by Cina, Joshua A. Perper, Stephen J. ; Cina, Joshua A. Perper, Stephen J.
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Phosgene Experiments
In an attempt to find an antidote to phosgene, a toxic gas used as a weapon by the Germans during World War I, Nazi doctors exposed 52 concentration camp prisoners to the gas at Fort Ney near Strasbourg, France. Phosgene gas causes extreme irritation to the lungs and severe shortness of breath, chest pain and disability. Many of the prisoners, who according to German records were already weak and malnourished, suffered pulmonary edema after exposure and four of them died from the experiments. In essence, they drowned in their own body fluids. The survivors had severe lung damage for the rest of their lives. There is no record that any antidotes were given to the prisoners though that was the stated goal of the experiment.
Bone, Muscle and Joint Transplantation
Between September 1942 and December 1943, physicians conducted a series of surgical experiments in order find out whether a limb or joint from a person could be successfully attached to an amputee. Nazi doctors at Ravensbruck concentration camp amputated legs and shoulders from Polish inmates in futile attempts to transplant them onto other victims who been intentionally maimed. They also removed sections of bones, muscles, and nerves from prisoners to study regeneration of these body parts.
Victims suffered excruciating pain, mutilation, and permanent disabilities.
Sterilization Techniques
The Nazis attempted to find out which sterilization method was the easiest, most rapid, and most effective to use on the millions of people deemed “enemy” populations. Experiments were conducted on both men and women prisoners at Auschwitz and Ravensbrueck under the direction of the Nazi doctors Carl Clauberg and Horst Schumann. The sterilization was done by drugs, surgery, and x-rays to the genitals at different intensities resulting in severe burns and infected sores. Some women had caustic substances forced into the cervix or uterus, and experienced severe abdominal pain and bleeding. The degrading, forced sterilization also resulted in severe depression for many of the victims. After the war, Dr. Schumann fled to Africa where, in a remarkable change of heart, he worked tirelessly in remote areas saving victims of sleeping sickness. He later described himself as “having found the serenity and the calm necessary for the moral balance of a human being.” He was repatriated to Germany in 1966 where he was imprisoned for several years for his crimes decades earlier. He was eventually released without standing trial because of a very poor state of health. In custody, he alternated between statements such as “It was terrible what we did” and others defending or denying his actions. He died in 1983.
Human Petri Dishes
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Artificial Insemination Experiments
After hearing that Dr. Carl Clauberg had successfully treated a high-level SS
officer’s infertile wife, Heinrich Himmler ordered Clauberg to conduct artificial insemination experiments. Some 300 women at Auschwitz subsequently underwent artificial insemination at the hands of Clauberg. In addition to the physical humiliation of the procedure, he reportedly taunted his victims by informing them that he had just inseminated them with animal sperm and that monsters were now growing in their wombs. Clauberg was ultimately arrested and imprisoned in the Soviet Union, then repatriated to Germany where he returned to medical practice. Due to an outcry by survivor groups, he was arrested in 1955 and died mysteriously in his cell in a West German prison in 1957.
Seawater Experimentation
In 1944, Dr. Hans Eppinger and others Nazi doctors at the Dachau concentration camp conducted experiments on how to make seawater drinkable. The doctors forced roughly 90 Gypsies to drink only seawater while also depriving them of food. The Gypsies became so dehydrated that they reportedly licked floors after they had been mopped just to get a drop of fresh water. The cruel experiments caused extreme pain and suffering and resulted in serious bodily injury and death.
Dr. Eppinger killed himself by poison on September 25, 1946, exactly 1 month before he was scheduled to testify in the Nuremberg trial.
Incendiary Bomb Experiments
Experiments were conducted at Buchenwald extermination camp in order to test pharmaceutical treatments for phosphorus burns on prisoners. Phosphorus from bombs was applied to the skin of camp prisoners and then ignited. The skin was allowed to burn for more than a minute before the flames were extinguished.
Human Petri Dishes
German soldiers contracted many typhus cases after invading the Soviet Union.
