I was stunned to open today’s newspaper and read an incredible letter to the editor, not only defending abortion, but making a case which the Nazi doctors would have been proud of. A Melbourne doctor castigated a fellow paediatrician for following his conscience over the abortion issue.
Evidently the doctor had left – or was thinking about leaving – Victoria to avoid having to refer a patient for an abortion. But the letter writer thought this was just not on. “Termination of pregnancy is an unavoidable part of medical practice,” he opined.
It is? Really? One might as well try to argue that unethical experimentation on prisoners is an unavoidable part of medical practice. That seemed to be what the Nazi physicians sought to argue in their own defence. In 1947 twenty Nazi doctors were tried and found guilty at the Nuremberg trials for this very thing.
They not only argued that it was unavoidable, but they had to do it. They said that such brutal experiments and the killing of patients were morally permissible, because they were not doing it on their own authority, but under the authority of German law.
The judges at Nuremberg weren’t buying this however. They rightly argued that we are all accountable to a higher law, and that such justifications will not be tolerated. Moral accountability must always trump cheap excuses and moral buck-passing.
Yet our letter writer continues to push amoral and shallow thinking on this issue. He implies that we must perform abortions, or revert back to the dark old days of backyard abortions. “I don’t think my peers will ever forget the horrors of the pre-legalisation era when, for example, women died from gas gangrene as a complication of ‘criminal’ abortion.”
This is bogus for several reasons. Legalising abortion did not make abortion safer. It was made safer in the 1940s and onwards with the availability of antibiotics. Also, the majority of abortions performed before legalisation were done in doctor’s offices, not in “backyards”.
And there were far fewer people who died from abortions prior to legalisation than is usually alleged. Bernard Nathanson ought to know. He was a leading abortionist during this period – having performed 60,000 abortions – and helped to make up the figure of 5,000 to 10,000 deaths a year prior to legalisation. He says: “I confess that I knew the figures were totally false, and I suppose the others did too if they stopped to think of it. But in the ‘morality’ of our revolution, it was a useful figure, widely accepted, so why go out of our way to correct it with honest statistics? The overriding concern was to get the laws eliminated, and anything within reason that had to be done was permissible”.
Moreover, the doctor fails to tell us about all the women who are injured or killed undergoing abortions today – that is, legal abortions. Legalisation has done nothing to protect women. It has simply legalised the harm, injuries, complications and death they face as a result of the procedure.
But it is the conclusion of his letter which is the most chilling. This is what he actually says: “Referrals that leave you uncomfortable are par for the course in clinical practice. I see the occasional patient referred with infertility whom I would consider far from an ideal parent, but I still refer her to a subspecialist. Good doctors don’t moralise, they leave that to the clergy.”
It is the final sentence of course that really is the most frightening – and sickening. Doctors have no moral obligations? They should not even think about the moral implications of their work? Morality is simply outside the practice of medicine?
This is as incredible as it is frightening. Indeed, it seems to be the very sort of reasoning that the Nazi doctors used in their defence before the Nuremberg tribunal. They too tried to pass the buck, and evade any moral considerations. Indeed, they claimed that they were not killing by their own authority, but were simply obeying the laws of Germany.
Such a defence was found to be morally bankrupt and intellectually indefensible. The twenty Nazi doctors were rightly convicted for the horrible human experiments they conducted on prisoners of war. But there were many more German doctors who were complicit in the Nazi program.
We all know of the “Angel of Death,” Josef Mengele, but much of the German medical and scientific community was involved – either directly or indirectly – in the horrors unleashed by the Nazis. Indeed, whole volumes have been written documenting the involvement of these doctors in Hitler’s monstrous program. Three key volumes are:
– Naomi Baumslag, Murderous Medicine: Nazi Doctors, Human Experimentation, and Typhus (Praeger Publishers, 2005).
-Robert Jay Lifton, The Nazi Doctors: Medical Killing and the Psychology of Genocide (Basic Books, 1986).
-Vivien Spitz, Doctors from Hell: The Horrific Account of Nazi Experiments on Humans (Sentient Publications, 2005).
All three books are well worth reading, and could be extensively quoted from here. But let me cite another authority, bioethicist Edmund Pellegrino. In 1997 he penned an important article entitled “The Nazi Doctors and Nuremberg: Some Moral Lessons Revisited”. It is worth citing here.
He writes, “Moral lessons are quickly forgotten. Medical ethics is more fragile than we think. Moral reasoning based on defective premises tends to recur in new settings. Not all of the Nazi physicians were mentally deranged – they believed they were doing the right thing. If we are to avoid even attenuated errors of the same kind, we are obliged to examine a few of their errors even now.”
He reminds us of the ten basic principles contained in the 1949 Nuremberg Code (see the link provided below), and discusses how an entire nation could embark upon such a course:
“What the Nazi doctors illustrate is that ethical teaching has to be sustained by the ethical values of the larger community. In Germany, this support system was weakened well before the Holocaust and the experiments at Auschwitz. German academics, especially psychiatrists, were leaders in theories of racial superiority, social Darwinism, and the genetic transmissibility of mental illness before Hitler came to power. They even urged the Hitler regime to adopt these nefarious ideals.
“Clearly, protection of the integrity of medical ethics is important for all of society. If medicine becomes, as Nazi medicine did, the handmaiden of economics, politics, or any force other than one that promotes the good of the patient, it loses its soul and becomes an instrument that justifies oppression and the violation of human rights. Subversion becomes a greater danger whenever medicine comes too close to the power of the state. The German medical profession eagerly supported Hitler’s Third Reich and made itself the Reich’s willing agent.”
He concludes as follows: “Clearly, there are moral lessons still to be learned from the Nuremberg Trials and there always will be. These lessons must be repeatedly relearned. They are pertinent to other contexts and other issues in today’s intensive bioethics debates. The Nuremberg Trials and the Holocaust are metaphors for absolute moral evil, the lessons of which are as old as ethics itself. This we must never forget if we wish to be certain that the moral disasters revealed at Nuremberg never occur again.”
I am not suggesting that the doctor quoted above is in the same league as the Nazi doctors. But his apparent disregard for any moral considerations in the field of medicine is very worrying indeed. It would seem that a similar lack of interest in ethics helped pave the way for Nazi medicine. As Pellegrino argues, it appears we really have learned very little from the horrors of the recent past.