Götz Aly, Peter Chroust, Christian Pross. Cleansing the Fatherland: Nazi Medicine and Racial Hygiene. Baltimore: Johns Hopkins University Press, 1994. xvi + 295 pp. $48.50 (cloth), ISBN 978-0-8018-4775-2; $19.95 (paper), ISBN 978-0-8018-4824-7.
Reviewed by Douglas R. Skopp (State University of New York-Plattsburgh)
Published on H-German (April, 1996)
The Hippocratic Oath requires its adherents to "do no harm" to their patients. Physicians in Nazi Germany swore a contrary oath to the Fuehrer and the Reich. When they felt called to "cleanse" the Fatherland of "useless lives" rather than to alleviate the suffering of individual patients, the "search for truth in medicine turned into destruction..." (2). This monstrously misplaced loyalty is at the heart of Nazi medicine. Nazi doctors saw themselves as ministering to the collective Volk, curing it of alleged diseases, even when it meant harming millions of innocents. There was no place in Nazi ideology for "unwertes Leben" - a phrase which originated in the 1920 treatise by the German lawyer K. Binding and psychiatrist A. Hoche who argued that, for the sake of the survival of the Volk, it was justifiable to "euthanize" individuals with congenital diseases or birth defects as well as other "undesirables," with or without their consent. For some doctors this was an idealistic mission which they believed would ultimately benefit every citizen and strengthen the "human race". For others it was an opportunistic avenue for influence and prestige. In the end, it may be impossible to sort out one group of physicians from the other. It was easy for members of this traditionally authoritarian profession to disguise sordidness with hollow fervor. For many doctors, the two motives probably blended into a single ideological determination to pursue a successful medical career within the Nazi state at all costs. As stated in the foreword of this volume, fifty percent of the physicians were members of the Party, twenty-six percent were in the SA, and seven percent belonged to the SS (x). If ever history afforded an example of the unimaginable, it is the cooperation between physicians and Nazi Germany.
This book joins a growing body of studies on the subject of Nazi medicine, and its usefulness is apparent on many levels. In the foreword, Michael Kater, whose own path-breaking Doctors under Hitler (1989) showed the interrelationship between physicians and the Nazi state, places Nazi medicine in a larger historical context. He also argues that medical atrocities have not ceased in Germany or beyond since the end of World War II. The introduction is provided by Christian Pross, the medical director of the Berlin Center for the Treatment of Torture Victims and a leading spokesman for young German physicians determined to expose their profession's misconduct in the 1930s and 1940s and its subsequent cover-up attempts. Originally printed in G. J. Annas, M. Grodin, eds., The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation (1992), the introduction assesses recent German scholarship on Nazi medicine and medical atrocities. One of Pross's targets is Robert Jay Lifton's oral history approach in The Nazi Doctors (1986), which Pross says trivializes the Holocaust by inventing "doubling" - a specious psychologized explanation for medical torture. That said, Pross underestimates the heightened sensitivity and analytical frameworks which Lifton's book stimulated. Perhaps of greater scholarly consequence has been the Association for Research on Nazi Health and Social Policy, which Pross helped to found in 1983, and its journal, Beitraege zur nationalsozialistichen Gesundheits- und Sozialpolitik. Four of the five chapters of this volume are in fact translated from that journal. Regrettably, Pross ignores the many recent English- language studies, most notably by Michael Burleigh, Robert Proctor, Cornelie Usborne and Paul Weindling on racial policies and medical practices in Weimar and Nazi Germany.
