Andrzej Jakubik, MD, PhD, born 1938, psychiatrist and psychologist, Professor at the Institute of Psychiatry and Neurology in Warsaw.
Zdzisław Jan Ryn, MD, PhD, born 1938, Professor Emeritus of Psychiatry and formerly Head of the Department of Social Pathology at the Collegium Medicum, Jagiellonian University, Kraków. Vice-Dean of the Faculty of Medicine of the Kraków Medical Academy (1981–1984). Polish Ambassador to Chile and Bolivia (1991–1996) and Argentina (2007–2008). Professor of Psychiatry at the University of Physical Education (AWF) in Kraków. Co-editor of Przegląd Lekarski – Oświęcim.
Only minor and incidental contributions have been published hitherto in the Polish literature on the subject of pseudo-medical experiments conducted in diverse Nazi camps [Editor’s note: the article was published in 1973. For a contemporary article and up-to-date research, read also “Experimental Block No. 10 in Auschwitz” by Maria Ciesielska]. There has been considerable confusion over the various types of illicit activities practised by SS doctors and orderlies, who for example did their medical training by carrying out surgery on prisoners. Such actions have sometimes been mistaken for medical experiments. Various attitudes have been taken to such activities so far in Polish publications, and in general there has been little or no consistency in the way they have been treated. Given such a situation, this article attempts to present a synthetic overview based on selected cases and archival materials. It will not be a full picture of all the types of experiments and criminal acts perpetrated by Nazi physicians, pharmacists and orderlies; neither will it cover the full list of camps and sub‑camps, nor even of the prisons in which the Nazis conducted their experiments.
Pseudo‑medical experiments were conducted in many camps and on a wide scale. The Nazis deliberately destroyed the records of these activities, hence the research which is being done today is based on the surviving remnants of the documentary evidence, the statements made by the organisers of these experiments, the testimonials given by victims and their medical examinations.
The chief aim of this article is to consider the medical, ethical, moral, and legal aspects which come to light in the context of publications on pseudo‑medical experiments, and to differentiate between the criteria defining pseudo‑medical experiments from those which define therapeutic experiments.
Children at a German Nazi concentration camp
According to the legal definition, a biological experiment carried out on a human being consists in “planned actions which bear an influence on the human body, undertaken in order to obtain empirical verification of theoretical hypotheses or to discover laws of nature which hitherto have been either completely unknown or insufficiently known” (Sawicki, 1966). One of the types of biological experiments carried out on humans are those which are done to increase the number of individuals who are to learn the already known laws or methods. Biological experiments on humans should be distinguished from therapeutic (medical) experiments, in which what the doctor does is, to a certain extent, in the immediate interest of the patient or “experimental subject,” as such patients have come to be called. On the other hand, a person subjected to a biological experiment receives no benefit from it in respect of his or her health, all that matters is the experimenter’s scientific interest.
Experimental methods were first introduced in research on inanimate nature, in disciplines such as mechanics, physics, and chemistry, but not until the 17th century in the biological sciences. However, biological experiments on human subjects were widespread already by the turn of the 19th and 20th centuries. By that time many physicians who wanted to test a hypothesis on the infectiousness of a particular disease were deliberately infecting healthy individuals with it. Experiments were conducted in which humans were infected with syphilis (Wallace, Walter, Lindwurm et al.), typhus, and gonorrhoea. Children were given earthworm embryos in their food (Epstein, Grassi, and Calandruci), and they were also infected with scarlet fever. Bartolo applied an electric current to the brain of a woman whose occipital lobe was exposed due to skull cancer. The patient died.
In 1902 Moll admonished the world’s physicians to steer clear of such practices, citing some thousand cases of experiments carried out on humans and officially published in scientific books and journals. Nonetheless the experiments continued, involving whooping cough, beriberi, bubonic plague, leprosy, pellagra, malaria, and polio. They were carried out mostly on prisoners, convicts sentenced to death, the incurably ill, children, the mentally ill, and the natives of colonial countries.
Despite protests by many people and appeals to morality, the legal issues associated with the phenomenon were never addressed. A conspiracy of silence persisted right until the end of the Second World War.
The basic aim of the biological experiments conducted here was to find the fastest, cheapest and most efficient method of sterilisation, in order to wipe out whole nations.
