“First, do no harm,” a phrase from the Hippocratic aphorisms is a straight forward directive, a promise made by physicians at the onset of their careers. But what happens when policies that masquerade as a public “health” campaign are, in reality, a system of atrocities committed in the name of science and carried out by physicians, no less? How could that happen? Students at New York Medical College (NYMC) addressed that question, and other ethical considerations after a three-part presentation that covered the arrest and trial of Nazi war criminal Adolph Eichmann, an overview of biomedical ethics and student interviews with Holocaust survivors at an outing to the Museum of Jewish Heritage on November 15. View the Museum of Jewish Heritage photo gallery. View the Museum of Jewish Heritage video.
Members of the NYMC and Touro communities attended the exhibit: The Capture and Trial of Adolph Eichmann, a retrospective about the abduction of Hitler’s chief architect of the Holocaust. The exhibit featured recently declassified files and archival materials surrounding Eichmann’s capture by the Israeli intelligence agency, Mossad, and his conviction in Israel. On display were cold-war era surveillance gear, Eichmann’s false passports, a ledger with names of the victims and the bullet-proof compartment where Eichmann sat during his trial.
Philosopher Hannah Arendt reported on Eichmann’s trial in 1961 for The New Yorker and wrote about it in her book Eichmann in Jerusalem: A Report on the Banality of Evil. At a follow up discussion at the Orthodox Union, Edward C. Halperin, M.D., M.A., chancellor and chief executive officer, quoted from Arendt’s writings.
“For evil to succeed, the average person must treat evil as normative,” said Dr. Halperin, who later asked, “Was Eichmann an uneducated ‘cog’ in the wheel? Was he a true believer? A sociopath? Do you need to personally fire a revolver at someone to be a murderer or are enablers of violence also murderers?”
Ira J. Bedzow, M.A., Ph.D., assistant professor of medicine and director of the biomedical ethics and humanities program, continued the dialogue, saying that Eichmann claimed it was worse to violate his loyalty to the Nazi Party, than it was killing millions of people.
Eichmann’s attitude was, “I’m just following orders,” said Dr. Bedzow.
“Physicians were a driving force behind the Holocaust,” he explained. “But unlike other genocides in history the Holocaust was seen as a public health campaign.”
Why wasn’t the Hippocratic Oath valued more than any other? Because, said Dr. Bedzow, “the oath pertaining to perceptions of the individual took a back seat to the health of the society, as stated by the Nazi party. It was the alleged benefits to the German people versus the rights of the individual.”
One-on-one with survivors
Kevin Alter, a graduate student in the Graduate School of Basic Medical Sciences, researcher and teaching assistant for Dr. Halperin’s class, the History of Medicine, introduced four NYMC students who interviewed Holocaust survivors. The students said some survivors still experienced post-traumatic stress disorders. Others said they were more likely to reveal details of their past to strangers, but not their families. After 40 years, one man found it cathartic to organize international support group meetings and take up painting.
Mr. Alter asked the students what they had learned, and how it could be implemented when it came to practicing medicine.
“I was forced to think very deeply about this person sitting in front of me,” said Kate Morant, School of Medicine Class of 2020, “what his life would feel like, how his story would challenge your internal beliefs and how, as medical professionals, we may be confronted with ethical issues of a greater magnitude. We will face small ethical problems all the time and will have to address how we approach them. Whether we’re informed by the oaths we take or our own personal beliefs, it’s important how we view those things.”
“It taught me about listening to our patients,” said Nico Kumar, School of Medicine Class of 2020. “Not only about what they are feeling at the moment, but learning about their lives,” he said. “A Holocaust survivor could come in one day, and that would inform a ton of stuff about their health. We live in tumultuous times in terms of health care policy. This experience highlighted the importance of, as physicians, not remaining silent regarding change and things that are happening in the health field.”
“The interview opened my eyes about talking to patients about sensitive subjects,” said Alicia Brady, School of Medicine Class of 2020. “Sometimes it’s hard to find the right questions to ask and not be too invasive, while getting the story.”
Looking toward history
Debates in biomedical ethics such as genetic engineering and death with dignity laws are not new. “We’re still asking the some of the same questions we asked at the turn-of-the-century,” said Dr. Bedzow. “If we can find out how they were answered, we could form a relevant view. Our professional integrity has to be continually reinforced, not just with an oath, but with daily practices through habits of ethics and integrity, and being truly informed about where your profession has gone, and where it’s going.”