[Manfred Pflanz (1923-1980) - A key Protagonist for the Institutionalization of Social Medicine and Medical Sociology in Germany]. / Manfred Pflanz (1923­1980) ­ zentraler Akteur bei der Institutionalisierung von Sozialmedizin und Medizinsoziologie.

Manfred Pflanz, an internist with his focus on social medicine, medical sociology and epidemiology, (1923-1980) played a key role in the institutional integration of social science expertise into medicine in the Federal Republic of Germany during the 1960s and 70 s. The present study, a biographic sketch of Pflanz, describes his work, his programmatic ideas on social medicine and medical sociology, and his activities as an expert consultant in public health for various political entities. This should enable getting an insight into the origins and ramifications, as well as the contemporary programs and international embeddedness of the overlapping fields of social medicine and medical sociology in Germany.

Eugenic concerns, scientific practices: international relations in the establishment of psychiatric genetics in Germany, Britain, the USA and Scandinavia, c.1910-60.

The article describes the emergence of research programmes, institutions and activities of the early protagonists in the field of psychiatric genetics: Ernst Rüdin in Munich, Eliot Slater in London, Franz Kallmann in New York and Erik Essen-Möller in Lund. During the 1930s and well into the Nazi period, the last three had been research fellows at the German Research Institute for Psychiatry in Munich. It is documented that there was a continuous mutual exchange of scientific ideas and practices between these actors, and that in all four contexts there were intrinsic relations between eugenic motivations and genetic research, but with specific national adaptations.

The animal model of human disease as a core concept of medical research: Historical cases, failures, and some epistemological considerations.

This article uses four historical case studies to address epistemological issues related to the animal model of human diseases and its use in medical research on human diseases. The knowledge derived from animal models is widely assumed to be highly valid and predictive of reactions by human organisms. In this contribution, I use three significant historical cases of failure (ca. 1890, 1960, 2006), and a closer look at the emergence of the concept around 1860/70, to elucidate core assumptions related to the specific practices of animal-human knowledge transfer, and to analyze the explanations provided by historical actors after each of the failures. Based on these examples, I argue that the epistemological status of the animal model changed from that of a helpful methodological tool for addressing specific questions, but with precarious validity, to an obligatory method for the production of strong knowledge on human diseases. As a result, there now exists a culture of biomedical research in human disease that, for more than a century, has taken the value of this methodological tool as self-evident, and more or less beyond question.

Medicine during the Nazi period and the Holocaust: what are the implications? An interview with Volker Roelcke.

In this interview, Volker Roelcke explains and analyzes historical evidence refuting erroneous assumptions about medical atrocities committed by physicians during the Nazi era, provides insight into the implications of medicine during the Nazi period and the Holocaust for medicine and bioethics today, analyzes the history of the term "genocide," and suggests formats for future teaching, among other topics.

[Biography, social context, and the body in an experimental system: evidence as result of an integrated methodology exemplified by the hypertension research of Thure von Uexküll]. / Biografie, sozialer Kontext und Körper im Experiment: Evidenz durch integrierte Methodik am Beispiel der Blutdruckforschung bei Thure von Uexküll.

The Wiesbaden congress of internal medicine in 1949 played host to a heated debate on issues of method, epistemology, and evidence in psychosomatic medicine. Paul Martini, specialist in internal medicine and protagonist of methodically conducted clinical trials, criticized the methodology of knowledge production in psychosomatic medicine and disputed the validity of its claims. Starting from this controversy, the contribution reconstructs the formation and implementation of an experimental system on the origins of hypertension in which Thure von Uexküll, specialist in internal medicine as well as in psychosomatics, aimed to integrate somatic variables as well as the subjectivity, the biography, and the social relations of the patient. In this experimental system, the interpretations of patients had a privileged status. For Uexküll, empirical evidence, traceability, and reproducibility were seen as basic criteria for relevant and valid knowledge-requirements formulated by Martini in 1949.

[Sulfonamide-research on human subjects in Nazi concentration camps: a critical re-evaluation of the epistemological and ethical dimension]. / Die Sulfonamid-Experimente in nationalsozialistischen Konzentrationslagern: Eine kritische Neubewertung der epistemologischen und ethischen Dimension.