Thus the term “negative demography” did not just mean sterilisation but also included other depopulation methods and activities. The infamous sterilisation experiments conducted by Clauberg were done on specially selected women between the ages of 20 and 40 who had given birth and had not stopped menstruating in the camp (Fejkiel, 1957). After a detailed medical interview victims selected for the experiment were made to sit in a gynaecology chair. A radiological contrast medium was injected into their Fallopian tubes which were then X‑rayed to test for patency. On verification of patency victims were told to run around the room for a while, and then they were X‑rayed again while a special liquid, most probably a solution of formalin, was injected into their Fallopian tubes. The experiment was repeated 3 to 6 times on the same women at intervals of 3 to 4 weeks. The injected substance was expected to block the Fallopian tubes after 6 weeks of all the women subjected to it, which was to be confirmed in a check‑up examination carried out again with the use of a contrast agent. In the next stage of the experiment, which was planned but never accomplished, after a year the victims were to have intercourse with male prisoners to test the effectiveness of this method of sterilisation practically. Victims of the experiment fell ill with inflammation of various parts of the reproductive organs. The exact number is not known, but has been estimated in the hundreds. When the Auschwitz camp was dismantled victims of this experiment were transferred to Ravensbrück, where the experiments continued.
Dr. Josef Mengele, nicknamed The Angel of Death
Sterilisations were also done using 5–15 minute X‑ray sessions of women’s reproductive organs. Many women died after these irradiations. Those who survived were subjected after three months to two check‑up operations, in which their ovaries were successively removed and examined. Male victims had one testicle X‑rayed and were castrated after a month. The aftereffects of these experiments were not only infertility and castration, but also complications such as burns and abscesses, especially in the abdominal wall and reproductive organs. These experiments were conducted on a mass scale. There were also attempts to artificially inseminate women, which were conducted in association with sterilisation experiments.
Cancer research projects were done involving the removal of large parts of women prisoners’ cervices. A specially constructed intravaginal camera was used during these experiments, causing pain and exhausting the victim (Sehn, 1946).
Women had cancer tissue implanted in the uterus for experimental purposes (Grzywo‑Dąbrowska and Grzywo‑Dąbrowski, 1946). A variety of surgical operations was carried out on no medical indications at all, just for practice, in other words for no experimental purpose either. For instance, limb amputations were done on patients suffering from ulcers. Other operations done on no grounds were laparotomies, hernia operations, the extraction of nerves, muscles, and bones. Labour was induced in pregnant women for no reason.
The changes occurring in various organs were observed for diverse diseases, including starvation sickness (Kowalczykowa, 1948). Victims were photographed, then they were killed with a phenol injection and their liver, spleen and pancreas extracted and preserved.
Experiments were conducted involving infectious diseases such as typhus, tuberculosis, malaria, and phlegmon (Fejkiel, 1955). Healthy individuals were artificially infected with injections of the blood of persons suffering from typhus. The blood was taken at various stages of the disease to determine the incubation period and to discover at which point a patient’s blood is most infectious. There were also determinations of the quarantine time needed following typhus. Also certain unspecified anti‑typhus vaccines were tested.
In other biological experiments the aim was to determine the sulphonamides and salicylates in the blood and how the body reacted to an injection of a malaria sufferer’s blood. Blood group determinations were carried out and blood components were determined on the basis of saliva tests.
A dwarf family on their arrival at Auschwitz became a subject for Dr. Mengele’s “research interests.” Nearly all of them died.
Documents relating to the pharmacological experiments show that experiments involving eleudron and sulphapyridine which had been started in Dachau continued in Auschwitz. There were also large‑scale experiments with the use of substances called Be‑1032, Be‑1034, 3582, rutenol and periston. These drugs were tested for a variety of infectious diseases, chiefly typhus, tuberculosis, and phlegmon, on subjects who were specially infected for the experiment. Many of the individuals subjected to these mass experiments died, and many developed painful diarrhoea, nausea, vomiting, blackouts, and circulatory disorders. A group of 150 women all died following a test in which an unknown sleeping drug was administered to them. Another notorious type of experiment involved the application of narcotics, the purpose of which was probably to make subjects disclose information. An injection containing the drug (mescaline perhaps?) was administered, and the victim’s reactions were scrupulously observed. After about 15 minutes victims were led out for half an hour’s physical exercise, followed by an interrogation in which they were asked a variety of questions. The reactions to the drug which were recorded included disruption of consciousness, loss of sense of direction, and somnolence (Kłodziński, 1965).
