Facing the Guilt and Commemorating the Victims: German Radiology and Radiation Oncology During National Socialism.

Whereas the scientific community is aware of atrocities committed by medical doctors like Mengele, the specifics of radiology and radiation oncology during National Socialism remain largely unknown. Starting in 2010, the German Radiology Association and the German Association of Radiation Oncology coordinated a national project looking into original archival material. A national committee convened in 2013 to discuss the project's findings, which were also the subject of a symposium at the University of Tuebingen in 2016 on radiology under National Socialism. The project identified approximately 160 radiologists who were victimized because of their Jewish descent, among them Gustav Bucky (known for the Bucky factor in x-ray diagnostics). Radiologists throughout Germany took part in forced sterilizations. The "Schutzstaffel," commonly known as SS, had a special radiology unit that was established for tuberculosis screening. Radiation was also used for sterilization experiments in the Auschwitz concentration camp with subsequent surgical procedures to enable histological analysis of the irradiated tissue. Reflection on medicine during the Holocaust will be strengthened by specific facts related to the respective medical field. Radiologists were involved in atrocious medical experiments as well as in supporting Nazi policies in Germany. These facts provoke ethical considerations about marginalized patient groups and doctor-patient communication. They also raise questions about "evidence-based" medicine as sole justification for medical procedures. In summary, historical studies will be able to help in the professional identity formation of radiologists gaining awareness to ethical issues of today.

Study of deaths by suicide of homosexual prisoners in Nazi Sachsenhausen concentration camp.

Living conditions in Nazi concentration camps were harsh and inhumane, leading many prisoners to commit suicide. Sachsenhausen (Oranienburg, Germany) was a concentration camp that operated from 1936 to 1945. More than 200,000 people were detained there under Nazi rule. This study analyzes deaths classified as suicides by inmates in this camp, classified as homosexuals, both according to the surviving Nazi files. This collective was especially repressed by the Nazi authorities. Data was collected from the archives of Sachsenhausen Memorial and the International Tracing Service in Bad Arolsen. Original death certificates and autopsy reports were reviewed. Until the end of World War II, there are 14 death certificates which state "suicide" as cause of death of prisoners classified as homosexuals, all of them men aged between 23 and 59 years and of various religions and social strata. Based on a population of 1,200 prisoners classified as homosexuals, this allows us to calculate a suicide rate of 1,167/100,000 (over the period of eight years) for this population, a rate 10 times higher than for global inmates (111/100,000). However, our study has several limitations: not all suicides are registered; some murders were covered-up as suicides; most documents were lost during the war or destroyed by the Nazis when leaving the camps and not much data is available from other camps to compare. We conclude that committing suicides in Sachsenhausen was a common practice, although accurate data may be impossible to obtain.

[Medicine in concentration camps: deliberate neglect, minimal care, medical crimes. A permanent exhibition at the memorial site of Sachsenhausen]. / Medizin im Konzentrationslager: Gezielte Vernachlässigung, medizinische Minimalversorgung, ärztliche Verbrechen Dauerausstellung in der Gedenkstätte Sachsenhausen.

In November 2004, the exhibition "Medicine and Crime" was opened at the Memorial Site of Sachsenhausen near Berlin. The exhibition is located in barracks R I and R II, which have persisted in their original form. These barracks were part of the camp infirmary, which was extended repeatedly up to the end of the war. Its medical facilities included laboratories, operating theatres and wards. The infirmary was the place where "racial research" and numerous medical experiments were carried out on inmates. SS doctors performed compulsory sterilisations and castrations. Several thousand inmates were murdered in systematically planned programmes to dispose of the sick, such as "Operation 14f 13". As shown in the exhibition, the infirmary was also meant for providing minimal medical care for inmates to prevent the spread of contagious diseases and epidemics. In 1942, after setbacks in the war, attention was paid to restoring sick inmates' ability to work. Overcrowding, inhuman treatment and poor supply of medicines led to largely disastrous conditions in the infirmary. It is a special aspect of this exhibition that the events in the infirmary are told from the perspective of the inmates, i. e. the victims, not the perpetrators.

[Psychiatrists criticising psychiatry: the asylum director Gustav Kolb (1870-1938) and his struggle for social reforms and professional aims]. / Psychiatriekritik durch Psychiater. Sozialreformerische und professionspolitische Ziele des Erlanger Anstaltsdirektors Gustav Kolb (1870-1938).

Against a background of public criticism of institutional psychiatry, which had been growing since around 1900, the director of the institute in Erlangen, Gustav Kolb, devised and set up what was known as "open care", with the intention of reforming clinical psychiatric care. This led to the creation of a new type of outpatient care clinic, which became a defining characteristic of public mental health care during the time of the Weimar Republic. A closer examination of it as a concept and in practice shows, however, that Kolb was primarily pursuing aims related to the politics of the profession, for with "open care", he considerably extended the area of competence of institutional psychiatry. He also sought to improve the professional situation of institutional psychiatrists, which was constantly being complained about by members of the profession at the time, by creating the position of "care doctor" and with it a new career perspective for doctors at institutions. Kolb's model of "open care" can thus be interpreted as being the professionalisation strategy of a member of the psychiatric profession during the Weimar Republic.