The Abuse of Man: An Illustrated History of Dubious Medical Experimentation
http://www.100md.com
《新英格兰医药杂志》
The Abuse of Man describes numerous unethical human experiments that were performed from the 18th century to the present. On its cover is a photograph taken in 1942 at the Dachau concentration camp of two Nazi "doctors," Holzloehner and Rascher, observing a human subject immersed in ice water during an experiment on hypothermia. Neither wears the physician's white coat; both are in SS uniforms. Pictures like this have often been used by physicians to distance themselves from Nazi medical atrocities and the Nuremberg Code, the authoritative set of 10 directives for human experimentation formulated by U.S. judges at the trial of the Nazi doctors at Nuremberg, Germany.
The author, Wolfgang Weyers, is a German dermatologist. He seeks to plumb the depth of his own specialty, which he refers to as a Jewish specialty "intimately, integrally and inextricably linked to unethical human experimentation," and to place it on a continuum with the Nazi doctors and their atrocities. In this regard, the book, with its own rather bizarre focus on Jewish dermatologists, continues the author's earlier work, Death of Medicine in Nazi Germany: Dermatology and Dermatopathology under the Swastika (Lanham, Md.: Madison Books, 1998). In cataloguing U.S. experiments, Weyers seems fixated on Jewish dermatologist Albert M. Kligman, at the University of Pennsylvania, and his unethical experiments on the skin of inmates at Holmesburg Prison, in Philadelphia. This is a valid example of dubious medical experiments and the abuse of a vulnerable population in the name of research. But by overemphasizing dermatology, the author loses perspective even as he tries to put things into perspective.
Illustrations have the power both to convey information and to provoke emotion. But to portray dubious dermatologic experiments in a continuum with the Nazi experiments and with the atrocities of Unit 731 of the Imperial Japanese Army in China is extravagant. Imprudent ethical faults in research on prisoners, orphans, and patients are different in both scale and design from the experiments in industrialized Nazi concentration camps, which had torture as their method and death as their end point.
The author is correct, however, to insist that the Nazi atrocities hold critical lessons for physicians worldwide. How was it possible, as General Telford Taylor asked in his opening remarks at the Doctors' Trial, in 1946, that these physicians "all of whom were fully able to comprehend the nature of their acts [could be] responsible for wholesale murder and unspeakably cruel tortures?" During cross-examination of Dr. Andrew Ivy, the prosecution's major expert witness at the Doctors' Trial, Nazi defense lawyers referred to particular U.S. and European experiments to suggest that Nazi physicians had followed common medical research practices and therefore were on a continuum with U.S. and European researchers. The judges at Nuremberg were not convinced; neither are readers of The Abuse of Man likely to be.
Despite these flaws, The Abuse of Man offers a useful and accurate synopsis of classic works on human experimentation, including Factories of Death: Japanese Biological Warfare 1932-45 and the American Cover-up, by Sheldon Harris (London: Routledge, 2001); Racial Hygiene: Medicine under the Nazis, by Robert N. Proctor (Cambridge, Mass.: Harvard University Press, 1989); Bad Blood, by James H. Jones (New York: Free Press, 1993), Undue Risk: Secret State Experiments on Humans, by Jonathan D. Moreno (London: Routledge, 2000); Acres of Skin: Human Experiments at Holmesburg Prison, by Allen M. Hornblum (London: Routledge, 1999); and The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation, edited by George Annas and Michael Grodin (New York: Oxford University Press, 1992).
Like Telford Taylor at Nuremberg, Nobel laureate and Holocaust survivor Elie Wiesel continues to ask critical questions about the Nazi doctors. "Why did their education not shield them from evil? How is it possible? How was it possible?" Wiesel replies, "I really do not have the answer." But he does say, "Human beings were not human beings in their eyes. They were abstractions. This is the legacy of the Nuremberg Tribunal and the Nuremberg Code. The respect for human rights in human experimentation demands that we see persons as unique, as ends in themselves."