Dr. Mengele was interested especially in twins and dwarfs for his criminal “scientific research”
Still other experiments included the administration of acrichine to induce jaundice, the making of plaster casts of women’s sex organs, the application of electric shocks and other pseudo‑medical experiments on which there have been relatively few publications so far.
The horrifying facts revealed during the Nazi doctors’ trial in the American Military Tribunal in Nuremberg in 1947 (Mikulski, 1967) and the Japanese doctors’ trial in the Soviet Military Tribunal at Khabarovsk (1949) shocked world opinion. Vast numbers of victims, mercilessness, cruelty and criminality motivated by the lowest impulses — such were the lengths to which the experimenters went.
Biological experiments were carried out on human guinea pigs, chiefly Polish women, but also women of other nationalities, including mentally ill women (Klimek, 1968). Experimental operations were done only on healthy, well‑built young women who were political prisoners. Most of them were subjected to several operations, some even as many as six times. The following types of biological experiments were conducted:
1. Operations done to examine the effects of surgical infections (by pus‑forming microorganisms, usually Staphylococcus aureus, malignant oedema, gas gangrene, or tetanus germs) injected into the calf muscles or inserted into an open wound. The experiments were done to test the therapeutic properties of sulphonamide drugs and other medications, which were put into the infected wound. The blood vessels at both ends of the wound were constricted to prevent blood flow, which was to simulate the prevalent conditions in battlefield wounds. This was also why the infection was aggravated by having broken glass, sawdust, and pieces of fabric rubbed into the wound.
2. Aseptic bone, muscle and neural operations. Their aim was to observe cell regeneration. Three types of bone operation were practised: fractures (the lower leg bones were surgically exposed, broken, and set together using clamps, the wound was sewn up and the leg put in plaster); bone transplants (the left tibia was transplanted into the right tibia and vice versa, or the fibula was transplanted into the tibia); and an operation called Knochenspäne, involving an incision to obtain a bone chip, which would then be removed in a second operation, along with a piece of the bone it was in. Muscle surgery entailed the multiple excision of progressively larger pieces of thigh and lower leg muscle in a series of operations. Neural operations involved the extraction of some of the nerves in the lower leg.
At first these operations were performed in operating theatres in aseptic conditions. Later, when the women started to resist, operations were done forcibly. SS‑men gagged victims’ mouths and held their legs down, and the operations were carried out in dreadfully unhygienic conditions, on wooden boards in a bunker. Victims were operated in their clothes and did not even have their legs washed.
It has been estimated that out of the large number of Polish women who were victims of these experiments 3.5% died during the operation and 4% were later shot. Fortunately 84% managed to survive; around 90% of the Polish victims returned home, but some died shortly afterwards due to causes resulting directly from these operations.
One Ukrainian woman was used in a strange experiment which gave her no chance of survival at all. Her shoulder blade was removed and transplanted into a young man who had had a shoulder joint with a tumour amputated. A group of ten mentally ill women prisoners had one of their legs amputated at the hip joint, or an arm and shoulder blade amputated. These women were all killed on the operating table with an injection containing a lethal dose of evipan (Klimek, 1968).
Many other completely unwarranted operations were carried out on human guinea pigs apart from these biological experiments, for instance resections of the stomach or removal of the thyroid gland. They were meant to advance the camp physicians’ practical experience (testimony given by S. Salvesen). We know of cases of epileptics having the adrenal glands removed, and these glands being subsequently transplanted into bronchial asthmatics. Women were sterilised by having the middle part or the whole of their ovaries removed. These operations were done on mentally ill German women and young Roma women, some of them 8 to 12‑year‑old girls. Later X‑ray check‑ups were done by introducing a contrast agent into the uterus without the application of an anaesthetic. Many women died as a result of such experiments (Półtawska, 1962, 1963).
Other types of experiments included malaria experiments and enemas done on typhus sufferers with the use of pregnant women’s urine. This was carried out on about 30 women, with no change at all (neither an improvement nor a deterioration) being observed (testimony given by Dr. Percival Trejte).
