Could the Nazi biomedical crimes of the 1930s and 1940s be repeated in twenty-first-century United States? This is the question at the heart of Sheldon Rubenfeld’s 2010 edited volume, Medicine After the Holocaust: From the Master Race to the Human Genome and Beyond (p. 3). To address this provocative and important issue, Rubenfeld employs more than twenty short essays discussing various aspects of medical and scientific history, ethics, and traditions from the nineteenth century to the present day, with intriguing and often open-ended conclusions.
Numerous contributors to this volume will be instantly recognisable for their achievements: National Institutes of Health (NIH) Director and former leader of the Human Genome Project Francis S. Collins penned a short foreword (pp. xix–xxi), whilst Nobel Prize Winner James D. Watson contributed an interesting essay discussing his own early experiences in the field of human genetics (pp. 71–81). Other prominent essayists include bioethicist Arthur Caplan, historians Volker Roelcke and William Seidelman, and several religion and ethics experts. Many of the essays themselves were derived from lectures given in conjunction with an exhibition on ‘Eugenics, Euthanasia, Extermination’ at the Holocaust Museum Houston in 2007–8 (p. 225).
With this impressive and diverse list of authors, Medicine After the Holocaust clearly has great strengths. Many of the essays are extremely deeply insightful, prompting important questions about the responsibility of German medical practitioners for their government’s abuses before and during the Second World War. Rubenfeld’s intended focus, however, is clearly the contemporary world rather than the past, and most of the writings concern the trajectory of medical and scientific ethics in twenty-first-century United States.
Intriguingly, Rubenfeld makes no effort to impose a consensus on his contributors, and several of the authors directly disagree with one another. Side-by-side essays discussing ‘aid in dying’/’assisted suicide’ (the authors disagree vehemently on this terminology) are particularly thoughtprovoking, as are those dealing with the underexplored implications of the 1946–7 Nuremberg ‘Doctors’ Trial’ for contemporary medical ethics, the ‘War on Terror’, and human rights (pp. 49–65, 83–105). By having his contributors address these issues from a broad range of perspectives, ranging from history and theology to research science and medicine, Rubenfeld makes an important and meaningful contribution to numerous ongoing discussions and debates, especially those surrounding the important notion of ‘informed consent’ in research. The relationship between doctor and patient is also a recurring and important topic of discussion.
Despite these undeniable strengths, however, the book has some unfortunate aspects that detract from its quality. Firstly, more careful editing could have been employed in some places to make the text more readable. A number of essays begin by,effectively, rehashing the same historical terrain and presenting a fairly standard history of eugenics from Francis Galton through to the Second World War. This is clearly important information for the non-specialist reader to encounter, but some of the highlysimilar accounts could have been reduced to make the book more readable as a unified text, rather than as a collection of self-contained essays.Secondly, whilst most essays are strong and thought-provoking, a few appear to be somewhat out of place. In their original lecture form these contributions may have seemed more pertinent to the overarching themes, but in this reduced and printed state their inclusion is somewhat puzzling to the reader.
Finally, and most broadly, several of the essays argue the importance of Judaeo–Christian religious belief in the prevention of future medical and scientific research abuses. Rubenfeld himself extols the importance of religion to medical ethics, and he encourages medical students to examine the history of eugenics, along with ‘the origins of the traditional Hippocratic Oath and of bioethics as well as the Judeo–Christian foundation for the moral practice of medicine’ as an essential part of their training (p. 6). In addition, at least five other essays deal explicitly with the relationship between science and religion, with conclusions ranging from a denunciation of ‘soulless scientism’ (p. 118), to the more moderate encouragement of pluralism and discourse between ‘religions and secular systems’ to prevent the emergence of future totalitarianism (p. 178).
Every religion, surely, has important insights to offer bioethics, science and medicine, but these essays regrettably ignore the emerging historiography surrounding the interplay between religion and eugenics itself. This relationship was often more complicated than previously imagined, and more nuanced than these authors present. Jonathan Spiro’s recent work on American eugenicist Madison Grant, for instance, has shown that the country’s white supremacists often saw themselves as the defenders of, not only white skin, but also their Protestant faith, belief in which was seen as integrally connected to racial identity – Jonathan Peter Spiro, Defending the Master Race: Conservation, Eugenics, and the Legacy of Madison Grant (Burlington, VT:University of Vermont Press, 2008)). Likewise, Christine Rosen’s 2004 work examining religious supporters of eugenics has revealed favourable views toward the field among people of several faiths in the United States for a variety of intriguing reasons – Christine Rosen, Preaching Eugenics: Religious Leaders and the American Eugenics Movement (Oxford: New York, 2004).
More recently, Sheila Faith Weiss has revealed the depth of Otmar von Verschuer’s Protestant religious views. Best known for being Josef Mengele’s doctoral supervisor and serving as the head of Germany’s leading eugenics research institute during the Second World War, Verschuer frequently peppered his writings and speeches with Scriptural ‘justifications’ for sterilisation and other eugenic policies. Another leading German eugenicist, Hermann Muckermann, was a devout Catholic and apparently saw no conflict between his religious views and eugenics – Sheila Faith Weiss, The Nazi Symbiosis: Human Genetics and Politics in the Third Reich (Chicago, IL: University of Chicago Press, 2010) pp. 61–6.
None of this is to say that religion should not or cannot offer important lessons for contemporary bioethics issues, but merely that the perceived dichotomy between religion and science may not be as great as these authors, and others, appear to believe. Further, the view that religious belief alone and in itself offers a special recipe for avoiding future medical and human rights abuses should be viewed with some scepticism and a great deal more historical examination. Given Rubenfeld’s emphasis on religion, an essay acknowledging and addressing the historical interplay between eugenics and faith would have been a valuable and thought-provoking addition.
Despite these relatively small issues, Rubenfeld’s book is an important work that raises many important questions for twenty-first-century readers of any background. It is perhaps most relevant to medical practitioners seeking an overview of the issues it addresses, or undergraduate students being exposed to these questions for the first time. Thanks to the short length and nature of its essays, it is easy to imagine university instructors using individual sections as reading assignments, if not the entire work as a class textbook. While not perfect, Rubenfeld’s book will no doubt have a significant resonance for years to come. The publication of a revised edition taking these considerations into account would be highly welcome.