Weyers agrees, and to the extent that readers of his book may be more likely to see the victim of the Nazi freezing experiment in the cover photograph as a flesh-and-blood human rather than as a faceless thing and an abstraction, the reader's march through this dark and horrific historical parade of unethical medical experiments may be worth the effort.
Evelyne Shuster, Ph.D.
Veterans Affairs Medical Center
Philadelphia, PA 19104
evelyn.shuster@med.va.gov(By Wolfgang Weyers. 755 p)
The author, Wolfgang Weyers, is a German dermatologist. He seeks to plumb the depth of his own specialty, which he refers to as a Jewish specialty "intimately, integrally and inextricably linked to unethical human experimentation," and to place it on a continuum with the Nazi doctors and their atrocities. In this regard, the book, with its own rather bizarre focus on Jewish dermatologists, continues the author's earlier work, Death of Medicine in Nazi Germany: Dermatology and Dermatopathology under the Swastika (Lanham, Md.: Madison Books, 1998). In cataloguing U.S. experiments, Weyers seems fixated on Jewish dermatologist Albert M. Kligman, at the University of Pennsylvania, and his unethical experiments on the skin of inmates at Holmesburg Prison, in Philadelphia. This is a valid example of dubious medical experiments and the abuse of a vulnerable population in the name of research. But by overemphasizing dermatology, the author loses perspective even as he tries to put things into perspective.
Illustrations have the power both to convey information and to provoke emotion. But to portray dubious dermatologic experiments in a continuum with the Nazi experiments and with the atrocities of Unit 731 of the Imperial Japanese Army in China is extravagant. Imprudent ethical faults in research on prisoners, orphans, and patients are different in both scale and design from the experiments in industrialized Nazi concentration camps, which had torture as their method and death as their end point.
The author is correct, however, to insist that the Nazi atrocities hold critical lessons for physicians worldwide. How was it possible, as General Telford Taylor asked in his opening remarks at the Doctors' Trial, in 1946, that these physicians "all of whom were fully able to comprehend the nature of their acts [could be] responsible for wholesale murder and unspeakably cruel tortures?" During cross-examination of Dr. Andrew Ivy, the prosecution's major expert witness at the Doctors' Trial, Nazi defense lawyers referred to particular U.S. and European experiments to suggest that Nazi physicians had followed common medical research practices and therefore were on a continuum with U.S. and European researchers. The judges at Nuremberg were not convinced; neither are readers of The Abuse of Man likely to be.
Despite these flaws, The Abuse of Man offers a useful and accurate synopsis of classic works on human experimentation, including Factories of Death: Japanese Biological Warfare 1932-45 and the American Cover-up, by Sheldon Harris (London: Routledge, 2001); Racial Hygiene: Medicine under the Nazis, by Robert N. Proctor (Cambridge, Mass.: Harvard University Press, 1989); Bad Blood, by James H. Jones (New York: Free Press, 1993), Undue Risk: Secret State Experiments on Humans, by Jonathan D. Moreno (London: Routledge, 2000); Acres of Skin: Human Experiments at Holmesburg Prison, by Allen M. Hornblum (London: Routledge, 1999); and The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation, edited by George Annas and Michael Grodin (New York: Oxford University Press, 1992).
Like Telford Taylor at Nuremberg, Nobel laureate and Holocaust survivor Elie Wiesel continues to ask critical questions about the Nazi doctors. "Why did their education not shield them from evil? How is it possible? How was it possible?" Wiesel replies, "I really do not have the answer." But he does say, "Human beings were not human beings in their eyes. They were abstractions. This is the legacy of the Nuremberg Tribunal and the Nuremberg Code. The respect for human rights in human experimentation demands that we see persons as unique, as ends in themselves."
Weyers agrees, and to the extent that readers of his book may be more likely to see the victim of the Nazi freezing experiment in the cover photograph as a flesh-and-blood human rather than as a faceless thing and an abstraction, the reader's march through this dark and horrific historical parade of unethical medical experiments may be worth the effort.
Evelyne Shuster, Ph.D.
Veterans Affairs Medical Center
Philadelphia, PA 19104
evelyn.shuster@med.va.gov(By Wolfgang Weyers. 755 p)