The extreme attitude adopted by German doctors on biological experiments was an outcome of the Nazi principle that doctors had an absolute right to conduct experiments on prisoners whenever such experiments were justified by scientific or national interests. Hence they were permitted to carry out experiments without the subject’s consent, and even against his or her will, since according to Nazi law doctors’ first duty was to their country.
In 1947, after the verdict was handed down at the Nuremberg trial the West German Bundesärztekammer Medical Association passed a resolution which said the following: “Alongside world opinion, German doctors have reacted with horror to the incidents which were the subject of the Nuremberg doctors’ trial. The general community of German medical practitioners expresses its grief and sorrow for the victims of a tyranny which attempted to make use of the achievements of science and found henchmen ready to work for it in this field. German physicians are full of sadness particularly because of the fact that the individuals who perpetrated these crimes which have aroused repugnance worldwide came from their own ranks” (Sehn, 1958). The German Medical Association has published a book entitled Wissenschaft ohne Menschlichkeit. Medizinische und eugenische Irrwege unter Diktatur, Bürokratie und Krieg [Medicine bereft of humanness: misguided paths in medicine and eugenics under dictatorship, bureaucracy, and war] (Mitscherlich and Mielke, 1949).
The predominant type of pseudo‑medical experiments carried out at Dachau were experiments for the Luftwaffe, such as low pressure and low temperature experiments and observations of the effects of seawater on the human body (Musioł, 1968).
An airtight chamber was used to observe the human body’s reaction to high and low pressure. From five to fifteen prisoners were locked in the chamber and subjected to a gradual or sudden change in the air pressure, which would be either increased or decreased. Under low pressure conditions disturbed behaviours were observed. Prisoners would tear out their hair, scratch their faces with their nails, beat their heads against the wall, or howl until they became unconscious. When the pressure was increased prisoners were observed to undergo profound disturbances of consciousness. They would remain in this state for a while, until they finally collapsed. Ultimately a haemorrhage into the lungs ensued, leading to an agonal (near‑death) condition. Those who survived the experiment suffered from severe shock and mental disorders due to cerebral haemorrhage. Autopsies were carried out on the victims, some of whom were still alive. Samples were removed from their brains, necks, lungs, sympathetic nervous system, liver, heart muscles, kidneys, and muscles from their limbs. This material was then conserved. About 25% of the victims died, but this figure does not include deaths which occurred later and were caused by the aftereffects of the experiment.
The aim of experiments in which the effects of low temperatures on the human body were examined was to find a way to warm up airmen who had been shot down into the sea, and to design clothing for airmen. About 20% of the victims of these experiments died. They were immersed in a tub of cold water, either naked or in an airman’s suit, with or without the administration of an anaesthetic. Lumps of ice would be put into the water to keep the temperature low. After some time victims lost consciousness, but were kept from drowning by a lifebuoy. A cable thermometer inserted into the victim’s anus or stomach recorded internal body temperature, and special instruments monitored the heart and other organs. Blood samples were taken from the victim’s veins and neck arteries and temperature was measured at regular intervals. The experiment would last for anything up to 36 hours, or even more. The lowest internal temperature recorded shortly before the victim died was 19°C (66.2°F). Whenever a victim was about to lose consciousness or was on the verge of absolute exhaustion an injection of fortifying drugs would be administered. Death ensued when the temperature in the brain (the myelencephalon and rhombencephalon) fell to 28°C (82.4°F), after which a post mortem was carried out.
Low‑temperature experiments were also carried out in atmospheric conditions. Prisoners were kept outside naked for 15 hours at temperatures of −25°C (−11°F). Every hour they were doused down with cold water and their temperature was taken. These were the cruellest experiments conducted in Dachau, and most of the victims died.
In low‑temperature biological experiments it was possible to try to save a prisoner’s life by a fast re‑warming process. A variety of methods were applied: rubbing his body mechanically, warming him in the sun or with the use of an infrared lamp, by diathermy, or hot water. A method that aroused a particular amount of interest was the so‑called “animal warmth” (animalische Wärme in German) method. There were eight cases of women prisoners from Ravensbrück being used for this method. It turned out that one woman could restore the life functions back to a frozen body by sexual intercourse faster than two, perhaps because on her own it was easier not to feel inhibited. However, the process still took a long time. Only those individuals whose physical condition allowed them to have sexual intercourse were warmed up exceptionally fast and recovered their normal condition.