Experiments were designed to test the efficacy of vaccines against typhus, smallpox, cholera, and other diseases on camp prisoners who had been purposely injected with the respective infectious agents. More than 90% of the inmates involved in these studies died. Other experiments involved infecting 76
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the subjects with malaria and tuberculosis. Many of these experiments involved Catholic priests. More people died of the treatments than of the diseases themselves.
Polygal Experiments
When Himmler was told that the cause of death of most soldiers on the battlefield was uncontrollable bleeding, he ordered the dependable Dr. Rascher to develop a blood clotting agent to be administered to German troops before a battle. Rascher conducted experiments to test the effectiveness of polygal, a blood coagulant, which he developed for the treatment of bleeding wounds. After infusing his subjects with this medication, he quantified it effectiveness by measuring the rate of blood drops oozing from freshly cut amputation stumps of living and conscious prisoners at the Dachau crematorium.
German Academicians
Professors in the highest institutions of medical learning in Germany supported the Nazi theories of racial eugenics and racial selection and participated to various degrees in the murder of innocent men, women and children. It is likely that some of the support radiated from a fear of the regime taking away their positions, livelihood, family, and life if they did not cooperate with the government. It is also likely that some academic physicians truly believed in the Nazi cause and did everything they could to help. Dr. Carl Schneider (1891–1946), Professor and Chairman of the Department of Psychiatry of the University of Heidelberg, psychologically assessed children he knew would be killed under the Nazi eugenics programs and had their brains collected and dissected after they were murdered. Schneider committed suicide after the war. Dr. Hermann Stieve, a leading anatomist and professor at the University of Berlin and the Berlin Charité Hospital, investigated the impact of fear and stress on the menstrual patterns of women who had been informed that the Gestapo would kill them on a particular date. Upon the women’s execution, their pelvis was opened and the uterus excised for microscopic examination of the endo-metrium (the lining of the womb that eventually sheds at the end of the menstrual cycle). Shamelessly, Stieve published reports of his findings and even lectured about them to medical students in East Berlin after the war. Dr. Eduard Pernkopf, the Chair of The Institute of Anatomy of the University of Vienna and Dean of the associated medical school, possessed all the anatomic illustrations portraying the murder victims of the Nazi terror regime. In 1998, an investigation reluctantly conducted by the University after the repeated requests of Jewish organizations and the Israeli government reported that the Institute of Anatomy had received almost 1,400 cadavers from the Gestapo execution chamber in the Vienna Regional Court Are the Results of Nazi Criminal Experimentation Reliable?
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(Landesgerichte). While the Institute’s collection was destroyed by a bomb near the end of the War, the investigation did identify approximately 200 specimens from the Nazi era that were still in other University’s collections.
Are the Results of Nazi Criminal Experimentation Reliable?
As we pointed out before there are many that question the accuracy and reliability of most of the Nazi medical research done in the death camps or elsewhere on unwilling victims. Brigadier General Telford Taylor, Chief Counsel for the prosecution at Nuremberg, stated unequivocally tha
t the Nazi experiments were unscientific,
“a ghostly failure as well as a hideous crime . . . Those experiments revealed nothing which civilized medicine can use.” Arnold Relman, editor of the New England Journal of Medicine, similarly stated that the Nazi experiments were such a “gross violation of human standards that they are not to be trusted at all” and for this reason, the Journal would not publish material related to the criminal research.
Doctor Leonard Hoenig, Assistant Professor of Medicine at the University of South Florida College of Medicine, categorized the Nazi experiments as “pseudoscience” since the Nazis blurred the distinction between science and sadism. The Nazi data was not derived from scientific hypothesis and research, but rather inspired and filtered through a racial ideology of genocide. Doctor Hoenig maintained that nothing scientific could have resulted from sadism.
