The Ethics of Utilizing Nazi Medical Data for Patient Benefit

This essay delves into the complex ethical debate surrounding the use of medical data and knowledge derived from the atrocities and human rights violations committed by the Nazis during World War II. It explores the core principles of medical ethics, including autonomy, non-maleficence, beneficence, and justice, and how these were violated by the Nazi experiments. The essay examines the historical context, the Nuremberg Trials, and the establishment of the Nuremberg Code as a response to these atrocities. It analyzes the arguments for and against using data obtained through unethical means, considering the potential benefits to current and future patients versus the moral implications of honoring such unethical research. The essay also discusses the importance of informed consent, utilitarian and Kantian principles and the need to prevent future unethical research. Ultimately, the essay seeks to determine the circumstances, if any, under which the use of such data is ethically permissible, emphasizing the need to balance potential benefits with the imperative to uphold ethical standards and respect human rights.

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Is it ethical to use medical evidence/information/knowledge that was gained from terrible
atrocities and human rights violations in order to benefit future or current patients?
INTRODUCTION
History is tainted with misguided medical experimentation against vulnerable peoples. These
unethical human experiments violate the principles of medical ethics which include, autonomy,
non-maleficence, beneficence and justice (Kirkwood, 2020). The ethical controversy surrounding
such experiments became the forefront of medical ethics following World War II, when the
world learned of the Nazi’s horrific crimes against the Jewish population. Leading Nazi doctors
were brought to justice in the Nuremberg Trials which exposed their sadistic human experiments
conducted at the Dachau and Auschwitz, along with many other concentration camps. One of the
most notable of the Nazi experiments was their hypothermia experiments which violated the
principles of medical ethics that all researchers and medical professionals must abide by in
present dat. Despite this fact, data from these experiments have been used on multiple occasions
and some have led to medical discoveries that saved countless lives. This raised some serious
questions in the medical ethics community: is it ethical to use medical evidence/information/
knowledge that was gained from terrible atrocities and human rights violations in order to
benefit future or current patients? In other words, is it ethically justifiable to use unethically
sourced data? And are there any circumstances where using such data is ethically permissible?
The rationalisation for the use of the data is based on benefits versus costs and paying homage to
the dead, both of which must meet the condition that the use of such data would not encourage
further unethical research. Thus, unethically sourced data can be used so long as the intended
benefit is to save lives and not to promote further unethical research.
POTENTIAL PARAGRAPH
 Before explaining why the use of data obtained through these unethical human
experiments, specifically those conducted by the Nazis during World War II, can yield
benefits for current and future patients, it is important to define the terms ‘data’ and
‘subjects.’
 When reviewing how the Nazis conducted their atrocious experiments, it becomes
increasingly difficult to remain objective regarding its subsequent use. This difficulty is
further complicated by the use of the vague term ‘data.’
 Data is defined as an impersonal recordation of words and numbers (Cohen, 2010).
However, the definition appears to be unattached to the torture and pain suffered by the
‘subjects’ who consisted of the vulnerable Jewish prisoners.
 In fact, all records of the experiments indicate that the subjects, more specifically the
prisoners in the concentration camps, did not consent to any of the experimentation that
they were a part of. In many cases, the experiments were performed by unqualified
persons and under the most horrendous physical conditions.

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 All experiments were conducted with no thought or precautions to the wellbeing of the
subject from the possibilities of injury, disability or death. In virtually all the
experiments, the subjects experienced pain, resulting in permanent injury, mutilation or
death. In addition, the fact that during World War II, Nazi doctors had unfettered access
to human beings that could use in medical experiments in any way they chose, further
perpetuated and encouraged this kind of experimentation.
 In one way, these experiments were just another form of mass torture and murder so our
moral judgment of them is clear, to use unethically sourced data would be indirectly
supporting the experiments.
 However, they also pose an uncomfortable moral challenge: what if some of the medical
experiments yielded scientifically sound data that could be put to good use? Would it be
justifiable to use that knowledge?
 Since the Nuremberg Trials, our society has had to confront the reality that the Nazi
doctors were guilty of premeditated murder masqueraded as research. Professional
modern medicine has had little difficulty condemning the Nazi doctors as evil men.
 But what is being said of the continued use of the Nazi doctors' medical research? Many
scholars are now discovering in reputable medical literature, multiple references to Nazi
experiments, or republished works of former SS doctors.
 These studies and references frequently bear no disclaimer as to how the data was
obtained. Several scientists who have sought to use the Nazi research have stirred soul-
searching about the social responsibility and potential abuses of science. These incidents
prompt a number of questions for the scientific community.
 Is it ever appropriate to use data as morally repugnant as that which was extracted from
victims of Nazism? If so, under what circumstances? It can be strongly argued why using
data obtained from such atrocities can and should be used for future and current benefits
of patients, so long as they yield more benefits than costs, pay homage to the victims of
the experiments and do not encourage similar future experimentation.
ORIGINS OF ETHICS
As Dr. Arthur Caplan, a notable medical ethicist stated, “the whole discipline of bioethics rises
from the ashes of the Holocaust” (AHRP, 2016).
 When examining past events, one must provide retrospectively critique the doctors who
performed the experiments on prisoners in the concentration camps in order to make
accurate moral judgments. However, the relevance for today cannot be overstated as it
can have serious implication on what should be done today.
 The crimes of the Nazi doctors were so immoral that they should be causally dismissed
by some principle of cultural ethical relativism, in other words ‘you can’t judge people of
that time, in that place, by our standards today,’ and ‘there was a war going on and a
suspension of normal rules are to be expected.’

