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Tuesday, April 25, 2006
 
Does Doctor Mengele Live On?
Another medical school interview story - this one relates to Yom Hashoah (Holocaust Remembrance Day) which is today.

I was interviewing at Loyola Medical School in Chicago (not the same Jesuit school I have posted about previously). My interviewer was an elderly, white-haired physician, very nice, and very Jesuit (whatever that means...). After exchanging pleasantaries and going over my application, he told me he wanted to ask me an ethical question. It turned out that during World War II, this physician had been part of the U.S. Army force that liberated the Dachau concentration camp in Germany. One of the horrifying stories of the Shoah are the medical experiments conducted by the Nazi "doctors" on the concentration camp inmates.

The Loyola interviewer had a very simple question for me. He wanted to know what I thought should be done with the "research" conducted by the Nazi doctors. Should the data, which in typical Nazi form was carefully and judiciously acquired and recorded, now be used? From a purely detached scientific point of view, much of it was impeccable.

I paused for a moment and thought.

I replied that I didn't think the data should be used in any way, shape, or form as it was not acquired ethically and therefore not valid. To use it would be tantamount to accepting it,and thus validating the methods by which it was acquired. He seemed satisfied with my answer. A week later I was accepted to Loyola (but ended up going elsewhere).

Fast forward twenty years to a conversation I had last week. One of our employees, Jose, a twenty-something year old gentleman who is responsible for recruiting patients for some of the drug company studies we do, was joking with me about a protocol we were starting. We were trying to recruit a 53 year old patient for a study that has a minimum age of 55. I jokingly suggested that we lie about his age, and Jose said that it would be unethical to do so.

His response reminded me of my interview at Loyola, so I decided to pose the same question to him. He too paused and thought about it for a moment. His response was that we should in fact use the data, as it had already been acquired and maybe some good could come of it that way. I told him I disagreed with him, but that I understood his way of thinking.

Yesterday, Jose came to me and told me he had been thinking about the question I asked him. He told me that it bothered him over the weekend, and that he had posed the same question to some of his friends. He said they responded in the same way he did, but that they also understood where I was coming from.

I have always liked Jose, and in particular because he is thoughtful and smart. It has taken many years for many Jews to be able to bring themselves to visit Germany, to buy German products and to forgive in some ways. While I can understand a point of view that seeks to find good where all there is is evil, in my eyes, some things are just not forgiveable.

After World War II and the Nazi doctors' atrocities became clear, the World Medical Association issued the Declaration of Geneva. Recognizing the limitations of the Hippocratic oath, the Geneva Declaration specifically reminds physicians of their responsibilities to humanity:

I WILL NOT PERMIT considerations of age, disease or disability, creed,
ethnic origin, gender, nationality, political affiliation, race, sexual
orientation, social standing or any other factor to intervene between my duty
and my patient;
I WILL MAINTAIN the utmost respect for human life;
I WILL NOT USE my medical knowledge contrary to the laws of humanity, even under threat;


As I continue to think about Jose's response to the Loyola interviewer's question, I submit it to you my (few, but proud!) readers.
Comments:
I agree with your answer Wanderer. I have nothing to add.
 
To use data obtained unethically is to legitimize it and give it the patina of acceptibility. Can't do that.
 
Wow...excellent question.
 
What I am going to say should in no way be intepreted that I am comparing it to those atrocities, but Doctor Bean, what about experiements done of lab animals for either cosmetic or medical purposes. Many people would say that is unethical (I feel that way towards the former.) Or using organs that are illegally obtained, stem-cell research etc.

Again, what happen in Germany (and currently in many countries today) can't even compare to these examples, but isn't ethics subjective? Does that make sense?
 
Sweettooth120: Great question. Easy answer. Those who say that it's unethical to experiment on animals are wrong, so it's fine to use the date from that. No research is done on illegally obtained organs as far as I know. If there is such research, the data shouldn't be used.

Next!
 
oops. "date" should be "data".
 
Ethics are certainly subjective, up to a certain point. Even after the human experiments of the Nazi doctors came to light, our own U.S. Public Health Service continued an unethical experiment on 399 black men in the late stages of syphilis (known as the Tuskegee Experiment). The experiment continued for thirty years, and probably because it was racist to begin with.

We must be very careful about ethically conducting research, in particular when human subjects are involved. I think a lesser degree of ethics applies to animals and stem cells, but nonetheless, they do apply to a certain extent. I think even Doctor Bean would concur that there must be a point to animal research, and that it be conducted rigorously and scientifically, with the animals treated as humanely as possible.
 
I think your answer to the Loyola professor was perfect. I could not agree with you more.
 
"there must be a point to animal research, and that it be conducted rigorously and scientifically, with the animals treated as humanely as possible"

Absolutely.
 
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