Richard Feldman: Atrocities led to ethical standards for human trials

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Dr. Richard FeldmanEva Kor, the prominent Hoosier Holocaust survivor, died recently. Although diminutive in size, Eva was a strong, determined and inspirational person who dedicated her life to expressing her personal messages concerning the Nazis’ unparalleled inhumanity and history’s arguably most evil episode.

Eva survived the horrific experiments conducted on identical twins by Dr. Josef Mengele at Auschwitz. Twenty-three Nazi physicians faced charges at the Nuremberg trials, seven of whom were executed for their sadistic experiments—atrocities conducted on children and adults.

These monstrous doctors disgraced their profession and their Hippocratic oaths. Their “medical” experiments punctuate Nazi Germany’s cruel, brutal and ruthless obsession to “cleanse” the world of Jews and other groups they considered unworthy of living.

What were these experiments conducted in total disregard for the subjects’ indescribable pain, mutilation, misery and ultimately their survival? And what do we do with this knowledge obtained through immoral means?

Experiments were performed to discover how long downed pilots could survive frigid waters. Many subjects died painfully with frozen extremities and hypothermia.

Simulated high-altitude experiments using decompression chambers were conducted to find the cause of high-altitude illness in pilots. Experiments studied how long it took subjects to die of dehydration when given seawater as their sole source of hydration. In other experiments, prisoners received medications to prevent hemorrhage and were subsequently subjected to extremity amputations without anesthesia.

The effectiveness of new sulfa antibiotics was tested on simulated battlefield wounds. Wounds were inflicted and then contaminated with virulent bacteria and added debris as the prisoners endured excruciating pain.

Racially motivated eugenic experiments involved finding methods of mass sterilization of undesirables. Identical twin experiments sought to find ways to induce multiple births to further Aryan dominance.

Twin experiments also studied environmental versus genetic determinants in human physiology. Identical twins endured painful and debilitating bodily insults and then were killed and autopsied to see what comparable changes took place.

Virtually all the experiments were either pseudoscience or yielded worthless information. Some research was tainted by political interference, and others lacked scientific integrity. There was little knowledge gained of enduring value. Possible exceptions were the understanding and treatment of hypothermia and high-altitude illnesses.

There has been a long philosophical debate over what to do with this immorally obtained medical knowledge. Some suggest that nothing should be used, and some governmental agencies and journals have barred its use or acknowledgement in publications. Others believe that, if the information has important medical benefit to mankind, it should be used.

A dominant position is that, if the knowledge is of compelling medical benefit and not available from other sources, it should be used with explicit denouncement of the unethical way it was obtained. I imagine if we could ask these unfortunate victims of the Nazi atrocities if the information from their suffering should be used to help others, they would give their blessings.

There was one definite positive result: The world medical-scientific community agreed to strict ethical standards for research involving human subjects. These were based on principles formulated by the judges at the Nuremberg Trials and subsequently formalized by The Declaration of Helsinki.

May we never forget.•

__________

Feldman is a family physician, author, lecturer and former Indiana State Department of Health commissioner for Gov. Frank O’Bannon. Send comments to ibjedit@ibj.com.


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