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PubMed2003

Long-term coping of Holocaust survivors: a typology.

BACKGROUND: The nature of long-range impairment resulting from exposure to the atrocities of the Holocaust has been studied extensively. Some survivors reported a high level of psychological distress, while others, who were exposed to similar experiences, reported little, if any, symptoms. The present study aimed to validate Danieli's (1-3) typology of differentiated patterns of long-term coping and adaptation among Holocaust survivors in an Israeli sample. METHOD: A sample of 150 Holocaust survivors participated in this study. Data were gathered as part of a larger study that assessed long-term coping styles of elderly Holocaust survivors when confronted with another life-threatening event, namely cancer. RESULTS: The results point to the heterogeneous coping styles of Holocaust survivors and enable the formulation of a Survivor's Typology describing three types of adaptation: The "Victim," the "Fighter" and "Those Who Made It." The "Victim" type was found to be the most vulnerable. The "Fighter" and "Those Who Made It" types, who comprised over 80% of the sample, reported successful adaptation in the aftermath of the Holocaust.

Adaptation, Psychological↗

PubMed2004

'Coalition-In-Iraq' countries 'internal' civil violent deaths compared to the USA 'external' violence of September 11th 2001.

BACKGROUND: The atrocity of 9/11 exemplified 'external' caused civil violent deaths, which have major policy implications for the countries contributing armed forces to the 'Coalition-In-Iraq' [C.I.I]. C.I.I Government's resources for perennial 'internal' violent deaths (suicide, homicide and road), are likely to be threatened by alternative priorities. C.I.I 'internal' deaths are compared with those of 9/11 to provide information to determine relative risks. MATERIAL/METHODS: To uniformly compare mortality between countries we utilise the most recent WHO mortality data, taking the latest three years 1997-1999 and calculating an average annual number and rate of 'internal' deaths in each country, these are compared with the 9/11 fatalities, calculating a proportional ratio, as an indicator of differential damage to families and society. RESULTS: USA 'external' deaths were 3,074 people and annual average suicides were 30,966. Total 'internal' deaths exceeded 'external' more than 30 times. Every fortnight there are more USA 'internal' violent deaths than on 9/11. Except Australia and Bulgaria, every country had more suicides than died on 9/11. Apart from Bulgaria, total 'internal' deaths exceeded the 'external' toll in all other CAI countries- by 14 times in Japan; 6 in Republic of Korea, 4 in Italy, 3 in Spain and the UK, twice in Canada and 1.5 times in Australia. CONCLUSIONS: The extent of 'internal' civil violent deaths, such as suicide, highlight the perennial pressures upon psychiatric services and the need to defend resources at a time of competing priorities.

Cause of Death↗

PubMed2003

The first Nobel Peace Prize, Henry Dunant (founder of the International Red Cross) and his "Mémoirs".

To celebrate the memory and work of Henry Dunant, on the centenary of the presentation of the first Nobel Peace Prize, rightly awarded to Dunant for his having founded the institution of the International Red Cross, this paper presents the reader with some insights into his activities and sufferings, his trials and tribulations, and the hope and strength of his character. The ceaseless efforts made by Dunant to bring about the Institution which today represents Hope for so many suffering people who are silent victims of wars and atrocities, are fleetingly presented. The authors' intention is to give due recognition to Dunant for his work, and to highlight the humanity and the moral and social worth of the face behind the International Red Cross.

Awards and Prizes↗

PubMed2003

Embryonic stem cell research: one small step for science or one giant leap back for mankind?

At the forefront of modern debate over the ethical use of biotechnology is embryonic stem cell research. In this poignant analysis of its legitimacy, the author examines the history of this research in light of the United States' policy favoring the protection of human beings over scientific progress. Stem cells, which can divide in culture to create specialized cells in the human body, possess significant potential for curing disease, particularly when taken from human embryos. However, as evidenced by the research atrocities committed under the Nazi regime, the benefits of human research do not come without a cost to humanity. Recognizing this, the later trial of these scientists produced the Nuremberg Code, a set of natural law principles guiding future research on humans that continues to influence health policy decisions. Drawing on this background, the author first considers the appropriate legal status for a human embryo. Biologically, the characteristics of a human embryo place it between human tissue and a constitutional person. Judicially, the answer is even less clear. The author analyzes case law in the context of abortion and in vitro fertilization, as well as classifications by the common law, state legislation, and the National Bioethics Advisory Commission, to conclude that a human embryo should be subject to the same legal and ethical restrictions as any other "human subject." Accordingly, the author argues that embryonic stem cell research violates the ethical standards and purposes of the Nuremberg Code and should be banned by federal legislation. Such a prohibition will fulfill the societal policy choice of protecting potential life and vulnerable human subjects.

