However, it is vital that such research is conducted, because if Germans do not understand what motivated the behaviour of doctors in the past, they will struggle to make decisions about ethical issues that confront doctors and scientists working in gynaecology, embryology and reproduction today, he will say.
Rolf Winau, Professor of the History of Medicine and Director of the Centre for Humanities and Health Sciences at the Charité (the medical faculty) in Berlin, Germany, will say: "This research should not be about blaming or accusing individuals long after the event, but should shed light on how and why professionals in a particular branch of medicine behaved. Knowledge about such behaviour is as important as the knowledge about the success of scientific medicine. Only this knowledge will make it possible to reflect on our present situation."
His remarks come against a background of Germany having some of the strictest laws on human reproduction in Europe. With the shadow of the Nazi-era eugenics hanging over them, in recent years Germans have prohibited a number of procedures that actually could benefit both parents and children. Examples include: preimplantation genetic diagnosis, which can detect genetic diseases in an embryo before it is transferred to a woman; and freezing embryos for use at a later stage, which means that Germany has one of the higher rates of multiple births in Europe, because doctors have to transfer all the embryos they manage to create, regardless of the embryo's quality - 40% of all ART births in Germany are multiple births, which carry risks for both the mother and the babies. Cloning, surrogacy and egg donation are illegal too.
Prof Winau says: "From 1952 to 1980 there was no research at all into medicine during the Nazi era. Today, there are still a great number of doctors who do not wish to be 'disturbed' by remembering the dark times of German medicine. Only a few hospitals have faced up to their history."
Examples of that history include Walter Stoeckel, professor ordinarius at Berlin University and president of the German Society of Gynaecology in 1933-34. He co-operated with the Nazis and was responsible for the expulsion of Jewish doctors from the Society. "Stoekel made it clear that he and other German gynaecologists placed great hopes in Hitler, sending him their 'enthusiastic admiration' in a telegram," says Prof Winau.
"The execution of the law on preventing genetic diseases in children is an example of the conformity of many Germany gynaecologists to the racial ideas and the concept of racial hygiene of the Third Reich. Opposition to this law hardly existed. There was no discussion in the medical journals about whether the law was ethically justified, but only about how the sterilization could be undertaken most effectively.
"For instance, the head of the Brandenburg gynaecology hospital in Neukoelin, Benno Ottow, remarked that 'never in the history of mankind has the doctor been so integrated into the people's fate and in the people's state as he is under National Socialism'. Full of pride, he stated that the first chamber of the hereditary health court that he belonged to as a judge 'agreed in mutual assessment and consulted thoroughly more than 1,000 people with hereditary diseases in half a year about the requirement for their sterilization'. He then discusses, as greater length, the practicalities of sterilization and how to deal with psychiatric patients who had to be forced by the police to the operating table."
Many scientists seized on the opportunities offered by the regime to pursue their research. "Not all who used this opportunity did so from unscrupulous motives; however, for many scientists, the scientific impetus triumphed over ethical scruples. This definitely goes for the anatomist Hermann Stieve, who undertook a fundamental examination of ovulation in executed women from the Ploetzensee prison between 1942 and 1944. His scientific thirst for knowledge led to him seizing the opportunities offered to him without questioning them," says Prof Winau.
The magnitude of the crimes committed by these men, and many others, makes it vital to understand why they behaved in the way that they did. "We have to study the history of medicine in the Nazi era in order that we understand the roots and mechanisms of an inhuman medicine, and why over 45 per cent of all German physicians were Nazis and why some of them worked as researchers in the concentration camps. We need to study the 'Rassenhygiene', the German version of eugenics, in order to show how far eugenic and racial thinking can go, so that we can have it in mind when we discuss ethical questions on reproduction and fertility. If we do not, we face uncertainty, lack of information and confusion when considering ethical questions in the future.
"The study of Nazi medicine was a taboo in both German states until recently. It is time to deal with this issue in universities, on courses and in society. German gynaecologists and teachers have to confront it. But there is still a lot to do."
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