The Doctor’s Dilemma: Moral Autonomy or Obedience to the State?

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Joshua John Schultz

Keywords

Karl Brandt, Nuremberg Trials, Hippocratic Oath, non-maleficence, beneficence, consent,

Abstract

Before World War II German physicians and scientists were responsible for major advances in medicine. The actions of doctors in the Nazi system were an aberration of this legacy. This paper examines the doctors’ trial at Nuremberg in 1946. Its primary aim is to flesh out the ethical backdrop in which Nazi doctors practiced medicine and carried out their research. The notion of common law underpinned the Nuremberg trials. Therefore, German doctors could be tried according to laws created after the crime had already been committed—ex post facto. The Hippocratic Oath was cited by Dr. Andrew Ivy and Dr. Leo Alexander as part of the common law of medicine. Dr. Karl Brandt and his defense lawyer Dr. Robert Servatius countered this argument via ethical relativism. Brandt claimed he was acting in the best interests of the State and his community. He and Dr. Servatius argued that the morality of German doctors in the Nazi system represented an alternate morality to that of western democracies. Therefore, any judgment rendered against him would represent “victor’s justice”. In the end Brandt was found guilty of negligence due to the presence of non-German citizens in the T-4 “euthanasia” program of which Brandt had been in charge. Nazi medicine showed how far the boundaries of a physician's code can be stretched. Physicians must discern when to work with the system and when to resist a system that transgresses so-called common laws such as those contained within the Hippocratic Oath.