Anatomy From Nazi Germany to Today.

This viewpoint reviews the anatomical body procurement used in Nazi Germany, notes the continued use of those images, and calls for disclosure of the biographical history of the people whose bodies and tissues are now studied.

"Forgotten" Chapters in the History of Transcervical Sterilization: Carl Clauberg and Hans-Joachim Lindemann.

Transcervical sterilization is a non-surgical method of permanent female sterilization that is widely used and critically discussed. A review of the historiography of the method reveals that instances of its coercive use are not included in the historical account. This study offers a reexamination of the work of Carl Clauberg and Hans-Joachim Lindemann, to more deeply contextualize within the framework of current usage the coercive use of transcervical sterilization during the Third Reich and in postwar Germany. This inquiry is based on postwar criminal trial records on Clauberg, and on archival documents detailing Lindemann's activities in 1979. A comparative analysis examines arguments by medical historian Karl-Heinz Roth, and identifies shared characteristics and differences between Clauberg and Lindemann, their methods and scientific connections. The results demonstrate that the technique of transcervical sterilization has an abusive potential that may be explained as a function of the person of the physician, of the scientific method itself, and of societal and political influences. The analysis supports the argument that insights from the cases of Clauberg and Lindemann are transferrable geographically and over time, and have the potential to inform current medical practice, such as transcervical sterilization with the Essure device, whose historiographic exploration remains a desideratum.

Thoughts on practical core elements of an ethical anatomical education.

While questions of ethics in body procurement have become a focus of attention in many medical schools around the world, the recent report by a medical student regarding disturbing incidences in an anatomical dissection course (Terry, ) underlines the importance of a discussion of ethical practices in anatomical education. Here thoughts on core elements of instruction are proposed which are based on the premise that both, ethical body procurement and ethical anatomical education, are the foundation for a humanism-based professional training of students in medicine. As the anatomical dissection course presents an exceptional situation for students, practical guidelines for a curriculum founded on ethical considerations are essential. They include a preparatory phase before the start of the course in which students are asked about their expectations and fears concerning anatomical dissection; an introduction to the history and ethics of anatomy; a time for reflection in the dissection room before the start of dissection; a regular opportunity for reflections on dissection in parallel to the course with students and faculty; and a memorial service for the donors organized by students for faculty, students and donor families. Finally, anatomical faculty should undergo training in ethical educational practices. Many anatomy programs have incorporated various of these ideas, while others have not done so. Guidelines for ethical anatomical practices can strengthen the foundation of a humanistic approach to medicine in future physicians and health care workers.

Posthumous Testimony for Dr. Leo Gross and his Family / Restoration of the 'Lost' Biography of a Physician Victim of the Holocaust

At a time when the last direct witnesses of the Holocaust are passing, new approaches to the restoration of 'lost' biographies of victims need to be considered. This investigation describes the potential of an international collaboration including surviving family members. Archival documents discovered in Jerusalem in 1983 concerned a discussion on the cancellation of a medical licence for a German Jewish physician, Dr. Leo Gross of Kolberg, who had been disenfranchised from medical practice under Nazi law. After applying for a medical licence during a 1935 visit to Palestine, Gross remigrated to Germany, where he was imprisoned in a concentration camp. No further information was found until 2014, when a group of scholars linked a variety of archival and internet-accessible sources and located a nephew of Gross. The nephew's testimony, cross-referenced against data from other sources, enabled the reconstruction of the 'lost' biography of his uncle and family, in fact a posthumous testimony. The resulting narrative places Dr. Leo Gross within his professional and social network, and serves his commemoration within this context of family and community. The restored biography of Dr. Leo Gross presents an exemplary case study for the future of Holocaust testimony.

Public health in the Vilna Ghetto as a form of Jewish resistance.

We describe the system of public health that evolved in the Vilna Ghetto as an illustrative example of Jewish innovation and achievement during the Holocaust. Furthermore, we argue that by cultivating a sophisticated system of public health, the ghetto inmates enacted a powerful form of Jewish resistance, directly thwarting the intention of the Nazis to eliminate the inhabitants by starvation, epidemic, and exposure. In doing so, we aim to highlight applicable lessons for the broader public health literature. We hope that this unique story may gain its rightful place in the history of public health as an insightful case study of creative and progressive solutions to universal health problems in one of the most challenging environments imaginable.

