Skip to main content
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2003 Dec;95(12):1216–1225.

Nuremberg and Tuskegee: lessons for contemporary American medicine.

David M Pressel 1
PMCID: PMC2594827  PMID: 14717481

Abstract

The activities of German doctors during the Nazi regime are well known and documented. They include efforts at eugenic sterilization and euthanasia, gruesome medical experimentation, and contributions to genocide. The German medical profession embraced the Nazi ideology of racial superiority. Nazi doctors enthusiastically perverted traditional medical mores of viewing each patient as a full individual towards a misguided sense of protecting the racial well-being of the nation from the perceived threat of certain groups of people. Similarly, some 20th-century American physicians engaged in activities prompted by a misguided sense of patients' worth as individuals. This essay will examine the ethical problems of Nazi medicine and ethical missteps in the United States in the context of challenges for contemporary physicians, particularly the way in which we refer to our patients.

Full text

PDF
1217

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ALEXANDER L. Medical science under dictatorship. N Engl J Med. 1949 Jul 14;241(2):39–47. doi: 10.1056/NEJM194907142410201. [DOI] [PubMed] [Google Scholar]
  2. Barondess J. A. Medicine against society. Lessons from the Third Reich. JAMA. 1996 Nov 27;276(20):1657–1661. doi: 10.1001/jama.276.20.1657. [DOI] [PubMed] [Google Scholar]
  3. Beardsley E. H. Good-bye to Jim Crow: the desegregation of Southern hospitals, 1945-70. Bull Hist Med. 1986 Fall;60(3):367–386. [PubMed] [Google Scholar]
  4. Beecher H. K. Ethics and clinical research. N Engl J Med. 1966 Jun 16;274(24):1354–1360. doi: 10.1056/NEJM196606162742405. [DOI] [PubMed] [Google Scholar]
  5. Berger R. L. Nazi science--the Dachau hypothermia experiments. N Engl J Med. 1990 May 17;322(20):1435–1440. doi: 10.1056/NEJM199005173222006. [DOI] [PubMed] [Google Scholar]
  6. Bosk C. L. Occupational rituals in patient management. N Engl J Med. 1980 Jul 10;303(2):71–76. doi: 10.1056/NEJM198007103030203. [DOI] [PubMed] [Google Scholar]
  7. Fabrega H., Jr Does a clerkship affect students' views of psychiatric patients? J Nerv Ment Dis. 1995 Dec;183(12):736–742. doi: 10.1097/00005053-199512000-00002. [DOI] [PubMed] [Google Scholar]
  8. Faden R. R., Lederer S. E., Moreno J. D. US medical researchers, the Nuremberg Doctors Trial, and the Nuremberg Code. A review of findings of the Advisory Committee on Human Radiation Experiments. JAMA. 1996 Nov 27;276(20):1667–1671. [PubMed] [Google Scholar]
  9. Fairchild A. L., Bayer R. Uses and abuses of Tuskegee. Science. 1999 May 7;284(5416):919–921. doi: 10.1126/science.284.5416.919. [DOI] [PubMed] [Google Scholar]
  10. Geller G., Levine D. M., Mamon J. A., Moore R. D., Bone L. R., Stokes E. J. Knowledge, attitudes, and reported practices of medical students and house staff regarding the diagnosis and treatment of alcoholism. JAMA. 1989 Jun 2;261(21):3115–3120. [PubMed] [Google Scholar]
  11. Hanauske-Abel H. M. Not a slippery slope or sudden subversion: German medicine and national socialism in 1933. BMJ. 1996 Dec 7;313(7070):1453–1463. doi: 10.1136/bmj.313.7070.1453. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Harkness J. M. Nuremberg and the issue of wartime experiments on US prisoners. The Green Committee. JAMA. 1996 Nov 27;276(20):1672–1675. [PubMed] [Google Scholar]
  13. Heilicser B. Redefining "dirtball". Ann Emerg Med. 1995 Apr;25(4):559–560. doi: 10.1016/s0196-0644(95)70276-8. [DOI] [PubMed] [Google Scholar]
  14. Hill T. E. The ER incident. Ann Intern Med. 1992 May 15;116(10):867–868. doi: 10.7326/0003-4819-116-10-867. [DOI] [PubMed] [Google Scholar]
  15. Kampmeier R. H. Final report on the "Tuskegee syphilis study". South Med J. 1974 Nov;67(11):1349–1353. doi: 10.1097/00007611-197411000-00019. [DOI] [PubMed] [Google Scholar]
  16. Kelly J. A., St Lawrence J. S., Smith S., Jr, Hood H. V., Cook D. J. Medical students' attitudes toward AIDS and homosexual patients. J Med Educ. 1987 Jul;62(7):549–556. doi: 10.1097/00001888-198707000-00003. [DOI] [PubMed] [Google Scholar]