Existing scholarship on the experiments performed in concentration camps beginning in 1942 on the value of sulfonamides in treatment of wound infections, in which inmates were used as experimental subjects, maintains that not only were the experiments ethically and legally completely reprehensible and unacceptable, but that they were also bad science in the sense that they were investigating questions that had already been resolved by valid medical research. In contrast to this, the paper argues on the basis of contemporary publications that the value of sulfonamides in the treatment of wound infections, including gas gangrene infections, was not yet established, that is, that the questions pursued by the experiments had not been resolved. It also argues that regarding their "design" and methodical principles, the experiments directly followed the rationality of contemporary clinical trials and animal experiments. However, for the step from animal to the human experiment, the experimental "objects" were only in regard to their body, but not to their individuality and subjectivity regarded as "human". In a concluding section, the paper lines out some implications for an adequate historical reconstruction of medical research on humans, in particular the importance of a combined focus on the scientific rationality as well as explicit or implicit value hierarchies. Further, the article points to the potential impact of such a revised image of the sulfonamide experiments for present day debates on the ethics of medical research.

Medicine during the Nazi period and the Holocaust: what are the implications? An interview with Volker Roelcke / Medicina durante el período nazi y el Holocausto: ¿cuáles son las implicaciones? Una entrevista con Volker Roelcke

Abstract In this interview, Volker Roelcke explains and analyzes historical evidence refuting erroneous assumptions about medical atrocities committed by physicians during the Nazi era, provides insight into the implications of medicine during the Nazi period and the Holocaust for medicine and bioethics today, analyzes the history of the term "genocide," and suggests formats for future teaching, among other topics.

Resumen En esta entrevista, Volker Roelcke explica y analiza evidencia histórica que refuta las suposiciones erróneas acerca de las atrocidades cometidas por los médicos durante la era nazi, brinda información sobre las implicaciones de la medicina durante el período nazi y el Holocausto para la medicina y la bioética en la actualidad, analiza la historia del término "genocidio", y sugiere formatos para la enseñanza futura, entre otros temas.

Psychiatric genetics in Munich and Basel between 1925 and 1945: programs-practices-cooperative arrangements.

The first research institution worldwide to exclusively devote its research to psychiatric genetics was the Department of Genealogy and Demography at the German Institute for Psychiatric Research (Deutsche Forschungsanstalt für Psychiatrie) in Munich, founded in 1917. In 1924, it was integrated into the Kaiser Wilhelm Society. From its foundation until the end of World War II in 1945, the department was directed by the Swiss citizen Ernst Rüdin, one of the protagonists of the racial hygiene movement in Germany. Riidin also initiated the establishment of the Department for Heredity Research (Abteilung für Erbforschung) at the Psychiatric Hospital of the University of Basel, Switzerland; from 1932 until 1944, this department was directed by Rüdin's student Carl Brugger. The paper analyzes the development of the research agendas and related practices of both institutions. Instead of using a rather static comparative approach, the focus is on the dynamic interrelationships and mutual dependencies between the two departments and their staffs in the different political contexts of contemporary Germany and Switzerland. This approach reflects the international cross-relations in the field of psychiatric genetics and the factual dominance of the Munich institution at least until the mid-1930s. However, in spite of similar research agendas, the common motivation by eugenic ideas, and close personal relationships, the differing economic resources, research infrastructures, political ramifications, and related value preferences had considerable impact on the development of the two programs.

[Ethics in clinical research: contextualizing and reductionist problem definitions, forms of ethical reflection and some particular implications]. / Zur Ethik der klinischen Forschung: Kontextualisierende und reduktionistische Problemdefinitionen und Formen ethischer Reflexion, sowie einige Implikationen.

The present paper starts off with a short outline of issues, conflicts, and goals of ethical reflection about clinical research. It is then argued that non-reductionist, patient-centred ethics should critically reflect on medically preformed problem definitions, ways of problem solution, and evaluations. The shortcomings of such preformed perceptions and interpretations are illustrated using the examples of dementia research, and the complexities of the notion of risk. A more comprehensive approach including the perceptions, interpretations, and evaluations of the patients' perspective necessitates a form of ethical reflection which takes into account the social and cultural contexts of clinical research, and which therefore relies on concepts and methods of the cultural sciences (in particular history, sociology, and cultural anthropology). The decision for a reductionist, or for a contextualising mode of ethical reflection represents in itself a value decision and needs to be explicitly justified.