30 June 2004

Nazi Eugenics Should Be Confronted

by Kate Melville

Researching the history of reproductive medicine during the Nazi era is still taboo, a leading German professor told the 20th annual conference of the European Society of Human Reproduction and Embryology. However, it is vital that such research is conducted, because if Germans do not understand what motivated the behaviour of doctors in the past, they will struggle to make decisions about ethical issues that confront doctors and scientists working in gynaecology, embryology and reproduction today, Rolf Winau said.

Winau, Director of the Centre for Humanities and Health Sciences at the Charité in Berlin, Germany, said: "This research should not be about blaming or accusing individuals long after the event, but should shed light on how and why professionals in a particular branch of medicine behaved. Knowledge about such behaviour is as important as the knowledge about the success of scientific medicine. Only this knowledge will make it possible to reflect on our present situation."

His remarks come against a background of Germany having some of the strictest laws on human reproduction in Europe.

With the shadow of the Nazi-era eugenics hanging over them, in recent years Germans have prohibited a number of procedures that actually could benefit both parents and children. Examples include: preimplantation genetic diagnosis, which can detect genetic diseases in an embryo before it is transferred to a woman; and freezing embryos for use at a later stage, which means that Germany has one of the higher rates of multiple births in Europe, because doctors have to transfer all the embryos they manage to create, regardless of the embryo's quality - 40% of all ART births in Germany are multiple births, which carry risks for both the mother and the babies. Cloning, surrogacy and egg donation are illegal too.

Prof Winau said: "From 1952 to 1980 there was no research at all into medicine during the Nazi era. Today, there are still a great number of doctors who do not wish to be 'disturbed' by remembering the dark times of German medicine. Only a few hospitals have faced up to their history. The execution of the law on preventing genetic diseases in children is an example of the conformity of many Germany gynaecologists to the racial ideas and the concept of racial hygiene of the Third Reich. Opposition to this law hardly existed. There was no discussion in the medical journals about whether the law was ethically justified, but only about how the sterilization could be undertaken most effectively."

Many scientists seized on the opportunities offered by the regime to pursue their research. "Not all who used this opportunity did so from unscrupulous motives; however, for many scientists, the scientific impetus triumphed over ethical scruples. This definitely goes for the anatomist Hermann Stieve, who undertook a fundamental examination of ovulation in executed women from the Ploetzensee prison between 1942 and 1944. His scientific thirst for knowledge led to him seizing the opportunities offered to him without questioning them," says Prof Winau.

"We have to study the history of medicine in the Nazi era in order that we understand the roots and mechanisms of an inhuman medicine, and why over 45 per cent of all German physicians were Nazis and why some of them worked as researchers in the concentration camps. We need to study the 'Rassenhygiene', the German version of eugenics, in order to show how far eugenic and racial thinking can go, so that we can have it in mind when we discuss ethical questions on reproduction and fertility. If we do not, we face uncertainty, lack of information and confusion when considering ethical questions in the future. The study of Nazi medicine was a taboo in both German states until recently. It is time to deal with this issue in universities, on courses and in society. German gynaecologists and teachers have to confront it. But there is still a lot to do."