Editorial
Preventing healers from becoming killers
For the first time, a Lancet Commission is dedicated
to the history of medicine: Nazi medicine. The report,
The Lancet Commission on medicine, Nazism, and the
Holocaust: historical evidence, implications for today,
teaching for tomorrow, launched on Nov 9, is the most
up-to-date scholarly evidence on the history of Nazi
medicine and its central role in the so-called Final
Solution—the German Government’s plan to annihilate
European Jewry. 6 million Jews were murdered, along
with 250 000–500 000 Roma and Sinti people, gay
men, political prisoners, and others. The Commissioners
consider the report necessary due to “the decades-long
post-war refusal of the medical community to engage
with this history in Germany and worldwide and the
long-standing myths about the relation between the Nazi
regime and medicine”. The Commission also calls for this
history to be taught within all health education curricula.
How do healers become killers? How could medical
professionals perform heinous experiments on concen­
tration camp victims? The awful truth that the report
painstakingly describes is that the medical profession
in Germany subscribed to an antisemitic, racist, and
eugenics-based ideology towards populations that they
deemed to be genetically inferior. In 1933, Nazi Germany
introduced a forced sterilisation law, developed
with legislation prepared by German physicians.
310 000–350 000 victims underwent sterilisation.
Between 1939 and 1945, at least 230 000 victims
were murdered in killing programmes, including
7000–10 000 children in one programme, as well as others
in the Aktion T4 programme to euthanise institutionalised
people with physical, mental, and developmental disabilities.
The Commission’s report also calls out several myths
about the role of physicians during the Nazi period. For
example, there were not just a few extreme cases, such
as Dr Josef Mengele. Over half of German physicians
were members of the Nazi Party. Another myth is
that Nazi science was so-called pseudoscience; yet a
substantial amount of the medical research conducted
in Nazi Germany was based on the scientific method
and published in international journals. The report
also eliminates the myth that there was little to no
Jewish medical professional life in the ghettos. Jewish
physicians managed clinical settings and cared for their
patients even in dire circumstances.
www.thelancet.com Vol 402 November 18, 2023
Why does this dark chapter in medicine have
Keystone-France/Gamma-Keystone via Getty Images
implications for today? The history of Nazi medicine
provides well documented examples that can help to
develop a professional identity among future health-
care professionals. Physicians have “enormous power
over the lives of individuals and communities”, we wrote
in 2019. Even with the safeguards first put in place
with the Nuremberg Code of Ethics to ensure ethical
human research following the Holocaust, no amount
of oversight will stop all professional misconduct. Published Online
November 8, 2023
The leadership of all bioscientific institutions and https://doi.org/10.1016/
professional societies is required to ensure that history- S0140-6736(23)02501-1
informed professional identity formation is seen as an See The Lancet Commissions
page 1867
essential element in health education.
Unfortunately, there is still unfinished business to be
addressed from the Nazi medicine era. There are human
remains at universities and bioscientific institutions. These
institutions should actively identify and commemorate
victims of Nazi medical crimes and initiate research to
better understand their connections to human rights
violations. It is the least that these institutions can do.
There is hope that comes from pointing a spotlight
on the worst of physicians’ behaviour. The Commission
is an example for all health professionals that truth and
reconciliation may be possible. German Commissioners,
some the children of Nazi-era parents and others from
former Nazi-occupied countries, and Jewish people from
the USA and Israel, some the children and grandchildren
of Holocaust victims and survivors, worked side by
side to wrestle with this history and its implications for For more on the genocide of
the health profession today. An international medical European Roma see https://
encyclopedia.ushmm.org/
student advisory council provided a fresh view on the content/en/article/genocide-of-
relevance of medicine, Nazism, and the Holocaust and european-roma-
gypsies-1939-1945
were a future-oriented and optimistic presence.
For more on the Commission’s
Medicine in the Nazi period left a permanent announcement see Comment
stain on the medical profession. 77 years after the Lancet 2021; 397: 862–64
For more on the hypothermia
Nuremberg Medical Trial, which charged 23 leading experiments see New Engl J Med
German physicians and administrators for their willing 1990; 322: 1435–40
participation in war crimes and crimes against humanity, For more on our comments on
medicine and the Holocaust see
the health professions must now have the moral Comment Lancet 2019;
backbone to prepare students to safeguard against 394: 105
For more on the Nuremberg
and report atrocities, address institutional racism and Code of Ethics see https://ori.
antisemitism, defend against unethical research, and hhs.gov/content/chapter-3-The-
Protection-of-Human-Subjects-
report abusive doctors so that this will never happen nuremberg-code-directives-
again. n The Lancet human-experimentation
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