German Nazi doctors conducting pseudo-medical experiments
A set of experiments to test the practicality of seawater for drinking was conducted on a group of Roma men. They were confined in a room and fed well for three days, after which they were starved for seven days. They were divided into five groups. Two groups were given pure seawater, two groups were given seawater with a saline solution added to it, and one group was given distilled seawater with no additives. Each of the participants in the experiment had to drink half a litre of seawater a day. Blood, urine, faeces, and saliva samples were taken every day. The effects of the experiment were very severe, but none of the victims died.
The aim of the malaria experiments was to find a substance which would make the human body resistant to malaria germs. Anopheles maculipennis mosquitos were bred in special cages and fed on flies. Mosquitos were applied on a piece of gauze to victims’ forearms or thighs to bite and infect them with the disease, though a few victims were infected by a subcutaneous injection of sporozoites obtained from the salivary glands of infected mosquitos, or by an intravenous injection of blood from a human suffering from malaria. Sometimes a combined method of infection was employed, using mixed malaria parasites injected subcutaneously with the blood of carriers of various strains (Stammträger). 69 different strains of malaria, and many more methods of infection were tested. Quinine, and neosalvarsan were tested as treatments. Over 2,000 victims, chiefly Polish Roman Catholic priests, were infected with the disease, and about 450 of them died, many of them due to the toxic effects of antipyrine and pyramidon, which were administered to bring down fever, and of salvarsan, which caused acute yellow atrophy of the liver.
Another type of experiment carried out concerned phlegmon. Victims were injected subcutaneously, intravenously or intramuscularly with pus extracted from sick prisoners’ abscesses or ulcers, or from cadavers. Many of the victims of these experiments died due to disseminated infection. Others developed abscesses on their entire body. It was very rare for a victim not to be infected at all. Prisoners with phlegmonous nidi received surgical treatment (abscesses were incised and drained; often victims had both arms and legs amputated, a kidney operation, a skull trepanation etc.), or had pharmacological treatment. When victims were treated with sulphonamides healing was delayed, and muscular, cardiac, hepatic, renal and pulmonary dystrophy would be observed in post mortems. There were many cases of victims vomiting blood or having diarrhoea with blood, duodenal ulcers, inflammation of the kidneys or jaundice due to treatment with a variety of other medications.
There were other experiments connected with jaundice. About 170 prisoners suffering from liver and gallbladder conditions and healthy prisoners had liver biopsies done several times a day, which led to perforations of the stomach and intestines, and liver damage. The victims were operated.
Experimental methods were used to treat prisoners suffering from tuberculosis. They were given calcium, codeine, pneumothorax treatment and other surgery. Some of them were kept in bed with no medications or additional food. Others received homeopathic treatment, and the remaining tuberculosis sufferers were told to take exercise, walks, and cold baths. Another treatment that was applied was a special method of breathing. The number of prisoners subjected to these experiments is not known, but we do know that they were sent to the Hartheim gas chambers.
Haematology tests were made with a substance called polygal‑10 which was supposed to increase blood coagulation. Many prisoners paid with their lives for such experiments: not only were they blood donors, but they were shot solely for the purpose of allowing Nazi doctors to observe the effects of the medication.
Surgery such as operations on the stomach, gallbladder, appendix, hernias, kidneys, lungs, thyroid, urinary tract, and nervous system, was conducted in cases where there were absolutely no medical indications for such procedures, and with the use of a variety of methods. Some victims had limbs amputated, and blood vessels from them were transplanted into other victims. Several sterilisations were performed, but we have no further data on them. The total number of prisoners involved in experiments is estimated at 5,485, out of which 2,073 died (Musioł, 1968). These figures are incomplete, as we do not have data on all the experiments.
While admitting the possibility of medical experimentation on humans for the purpose of scientific progress, the American Military Tribunal appended its verdict with a ten‑point code of principles which should be observed to avoid violations of the fundamental moral, ethical, and law‑abiding concepts (From Trials of War Criminals). The Nuremberg Code is as follows:
1. The voluntary consent of the human subject is absolutely essential. This means that the persons 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 them to make an understanding and enlightened decision. This latter element requires that before the acceptance of an affirmative decision by the experimental subjects there should be made known to them 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 their health or persons which may possibly come from their participation in the experiment. 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, unprocurable 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 experimentation 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 mental 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 experimental physicians also serve as subjects.
