Reviewed by Richard Weikart, Department of History, California State University, Stanislaus.
Published by H-German (February, 2003)

This collection of six essays by leading scholars on medicine under the Nazi regime provides a useful introduction to the state of research on Nazi eugenics, euthanasia, and medical research. Most of the essays are summations of arguments and information already published in books and articles by these scholars, so specialists will not find much new material here, but this book serves as an excellent orientation for undergraduate and graduate students, as well as physicians and the general public.

As Michael Burleigh perceptively notes in his concluding essay, this volume, despite its title, does not really explore medical ethics to any considerable extent, nor does it examine the ethical context in which German physicians were educated and trained. Rather it examines primarily the unethical conduct of physicians during the Nazi period and demonstrates the prevalence of collaboration by German physicians in Nazi atrocities.

Michael Kater, author of Doctors under Hitler, opens his excellent essay on "Criminal Physicians in the Third Reich" by providing a definition of criminality that is highly debatable. He claims that anyone joining any Nazi organization, including the Nazi Party and the Nazi Physicians' League, was thereby a criminal by association. His data showing that German physicians joined Nazi organizations at a much higher rate than other professionals is useful, but I think it would be more helpful to call this conduct immoral rather than criminal (unless accompanied by other misdeeds). The second half of Kater's essay on the professional misconduct of physicians cogently analyzes the factors causing physicians to participate in Nazi atrocities, which included the prevalence of social Darwinist and racial ideology, as well as new ethical norms introduced by the Nazis.

Henry Friedlander's fine essay on physicians who personally participated in murder in the T4 "euthanasia" program and in the death camps provides interesting glimpses at the lives and backgrounds of several physicians who perpetrated atrocities during the Nazi regime. I found the brevity of these descriptions tantalizing, since the information presented was insufficient to accurately discern the motives of these men. Surely, Friedlander is right, when he states, "They became killers because they adhered to the governing ideology and because they were arrogant, ambitious, and greedy" (p. 73). But how important were each of these factors?

Robert Proctor's interesting essay recapitulates his argument in The Nazi War on Cancer. He shows that German physicians during the Nazi period were in the forefront of research on the link between tobacco and cancer, a development aided by Nazi ideology, which placed prime importance on health. Even though the Nazis introduced some restrictions on smoking, they never pushed these restrictions very hard, and they did not significantly reduce tobacco consumption. Proctor is by no means trying to rehabilitate Nazism by claiming that anti-tobacco was as integral to Nazism as the death camps, but he raises the important point that this differentiated analysis "may also allow us better to see how fascism triumphed in the first place" (p. 55).

The final two essays by William Seidelmann and Michael Burleigh explore the legacy of Nazi medicine. Seidelmann rebukes the German medical profession for an unwillingness to admit its complicity with the Nazi regime. He also relates shocking examples of German physicians who participated in murder under the Nazi regime and continued practicing medicine afterwards as though nothing had happened. In some cases, these physicians even continued to do research and publish articles based on specimens they collected from the people they had murdered.

In his concluding remarks Burleigh questions the applicability of analogies from Nazi medicine to present discussions of voluntary euthanasia. He is right, of course, to point out that state-mandated killing is different from voluntary euthanasia. However, while stressing the differences, he ignores the ideological similarities between Nazi medical ethics and contemporary medical ethics. A good discussion of these similarities can be found in Wesley Smith's book, Culture of Death: The Assault on Medical Ethics in America. Ian Dowbiggin's new book on the euthanasia movement in America, A Merciful End, also shows that the divide between voluntary and involuntary euthanasia is not as great as some think.

The only essay in this volume really discussing "Origins" in depth is the first essay by Garland Allen, which focuses primarily on the American eugenics movement. His comparative approach reminds us that eugenics was not peculiarly German, but unfortunately, it also seems to imply that Nazi eugenics derived largely from American eugenics. Thus this volume ignores the thriving German eugenics movement in the pre-Nazi period, which provides crucial background to eugenics and euthanasia in the Nazi period. Allen's essay does provide a good overview of American eugenics ideology. However, I am not convinced by his argument that eugenics was spawned primarily by economic circumstances, which does not fit very well with the historical data. Blaming eugenics on capitalism, Allen ignores the prevalence of eugenics ideology among leftists. In the early eugenics movement in Germany almost all the leading figures (Ploetz, Schallmayer, Gruber, Forel, and Ehrenfels, to name a few) were opposed to capitalism and sympathized with socialism.