Abortion, Induced↗

PubMed2004

[Animal testing ethics and human testing. Thoughts on our conduct with and our relationship to animals].

After many years of experimental work with animals of diverse species, the author felt confronted with the question whether the great expenditure of sacrificed animal life would pay off when compared with the results gained. By self-critically considering his work, he gradually experienced a conversion from an unconcerned experimenter to a man feeling a deep sympathy with his fellow creatures. This motivated him to ponder the true nature of animals. Instead of applying ethics--though justified in its own realm--the author preferred to look at the problem using the General Systems Theory (GST), which can describe "the other side" of any system, the side into which any system may occasionally or necessarily transform. It occurred to him to assume that--provided we see a living organism as a system (as Ludwig von Bertalanffy, the founder of GST, did)--the "other side" of the animal would correspond to an innocent "genius" who suffers for man (thereby assuming a Christ-like position), whereas in its transitory life the true essence of the animal is hidden. Thus, by fancifully viewing the role of animals destined to suffer, a connection between GST and theology or religion arises. The consequence for us would be to pay honour to the test animal, irrespective of whether or not painful experiments could be avoided. The differentiation between a sacrifice (spiritually surrendering for a greater good) and a victim (involuntarily subjected to suffering) reveals that the experimental animal primarily belongs to the latter. But it can be elevated to the former when the full meaning of its suffering becomes obvious. The same holds true for "human testing", if, in contrast to the formidable atrocities, e.g. of concentration camps, the momentum of voluntariness is guaranteed, as pioneers of medical research frequently demonstrated by carrying out experiments on themselves.

Animal Experimentation↗

PubMed2005

[Physicians and terror: the historical perspective].

The topic of physicians who committed crimes or were involved in terrorists' activities, is not well known. This article does not present the well known horrific stories of the atrocities of the Nazi German physicians. The authors describe a number of doctors who were active during the French revolution, some murderous physicians-leaders, and present a few historical anecdotes. These examples might only emphasize the fact that, like other human beings, doctors, too, may suffer from bad character.

Germany↗

PubMedDate not supplied

Managing mass casualties in Israel.

The author relates her experiences as an observer at an Israeli mass casualty simulated exercise in a general hospital. Israeli people, who have seen their country engaged in several major wars over the last 40 years and who live with the potential for terrorist atrocity as a daily threat, treat such exercises with great seriousness. The scale and realistic nature of the exercise was impressive, and while such activities may not be directly translatable to a British situation, the energy, commitment and systematic approach of the Israeli personnel are qualities which British hospital and military staff could adopt.

Civil Disorders↗

PubMed1999

Ethical genetic research on human subjects.

Since the Nuremberg trials and the Nazi doctors trial following World War II, international ethics protocols have emerged designed to protect human subjects from the atrocities of medical experimentation that were literally routine under the Nazis. Some of the apparent "lessons" from the Nazi period have been encapsulated in the Declaration of Helsinki, perhaps the leading medical ethics protocol. This paper argues that these protocols have not been notably conducive to human welfare or to the protection of human rights in the field of human genetics research. The paper proposes new protocols and a new approach to the ethics of research on human subjects.

Access to Information↗

PubMed2006

World without borders: integrating clinical perspectives into the coronial jurisdiction in Victoria, Australia.