6. The degree of risk to be taken should never exceed that determined by the humanitarian 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.
8. The experiment should be conducted only by scientifically qualified persons. The highest 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 or she has reached the physical or mental state where continuation of the experiment seems to him or her be impossible.
10. During the course of the experiment the scientist in charge must be prepared to terminate the experiment at any stage, if there is any probable cause to believe, in the exercise of the good faith, superior skill and careful judgment required that a continuation of the experiment is likely to result in injury, disability, or death to the experimental subject.
Biological experiments on humans were conducted here on a large scale, managed by the Waffen SS Institute of Hygiene (Mikulski, 1971). The experiments were mostly on typhus, and their aim was to find the most effective method of artificially infecting humans with this disease, and to determine the value of the anti‑typhus vaccines and the effectiveness of certain drugs (e.g. rutenol and akridin) in the treatment of the disease. There were also experiments to examine the human body’s tolerance of a variety of anti‑malaria vaccines and of a composite vaccine against smallpox, typhoid fever, typhus, paratyphoid A and B, cholera and diphtheria. There was a group of victims, known as Passagepersonen, who were continuously re‑infected just for the sake of having a supply of any required strain of germs available at any time in a blood sample from them. The mortality rate in this group was very high (90%).
Experiments were carried out to test the effectiveness of a variety of pharmaceutical drugs in the treatment of phosphorus and rubber burns. Incendiary bombs were used to induce burns on victims of these experiments.
The effects of a variety of poisons on the human body were tested using diverse methods. For example, alkaloid derivatives were put into victims’ soup, or bullets coated with aconitine nitrate were shot into victims’ thighs. Death ensued within two hours but was preceded by eyesight disorders, loss of reflex reactions, motoric agitation, and intense drooling (ptyalism). Victims died in extreme pain.
Other experiments involved intravenous injections of various expired doses of blood serum. The aim was to determine the therapeutic utility of human plasma stored in field conditions beyond its expiry date. For victims the usual consequence of this experiment was death. Another group of prisoners were given additional food rations, but had blood samples of up to 400 ml taken from them. The overwhelming majority of them died on the same day due to asthenia (weakness).
Still other experiments included the treatment of infected wounds with concentrated carbolic acid, and the “treatment” of homosexuality with injections of large doses of male hormones.
According to our calculations, a total of 1,783 Buchenwald prisoners were subjected to pseudo‑medical experiments, of whom 523 died during the experiments (Mikulski, 1971).
In the course of time the ten points of the American Military Tribunal’s Nuremberg Code incorporated in the Doctors’ Trial verdict underwent certain modifications. The current (1973) American doctrine and practice does allow legal experimentation on prisoners, persons sentenced to the death penalty if they issue their consent, and also on children and the mentally ill provided their guardians issue consent. For the same reason it is legal to perform a biological experiment on persons who refuse on religious grounds to do national service when called up by the military.
The 1962 Drug Efficacy Amendment (the Kefauver Harris Amendments) to the Federal Food, Drug, and Cosmetic Act requires the informed consent of a person who is to be the subject of experimentation. The Act exempts by way of exception the requirement of obtaining informed consent in those cases where, on consideration of all the circumstances, a physician in his or her conscience acknowledges that the waiving of information to the experimental subject is purposeful and in the interest of the experimental subject (Sawicki, 1966). This attitude was heavily criticised.
Surgery was carried out here on no medical indications on prisoners suffering from urological complaints (Zegarski, 1965). These operations consisted in the creation of a second bladder, made out of a detached intestinal loop. The victims died. Many other completely unwarranted operations were carried out.
Several children were infected with viral hepatitis. The aim of this experiment was to identify the cause of the disease and develop an appropriate vaccine. Infectious material was injected intramuscularly or via a tube into the duodenum or the alimentary canal. The children also had check‑up tests done in which they suffered painful punctures of the liver.
Other experiments involved attempts to treat tuberculosis by the administration of inhalations of diverse substances, and kidney stones by a dilution method.