Joining Pross are Goetz Aly, a freelance political scientist and historian, and Peter Chroust, a scientific staff member of the Zentrum fuer Historische Sozialforschung at Universitaet Koeln. Aly provides selected entries from the diaries of Dr. Hermann Voss (Chapter 3), a prominent anatomist in Poznan who committed more than his share of atrocities only to gain further prominence after the war as a much-honored professor and text-book author at Universitaet Jena before his death in 1987. Chroust edits selected letters by Dr. Friedrich Mennecke (Chapter 5), who joined the SS in 1932 while still a medical student and who later "selected" victims for the euthanasia program as he toured psychiatric hospitals and concentration camps. After having been found guilty at Nuremberg of the murder of at least 2,500 people, Mennecke died mysteriously in prison in 1947. Both doctors illustrate Hannah Arendt's argument on the "banality of evil." Voss, who was supported by the Gestapo in his sales of skulls and bones to anatomical institutions across the Reich, writes calmly and unequivocally in his diary about his meals, an operetta, the weather, flowers, and his pleasure at the death of every possible Pole, Communist, and Jew. Mennecke's gloating in letters to his wife about his life-and-death authority and his insights into victims' souls is interspersed with comments on wines, cheeses, and valet services. His letters close with abundant "kissies". It may be true that, as Aly says, "The more murderous and repugnant the documents are, the easier it is for the reader to distance himself or herself from this system" (230). Yet these chatty, trivial documents have a repugnance all of their own. As Aly notes, they give us a glimpse of unhesitating evil at work precisely because they were not written after the fact.
Aly also offers two analytical narratives. In Chapter 2, he discusses the overall context and mechanics of the "euthanasia" program with special attention to "antisocial" victims like maladjusted adolescents, foreign laborers, and civilians who were mentally disturbed by air raids. Killing them, it was said, made more room for convalescing veterans and otherwise healthy civilians in need of medical attention. In Chapter 4, Aly exposes the link between "murder and modernization" in Nazi psychiatry. While full services were provided to patients who were thought curable, the remainder were killed to prevent the dilution of available resources. These chapters, while powerful and horrifying, somehow lack the sinister immediacy of the two which contain the diaries and letters. Still, by putting both approaches side by side in one volume, the authors provide an unforgettable picture of viciousness, arrogance, and pride.
Belinda Cooper's translation is readable, apt, and unobtrusive. Though a comprehensive bibliography would have further enhanced the work, each chapter's citations to archival and secondary materials are excellent. A further strength of the volume is its numerous illustrations, which somehow do more than just confirm the grisly details and implications of the text. The photographs of leading Nazi physicians and their victims depict "normal" looking human-beings, quite interchangeable with one another save for the white coats or military uniforms on the former and the inmates' clothing on the latter. The reproduction of forms, questionnaires, and ledgers designed to collect information for the evaluation and murder of human beings illustrate the horrifying thoroughness of the killing process by showing its impersonal banality. These might as well have been forms designed to assess the quality of a municipal water supply or the agricultural yield. Photographs of "death notices," official directives, floor plans, Dr. Voss's iron-cored truncheon, and the guillotine in Posen from which Voss derived so many "splendid specimens" all further bring home the incomprehensible terror of Nazi medical practices.
This is not the story of just a few nefarious physicians running amok in a time which encouraged fanaticism. Medical misconduct had active support at every level, from the Fuehrer himself to the printers that produced the forms, to the individuals who carved the gravestones that were advertised as "weatherproof and practical substitute stone" (92). Yet at its center were the Nazi doctors. Hundreds of physicians at every turn were involved in executions in one way or another. It is understandable that Pross and his colleagues, to say nothing of their readers, are outraged. Yet not everyone was a Voss or a Mennecke. Hundreds or even thousands of other physicians in Nazi Germany did not participate in these crimes. Instead, they attempted to the best of their ability to meet their professional responsibilities on a daily basis with integrity. How did these doctors avoid the whirlwind? As Michael Kater has suggested, their story must be told as well. In the end, the villainous Nazi physicians will find their fullest condemnation once they are contrasted with those who did not, despite external pressures, abandon Hippocrates.
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Douglas R. Skopp. Review of Aly, Götz; Chroust, Peter; Pross, Christian, Cleansing the Fatherland: Nazi Medicine and Racial Hygiene.
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