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 Many people today might even agree that the extraordinary danger, in this case of war,
excuses extraordinary means to serve the common good. Despite the fact that such a
belief totally rejects human rights, one is prevented from offering any judgment of these
actions according to the principles of cultural ethical relativism.
 If one cannot judge that human rights were seriously violated in Nazi Germany, then one
cannot argue that human rights are being violated today. Thus, if morality is to have any
validity today, the arguments of cultural ethical relativism should be rejected.
 Alan Buchanan states that there can be no moral progress unless we are able to apply the
same moral yardstick to the past and the present. The passage of time does not affect the
validity of moral judgment (Ronald Munson, Intervention and Reflection, p. 525).
 The fact that 65 years have passed does not diminish the evil manner in which the Nazi
medical experiments were conducted. The American Nuremberg Military Tribunal
judged some of the key doctors (The Nuremberg Trials).
 Some may wonder what is one to gain by allotting blame? Shouldn’t this energy be
focused on the future? Shouldn’t efforts be made to ensure that these wrongdoings do not
occur ever again? As Buchanan stated, it would be a serious mistake to assume that the
choice must be to either make judgments of culpability or to focus on future prevention
(Munson, p.530).
The Nuremberg Code of 1947 came into existence as a result of the Nazi doctors’ heinous
human experimentation in the many concentration camps throughout the German Third
Reich.
 The judgements made by the war criminals tribunal at Nuremberg established 10
principles to guide physicians in all human experimentation. Prior to the Nazi war crimes
tribunal, there was no written international code for doctors.
 The experience of the Nazi medical experiments performed in the concentration camps
has made it painfully aware that medical experiments on human beings need to conform
to well-defined ethical standards and should supersede the justification that such
experiments may yield results for the “greater good of society” that might not be obtained
by other methods or means of study.
 The first principle of the Nuremberg Code clearly states, “The voluntary consent of the
human subject is absolutely essential”. This is followed by an explicit clarification of all
the associated requirements, making it extremely difficult for research principle
investigators to twist it’s meaning.
 For an informed consent to be considered ethically valid, there must be full disclosure,
which entails that the potential participant must be thoroughly informed about the
purpose of the research, the procedures to be used, the benefits to the participant, if any,
and the potential risks and discomforts of participating in the research.
 Any deception jeopardizes the integrity of the informed consent process. There should
also be assurances of confidentiality or anonymity of the participant. The participant's
consent to participate in the research must also be voluntary and free of any coercion.