One group of victims suffered serious local and disseminated infections caused by deep cuts into the upper leg muscles, into which infected materials were introduced. Observations were made of the development and stages of the infection and the effects of a variety of therapeutic substances.
Another group of victims had artificially induced burns caused by chemical weapons, mostly mustard gas, applied to different parts of the body. The ensuing burns were treated with a variety of substances. This group had lethal gases tested on them, e.g. observations were made of the time it took for combustion gases to kill victims locked in an airtight lorry; and they were also exposed to the effects of chemical grenades.
There was a penal company which was involved in testing the durability of footwear and the effects of stimulant drugs. Prisoners were made to march along a road specially built for the experiment wearing the tested shoes. Each carried a 30 kg load, and had to cover a minimum of 30 km every day, which took them 10–12 hours. Stimulants were administered to some of these prisoners, who were then made to continue marching during the night, and the rise in their physical efficiency was observed.
There are no data available for the number of prisoners in this camp subjected to experiments.
In 1946–1949 the Geneva Conventions, the conventions on criminal liability for genocide, and the resolutions adopted by the General Assembly of the United Nations recognised the submission of prisoners‑of‑war and the inhabitants of countries under occupation to biological experiments of any kind whatsoever an international crime. The experimenter is personally responsible for carrying out such a crime and cannot invoke any person in justification of the undertaken actions.
According to the Polish legislation (as for 1973), “Biological experimentation on humans is admissible in principle providing the clear consent of the person subjected to the experiment. However, the experiment may only be carried out if its effects are reversible, as far as may be expected on the grounds of current knowledge and providing the lege artis principles are strictly adhered to during the experiment” (Sawicki, 1966).
Of course there are additional conditions which must be met. Consent issued by persons who are incarcerated or have been sentenced to death is absolutely incompatible with the principles and standards of life in a civilised society.
Experiments were conducted on the efficacy of various vaccines against typhus (after Trials of War Criminals). Many healthy prisoners were deliberately infected with typhus to maintain its viability. Over 90% of the victims died. Some of the prisoners were inoculated with one of the tested vaccines or they were administered an oral dose of a substance which was supposed to have a therapeutic effect against typhus, and after a few weeks they were infected with typhus germs. A smaller group was infected but not given any protective substances. Hundreds of victims died as a result of this experiment. Similar tests were done for malaria, smallpox, typhoid fever, paratyphoid A and B, cholera and diphtheria. Prisoners were also infected with viral hepatitis.
A victim of a low‑oxygen “medical experiment”
Experiments were carried out to find the most effective method for the treatment of mustard gas burns (cf. Natzweiler – proces . . . , no year of publication). Victims had cuts incised in them and the wounds were infected with mustard gas or phosgene. Attempts were made to treat phosgene poisoning with hexamethylenotetramine (Mitscherlich and Mielke, 1949).
115 Jews were selected for the skeleton collection of Strasburg University. They were photographed and anthropological measurements were taken of their bodies. Next they were killed (86 persons) in the gas chamber and comparative examinations, anatomical analyses and studies of their race, pathological body structure, and the size and shape of their brains etc. were carried out on the cadavers. Immediately after they were killed their heads were separated from their bodies and put in a special preserving liquid.
A group consisting of 20–30‑year‑old men with an advanced condition of uni- or bilateral pulmonary tuberculosis, tuberculosis of other internal organs, and healthy individuals, was selected for biological experimentation (Kłodziński, 1969). They had doses of human‑type tuberculosis bacilli applied by subcutaneous or intradermal injection into the armpit region. In addition victims had the skin on their chests scarified and bacilli were rubbed into the cuts. After some time skin samples were taken from the infected areas. Also victims had lymph nodes removed surgically. Sometimes tuberculosis bacilli were applied directly into the lungs through a tube. The process was monitored using X‑rays, and resulted in open secondary pulmonary tuberculosis. Analogous experiments were carried out on children. A total of 100 adults and 20 children are estimated to have been subjected to these experiments.
Apart from a variety of medically unwarranted surgical operations (Konopka, 1946) there were also attempts made in this camp to treat typhoid fever by special experimental methods (Mołdawa, 1967). An unidentified spray was applied on a mass scale on prisoners suspected of typhoid. Another wide‑scale practice at Gross‑Rosen was the use of a corrosive liquid in an enclosed precinct to gas prisoners. Samples were taken from their clothing and the equipment for tests. The aim was to find the best method of disinfection and insect control in front‑line conditions (Gładysz, 1962).
