Book Review

Hitler or Hippocrates: Medical Experiments and Euthanasia in the Third Reich

N Engl J Med 1993; 328:1429May 13, 1993

Article

Hitler or Hippocrates: Medical Experiments and Euthanasia in the Third Reich
By Paul Hoedeman. 260 pp., illustrated. Sussex, England, Book Guild, 1991. £12.95. ISBN: 0-86332-544-0

Physicians everywhere work in the shadow of the Nazi epoch. Whether they recognize it or not, what happened in Nazi Germany between 1933 and 1945 has some influence on the treatment of patients and the standards of permissible research and experiments. For example, today the Nazi record provides extreme examples of what can happen and what did happen in state-sponsored euthanasia programs, planned sterilizations of patients with specific diseases, and shocking medical experiments carried out on involuntary subjects. Moreover, the Nazi experience has relevance for many current medical debates, such as those on abortion, genetic screening, racial differences in susceptibility to diseases, and experiments on living subjects.

Paul Hoedeman's book on medical experiments and euthanasia in Nazi Germany is a disappointment. It purports to offer a general overview for the nonmedical public. However, it is poorly organized, analytically weak, and uncertainly translated from the Dutch. There is no index.

The book begins with a brief introduction of the Nazi influence on the German medical profession and then describes the role of Heinrich Himmler and the SS (Nazi special police) in running the extermination camps. There is a chapter on the development of the Nazi euthanasia program -- euthanasia here being a euphemism for the elimination of “unworthy life.” The rest of the book is devoted to medical experiments at specific camps: Ravensbruck, Buchenwald, Natzweiler, Dachau, and Auschwitz-Birkenau. These include short and incomplete accounts of experiments with typhus and typhoid vaccines, artificially induced wounds and gangrene, high-altitude and extremely cold conditions, sea-water injections, and the organs of twins. Many of these experiments led to the immediate deaths of the subjects. Throughout the book there are interesting portraits of the physicians responsible for the programs, men like Leonardo Conti, Karl Brandt, Karl Gebhardt, Sigmund Rascher, and Josef Mengele. Certainly these figures provide extreme examples of “the scientist gone berserk.”

The trouble with the organization of this book is that there is very little of it. The author presents a scissors-and-paste compilation of data, experiments, interviews, and testimony from the Nuremberg trials. There is little recognition of the historical context of the issues. For example, the author neglects the late 19th- and early 20th-century background of German medical science with regard to “racial hygiene,” “philosophical vitalism,” genetic determinism, and voluntary sterilization and euthanasia. He also fails to recognize the key point that there was a definite progression in the Nazi programs, beginning with racial hygiene, sterilization, and euthanasia in the late 1930s and ending with the wartime medical experiments and mass exterminations in the 1940s. Doctors, nurses, and technicians were drawn into the early programs and in a sense were trained to take leadership positions in the camps later on. Finally, the book does not analyze the ways in which racial categorizing infected the thinking and research of medical scientists.

More dependable scholarship on this important topic can be found in Michael Kater's Doctors under Hitler (Chapel Hill, N.C.: University of North Carolina Press, 1989), Robert Lifton's The Nazi Doctors (New York: Basic Books, 1986), a forthcoming book on the Nazi euthanasia program by Henry Friedlander, and 1989 issues of the Hastings Center Report (19(4):16-8 and 19(6):5-6). Incidentally, in 1990 the Journal published two interesting articles surveying the scientific value of Nazi medical experiments (322:1435-40 and 322: 1462-4).

Richard M. Hunt, Ph.D.
Harvard University, Cambridge, MA 02138