Nevertheless, the ethical question remains as to whether one should reject all of the results, even if some of the research could be determined to be scientifically valid and potentially helpful. There are two opposite points of view on this issue. The first is that the Nazi experiments are clearly so abhorrent in their disregard of the prisoners’ pain, suffering, health and life, that by using their results a scientist would brand himself or herself an accomplice to their crimes. Whatever the benefit to the public might be, one should relegate such results to oblivion and not use them. Dr. Henry Beecher, the late Harvard Medical School Professor, analogized the use of the Nazi data to the legal inadmissibility of tainted evidence. Dr. Beecher said that even though suppression of the data would constitute a loss to science in a few specific areas, “this loss, it seems, would be less important than the far reaching moral loss to medicine if the data were to be published.” An alternative point of view is that one should not forget the terrible crimes of the Nazis, but that at least the victims who died or were injured did not die in vain and their suffering might in some measure help humanity.
Perhaps an unbiased, reputable panel of scientists could critically evaluate the results of Nazi medical research and, if reliable results are found, they should be disclosed. The original experimenters should not be given personal credit for these atrocities. If there is any credit to be claimed for any useful scientific data it should go to the unwilling subjects and the names of the criminal researchers should be blotted out of memory forever. The obvious disadvantage of this philosophical approach is that any evaluation process implicitly confers some scientific validity to these monstrous acts of cruelty that have deeply debased the art and practice of medicine.
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Modern Day Human Experimentation
The purpose of medicine is to relieve human suffering, heal the sick and injured, promote health, improve the quality of life, and delay the inevitable death that awaits us all. In trying to achieve those lofty goals, even physicians harboring the best intentions may cause temporary or permanent distress, pain, disease, injury and occasionally death. We call such untoward effects of healing efforts iatrogenic diseases (from the Greek words “iatros” meaning doctor and “genesis” meaning formation). Obviously ethical physicians try their best to avoid iatrogenic complications of treatment but they may be compelled to attempt dangerous surgery or infuse a potentially toxic medication if the risk-to-benefit ratio is substantially in favor of the patient.
Any experimental or investigational treatment is more likely to cause iatrogenic injuries than standard therapy because it treads into unknown territory. In contrast to risky, heroic measures designed to save a given patient’s live, experimental treatment regimens are not necessarily designed to benefit the test subject. If they were, why would have of the patients be given a placebo and the remainder be given the potential cure? Rather, the experiment is conducted to determine the efficacy of treatment for many potential future patients – a good response in the patient receiving the drug is a welcome bonus. Rather than enrolling volunteers into programs most accurately deemed “human experiments” researchers have euphemistically christened medical experimentation on humans as “clinical trials.” Many modern, voluntary clinical trials, though described as “your only chance” or “the right thing to do,” are inherently dangerous and are, ultimately, human experimentation. This does not mean that we disapprove of these studies – they are the cornerstone of medical progress. Criteria for ethical and scientifically valid human experimentation have been established to minimize the risks to participants. Studies must be approved by a hospital’s IRB (Institutional Review Board) prior to enrolling any patients. International policy also dictates that medical experimentation on humans must be truly voluntary and adhere to strict guidelines. Informed consent is the key to compliance with these rules.
Nazi doctors committed the most egregious violations of the basic principles of ethical medical experimentation during the Second World War. Their research crossed the line between science and sadism again and again. On a smaller scale, more surreptitious but equally lethal experiments are still going on today throughout the world. Moreover, you may own stock in some of the perpetrating companies.
Chapter 9
Made in Japan: Unethical Experiments
Heresies are experiments in man’s unsatisfied search for truth.
– H.G. Wells
Before and during the Second World War, from 1935 to 1945, Japanese physicians engaged in criminal medical experimentation on thousands of human beings. These doctors dedicated themselves to the development of biological weapons at the direction of and with the full support of the Japanese Government. Their activities were little different from the medical atrocities committed by the Nazi physicians.
The involuntary subjects of experiments were mainly Chinese soldiers and civilians but also included members of other nationalities including Koreans, Burmese, Russians, Mongolians, and Americans.
