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[German medicine during the Nazi regime--cooperation and resistance].

The author reviews the collaboration between the medical profession and the Nazis in Germany during the period 1933-45, based mainly on recent literature. As several authors have pointed out, the medical profession became extensively involved in the implementation of a sterilisation programme, the practice of the racial laws, the exclusion of Jews from the medical practice, the Euthanasia Programme and the performance of painful and dangerous experiments on prisoners. Although the resistance to Nazism was weak and did not succeed in preventing the atrocities, it deserves historical attention. The resistance seems to have been motivated by an alternative ideology, such as Socialism, Christianity and Humanism. There were also some protests based on principles of medical ethics. Passive neutrality through "internal exile" seemed to have been difficult, and heroic resistance was rare, but did occur.

Ethics, Medical↗

Prisoner subjects and drug testing.

Objections to prison research are based more often on opposition to the evils of prison life than to unethical practices and to the memories of atrocities committed in the name of science in Nazi prison camps during World War II. The National Commission's pronouncements on prison research specifically illustrate this general phenomenon. Having decided that research on prisoners can be performed ethically, and having learned that most prisoner volunteers bitterly resent being deprived of the opportunity to participate in research, the Commission has nevertheless stipulated prison conditions that cannot realistically be met and thus has de facto eliminated such research. The most serious potential loss is the elimination of the unique facility in Lexington, Kentucky--the Addiction Research Center. Predicting the addiction liability of drugs is not likely to be feasible in any nonprison setting, so that the addiction potential of new marketed drugs will be established in the future as it was in the past--by trial-and-error in patients, who will become the unwilling, uninformed research subjects in this area.

Ethics, Medical↗

Human fertility and differential birth rates in American eugenics and genetics: a brief history.

Eugenics is a broad term used to describe a variety of social and state-sponsored reform movements. Although we usually think of Nazi atrocities when we hear the word "eugenics," in this article I discuss the manifestations of hereditary reform worldwide. In particular, I consider the history of eugenics in America, focusing on concerns about the differences in birth rates between various racial, ethnic, and educational groups. In the early twentieth century, the social and cultural expectations that surrounded the growing knowledge in genetics implied an ethical imperative for physicians. Physicians were expected to use their knowledge about genetics to help them decide what sort of advice and assistance should be given to those who wanted knowledge about birth control, or help in resolving problems concerning sterility and infertility. Today, with growing knowledge about human genetics, physicians are subject to increasing pressure to make similar judgments.

Birth Rate↗