Current status of identification of victims of the National Socialist regime whose bodies were used for anatomical purposes.

Research on the history of anatomy in the Third Reich has often focused on anatomists who collaborated with the National Socialist (NS) regime. Only recently has attention shifted to investigations of the victims, of which there are two groups: anatomists whose careers were disrupted by NS policies, and victims of the NS regime whose bodies were used for anatomical purposes. No systematic approach has yet been undertaken toward the identification of all the different groups of victims and the individuals' fates. This overview of currently available data on NS victims whose bodies were used for anatomical purposes reveals that an estimated total number of all bodies delivered to departments of anatomy lies at more than 40,000, and the so far documented number of executed persons among them at a minimum of 3,749. The traditional sources of body procurement and their significant changes in character during the NS period can be traced. Postwar attempts on finding the fate and identity of bodies of NS victims in anatomy can be divided into three phases. Most investigations focused on the removal of remaining "material" from NS victims from the anatomical collections, while identification and remembrance of individual victims was not a priority. So far, about 500 NS victims' names and biographies have been at least partially identified. Existing memorials rarely name individuals. New approaches to the identification of victims and the potential of a databank for these victims' biographies as an appropriate manner of remembrance are examined in this study.

What is happening in our anatomical dissection rooms?

A recent student article relates disrespectful and traumatizing events in a modern dissection room. This comment serves to remind anatomical educators' of their duties toward the medical students. It is the anatomical educators' duty to help students not only to become familiar with the structure of the human body but also with the emotional repertoire available when dealing with the living and the dead. And it is the educators' duty to accompany students through the dissection course experience in a manner that keeps them safe from emotional harm.

The history of the Vienna Protocol on dealing with Holocaust era human remains and its resonance with ethical considerations in African American bioarcheology.

The Vienna Protocol on How to Deal with Holocaust Era Human Remains describes what to do when possibly Jewish human remains are found. Based on Jewish medical ethics, it responds to the 2014-2017 discoveries of human remains stemming from biomedical contexts of the Nazi period. Among the finding sites were the Dahlem campus of the Free University of Berlin, the Medical University of Strasbourg, and Max Planck Institute archives. The Vienna Protocol is unique among similar recommendations on Nazi era human remains in its representation of the voices of those who suffered violence and were targeted as victims by Nazi persecution. In addition to discussing the ethics of dealing with physical human remains, these recommendations address the use of images (i.e., visual data) from the bodies of victims of Nazi violence. This paper presents the historical background of the Vienna Protocol and its impact. It also offers a first analysis as to why, at the time of the protocol's formulation, its authors were unaware of its resonance with ethical considerations from African American bioarcheology and a new ethical culture in bioanthropology. Potential reasons for this disconnect may include the historic marginalization of the voices of black scholars in anthropology within the wider scientific community. However, more detailed studies are needed to analyze similarities and differences between the histories and continuities of antisemitism and racism in Europe and the U.S.A., and their ties with scientific theories and practices of disciplines that gain knowledge from human remains.

American Association for Anatomy recommendations for the management of legacy anatomical collections.

Collections of human remains in scientific and private institutions have a long tradition, though throughout history there has often been variable regard for the respect and dignity that these tissues demand. Recent public scandals around the use of human remains, coupled with an increasing community awareness around accountability in such instances, forces scholars to confront the ethical and moral concerns associated with these collections. This includes specific focus on the acquisition, storage, use, and disposition of these remains, which were often collected with no consent and with little knowledge, or concern, about the individual or their respective culture and practices surrounding death and postmortem treatment. As a response, the American Association for Anatomy convened a Legacy Anatomical Collections Task Force to consider these issues and to develop recommendations to assist those working with these tissues in education, research, and museum collections. This has culminated with the development of Recommendations for the Management of Legacy Anatomical Collections. The recommendations provide both an ethical foundation and practical considerations for the use, storage, and disposition of legacy collections of human tissues, and deliver guidance for establishing appropriate management and oversight, investigating provenance, and engaging with communities of care. While these Recommendations are considered a living document which will change over time as ethical principles concerning human tissue evolve, they currently represent 'best practice' recommendations that can guide researchers, teachers, and museum associates as they consider the future of legacy anatomical collections in their care.

Research on bodies of the executed in German anatomy: an accepted method that changed during the Third Reich. Study of anatomical journals from 1924 to 1951.