The Japanese WMD Program
The Japanese Government became interested in the possibilities of biological warfare at the conclusion of World War I in 1918, when the medical bureau of the Japanese army assigned Major Terunobu Hasebe to head a research team to explore the potential of microbial weapons. Dr. Ito, who directed a team of 40 scientists, soon succeeded Hasebe. However, the real beginning of Japan’s biological warfare came only when Ishii Shiro entered the scene.
Dr. Shiro Ishii (1892–1959), a medical graduate of Kyoto Imperial University, was the central figure in the planning and execution of criminal biological experimentation on prisoners and in directing the use of biological weapons of mass destruction in attacks against China. He had a reputation of being brilliant but arrogant, rude towards his peers and obsequious towards his superiors. Upon graduation from medical school, he promptly joined the Japanese Imperial Army and after 3 years of postgraduate studies, he earned a PhD degree with expertise in the fields of bacteriology, immunology and preventive medicine. Beginning in 1928, Ishii took a 2-year tour of the West as a military attaché. In his travels, he did extensive research on the effects of biological and chemical warfare from World War I. It was a highly successful mission and it helped win him the patronage of Sadao Araki, J.A. Perper and S.J. Cina, When Doctors Kill: Who, Why, and How, 79
DOI 10.1007/978-1-4419-1369-2_9, © Springer Science+Business Media, LLC 2010
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Minister of the Army. Upon his return, he was appointed professor of immunology at the Tokyo Army Medical School and was given the rank of major. While there, Ishii quickly made a name for himself by inventing an effective water purification filter that he demonstrated before the Emperor. On a less noble front, Ishii urged the military to develop biological weapons to be used against the Chinese.
By the end of August 1932, Ishii led a group of ten scientists from the Army’s Medical College on a tour of the Chinese territory of Manchuria, which had been invaded by the Japanese a year earlier. The Japanese Army gave him control of three biological research cent
ers, including one in the city of Harbin in Manchuria. The preliminary experiments in biological warfare began as a secret project for the Japanese military with Ishii placed in command of the Army Epidemic Prevention Research Laboratory, at the Zhong Ma Prison Camp in Beiyinhe, a village south of Harbin. Ishii organized a covert research group, “Togo Unit,” to conduct chemical and biological weapons research. In 1935, a jailbreak and an explosion (believed to be an attack) forced Ishii to shut down this facility. He moved to Pingfang, approximately 24 km south of Harbin, to set up a new and much larger facility. A year later, Ishii built a huge compound for “Unit 731” that included more than 150 buildings over 6 km2.
The research was top-secret; the official story was that the unit was engaged in water-purification work. A special project code, “Maruta,” was used for experiments performed on human beings. Test subjects were gathered from the surrounding population and were sometimes referred to euphemistically as “logs” (maruta). This term originated as a ‘joke’ on the part of the staff because the official cover story for the facility provided to the local authorities was that it was a lumber mill. The tests were done in large underground rooms beneath a huge isolated building with subjects including male and female adults, infants, children, the elderly, and pregnant women.
Many experiments and vivisections (autopsies on living people) were performed without the use of anesthetics because it was believed that it might affect the results of the experimentation. The Commander of the Kuantung Army in Manchuria, Major General Hideki Tojo, supplied unit 731 with plenty of live experimental victims. He was a staunch supporter of Ishii and of biological warfare and he later became Japan’s Prime Minister. The unfortunate victims were infected with different contagious diseases and were killed at different time intervals following infection in order to study the various stages of plague, cholera, tuberculosis, and other serious illnesses.
Although the Geneva Convention of 1925 had banned both chemical and biological warfare, Japan had refused to sign the treaty and had deployed poison gas bombs at the beginning of the Second Sino-Japanese war in August 1937. Shiro Ishii was instrumental in the planning, manufacturing and testing of these weapons on humans. In 1940, Ishii was appointed Chief of the Biological Warfare Section of the Kwangtung Army, holding the post simultaneously with that of the Bacteriological Department of the Army Medical Academy. From 1940 to the end of the Second World War in 1946, Ishii directed his specialized units to engage in biological warfare by attacking the Chinese Ningpo, Chinhua, and Chechiang provinces.