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Leveraging holocaust history to influence modern healthcare practice, ethics

Newswise May 07, 2024

What can a Jewish hospital learn from World War II-era medical experiments carried out by Nazis?

A lot, as it turns out.

When the Center for Medicine, Holocaust and Genocide Studies was created at Cedars-Sinai two years ago, founding Director Sari J. Siegel, PhD, envisioned an international and interdisciplinary community of scholars working together to better understand the history of medicine during the Holocaust and other mass atrocities, broadly share that knowledge, and leverage it to help inform modern medical education, practice and ethics.

Siegel’s vision propelled her to serve on the first commission assembled by peer-reviewed medical journal The Lancet charged with examining medical practice during the Nazi era. The Commission of 20 comprises historians, medical ethicists, physicians and medical educators from around the globe. Their recently published report, “The Lancet Commission on Medicine, Nazism, and the Holocaust: Historical Evidence, Implications for Today, Teaching for Tomorrow,” includes Siegel’s expertise earned from her years of research into the roles of Jewish prisoner-physicians forced to work in Nazi concentration camps.

The commission notes, “Studying medicine under Nazism highlights the critical role of societal factors and of ethics in medical and scientific advancement. By learning about the abuse and distortion of medicine and medical ethics during this period, the medical community can better face the ethical pressures of today and tomorrow, fostering a deeper understanding of human rights as central to medical practice and research.”

As the Jewish world prepares to commemorate Yom HaShoah, Holocaust Rememberance Day, the Cedars-Sinai Newsroom sat down with Siegel, research assistant professor of Biomedical Sciences in the History of Medicine Program, to discuss the Center for Medicine, Holocaust and Genocide Studies—unique among medical centers in the U.S.—and how it’s using history to help educate, inform and influence modern medical practice.

Dr. Siegel, tell us about the center’s work.

The Center for Medicine, Holocaust and Genocide Studies is one component of Cedars-Sinai’s Center for the Arts and Humanities in Medicine. It is a research and education hub—a site for knowledge production and a platform to share and discuss findings. Our programming draws participants from around the world and has included virtual roundtable discussions and lectures; book, art and film talks; and an international symposium—all open to the public. The center’s interdisciplinary approach translates to events that have featured scholars of 15 nationalities from 12 academic disciplines, including political science, literature, ethics and psychology.

Every year we offer a two-month Strauss Fellowship to an early-career scholar conducting research at the intersection between health or medical practice and the Holocaust or other human atrocities. We’ve had Strauss Fellows from India and Hungary, and the list has grown to include China with our 2023-2024 Strauss Fellow.

Through the unique model of the Strauss Fellowship, we facilitate conversations between fellows and Cedars-Sinai physicians or researchers to gain clinical and scientific insights that help them interpret source material in new ways. The learning is reciprocal, as fellows share their brand-new research and shed light on unknown histories connected to the physicians’ respective medical fields.

In educating clinicians about their predecessors’ conduct—namely, doctors’ participation in, resistance against, and rehabilitation efforts following mass violence—the center works to strengthen physicians’ compassion and moral compass. It helps demonstrate that humanitarian medical practice is very important here at Cedars-Sinai, and it connects to Cedars-Sinai’s identity as a Jewish hospital that both hired and treated Holocaust survivors.

What are the findings of The Lancet Commision's report? 

The report has three main components. The first addresses history. It presents a state-of-the-field discussion that extends from the interwar period until decades after the end of the war. Our goal was to offer a nuanced historical perspective—something often lacking in discussions of this challenging history. Among our tasks was countering myths and misconceptions, which frequently stem from oversimplification.

For instance, we demonstrate that, contrary to common belief, medical experimentation in Nazi camps cannot be simply categorized as “pseudoscience.” Though they led to horrendous suffering, disfigurement, and sometimes death, many of the experiments were, in fact, designed in accordance with scientific standards and practices of the time. Some were performed in collaboration with esteemed academic institutions, and several were commissioned by the German military to yield actionable information.

The second component focuses on the implications of this history on modern medicine, science and health policy and identifies areas that could be vulnerable to unethical actions today. Human subject experimentation under the Nazi regime, for example, communicates to us that we must never lose sight of the humanity of patients and subjects in the pursuit of new information. Other discussions draw attention to the vulnerability and influence of political and economic contexts on medical ethics and to the challenges of competing loyalties—to name just two.

The third component presents a conceptual framework for bringing the subject of medicine, Nazism and the Holocaust into health sciences classrooms: history-informed professional identity formation. It lays out a road map for prospective educators aiming to build a course that informs students of the history while also recognizing the contemporary relevance of the history and its legacy. While the most obvious points of relevance arise when health professionals encounter ethical dilemmas, we also want to sensitize students to, for example, prejudice in clinical and research practices and potential abuses of power.

Can you share how our center’s work aligns with the commission’s recommendations regarding healthcare professional education?

To a certain extent, the Center for Medicine, Holocaust and Genocide Studies is a real-world manifestation of the commission’s educational goals. Given its presence in a medical center, the center’s audience is foremost the Cedars-Sinai faculty and staff, so our programming speaks to people further along in their learning trajectories—residents to retirees. It’s never too late for health professionals to learn aspects of this history that has resonance in many aspects of their clinical and research work. Plus, in supporting the research of Strauss Fellows, the center helps the creation of new knowledge that can, in turn, contribute to healthcare professional education at all stages.

How do current medical school curricula highlight the role of medicine and healthcare providers during the Holocaust?

Unfortunately, the history of medicine, Nazism and the Holocaust is largely absent from medical school curricula. That’s something the commission hopes to change; we want this education to be universal. A good start could be to integrate information into medical ethics and/or diversity, equity and inclusion courses. It’s important that this information not get lost in the mix, because it can facilitate the professional identity formation that will serve students and their future patients.

What keeps you engaged in this work, given the incredibly sad subject matter?

I have multiple drives: to create knowledge through my own research, to mentor fellow researchers, to mentor educators through the commission’s Teacher Training program, and to spread knowledge of this subject to people for whom the history can be transformative in their own healthcare training and practice.

Read more in Discoveries: The History of Medicine Can Inform the Future

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