While it is known that bodies of the executed were used for anatomical research in Germany during the Third Reich, it is unclear whether this type of work was unique to the time period or more common in Germany than elsewhere. The dissected persons and the anatomists involved have not been fully investigated. This study of anatomical journals from 1924 to 1951 shows that 166 out of 7,438 [2.2%] German language articles mentioned the use of "material" from the bodies of executed persons. In comparison, only 2 out of 4,702 English language articles explicitly mentioned bodies of the executed. From 1924 to1932, 33 of a total of 3,734 [1%] German articles listed the use of the executed. From 1933 to 1938 the number rose to 46 out of 2,265 [2%], and increased again from 1939 to 1945 to 73 out of 984 [7%]. After the war 15 out of 455 [3%] still dealt with "material" from the executed. German anatomists' familiarity with the use of the executed as a standard for healthy tissues even before 1933 may have contributed to the ease with which they accepted the "opportunities" (large-scale studies and research on women) presented to them by unlimited access to bodies of the executed provided by the abusive National Socialist (NS) legislation and continued using them for some years after the war. German postwar anatomy was built in part on the bodies of NS victims. Information given in some publications will help with further identification of these victims.

The women on Stieve's list: Victims of national socialism whose bodies were used for anatomical research.

Research on the history of anatomy in the Third Reich has often concentrated on the influence of the National Socialist (NS) regime on anatomists and their consequent unethical activities. Only recently, the focus has shifted to NS victims whose bodies were used for anatomical purposes. As a first approach to learning more about the victims, this study investigated the persons whose names Hermann Stieve, chairman of the Anatomical Department at the University of Berlin, had listed after using their bodies for his research. The study draws a group portrait and recounts selected biographies of the 174 women and eight men on the list. Most women were of reproductive age, two-thirds were German and a majority was executed for political reasons. Among the executed were at least two pregnant women. The corrected names, biographical data, and nationalities of all persons on the list are published here. None of them volunteered to be dissected, nor were the anatomists at the time interested in the victims' personal background. Future work will have to focus on the investigation of further biographies so that numbers can be turned back into people. This history is a reminder to modern anatomy that ethical body procurement and the anatomists' caring about the body donor is of the utmost importance in a discipline that introduces students to professional ethics in the medical teaching curriculum.

[Anatomy in National Socialism: stages of an ethical transgression]. / Anatomie im Nationalsozialismus: Stufen einer ethischen Entgrenzung.

Systematic research on the history of anatomy in National Socialism (NS) has only started in recent years. It has shown that anatomists used the bodies of NS victims for anatomical teaching and research purposes. In this they became complicit with the NS regime. There was a high percentage of Nazi party members among the anatomists, but at the same time there were anatomists whose careers were disrupted for so-called "racial" and political reasons. Decisive aspects of this history are first, the fact that traditional sources of anatomical body procurement included increasing numbers of NS victims and second, the gradual change of the traditional anatomical paradigm of working with the dead to a new paradigm of working with the "future dead" in human experimentation. This history has importance for the development of new ethical guidelines in anatomy.

Ethical concerns surrounding artificial intelligence in anatomy education: Should AI human body simulations replace donors in the dissection room?

The potential effects of artificial intelligence (AI) on the teaching of anatomy are unclear. We explore the hypothetical situation of human body donors being replaced by AI human body simulations and reflect on two separate ethical concerns: first, whether it is permissible to replace donors with AI human body simulations in the dissection room when the consequences of doing so are unclear, and second, the overarching ethical significance of AI use in anatomy education. To do this, we highlight the key benefits of student exposure to the dissection room and body donors, including nontechnical, discipline-independent skills, awareness and interaction with applied bioethics, and professional identity formation. We suggest that the uniqueness of the dissection room experience and the importance of the key benefits accompanying this exposure outweigh the potential and so far unknown benefits of AI technology in this space. Further, the lack of engagement with bioethical principles that are intimately intertwined with the dissection room experience may have repercussions for future healthcare professional development. We argue that interaction with body donors must be protected and maintained and not replaced with AI human body donor simulations. Any move away from this foundation of anatomy education requires scrutiny. In light of the possible adoption of AI technologies into anatomy teaching, it is necessary that medical educators reflect on the dictum that the practice of healthcare, and anatomy, is a uniquely human endeavor.