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Nazi Medical Crimes and the Nuremberg Doctors' Trial

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 h Skeletons in the Closet: Indignities and Injustices in Medicine h

i Nazi Medical Crimes and the Nuremberg Doctors’ Trial j

Dr. med. Friedrich H. Moll, MA

Curator Museum zur Geschichte der Urologie, Düsseldorf, Germany

Matthis Krischel
Lecturer
Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany

Prof. Dr. Heiner Fangerau

Director
Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany

The Nuremberg Doctors’ Trial was held from December 1946 to August 1947 at the Nurem-
berg Palace of Justice, which had hosted the Trial of the Major War Criminals the previous
year. Of the 23 defendants, 20 were physicians and three were government bureaucrats.
They were charged with crimes against humanity and war crimes for the murder of patients,
mainly psychiatric patients who were killed under the guise of centralized and decentral-
ized “mercy killings,” and medical experiments on concentration camp inmates.

“Euthanasia” Programs
Under Nazi rule, physicians had planned and enacted the “Euthanasia” program, a system-
atic killing of those they deemed “unworthy of life.”1 Victims were children and adults with
mental and physical disabilities who lived in state nursing homes. The first phase of the
program started in August 1939 and was targeted at children with disabilities who were sent
to “special children’s wards,” where they were killed by overdosing them with drugs. The
nature of these special wards was concealed from the public and from the children’s parents.
At the peak of the movement, which came after the start of World War II, more than
70,000 adults were murdered between 1940 and 1941 in what was called “Aktion T4,” which
was named for the street address (Tiergartenstrasse 4) of the government bureau that
planned and oversaw the program. People were transported from local institutions in “grey
busses,” which soon became infamous, to six killing centers, established at former nurs-
ing homes. The main criterion determining which institutionalized patients were to live
or die was their ability to work and contribute to their support. This centralized program
was discontinued after public opposition began to mount. The Catholic bishop of Münster,
Clemens August Graf von Galen, is widely credited with bringing the euthanasia program
to public attention in 1941. Historians have identified this centralized murder, in which
victims were killed by carbon monoxide in gas chambers and their bodies cremated after-
wards, as a stepping stone to the holocaust.2 After the end of the T4 program, decentralized
“euthanasia” continued at many of the local nursing homes and hospitals.

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 h Skeletons in the Closet: Indignities and Injustices in Medicine h

Pathological Museum of Concentration Camp Gusen I Results of a medical experiment dealing with
Courtesy of Gusen Memorial Committee phosphorous that was carried out by doctors at
Ravensbrueck.
National Archives

Medical Experiments
Medical experiments were carried out on prisoners at many concentration camps. Victims
included Jews, political prisoners, homosexuals and prisoners of war. Experiments fell into
two major categories. The first category was directly related to the war effort. Physicians
studied how the human body reacts to extreme conditions, such as high altitude, extreme
cold, nourishment by sea water and starvation. Camp doctors also tested toxins, pathogens
and experimental drugs and therapies, such as bone grafting, in the hope of eventually
improving the treatment of soldiers in the field and personnel in occupied territories. The
second category of experiments concerned Nazi racial, genetic and population policies.
This included Josef Mengele’s twin studies at Auschwitz, as well as sterilization and cas-
tration experiments, which were supposed to provide a way to render large populations
in Eastern Europe sterile after the war had been won.3 The purpose of these experiments
was to develop methods to sterilize millions of people with a minimum of time and effort,
and possibly without their knowledge. These experiments were conducted by means of X-
ray, surgery, injections and pharmaceutics. X-ray treatment usually also led to castration
in women and men, and in many cases, tissue samples were taken from victims, increasing
mortality as well as physical and psychological suffering.
Josef Mengele was a German SS officer and physician in the Nazi concentration camp
Auschwitz-Birkenau. He was born in 1911 in southern Germany and studied philosophy
at Munich and medicine at Frankfurt University. His PhD dissertation of 1935 dealt with
racial differences in the structure of the lower jaw. He joined the Nazi party in 1937 and the
SS in 1938. After being wounded at the Russian front in 1942, he was pronounced unfit for
duty. He then volunteered for duty at a concentration camp and was sent to the death camp
Auschwitz.4