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 It is vital that the participant understand what has been explained and be given the
opportunity to ask questions. It is also necessary that the participant be competent to give
consent. In the absence of competency, a legally approved advocate may provide consent.
 Participation in the research study should be authorized, preferably in writing. Everything
should be clearly stated in an informed consent document, written in an easily understood
format that avoids or explains technical terms, and whom to contact with further
questions.
 Looking at the medical experimentation performed on human beings under the Nazi
regime, one will begin to understand why the effort was made to develop the Nuremberg
Code, and the rationale for holding the participating doctors accountable for their actions.
In reality the medical experiments conducted by the Nazi doctors were only a small part
of the grand scale of systematic medical killing of the Third Reich. (Robert J. Lifton, The
Nazi Doctors, New York: Basic Books, 1986, p. 269).
IMPORTANCE OF THE EXPERIMENTS
All the Nazis medical research had a purpose and was ultimately designed to help
German military effort, especially in testing pharmaceuticals and aiding in the medical treatment
of injured military personnel. Consequently, the Nazi doctors felt that they were doing wonderful
work in advancing humanity. The problem with their actions was that the doctors took the
Hippocratic Oath, yet they knowingly violated the Hippocratic Principle of ‘do no harm.’ The
Nazi regime in and of itself was based around racial policies that methodically excluded certain
individuals from society, essentially categorizing them as non-humans. The policies, also known
as the Nuremberg Laws, allowed Nazi doctors to justify their view of prisoners, not as
individuals, but rather as ‘living culture’ or rats, to be used with no consideration for wellbeing.
In most cases, rats were treated far better than Jewish concentration camp inmates. Since the
Nazi doctors were guided by utilitarian moral principles, they did not need to consider informed
consent. The utilitarian moral code has no need to consider informed consent. If more social
good was to be gained without securing agreement, that was all that matters and was viewed as
morally legitimate (Munson, p.492). Utilizing utilitarian principles, Nazi Germany had no
difficulty designating the mentally retarded, habitual criminals, the physically handicapped,
patients w/ chronic diseases, as those less valuable members of society, referred to as 'life
unworthy of life,' & they could be legitimately sacrificed to improve life for the majority of the
population/ it's interesting to note that the definition of mentally retarded & undesired was
expanded over time to include anyone to the Nazi regime. Furthermore, according to Kantian
Principles, in other words, the categorical imperative, people cannot be forced to accept
treatment or be subject to medical experimentation for ‘the good of the majority.’ The Kantian
view states that ppl should always be treated as 'ends,' & never as 'means' only. Therefore it's
implicit w/ Kantian principles that a society cannot use a part of the population as slaves, as this
treats them merely as means. By exploiting a part of the population for the gain of the rest, or

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even to exploit a single individual would reflect utilitarian principles. The medical experiments
performed by all the doctors in the concentration camps were predominantly utilitarian in nature.
It should be noted that not one of the prisoners voluntarily waived their rights as human beings in
order to sacrifice themselves for the alleged greater good of German society - that option was
never a consideration, as the prisoners were considered 'less than human.'
The Nazi’s conducted many unethical human experiments which completely violated the
current principles of medical ethics and thus makes the use of data garnered from these
experiments questionable. The Nazi’s human experiments were very well documented because
there were so many doctors at so many camps conducting a multitude of cruel, unethical
experiments. Even medical students were given the opportunity to practice and operate on
people. Essentially, anyone who had the bare minimum qualifications of a doctor was afforded
the opportunity to conduct these unethical experiments. One can imagine, for the research
scientists and sponsoring pharmaceutical companies, this was paradise. Imagine having an
endless supply of ‘live human subjects’ on which to test any medical hypothesis. With so many
subjects available at hand, and an abundance of enthusiastic doctors ready to experiment, the
medical community has been graced with a vast amount of documentation on these experiments.
In fact, the results of many of these experiments were regularly published and distributed to the
German medical profession and in numerous postwar scientific publications. The most notable of
these experiments were the Nazi’s hypothermia experiments in which subjects, the prisoners,
were immersed in ice water. These experiments took place in Dachau concentration camp, under
the supervision of Dr. Sigmund Rascher. The purpose of this experiment was to establish the rate
of cooling of the human body in cold water and provide information about how and when re-
warming might be successful. Such data would help Nazi doctors discover how long German
pilots downed by enemy fire could survive in the freezing waters of the North Sea. Thus, in order
to stimulate conditions that German aviators suffered from in the Northern Sea and to find the
most effective way of rewarming them, the subjects were primarily men. The hypothermia
experiments consisted of two parts. The first part was to establish how long it would take to
lower the body temperature to the point of death. This was done either by putting the subject into
an icy vat of water for up to eight hours at a time or, by leaving the victim outside naked,
strapped to a stretcher, in sub-zero temperatures for nine to fourteen hours. At the time, it was
generally known that human beings did not survive immersion in the North Sea for more than
one to two hours. The second part focused on how to best resuscitate the frozen subject. This was
done by various means which were equally as cruel and painful as the freezing experiments, and
resulted in many deaths. Dr. Sigmund Rascher attempted to duplicate these cold conditions in
Dachau, and used about 300 prisoners in experiments recording their shock from the exposure to
cold, resulting in the deaths of about 80-90 subjects. While the Nazi doctors had a medico-
military purpose for this experiment, the way they went about conducting the experiments was so
ghastly that many people would never warm up to the idea of using this kind of data. The doctors
were so detached from the emotions of their victims that Doctor Rascher once requested the