A professional world without borders would allow for more appropriate collaboration between the Coroner's office and the healthcare sector in their endeavours to improve patient safety. In Victoria (Australia), the Clinical Liaison Service draws on the distinct experiences and expertise of medical, nursing and research personnel to evaluate clinical evidence for the investigation of healthcare deaths reported to the State Coroner's Office. This approach allows for greater intersectoral collaboration between the Coroner's office and healthcare sector than a traditional English-style coronial system that relies on the expertise of coroners, forensic pathologists and police officers to investigate unexpected deaths. Encouraging collaboration between these two sectors may have averted or at least mitigated the atrocities caused by Harold Shipman or the events at Bristol's Royal Infirmary. This paper describes the work processes employed by the Clinical Liaison Service (CLS) to investigate healthcare deaths in a coronial setting. To describe how this work has fostered the advancement of patient care.

Cooperative Behavior↗

PubMed2004

Houston biosecurity: building a national model.

On September 11, 2001, Al Qaeda terrorists committed an atrocity when they used domestic jetliners to crash into buildings in New York City and Washington, DC, killing thousands of people. In October 2001, another act of savagery occurred, this time using anthrax, not airplanes, to take innocent lives. Each incident demonstrates the vulnerability of an open society, and Americans are left to wonder how such acts can be prevented. Two years later, Al Qaeda operatives are reportedly regrouping, recruiting, and changing their tactics to distribute money and messages to operatives around the world. Many experts believe that terrorist attacks are inevitable. Every city is vulnerable to an attack, and none are fully prepared to handle the residual impact of a biological or chemical attack. A survey conducted by the Cable News Network (CNN) in January 2002, studied 30 major US cities, ranking them based on 6 statistical indices of vulnerability. Thirteen cities were deemed better prepared than Houston, 10 were in a similar state of preparedness, and only 6 were less prepared than Houston. We will discuss the protective measures that have been put in place in Houston, and future steps to take. Other cities can model Houston's experience to develop similar plans nation-wide.

Bioterrorism↗

PubMed2006

[Organ transplantation using organs taken from executed prisoners in China--a call for the cessation of Israeli participation in the process].

Organ transplantation using organs taken from prisoners convicted to death is being practiced in China for the last two decades. These transplantations, which harshly violate medical ethics and international conventions, have become a prosperous market in China. This review presents details of the testimonies of a former prisoner and a Chinese physician who fled to the U.S.A., portraying the horrifying process of organ harvesting from executed prisoners, sometimes even before they are even dead. For years the Chinese authorities have denied the existence of this process, but following massive international diplomatic pressure they have recently publicly admitted to it for the first time. Many Israeli transplant candidates, who are desperate due to the organ shortage in Israel, seek their way to China in attempts to try and save their lives. The fact that they are currently being funded by all medical insurance companies constitutes a sort of formal approval to this atrocity. We, as a society, should stop this funding immediately, and divert all our human and financial resources to increase organ donation from brain-dead donors in Israel.

Attitude to Health↗

PubMed1991

[The Oath of Geneva].

The atrocities of Nazi doctors as revealed by the Nuremberg trial caused the World Medical Association in 1948 to formulate a modernized version of the Hippocratic Oath. The author discusses particularly the notion of Humanity, newly introduced in this so-called Oath of Geneva: contradictions may arise between medical interests and criteria of humanity, which make it necessary to draw limits.

Ethics, Medical↗

PubMed1989

Investigation of incidents of terrorism involving commercial aircraft.

Deaths resulting from terrorism involving aircraft have occurred incident to hijackings as well as bombings. Passengers or groups of passengers have been chosen by terrorists as the recipients of violence based on citizenship, religion, and political beliefs. They have usually been segregated from other passengers and subsequently mistreated and/or murdered. Thorough documentation of the injuries of victims is essential to the investigation of such atrocities; a medicolegal autopsy correlated with a scene investigation is of paramount importance. Aircraft bombings can create extremely sensitive political situations and public demands for quick resolution. The autopsy of victims in such circumstances, if properly conducted, can yield invaluable trace evidence leading to the identification of the explosive device. The examination of any surviving victims as well as the aircraft is also critical in reconstructing the event. Deaths occurring as the result of in-flight aircraft bombings can produce injuries by five different mechanisms, viz. blast, shrapnel, decompression, impact with the aircraft, and ground impact.

Aircraft↗

PubMed1995

Crime and memory.