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Mengele performed physical and psychological experiments, experimental surgeries

without anesthesia, transfusions of blood from one twin to another and pathological stud-
ies of murdered twins. The full extent of his gruesome work will never be known because
the records and samples he sent to his PhD advisor Otmar von Verschuer (1896 -1969) at
the Kaiser Wilhelm Institute of Anthropology, Human Heredity, and Eugenics in Berlin
were destroyed.5 Von Verschuer was a leading German heredity pathologist, biologist and
geneticist, specializing in racial hygiene and twin research. In 1944, he received authoriza-
tion from Heinrich Himmler to work at the concentration camp in Auschwitz, where he
was teamed up with one of his most famous subordinates.6
Mengele was the most prominent German physician to avoid trial at Nuremberg – be-
cause he disappeared, first to the Bavarian countryside and later to South America, where
he lived under various aliases. Mengele died in Brazil in 1979. Six years later, his remains
were identified, and he was officially pronounced dead.7
Aribert Heim was born in Austria in 1914 and studied medicine in Graz and Vienna.
He became a member of the Austrian Nazi Party in 1935 and the SS in 1938.8 As SS doctor
at the Mauthausen-Gusen concentration camp from 1941 to 1942, he tortured and killed
inmates by direct injections of toxic compounds into their hearts, and performed opera-
tions without anaesthesia and removed organs from healthy inmates, leaving them to die
on the operating tables.
Besides his private experiments, Heim specialized in the preparation of human heads.
Some of these preparations were shown in the KZ Gusen Pathological Museum. Others
were sent to Heim’s friends as special gifts or were used as paper weights on his writing desk.
In 1942, Heim left the concentration camp when he was assigned to a different station
as SS physician. After the war, he was interned as a prisoner of war for two years, but his ac-
tions at Mauthausen remained unknown. Heim went on to practice medicine in Germany
until 1962, when he was warned that his deeds had been uncovered. He evaded prosecu-
tion and fled to Egypt, where he died in 1992. Until the 2009 discovery of his death, Heim
remained the Simon Wiesenthal Center’s most wanted Nazi war criminal.
Medical experiments at Mauthausen-Gusen included testing levels of testosterone, ex-
perimenting with delousing chemicals and medicines for tuberculosis, and (mal-) nutrition
experiments. Another camp physician, Hermann Richter, surgically removed significant
organs in order to determine how long a prisoner could survive without the organ in ques-
tion. Eduard Krebsbach, the executive camp doctor in Mauthausen between 1941 and 1943,
killed an undetermined number of prisoners by injecting phenol directly into their hearts.9

Verdicts and Aftermath of the Trial

After almost 140 days of proceedings, including the testimony of 85 witnesses and the sub-
mission of almost 1,500 documents, the American judges pronounced their verdict on Au-
gust 20, 1947. Sixteen of the doctors were found guilty – seven were sentenced to death
and hanged at the Landsberg War Criminal Prison on June 2, 1948; the other nine were
sentenced to terms ranging from 10 years to life. All of them were released early, and none
served more than eight years for his or her crimes. The remaining seven defendants were

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found not guilty. Several major perpetrators were never tried for their crimes, among them
Mengele and Heim.
Together with their verdicts, the judges of the doctors’ trial also gave their opinion
on medical experimentation. Their 10 points became known as the Nuremberg Code of
Medical Ethics and stress the rights of experimental subjects and the concept of informed
consent. Though they were never directly codified as law, they form an important building
block of medical ethics today and contributed to the World Medical Association’s Declara-
tion of Helsinki.10