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transfer of his hypothermia lab from Dachau to Auschwitz, which had larger facilities, and where
the frozen subjects might cause fewer disturbances. Apparently, Rascher’s concentration was
constantly interrupted when the hypothermia victims shrieked from pain while their extremities
froze white. The atrocious crimes that the Nazi doctors committed against their victims makes it
extremely difficult for much of the medical community to find valid justification for the use of
its data. To further this distaste, the doctors appeared to lack remorse and guilt for the pain and
suffering that they had caused their victims. As a result of this, the medical community is torn
between using this unethically sourced data for good and trying to respect the fallen victims by
not using it.
WHY SHOULD WE USE THE DATA?
The rationalisation for the use of unethically sourced data is largely based on the benefits
versus costs of its use and paying homage to the dead, both of which are under the proviso that
the use of such data would not encourage further unethical research. It is tempting to deflect the
question by saying the data are useless – that bad behaviour must have produced bad science, so
we do not even have to think about it. But there is no inevitable link between the two because
science is not a moral endeavour. If scientific data is too poor to use, it is because of a poor study
design and analysis, not because of the bad moral character of the scientist. In fact, some of the
data from Nazi experiments is scientifically sound enough to be useful. Data from the Nazi
hypothermia experiments was cited in scientific papers from the 1950s to the 1980s, but with no
indication of its nature (Gillam, 2015). The original source appears as a paper by Leo Alexander,
published in Combined Intelligence Objectives Subcommittee Files, which is an unusual type of
publication to be mentioned in a scientific journal and it is unclear that it comes from the trial of
the Nazi doctors at Nuremberg (Gillam, 2015). It appears the people who originally published
the documents believed that the data can be used for good but if people were to find out about
the nature of such data, they would disregard it. In fact, the medical profession in Germany,
until several decades ago, attempted to cover up the role played by the Nazi doctors rather than
trying to understand what had happened and how it was allowed to happen and the subject itself
has remained taboo. Attempts were made in the post war years to characterized these doctors, as
a lunatic fringe, on the fringe of the medical profession. We were presented w/ myths of
incompetence, madness on the part of a few & coercion. William Shirer (author of The Rise &
Fall of the Third Reich) described the Nazi doctors as 'irrational psychopathic butchers' on the
fringes of professional medicine (W.L Shirer (author of The Rise & Fall of the Third Reich,
Greenwich, Conn: Fawcett, 1962). In reality, the doctors weren't madmen, nor insane & this is
why it requires critical examination of the medical profession to understand their behaviour. It
would be irresponsible to simple caricaturize the Nazis doctors & scientists as mad, irrational or
devoid of conscience. These doctors, many of whom, were the leading professionals in their
fields, were highly regarded by their peers throughout the world. It was some of these
intentionally recognized doctors who were in the forefront of giving credibility to Nazi racist

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theories. The results of those studies have been available to medical researchers since the end of
WWII. But in recent years, several scientists who've sought to use the Nazi research stimulated
public controversy by raising the issue of social responsibility & potential abuse of science. In
the late 1980s, U.S. researcher Robert Pozos argued that the Nazi hypothermia data was critical
to improving the methods of reviving people rescued from freezing water after boat accidents,
but the New England Journal of Medicine rejected his proposal to publish the Data openly. This
is quite a tricky conundrum about whether or not the results of Nazi experiment should ever be
used. A simple utilitarian response would look at the more obvious consequences, as in, if good
can come to people now and in the future from using the data, then its use is surely justified.
After all, no further harm can be done to those who died. But a more sophisticated utilitarian
would think about the indirect and subtle consequences in addition to the more obvious ones.
Perhaps family members of those who were experiments on would be distressed to know the data
was being used and their distress might outweigh the good that could be done. Or perhaps the
data would send the message that the experiments weren’t so bad after all, and even encourage
morally narrow-minded doctors to do in their own unethical experiments. Of course, these bad
consequences could be avoided simply by making sure the data is used in secret, never entering
the public academic literature, but recommending deception to solve a moral problem is clearly
problematic in itself. The trouble is that focusing on the consequences - whether good or bad - of
using the Nazi data, misses an important point: there's a principle at stake here. Even if some
good could come of using the data, it would just not be right to use it. It would somehow deny or
downplay the evil of what was done in the experiments that generated them. This is a common
sentiment, but if it is to hold ethical weight, we need to be able to spell it out and give it a solid
foundation. A little reflection shows that, as a society, we don't have an absolute objection to
deriving some good out of something bad or wrong. Murder victims sometimes become organ
donors, for instance, but there is no concern that is inappropriate.