Sociable

Wednesday, July 21, 2010

Seeing the Opportunity in Human Execution

The current issue (16 July) of Science includes an article on mutations that protect from sleeping sickness but promote kidney disease in people of African descent. As a nephrologist, I know this is a BIG STORY. Several press releases have made their way to my editorial in-box about this cool and significant genetic-association study.

I am going to blog about something else in the issue (full article here).

Anatomy sometimes seems like the poor stepchild of the medical school. You have to keep it around, but it lacks the sexy research found in biochemistry or cell biology. When medical schools combine departments to save resources, anatomy often goes under the axe.

Turns out, a lot of what we know about anatomy may be ethically tainted. In the early 20th century, Germany and Austria produced some of the world’s finest scientists in many disciplines (rocket science, anyone?). As the Nazis rose to power, anatomists developed arrangements with executioners to obtain cadavers for dissection, instruction, and research.

In 1938, senior anatomists at the University of Vienna began an unusual arrangement: They worked closely with local Nazi officials to obtain corpses for teaching and research, receiving the bodies of prisoners shot in the Gestapo rifle range or guillotined in Vienna's assize court building. So many corpses were transferred that Viennese authorities ran a special streetcar, dubbed the "Death Transport," between the court and the medical school in the early morning. If the medical school morgue was full, court officials postponed the executions. Viennese physicians secured at least 1337 bodies of Nazi victims this way, according to a report issued by the University of Vienna in 1998.

I have emphasized that one sentence because this degree of coordination between executioners and medical schools amazes me, even given the atrocities of the era.

The article goes on to describe other ethical breakdowns during the Nazi years, including studies by Hermann Stieve on the effect of stress (scheduling of one’s execution) on ovulation and menstruation:

He sent an assistant to Plötzensee to obtain from prison doctors the women's medical histories, as well as data on their menstrual cycles and reactions to the announcement of their execution date. He also persuaded Plötzensee's director to continue conducting executions in the morning, despite the daylight air attacks in Berlin, so tissue samples could be processed the day of the execution.

A sidebar article discusses Pernkopf’s Atlas, considered by many the gold standard of anatomical illustration; however, Pernkopf and his artists were avid Nazis. Many of these dissections and illustrations came from the executions described above.

Should we still use these illustrations given their tainted past?

I say no. The examples shown are gorgeous, no doubt, but I managed to learn enough anatomy to practice medicine via other sources. Today, Amazon lists 41,906 results when I searched “anatomy” in their books section. We can live without Pernkopf.

I encourage everyone to read the original articles by Heather Pringle, author of The Master Plan: Himmler’s Scholars and the Holocaust (2005). 

What are you waiting for? Click those links and READ!

2 comments:

  1. My understanding is that there are some Nazi experiments on something like cold or heat resistance that provided medically valuable information that is not available from any ethical studies. In that case, you could argue that the good effects on patients of using this information outweighs the bad of using it. But in the case of the anatomy texts, as you point out, there is nothing unique about the information, so why even consider using it?

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  2. Having never heard of this one before today, I was unclear why it would be needed, no matter how beautiful it was. The sidebar article points out that some things discovered in that era used this research (Clara cells in the lung). Getting around that is a bit trickier; we can't go back in time and erase the knowledge that we have already built upon...

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