The Nuremberg Code

1. The voluntary consent of the human subject is absolutely essential. This means that
the person involved should have legal capacity to give consent; should be so situated
as to be able to exercise free power of choice, without the intervention of any element
of force, fraud, deceit, duress, over-reaching, or other ulterior form of constraint or
coercion; and should have sufficient knowledge and comprehension of the elements
of the subject matter involved as to enable him to make an understanding and enlight-
ened decision. This latter element requires that before the acceptance of an affirmative
decision by the experimental subject there should be made known to him the nature,
duration, and purpose of the experiment; the method and means by which it is to be
conducted; all inconveniences and hazards reasonable to be expected; and the effects
upon his health or person which may possibly come from his participation in the ex-
periment.
The duty and responsibility for ascertaining the quality of the consent rests upon each
individual who initiates, directs or engages in the experiment. It is a personal duty and
responsibility which may not be delegated to another with impunity.
2. The experiment should be such as to yield fruitful results for the good of society, un-
procurable by other methods or means of study, and not random and unnecessary in
nature.
3. The experiment should be so designed and based on the results of animal experimenta-
tion and a knowledge of the natural history of the disease or other problem under study
that the anticipated results will justify the performance of the experiment.
4. The experiment should be so conducted as to avoid all unnecessary physical and men-
tal suffering and injury.
5. No experiment should be conducted where there is a prior reason to believe that death
or disabling injury will occur; except, perhaps, in those experiments where the experi-
mental physicians also serve as subjects.
6. The degree of risk to be taken should never exceed that determined by the humanitar-
ian importance of the problem to be solved by the experiment.
7. Proper preparations should be made and adequate facilities provided to protect the
experimental subject against even remote possibilities of injury, disability, or death.

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8. The experiment should be conducted only by scientifically qualified persons. The high-
est degree of skill and care should be required through all stages of the experiment of
those who conduct or engage in the experiment.
9. During the course of the experiment the human subject should be at liberty to bring the
experiment to an end if he has reached the physical or mental state where continuation
of the experiment seems to him to be impossible.
10. During the course of the experiment the scientist in charge must be prepared to termi-
nate the experiment at any stage, if he has probable cause to believe, in the exercise of
the good faith, superior skill and careful judgment required of him that a continuation
of the experiment is likely to result in injury, disability, or death to the experimental
subject.

Endnotes
1. Freyhofer, H. The Nuremberg Medical Trial: The Holocaust and the Origin of the Nuremberg Medical Code.
New York: P. Lang, 2004. Print.
2. Noack, T. “Medizin im Nationalsozialismus.” In: Noack, T., Fangerau, H., Vögele, J. (eds) Geschichte, Theorie
und Ethik der Medizin. München: 2007.
3. Lifton, R.J. The Nazi Doctors: Medical Killing and the Psychology of Genocide. New York: Basic Books, 1986.
269ff. Print.
4. Posner, Gerald L. and John Ware. Mengele: The Complete Story. New York: McGraw-Hill, 1986. Print.
5. Weindling, P. “’Tales from Nuremberg‘: The Kaiser Wilhelm Institute for Anthropology and Allied Medical
War Crimes Policy.” Geschichte der Kaiser-Wilhelm-Gesellschaft im Nationalsozialismus: Bestandaufnahme
und Perspektiven der Forschung. Doris Kaufmann (Ed). Goettingen: Wallstein, 2000: p. 635-652. Print.
6. Ehrenreich, E. “Otmar von Verschuer and the ‘Scientific‘ Legitimization of Nazi Anti-Jewish Policy Holo-
caust and Genocide Studies” (2007) 21:55-72; Weiss, S.H. “After the Fall: Political Whitewashing, Profes-
sional Posturing, and Personal Refashioning in the Postwar Career of Otmar Freiherr von Verschuer.” Isis 101
(2010): 722–758.
7. Helmer, R. “Identifizierung der Leichenüberreste des Josef Mengele.“ In: Archiv fur Kriminologie 177 (1986),
S. 130-44.
8. Kempf, S. KZ-Arzt Aribert Heim. Die Geschichte einer Fahndung. Münster: Prospero, 2010. Print.
9. Klee, E. Das Personenlexikon zum Dritten Reich: Wer war was vor und nach 1945., Frankfurt am Main: Fisch-
er-Taschenbuch-Verlag, 2007. Print.
10. Weindling, Paul Julian. Nazi Medicine and the Nuremberg Trials. New York: Palgrave Macmillan, 2004. Print.

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