The conflict between knowing and not knowing, speech and silence, remembering and forgetting, is the central dialectic of psychological trauma. This conflict is manifest in the individual disturbances of memory, the amnesias and hypermnesias, of traumatized people. It is manifest also on a social level, in persisting debates over the historical reality of atrocities that have been documented beyond any reasonable doubt. Social controversy becomes particularly acute at moments in history when perpetrators face the prospect of being publicly exposed or held legally accountable for crimes long hidden or condoned. This situation obtains in many countries emerging from dictatorship, with respect to political crimes such as murder and torture. It obtains in this country with regard to the private crimes of sexual and domestic violence. This article examines a current public controversy, regarding the credibility of adult recall of childhood abuse, as a classic example of the dialectic of trauma.

Adult↗

PubMed1995

[50 years after Anne Frank: reactive of a transgenerational trauma in countertransference].

Traumatizations suffered in the course of the atrocities perpetrated by the National Socialists defy symbolization and, if unresolved, are passed on to subsequent generations. With reference to the psychoanalytic treatment of a forty-year-old homosexual of the "second generation", the author traces the problematic of the transgenerational handing-down of unresolved traumatizations. The son of a Jewess whose brother was murdered in a concentration camp, the patient had to stand in for his lost uncle and remained caught up in a "symbiotic illusion" with this omni-present/absent object and with the mother, thus being unable to attain to a personality of his own and achieve the Oedipal triad. The article concentrates entirely on this case and provides an impressive record of the mechanisms of transference and counter-transference involved and the various stages of the psychoanalytic process.

Adult↗

PubMed1994

[Fault, sacrifice and traumatic neurosis. Apropos of a case].

The present case is one of a patient suffering from traumatic neurosis, on whom psychotherapeutic work has been possible. The traumatic experience, which dates back to the Franco-Algerian War, could have gradually started making sense in the context of its onset and of the state in which the relationship between the patient and his father remained at the time. Something along the lines of an irrevocable mistake, irrevocable since logically referred to as a serious moral mistake on the part of the father towards his son, renders humanely comprehensible his upkeep of his atrocity as represented by the repetition of the revival symptoms.

Adult↗

PubMed1993

What a psychoanalyst learned from the Holocaust and genocide.

This paper is concerned with certain aspects of the Holocaust as it concerns children of survivors and child survivors. It describes transposition and somatisation and a split in the superego in children of survivors, bringing as an example the case of Rachel. It goes on to describe the psyche of child survivors, the split in their ego, their somatisation and the effect it had on the id, the ego and the superego of child survivors. Time did not permit examination of another interest of mine, the psyche of the German persecutor who inflicted the atrocities on communists, socialists and gypsies as well as Jews and homosexuals as if they were vermin.

Adaptation, Psychological↗

PubMed1993

[What can we learn from the past?].

The author sees the present outbreaks of violence as a confirmation of the continued relevance of the diagnosis of the present-day German condition set out in The Inability to Mourn in 1967. In post-war Germany a pall of silence hung over the subject of Nazi atrocities, guilt and shame were negated and no recollection of, or active mourning for, the millions of German and non-German war victims took place. The author sees an exact parallel to this in the present violence on the part of young people towards foreigners, asylum seekers, Jews and gypsies, and the way it is mutely condoned by a silent majority, interpreting this as an identical instance of the denial of shame and guilt and the incapacity for fellow-feeling towards the poor and the underprivileged. The accusations of part responsibility levelled at the post-1968 generation for the outbreaks of violence among young people are in Mitscherlich's view unfounded. This generation, she argues, was the first to break with the conspiracy of silence in connection with Germany's Nazi past, thus making a process of mourning possible in the first place, and goes on the contend that an increasing sensitivity among the German population towards the prevailing inhumanity that foreigners and the underprivileged are subjected to is an opportunity for renewed self-confrontation with the unbroken virulence of the Nazi mentality and for a resumption of the necessary process of mourning. Here she also sees a possibility of actively curbing the present wave of violence, in contrast to the call to be heard from some politicians for greater toughness in education and upbringing, an approach which she regards as representing not a solution to the problem but rather as a relapse into old authoritarian constraints.

Adolescent↗