[Psychiatry during National Socialism: historical knowledge, implications for present day ethical debates]

Abstract

This contribution is a synthesis of the results of historical research on psychiatry during the Nazi period and some implications for present day debates in medical ethics. The focus is on three issues: the relationship between physicians and the state, the impact of eugenically and economically motivated health and social policies for psychiatry (e.g. forced sterilization, patient killing/euthanasia) and psychiatric research. Three myths are deconstructed: 1) that medical atrocities were imposed from above by Nazi politicians on apolitical physicians, 2) that mass sterilization and patient killing had nothing to do with contemporary state of the art of medical reasoning and practice and 3) that ethically unacceptable research on psychiatric patients had nothing to do with the contemporary state of the art of biomedical sciences. It is argued that the findings on these issues of Nazi medicine are not specific to Germany and the period between 1933 and 1945 but they were the extreme manifestations of some potential problems implicit in modern medicine in general.