How Ethics Failed — The Role of Psychiatrists and Physicians in Nazi Programs from Exclusion to Extermination, 1933–1945

Abstract

Background: Disregard of Hippocratic medical ethics by major leaders in the Public Health establishment and the leadership role played by physicians during the Nazi era in Germany (1933-1945) pose continuing challenges for later generations to investigate and disclose. Aims: We review the history of evolution from humiliation of mental patients, other ill and disabled individuals and targeted ethnic groups to humiliation, sterilization, and "involuntary euthanasia" (a euphemism for medical murder). We focus on the role played by psychiatrists and neurologists during the Nazi period in Germany; we discuss the ethical norms of universal dignity, compassion and responsibility and we propose concrete steps to prevent recurrence of medically supported genocide. Methods: We explored the history of psychiatry of the period leading up to, including and immediately after the Nazi era in order to analyze the ethical standards and practices of psychiatrists and neurologists. Results: Psychiatrists, and neurologists, were guilty leaders and participants in the implementation of the Nazi programs, which escalated from humiliation and classification of their victims to the exclusion of the mentally ill and disabled, to devaluation and forced sterilization, to medical murder, then finally to the industrialized mass murder of millions, named the "Final Solution".

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“…Through Aktion-T4 program (a program of involuntary euthanasia in Nazi Germany), Hitler murdered an estimated 200 000 people with intellectual and developmental disabilities, a large number being people with DS. 28 Prejudice and discrimination against individuals with DS continue today. 29…”

Kallmann Syndrome: Eugenics and the Man behind the Eponym

“… 9 , 11 Sterilization gave way to killing with the approval of the Aktion T-4 program in 1939. Named after the location of its headquarters in Berlin (4 Tiergarten Street), the program was run by 50 volunteer physicians, authorizing specific doctors and officials to carry out mercy deaths/euthanasia of defective individuals, as recommended by physicians and psychiatrists throughout Germany (for detailed list see Lindert et al 13 ). Methods of killing included starvation, morphine injections, tablets, and gassing.…”

„80 Jahre nach dem Anschluss …“

“…Kinder-"Euthanasie"; [7]). Zusammen mit der medizinischen Forschung an sogenannten biologisch oder juristisch "minderwertigen" Menschen in unfassbarer Weise, lieferte das "Euthanasie"-Programm letztlich die "Vorlage für den Holocaust" [8].…”