History's Darkest Medical Abuse: How does knowledge of the past expose our failures in medical ethics?

The Holocaust, the Tuskegee syphilis study, Henrietta Lacks’ cells, these are all examples of events in history where medical professionals failed to follow their foundational morals. The hippocratic oath they all vowed to follow was broken, “I will use those dietary regimens which will benefit my patients according to my greatest ability and judgement, and I will do no harm or injustice to them.” (National Library of Medicine, 2012) How could such appalling events have had a positive influence on modern medicine and ethical decisions?

Case study 1: The Holocaust and Nazi medicine

The Holocaust was a devastating dehumanization program that not only discriminated against particular individuals, but harmed them through the illusion of “medicine”. This era objectified human beings, abusing them, experimenting on them, and when deemed unnecessary were unethically murdered.   

In concentration camps, prisoners were subjected to gas poisoning as a means to evaluate the effectiveness of antidotes. New methods were also attempted to heal fractures and war wounds. Prisoners' legs were intentionally broken or amputated. “The physicians enjoyed complete freedom to act without regard to basic medical ethics.”(Rosenbaum, n.d.)

A survivor (Ms. B, 77 years old) of the Nazi era tells a story about her horrifying experiences. She was a slave and a factory worker gave her a slice of bread, with her sister suffering from malnutrition, she hoped to hide it. When the Nazi guard found it, he heavily beat her “across her face, my ears, until blood poured out of both ears.”(Claims Conference, n.d.) She was given no medical attention. When taken to the hospital much later, she was already deaf and was informed that she had no eardrums left in her ears.

In terms of experimentation, once the Law for the Prevention of Offspring with Hereditary Diseases was passed in 1933, it led to excessive racial discrimination and the “sterilization of more than 200,000 Germans” (Rosenbaum, n.d.) Dr. Horst Schumann conducted experiments in Auschwitz, he tested with groups of 30 prisoners 2-3 times a week, exposing them to irradiation from X-rays.

Schumann was not the only doctor to execute such experiments, Dr. Josef Mengele wanted to “prove” the superiority of the Nordic race. He initially performed experiments on children that were given to him from the local kindergarten. He later expanded his research criteria to twins, dwarfs and people with abnormalities. The victims were photographed, their jaws and teeth were placed in plaster molds. An inmate painter was even instructed to make comparative drawings of body features. When they completed their analysis, “some subjects were killed by phenol injection and their organs were autopsied”(Rosenbaum, n.d.) for further knowledge.

Case study 2: Tuskegee Syphilis Study

The Tuskegee syphilis study was performed to evaluate the natural course of untreated syphilis. Specifically, whether it caused more cardiological or neurological damage and to determine the difference between the disease in black and white men. They collected 399 infected patients and 201 non-infected, as a part of a “special government healthcare program”. The participants weren’t told they had the syphilis disease or that the disease could be transmitted through sexual intercourse. They were simply told they had “bad blood” which could refer to a broad range of diseases or illnesses.

They had originally planned to provide treatment to the patients (arsenic, bismuth and mercury), but after their failure to conduct data it was decided to cut off medical provision and follow the subjects till their deaths. If untreated, syphilis can cause blindness, heart failure, paralysis and more. Once penicillin became available in the 1940’s, these men were specifically denied it and were not permitted to use it for another 2025 years, directly violating government legislation mandating the treatment of venereal disease. “It is estimated that more than 100 of the subjects died of tertiary syphilis.” (Encyclopaedia Britannica, n.d.)

The study utilized autopsies of the men to analyze the influence of the disease on the human body. To ensure the families would permit the autopsy upon the death of the participants, the government offered burial insurance to cover funeral costs. The study not only impacted the men that weren’t receiving medication, but also the women they had sexual intercourse with, passing on a disease without knowledge of either parties, “at least 40 wives had been infected and 19 children had contracted the disease at birth.”(Hendricks, 2004) 

Case study 3: Henrietta Lacks and HeLa cells

In 1951, a woman named Henrietta Lacks went to John Hopkins hospital due to extensive vaginal bleeding, upon examination her gynaecologist (Dr. Howard Jones) discovered a tumor on her cervix, hence she began undergoing radium treatments for cervical cancer. During a biopsy of her cancer cells, which was sent to Dr. George Gey, he found that “Mrs. Lacks’ cells were unlike any of the others he had ever seen: where other cells would die, Mrs. Lacks' cells doubled every 20 to 24 hours.”(Johns Hopkins Medicine, n.d.) 

In modern times, her cells are used to observe the impacts of various biological materials, such as  toxins, drugs, hormones and viruses, on cancer cell growth without the need for human involvement. They have been utilized to examine the influence of radiation and poisons, to analyze the human genome, to gain a deeper understanding of viruses function, and had a facilitating role in the development of the polio and COVID-19 vaccinations.

The HeLa cells pose a significant problem towards the ethics in biomedical sciences due to the lack of consent, as she died soon after being diagnosed with a prominent cervical cancer. It further resulted in a rise of questions about racial inequalities, as Henrietta’s family was not compensated for the research being done on her cells, despite the amount of money the HeLa cells research was generating.

Connections to the present:

These inhumane and deeply unethical experiments unseemingly allowed modern medicine to develop, setting boundaries for patients and physicians. Though it created much mistrust between the community and healthcare professionals, it eventually led to the implementation of laws that prevented such mishappenings. These events serve as a reminder that human’s own mistakes are the key to our evolution, to creating a better society, and an equitable environment.

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