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Not a slippery slope or sudden subversion: German medicine and National Socialism in 1933

BMJ 1996; 313 doi: (Published 07 December 1996) Cite this as: BMJ 1996;313:1453
  1. Hartmut M Hanauske-Abel, assistant professor of paediatrics and head of matrix biology laboratorya
  1. a Department of Paediatrics, Cornell University Medical College-The New York Hospital, New York, NY 10021, United States
  • Accepted 14 November 1996

The history of medicine this century is darkened by the downfall of the German medical profession, exposed during the doctors' trial at Nuremberg in 1946. Relying largely on documents published during 1933 in German medical journals, this paper examines two widely accepted notions of those events, metaphorically termed “slippery slope” and “sudden subversion.” The first connotes a gradual slide over infinitesimal steps until, suddenly, all footing is lost; the second conveys forced take over of the profession's leadership and values. Both concepts imply that the medical profession itself became the victim of circumstances. The slippery slope concept is a prominent figure of argument in the current debate on bioethics. The evidence presented here, however, strongly suggests that the German medical community set its own course in 1933. In some respects this course even outpaced the new government, which had to rein in the profession's eager pursuit of enforced eugenic sterilisations. In 1933 the convergence of political, scientific, and economic forces dramatically changed the relationship between the medical community and the government. That same convergence is occurring again and must be approached with great caution if medicine is to remain focused on the preservation of physical and medical integrity.

Die apokalyptische Ansicht der Welt ist eigentlich die, daß sich die Dinge nicht wiederholen.1


“The apocalyptic view of the world quintessentially is one in which events do not reoccur.” The notion that something will not happen again prepares the ground for cataclysmic re-enactments. In 1946, the year Wittgenstein scrawled this idea into his notebook, leading civilian and military representatives of German medicine were indicted at Nuremberg for crimes against humanity. Among them were assistant and tenured professors; clinic directors and the personal physician of the chancellor; the head of the German Red Cross; the highest ranking physician of the army and …

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