Fox Matthew A, Strous Rael D
Jakobovits Center for Jewish Medical Ethics, Faculty of Health Sciences, Ben Gurion University of the Negev.
Department of Psychiatry, Maayenei Hayeshua Medical Center, Bnei Brak, Sackler Faculty of Medicine, Tel Aviv University.
Harefuah. 2020 Apr;159(4):287-291.
The Holocaust represents a seminal event in the annals of medicine. For the first time in history, doctors played a prominent role in the extreme abuse of medical rights, violation of medical obligation to patients, infringement of patient autonomy, forced and unnecessary invasive and damaging procedures for political purposes and the ultimate injustice of involuntary euthanasia. Physicians provided the legitimacy, know-how and momentum that allowed these processes to take place in a symbiotic relationship with the political establishment during the Nazi era. It is critical that modern day physicians be aware of what transpired during this period. For that purpose, we describe a multiyear program bringing Israeli physicians on a learning mission to relevant sites of medical involvement and complicity in Nazi era crimes. These guided educational tours, under the auspices of the Israel Medical Association, originally took place in Poland and more recently, alternately visit Germany and Poland. At all sites, background information on medical practice during the Nazi era is provided, as well as ethical discussions on the merits (positive) or demerits (negative) of physicians who played a role at those particular locations. In addition to site visits, background discussions and lectures are provided to achieve a more comprehensive, deeper and more profound understanding of the issues. Emphasis is placed on learning from examples with relevance to modern day medicine, thus providing the principles from which participants can grow to become more ethical, principled and sensitive physicians as well as individuals. The tour includes formal and emotional ceremonies when relevant at extermination sites where physicians were directly involved, as well as focus groups allowing and encouraging emotional expression and catharsis. The critical role of personal growth during the tour is emphasized with both pre-tour and post-tour meetings providing buffering on both ends. Participants and staff, as well as documented feedback over the years, attest to the utility and profound value of these learning and growth-oriented medical missions.
大屠杀是医学史上的一个重大事件。在历史上，医生首次在极端滥用医疗权利、违反对患者的医疗义务、侵犯患者自主权、出于政治目的进行强迫和不必要的侵入性及伤害性程序以及非自愿安乐死的最终不公正行为中扮演了突出角色。在纳粹时代，医生们提供了合法性、专业知识和动力，使得这些行为得以与政治体制以共生关系发生。至关重要的是，当代医生要了解这一时期发生的事情。为此，我们描述了一个为期多年的项目，带领以色列医生前往与纳粹时代医疗参与和同谋相关的地点进行学习访问。这些有导游的教育之旅在以色列医学协会的支持下，最初在波兰进行，最近则交替访问德国和波兰。在所有地点，都会提供纳粹时代医疗实践的背景信息，以及对在这些特定地点发挥作用的医生的优点（积极方面）或缺点（消极方面）进行伦理讨论。除了实地参观，还会进行背景讨论和讲座，以更全面、深入和深刻地理解这些问题。重点是从与现代医学相关的例子中学习，从而为参与者提供原则，使他们成长为更有道德、有原则和敏感的医生以及个人。在医生直接参与的灭绝地点，如有相关情况，旅行会包括正式和情感性的仪式，还会有焦点小组，允许并鼓励情感表达和宣泄。旅行前和旅行后的会议在两端提供缓冲，强调了旅行期间个人成长的关键作用。参与者、工作人员以及多年来的书面反馈都证明了这些以学习和成长为导向的医疗任务的效用和深远价值。
