presented in a Symposium held in 1998 at the National Institutes of Health (NIH) in Bethesda, Maryland. The Symposium "Medical Research Ethics at the Millennium: What Have We Learned?" grew out of discussions on the NIH campus of how to deal with the Pernkopf Atlas of Human Anatomy, published during the apogee of fascism, several copies of which were held in the NIH medical library [1].

Drs. Robert B. Nussenblatt and Michael M. Gottesman, the organizers of the Symposium, explain in their Introduction the compromise reached at the NIH as to how to deal with these volumes, but also how the discussion led to deeper questions about medical ethics, with special regard to academic medicine and medical research both during and after the Holocaust [2]. It is these topics that our distinguished authors discuss.

Dr. Jeremiah A. Barondess explores how the experiences of the Holocaust have changed the way we think about medical ethics, including research ethics. Professor James F. Childress follows this up with a discussion of the Nuremberg Code, which evolved from the post-World War II trials of 23 individuals for crimes committed in the name of medical or scientific research. Ms. Barbara Mishkin takes this subject to the present, with discussions of current laws and policy governing human studies research. Dr. William E. Seidelman presents a detailed analysis of medical research in Germany and Austria during the Third Reich, with Pernkopf's behavior as a starting point, while Professor Proctor more generally reviews Nazi scientific studies, in their "subtlety and complexity."

Three scientists from Germany and Austria present their perspective on what the Nazi legacy has meant for their countries a half-century later. Dr. Michael Wunder, who played a major role in formulating the Nuremberg Code 1997, summarizes the current debates in Germany on the ethics of human experimentation; Professor Karl Holubar presents a preliminary report on the work of the Pernkopf Commission of the University of Vienna; while Dr. Wolfgang Schütz, Dean of that Medical Faculty, presents the recent efforts of that institution to acknowledge and deal with the legacy of the Holocaust.

It is worth commenting on the fact that this discussion of the effects of the Holocaust on medical and scientific ethics, as well as of the specific work in Vienna that triggered these discussions, is occurring so long after the events. This is evident in the presentations by Drs. Wunder, Holubar, and Schütz and was stressed in the 1984 volume Tödliche Wissenschaft, by Professor Benno Müller-Hill [3]. Indeed, four years ago Dr. James D. Watson presented a forceful lecture in Berlin, at the Congress of Molecular Medicine, on how much genetics in Germany is still hindered by the continuing failure to come to grips with the lessons of the Holocaust [4; see also 3, pp. 187-200].

Although this Journal has had frequent articles on many aspects of medical ethics, we have published remarkably little on the Holocaust [5]. We believe that it is our responsibility to bear witness to that tragic period, even as those who experienced it themselves become fewer, for the continuing lessons it can teach us about the ethics of science and medicine. Examples from the recent past, such as the Tuskegee syphilis study [6], as well as from the present--the meaning of informed consent, the rights of individuals versus that of society, the ethics of cloning--are informed only when we understand in depth the history of our profession, even in its most horrific behavior.

Alan N. Schechter
Robert L. Perlman

References

1. Pernkopf, E. Topographische Anatomie des Menschen: Lehrbuch und Atlas der Regionär-Stratigraphischen Präparation. Berlin: Urban & Schwarzenberg, 1943.

2. A summary of this discussion is available at http://www.nih.gov/news/NIH-Record/09_24_96/story01.htm.

3. See Müller-Hill, B. Murderous Science: Elimination by Scientific Selection of Jews, Gypsies, and Others in Germany, 1933-1945, translated by...