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Surgeon who refused to operate on man with swastika tattoo should not be disciplined, says German Medical Association

BMJ 2010; 341 doi: (Published 17 December 2010) Cite this as: BMJ 2010;341:c7279
  1. Ned Stafford
  1. 1Hamburg

A surgeon in Germany who refused to operate on a man already anaesthetised because he noticed a swastika tattooed on the patient’s upper arm should not be reprimanded, Jörg-Dietrich Hoppe, head of the German Medical Association, has said.

After noticing the tattoo of an imperial eagle perched on a swastika the surgeon said he could not continue, an 11 December article in the Munich daily newspaper Süddeutsche Zeitung reported. “I cannot operate on this man,” the newspaper quoted the surgeon as telling the patient’s wife. “I am a Jew.”

The 46 year old surgeon, who later explained that his conscience would not allow him to treat anyone with neo-Nazi sympathies, found a colleague who successfully performed the operation on the man’s thyroid gland.

The wife of the patient, who is a truck driver, has publicly criticised the surgeon, saying that he should lose his medical licence for failing to uphold the Hippocratic oath, the Süddeutsche Zeitung reported. But the hospital released a statement saying, “There has been positive feedback from the public praising the courage of the doctor.” The hospital added that the patient is doing well and had been released to go back home.

Professor Hoppe told the BMJ that the surgeon could reasonably explain that he was “too shocked” after seeing the swastika to perform the operation. Professor Hoppe noted that the surgeon, after seeing the swastika tattoo, nonetheless still had an obligation to care for the patient but that he had fulfilled this obligation by expeditiously recruiting another doctor to do the surgery.

“If it were an emergency that would be a different story,” Professor Hoppe said. “In an emergency he would have been obliged to perform the operation even if the patient was laced with swastikas.”

In an interview with the BMJ, Claudia Wiesemann, director of the Institute for Medical Ethics and History of Medicine at the University of Göttingen Medical School, noted that the World Medical Association’s 1948 Declaration of Geneva states: “I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient.”

She believes that the “doctor in Paderborn should have operated on the patient. He should have been prepared for situations of this kind,” she said. “However, I think the doctor should not be reprimanded for refusing to do the operation. Firstly, he took care to arrange for somebody else to step in and did not endanger the patient.”

The second reason, she added, is that the Declaration of Geneva was originally drafted “to preclude the horrible racial politics of medicine during German national socialism. It is a sadly ironic twist of history that exactly this paragraph now should serve to judge as morally unethical what the Paderborn physician has done—or not done—to a neo-Nazi. I feel it would be morally dubious for a German law court to pursue him for that.”


Cite this as: BMJ 2010;341:c7279

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