Mauthausen and Gusen, Stutthof, Flossenbürg, Majdanek, München
In these camps a variety of surgical procedures were conducted, the aim being to enhance medical practice. They included operations on the stomach, liver, kidneys and brain. Experiments involving infectious diseases, gynaecological conditions and toxicology were conducted on a considerably smaller scale. At Mauthausen tests were conducted on prisoners to examine the harmfulness of a range of foodstuffs. The aim of one of the research projects carried out at Monowitz was to examine the effects on the human body of passing an electrical current through the skull (Grzywo‑Dąbrowska and Grzywo‑Dąbrowski, 1946).
Dr Heinz Baumkötter – SS‑Hauptsturmführer and concentration camp doctor in Mauthausen, Natzweiler‑Struthof and Sachsenhausen.
Hitherto (1973) no country has compiled an integrated set of ethical and legal principles to regulate the issue of medical experimentation on human subjects. Many theoreticians who refer to the old traditions of French medicine are of the opinion that the principles of medical ethics rule out the possibility of experimentation merely for the benefit of science if this were to entail any harm whatsoever for humans. Hence from the legal point of view they see biological experiments as criminal acts regardless of whether or not consent has been obtained from the subject of the experiment.
But a resolution adopted in Paris on 25th November 1952 by the French Académie Nationale de Medicine offers another solution to the problem. It admits experimentation on voluntary, informed human subjects. The draft of a code of practice for biological and medical experimentation on human subjects presented at the 14th Assembly of the World Health Organisation in 1960 admits them on certain conditions. The WHO draft differs from the Nuremberg Code. Nevertheless many people are of the opinion that a physician has the right to embark on a high‑risk experiment on a patient if all other means and resources known to medical practice have failed and there is a prospect of the experiment saving the patient’s life, even at the cost of risking a permanent disability (Fejkiel, 1959).
In this complex set of problems a precise delineation of what is meant by “medical experiment” is a fundamental issue, allowing for the exclusion of Hitler’s “euthanasia programme” from its confines. By very definition the Nazi euthanasia project was not a medical experiment, nor even a pseudo‑medical experiment, but simply the mass murder of the elderly, disabled children, mental patients and the incurably ill by the use of a lethal injection, poison gases and other methods of collective slaughter. In its proper sense “euthanasia” means “the painless termination of the life of a sick person who is suffering without hope of recovery, on that person’s demand” (Ossowska, 1970).
Something that was just plain killing has been given an inadequate name.
The issue of medical experimentation lies on the border between ethics and law. This fact has been impeding the attempts made hitherto to resolve the problem from the legal point of view, and the impediment is the outcome of a lack of awareness that ethics has to go further than the law. Ethics comprises the entirety of moral assessments and standards held at any given time by a particular society. However, the medical ethics grounded on the Hippocratic humanist foundations of medicine has transcended the barriers of time and societies, becoming a timeless legacy of the whole of humankind. Thereby it has also transcended the realm of law, since the demarcation of bounds to the concept of morality is itself a moral issue.
No law, nor any regulation will be of service to a physician who is obliged to make an independent decision, to the best of available knowledge and in compliance with his or her conscience. “An official legislative regulation on such delicate matters would neither stop the physicians from abusing their rights, nor keep the patient from misconstruing the medical practitioner’s rights. For on the one hand the physicians could disregard the matter, disdaining the voice of their conscience under the protection afforded them by the law; and on the other hand the patients would never be able to tell the difference between physicians attending them in their capacity as practitioners of medicine, and physicians coming to administer torture” (Frankl, 1971).
With these ethical principles as guidelines, all physicians will know that they have the full moral right to medical experimentation, while biological experimentation on humans is unlawful and may be conducted only on animals. For “the real danger lies in the fact that whoever embarks on experimentation on human subjects does not know where it will stop” (C. Nicolle).
Translated from original article: Jakubik A., Ryn Z. “Eksperymenty pseudomedyczne w hitlerowskich obozach koncentracyjnych.” Przegląd Lekarski – Oświęcim. 1973.
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