  17. Kelly J. A., St Lawrence J. S., Smith S., Jr, Hood H. V., Cook D. J. Stigmatization of AIDS patients by physicians. Am J Public Health. 1987 Jul;77(7):789–791. doi: 10.2105/ajph.77.7.789. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Kevles D. J. Eugenics and human rights. BMJ. 1999 Aug 14;319(7207):435–438. doi: 10.1136/bmj.319.7207.435. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Lawrie S. M., Parsons C., Patrick J., Masson S., Sussmann J., Cumming D., Lewin J., Pickup S. A controlled trial of general practitioners' attitudes to patients with schizophrenia. Health Bull (Edinb) 1996 May;54(3):201–203. [PubMed] [Google Scholar]
  20. Leiderman D. B., Grisso J. A. The gomer phenomenon. J Health Soc Behav. 1985 Sep;26(3):222–232. [PubMed] [Google Scholar]
  21. Letterie G. S., Fox W. F., Jr Legal aspects of involuntary sterilization. Fertil Steril. 1990 Mar;53(3):391–398. doi: 10.1016/s0015-0282(16)53328-7. [DOI] [PubMed] [Google Scholar]
  22. Mirabi M., Weinman M. L., Magnetti S. M., Keppler K. N. Professional attitudes toward the chronic mentally ill. Hosp Community Psychiatry. 1985 Apr;36(4):404–405. doi: 10.1176/ps.36.4.404. [DOI] [PubMed] [Google Scholar]
  23. Moodley-Kunnie T. Attitudes and perceptions of health professionals toward substance use disorders and substance-dependent individuals. Int J Addict. 1988 May;23(5):469–475. doi: 10.3109/10826088809039212. [DOI] [PubMed] [Google Scholar]
  24. Packer S., Prendergast P., Wasylenki D., Toner B., Ali A. Psychiatric residents' attitudes toward patients with chronic mental illness. Hosp Community Psychiatry. 1994 Nov;45(11):1117–1121. doi: 10.1176/ps.45.11.1117. [DOI] [PubMed] [Google Scholar]
  25. Pernick M. S. Eugenics and public health in American history. Am J Public Health. 1997 Nov;87(11):1767–1772. doi: 10.2105/ajph.87.11.1767. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Rathore S. S., Lenert L. A., Weinfurt K. P., Tinoco A., Taleghani C. K., Harless W., Schulman K. A. The effects of patient sex and race on medical students' ratings of quality of life. Am J Med. 2000 May;108(7):561–566. doi: 10.1016/s0002-9343(00)00352-1. [DOI] [PubMed] [Google Scholar]
  27. Rose L. Homophobia among doctors. BMJ. 1994 Feb 26;308(6928):586–587. doi: 10.1136/bmj.308.6928.586. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Rothman D. J. Ethics and human experimentation. Henry Beecher revisited. N Engl J Med. 1987 Nov 5;317(19):1195–1199. doi: 10.1056/NEJM198711053171906. [DOI] [PubMed] [Google Scholar]
  29. Saha S., Komaromy M., Koepsell T. D., Bindman A. B. Patient-physician racial concordance and the perceived quality and use of health care. Arch Intern Med. 1999 May 10;159(9):997–1004. doi: 10.1001/archinte.159.9.997. [DOI] [PubMed] [Google Scholar]
  30. Seidelman W. E. Mengele medicus: medicine's Nazi heritage. Milbank Q. 1988;66(2):221–239. [PubMed] [Google Scholar]
  31. Selleck C. S., Redding B. A. Knowledge and attitudes of registered nurses toward perinatal substance abuse. J Obstet Gynecol Neonatal Nurs. 1998 Jan-Feb;27(1):70–77. doi: 10.1111/j.1552-6909.1998.tb02593.x. [DOI] [PubMed] [Google Scholar]
  32. Shea S., Fullilove M. T. Entry of black and other minority students into U.S. medical schools. Historical perspective and recent trends. N Engl J Med. 1985 Oct 10;313(15):933–940. doi: 10.1056/NEJM198510103131506. [DOI] [PubMed] [Google Scholar]
  33. Sofair A. N., Kaldjian L. C. Eugenic sterilization and a qualified Nazi analogy: the United States and Germany, 1930-1945. Ann Intern Med. 2000 Feb 15;132(4):312–319. doi: 10.7326/0003-4819-132-4-200002150-00010. [DOI] [PubMed] [Google Scholar]
  34. Trierweiler S. J., Neighbors H. W., Munday C., Thompson E. E., Binion V. J., Gomez J. P. Clinician attributions associated with the diagnosis of schizophrenia in African American and non-African American patients. J Consult Clin Psychol. 2000 Feb;68(1):171–175. doi: 10.1037//0022-006x.68.1.171. [DOI] [PubMed] [Google Scholar]
  35. Varma J. K. Eugenics and immigration restriction: lessons for tomorrow. JAMA. 1996 Mar 6;275(9):734–737. doi: 10.1001/jama.275.9.734. [DOI] [PubMed] [Google Scholar]
  36. Williams D. R. Race, socioeconomic status, and health. The added effects of racism and discrimination. Ann N Y Acad Sci. 1999;896:173–188. doi: 10.1111/j.1749-6632.1999.tb08114.x. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES