I herewith submit the enclosed article on medical ethics. This might seem a very dull and dry subject of little interest or value to you. If you have any association with lyme disease I suggest you think again. What is happening with LD in the country, Drs. Jones and Jemsek etc and what is happenining to the rest of us fits this situation to perfection. I subbest you read below:
PubMed Articles in PubMed by Author: Pellegrino, E. D.
EDITORIAL The Nazi Doctors and Nuremberg: Some Moral Lessons Revisited Edmund D. Pellegrino, MD
-------------------------------------------------------------------------------- Exactly 50 years ago, the world learned of the moral depravity of the 20 Nazi physicians who were tried and convicted in Nuremberg for the part they played in the brutal human experiments at Auschwitz [1-4]. Ethicists have since expounded on the moral lessons to be learned from the Nuremberg Trials. So obvious these moral lessons seem now, and so gross the malfeasance, that it seems redundant to revisit them. Certainly we do not need to study such gross moral pathology that could never happen again.
That is a dangerous conclusion. Moral lessons are quickly forgotten. Medical ethics is more fragile than we think. Moral reasoning based on defective premises tends to recur in new settings. Not all of the Nazi physicians were mentally deranged-they believed they were doing the right thing. If we are to avoid even attenuated errors of the same kind, we are obliged to examine a few of their errors even now.
In light of the enormity of the crimes of the Nazi doctors, it seems easy to acquiesce to the 10 basic principles promulgated by the Tribunal to keep human experimentation within moral, legal, and ethical boundaries [5]. But acquiescence does not equate with comprehension.
The first principle of the Nuremberg Code is this: "The voluntary consent of the human subject is absolutely essential." However, this principle was compromised almost immediately after the Nuremberg trials. The Helsinki Declaration, which superseded the Nuremberg Trials, weakened the provision by placing too much emphasis on the advancement of science and not enough on the integrity of the subject. Katz faults the U.S. Department of Health and Human Services Rules and Regulations for lack of a similar failure fully to protect human research subjects [6].
Even more distressing are the instances of unethical research behavior that have occurred since the revelations of the Nuremberg Trials and wide acceptance of the 10 principles they promulgated. Only a few such instances need to be listed here: the Tuskegee Syphilis Study, the Willowbrook Hepatitis Study, U.S. radiation experiments, the Jewish Chronic Disease Hospital Study and the lysergic acid study supported by the Central Intelligence Agency, and others that have not been brought to light [7-10].
Clearly, the major lesson of the Nuremberg Trials has not been learned. Ethicists have the painful responsibility of reaffirming that lesson even in the United States. Failure to respect the absoluteness of the requirement for truly informed consent is a major factor behind current moves to strengthen regulatory mechanisms regarding research involving humans.
The integrity of medical ethics is important not because it protects the physicians' prerogatives but because it is a bulwark against the use of medical knowledge for purposes other than for the good of the sick. The German physicians indicted at Nuremberg had been taught by some of the world's best historians of medicine and ethics [11]. They could not plead ignorance of ethics and, in fact, made constant allusions to medical ethics and the Hippocratic tradition in their testimony [12]. They even convinced themselves that their heinous acts were consistent with those principles.
What the Nazi doctors illustrate is that ethical teaching has to be sustained by the ethical values of the larger community. In Germany, this support system was weakened well before the Holocaust and the experiments at Auschwitz. German academics, especially psychiatrists, were leaders in theories of racial superiority, social Darwinism, and the genetic transmissibility of mental illness before Hitler came to power [13]. They even urged the Hitler regime to adopt these nefarious ideals.
Clearly, protection of the integrity of medical ethics is important for all of society. If medicine becomes, as Nazi medicine did, the handmaiden of economics, politics, or any force other than one that promotes the good of the patient, it loses its soul and becomes an instrument that justifies oppression and the violation of human rights.
Subversion becomes a greater danger whenever medicine comes too close to the power of the state [14]. The German medical profession eagerly supported Hitler's Third Reich and made itself the Reich's willing agent. Hitler, like his counterparts in Stalinist Russia and Imperial Japan, recruited medicine at the very beginning of his regime. Physicians should have refused. Even Hitler would probably not have prevailed against a united profession exerting its collective moral power. But the caduceus joined the swastika in a lethal symbiosis that cost millions of lives and forever branded German medicine as a traitor to every tradition that ever made medicine a beneficent rather than a maleficent enterprise.
This lesson becomes even more important as medicine becomes increasingly bureaucratized, institutionalized, and dependent on government and politics for its support. Medical power is too great to be left unregulated, but it is also too great to be enslaved by government, however benign the government's intentions might be.
The Nazi doctors were rational beings. To be sure, they acted within psychological and sociohistorical contexts [15-17]. Ultimately, they justified their actions by what they considered to be moral reasons that have received insufficient attention [18]. During the testimony, the defendants and their lawyers repeatedly advanced a few moral premises with a familiar ring: They were not killing by their own authority but obeying the laws of the state, which can determine the method of death [12]. To resist would have been treasonous; ethics must be subordinate to the demands of war. Consent from those condemned to death was unnecessary. The death of a few prisoners would save many German lives; medical ethics could be set aside by law.
We see here the initial premises that law takes precedence over ethics, that the good of the many is more important than the good of the few, that national emergencies supersede ethics, and that some persons (prisoners in this case) can lose their claim to humanity. The lesson here is that moral premises must be valid if morally valid conclusions are to be drawn. A morally repulsive conclusion stems from a morally inadmissible premise.
Perhaps, above all, we must learn that some things should never be done. We will know when to say "no" if we extrapolate our moral premises to their logical conclusions. This the Nazi doctors did not do.
Clearly, there are moral lessons still to be learned from the Nuremberg Trials and there always will be. These lessons must be repeatedly relearned. They are pertinent to other contexts and other issues in today's intensive bioethics debates. The Nuremberg Trials and the Holocaust are metaphors for absolute moral evil, the lessons of which are as old as ethics itself [19]. This we must never forget if we wish to be certain that the moral disasters revealed at Nuremberg never occur again.
Author and Article Information
Top Author & Article Info References
Georgetown University Medical Center; Washington, DC 20007 Current Author Address: Edmund D. Pellegrino, MD, Center for Clinical Bioethics, Georgetown University Medical Center, 400 Reservoir Road, NW, Washington, DC 20007.
References
Top Author & Article Info References
1. Alexander L. Medical science under dictatorship. N Engl J Med. 1949; 241:39-47.
2. Lerner BH, Rothman DJ. Medicine and the holocaus:: learning more of the lessons. Ann Intern Med 1995; 122:793-4.
3. Caplan AL, ed. When Medicine Went Mad. Totowa, NJ: Humana Pr; 1992.
4. Barondess JA. Medicine against society. Lessons from the Third Reich. JAMA. 1966; 276:1657-61.
5. Judgement and aftermath. In: Annas GJ, Grodin MA, eds. The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation. New York: Oxford Univ Pr; 1992:102-3.
6. Katz J. The consent principle of the Nuremberg Code: its significance row and then. In: Annas GJ, Grodin MA, eds. The Nazi Doctors and the Nuremberg Code. Human Rights in Human Experimentaticn. New York: Oxford Univ pr; 1992:231-3.
7. Moreno JD, Lederer SE. Revising the history of Cold War research ethics Kennedy Institute of Ethics Journal. 1996; 6:223-38.
8. Beecher HK. Ethics and clinical research. N Engl J Med. 1966; 274:1354-60.
9. Jones JH. Bad blood: the Tuskegee syphilis experiment. New York: Free pr; 1981.
10. Annas GJ. The Nuremberg Code in U.S. courts: ethics versus expediency. In Annas GJ, Grodin MA, eds. The Nazi Doctors and the Nuremberg Code Human Rights in Human Experimentation. New York: Oxford Univ Pr; 1992:212-6.
11. Hanauske-Abel HM. Not a slippery slope or sudden subversion: German medicine and national socialism in 1993. Br Med J. 1996; 3:1453-63.
12. Trials of War Crim nals before the Nuernberg Military Tribunals under Control Council Law no. 10. October 1946-April 1949. Washington, DC: US Gov Pr; Office; 1949.
13. Burleigh M. Death and Deliverance: "Euthanasia" in Germany c. 1900-1945. New York: Cambridge Univ Pr; 1994.
14. Pellegrino ED. Guarding the integrity of medical ethics. Some lessons from Soviet Russia. JAMA. 1995; 273:1622-3.
15. Lifton RJ. The Nazi Doctors: Medical Killing and the Psychology of Genocide. New York: Basic Books: 1986:435.
16. Gibson JT, Haritos-Fatouros M. The education of a torturer. Psychology Today. 1986; 20:50-8.
17. Naumann B. Auschwitz. London: Pall Mall Pr; 1966.
18. Caplan AL. The doctors' trial and analogies to the Holocaust in contemporary debates. In: Annas GJ, Grodin MA, eds. The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation New York: Oxford Univ Pr; 1992:259-75.
19. Fasching DJ. The Ethical Challenge of Auschwitz and Hiroshima: Apocalypse or Utopia? New York: State University of New York Pr; 1993.
-------------------- Thomas Parkman Posts: 341 | From Columbia SC 29206 | Registered: Feb 2003
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Michelle M
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A powerful read.
Michelle
Posts: 3193 | From Northern California | Registered: Apr 2005
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shazdancer
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quote:Clearly, protection of the integrity of medical ethics is important for all of society. If medicine becomes, as Nazi medicine did, the handmaiden of economics, politics, or any force other than one that promotes the good of the patient, it loses its soul and becomes an instrument that justifies oppression and the violation of human rights.
Subversion becomes a greater danger whenever medicine comes too close to the power of the state.
Sounds like the CDC, the NIH, and IDSA are coming close to this danger.
That said, I would not invoke the Nuremburg trials (and I am rethinking even invoking Tuskegee) when making an argument with outsiders about the injustices of this disease. It's kind of like equating Nazism with any wrongdoing -- it tends to stop discussion, while a side argument develops over whether the current problem is "as bad as all that."
But argue that the Lyme guidelines (and some of the researchers) breach moral ethics? Absolutely!
To give out the wrong IV antibiotics for an inadequate length of time, then disregard that some patients began to get better, then report the conclusion that, therefore, long-term antibiotics don't work, then to broadcast this "proof" far and wide, is unconscionable,IMHO.
Not to mention it's just really crappy science!
Thanks for the info, Shaz
Posts: 1558 | From the Berkshires | Registered: Jul 2001
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Greatcod
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How about the silence of American Medicine and Psychiatry in the face of a President who is deeply troubled and conflicted. A dangerous man who inflicts his pain on the world. They don't loose a second in telling us that we are head cases (without examination), but lay nary a hand on him. How many books or articles by "professionals" have you seen about the topic? I read "Bush on the Couch" by a psychiarist, and have not come across any others.
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Highly inappropriate. Since you went there, who is inflicting pain, suffering and mutilation in Africa? Lunatic muslims. Who has been responsible for literally thousands of murders around the world? Lunatic muslims. Who is the greatest threat to the world? If you say Bush you need to move out of Disneyland.
I could go on and on but I sense you're a Ted Kennedy/Jimmy Carter demo. who believes if we appease we will be fine.
Clinton appeased and look where it got us. This whole topic should be deleted. Great, the crazy Lymies are now comparing their treatment to nazi doctors. Yeah, that'll get us more funding, better treatment.
Posts: 52 | From California | Registered: Aug 2005
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NP40
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quote:Originally posted by Semi-Retired: Notsogreatcod,
Highly inappropriate. Since you went there, who is inflicting pain, suffering and mutilation in Africa? Lunatic muslims. Who has been responsible for literally thousands of murders around the world? Lunatic muslims. Who is the greatest threat to the world? If you say Bush you need to move out of Disneyland.
I could go on and on but I sense you're a Ted Kennedy/Jimmy Carter demo. who believes if we appease we will be fine.
Clinton appeased and look where it got us. This whole topic should be deleted. Great, the crazy Lymies are now comparing their treatment to nazi doctors. Yeah, that'll get us more funding, better treatment.
Don't want to turn this into a political thread but, are you serious ?
Seems to me Clinton actually CAUGHT the perpetrators of the 1st WTC bombing, tried and convicted them. How's that whole Osama thing coming along ?
Oh, that's right, the Bin Laden and Bush family's are business partners in the Carlyle Group. Can't let a little thing like 3,000 American deaths get in the way of profits.
Bush/Cheney's actions have killed 600,000 civilians in Iraq, 3,000 soldiers dead, 20,000 seriously wounded, they've codified into law the indefinite detention, no right to a trial, repeal of habeus corpus, authorization of torture of AMERICAN citizens, want unfettered access to ALL of your personal information without warrant.
Who's the threat to our country ?
Ben Franklin said it best: "Those who would give up essential liberty for a small measure of security, deserve neither.
Bush is a narcissistic, immature, spoiled frat boy, delusional dunce who along with the other Republican Fascists have so severely damaged our country it may take decades to repair.
And you're worried about a handful of muslims ?
Posts: 1632 | From Northern Wisconsin | Registered: Jan 2005
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Greatcod
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The thread is about Medical Ethics, and part referred to the many German doctors who went with the Nazi flow, as most did. Bush is a recovering alcoholic who embraced a grandiose religous scheme rather than do the hard work of introspective growth. I've known hundreds of alcoholics like that like that. He is an angry dangerous man, and has taken us down a very dark path. American psychiatry knows that, they are not stupid, they simply have chosen to do and say nothing. Like the German doctors did nothing when their meglomaniac came to power. As it relates to Lyme, corporate medicine is quite content to leave us sick and untreated, and with a few significant exceptions, to mock us as psychosomatic. Silence speaks loudly.
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I must strongly dissent with the lines of reasoning cited above. This posting is not about American policitical figures. That is another topic entirely and to bring up such a subject, dare I say obsession, is to totally derail the seriousness of the question at hand. I have noticed that Lyme patients tend to go off on tangents all and time and in their confusion undermine valid arguments and real aspects of their appalling condition in favor or some other object that has nothing to do with that situation. Lyme people seem to have a positive genius for shooting themselves in the foot.
As for saying that any evil is as evil as the Nazi evil and that by bringing that subject into the subject of medical ethics in the area of borreliosis, its diagnosis and treatment is a serious error because of the exaggeration involved would, I agree, be a potential problem, if it were one of such gross exaggeration. But that is precisely the point. It is not.
Tens of thousands of American citizens are going to be disabled and many die horroble deaths because of the ignorance, arrogance and medical prostitution of a small group of doctors who should and possibly do know better. Cheers. Thomas Parkman
-------------------- Thomas Parkman Posts: 341 | From Columbia SC 29206 | Registered: Feb 2003
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quote:How about the silence of American Medicine and Psychiatry in the face of a President who is deeply troubled and conflicted. A dangerous man who inflicts his pain on the world.
They don't loose a second in telling us that we are head cases (without examination), but lay nary a hand on him. How many books or articles by "professionals" have you seen about the topic? I read "Bush on the Couch" by a psychiarist, and have not come across any others.
That statement alone speaks volumes about your misperception of President Bush doesn't it?
It may be that no reputable professional would draw the same conclusions as you.
Medical ethics does not equate to your misguided politic. Your post is irresponsible and not even close to being on topic.
Posts: 681 | From California | Registered: Oct 2005
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I took away two very profound statements from the article you posted:
quote:Clearly, protection of the integrity of medical ethics is important for all of society. If medicine becomes, as Nazi medicine did, the handmaiden of economics, politics, or any force other than one that promotes the good of the patient, it loses its soul and becomes an instrument that justifies oppression and the violation of human rights.
This lesson becomes even more important as medicine becomes increasingly bureaucratized, institutionalized, and dependent on government and politics for its support. Medical power is too great to be left unregulated, but it is also too great to be enslaved by government, however benign the government's intentions might be.
Thank you for the post. I have become more enlightened by it.
Posts: 681 | From California | Registered: Oct 2005
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hopeful123
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thanks for the posting, thomas and thanks for getting us back to the subject of medical ethics.
how DO these doctors live with themselves? I am sorry i missed the protest at the Westchester Medical Center. i live near enough to have gone.
best, hopeful123
-------------------- some days you're the bug, some days you're the windshield Posts: 1160 | From NY | Registered: Oct 2002
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posted
Exactly-a corporate bottom line mentality rules medicine, including academic medical research. And we pay the price in the diminished quality of our lives. I'll add that German Psychiatrists were among the more eager medical supporters of Big Al. Carl Jung, I think it was, actually held a high position in Nazi government. Bush is taking us in the direction of Nazi Light,where policy is ruled by the demands of the corporations. God told him to do that.
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Perhaps your hatred for our president could be better served doing research to improve your neurolyme.
Posts: 52 | From California | Registered: Aug 2005
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Boomerang
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Greatcod, learn from those wiser than you.......
Perhaps someday you will understand.
Posts: 1366 | From Southeast | Registered: Sep 2005
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posted
hi just a few thoughts after reading the article --which is intent in describing where we are headed
--- the world of medicine is essentialy a "box" that is dictated by "proven "science". Unfortunately-- scientific results from clinical trials and the likes --can be easily massaged or distorted for a nominal cost to companies and or organizations.
As many other citizens, throughout the earth -lyme victims are suffering the some of the consequences-
what has happened to science should not happen to each of us- the bitter self can disort the truth and reak chaos.
As the number of lyme victims increases - a greater voice will be heard. The turning point--- " Spoken words that are factual - and fit in the the scientific box"
I have to hope for that day !!
mags
Posts: 259 | From California | Registered: Mar 2006
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Perhaps your hatred for our president could be better served doing research to improve your neurolyme.
His views are not from neurolyme and many serious scholars have similar views. None of this pertains to the thread.
Posts: 731 | From Humble,TX | Registered: Feb 2005
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quote:Originally posted by Thomas Parkman: Tens of thousands of American citizens are going to be disabled and many die horroble deaths because of the ignorance, arrogance and medical prostitution of a small group of doctors who should and possibly do know better. Cheers. Thomas Parkman
It's a good point Thomas. IMO they definitely know better. The question becomes whats the motivation behind such propaganda?
Possibilities suggested are money...which if the case would be a crime very easily compared to nazi criminals. To let us suffer so corporations can save a buck is unconscionable.
While money is usually a good place to look to find motivations on this issue imo there are other factors that must be looked into.
Mainly the fact that we are currently in a MRSA epidemic which will (not if) become a VRSA epidemic if we continue abx usage. To attempt to cure one epidemic we spur the growth of another.
While I do believe or gov is guilty of some very serious issues to the point of undermining our democratic foundations...on this issue i'm withholding blame until the picture becomes clearer.
Posts: 731 | From Humble,TX | Registered: Feb 2005
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While money is usually a good place to look to find motivations on this issue imo there are other factors that must be looked into.
Mainly the fact that we are currently in a MRSA epidemic which will (not if) become a VRSA epidemic if we continue abx usage. To attempt to cure one epidemic we spur the growth of another.
While I do believe or gov is guilty of some very serious issues to the point of undermining our democratic foundations...on this issue i'm withholding blame until the picture becomes clearer. [/QB][/QUOTE]
I think it has to do with both money and the fear of the development of more superbugs. But, ask yourself this..
If those wealthy politicians contracted a disease such as lyme, do you think they would waste a second contemplating the risk factors of antibiotic usage, or do you think they would jump at the treatment that would best suit their needs?
I think we all know the answer to that, so why should they be able to get the treatments they need, yet deny us that same right? The wealthy are looking out for the wealthy, just as it's stated.. "survival of the fittest (or wealthiest)".. that's what's important to them, after all, they are the power that controls all of that which is beneath them, so they are "the important ones"..
Screw the rest of us, we are worthless to the all-powerful. We only exist to contribute to "their" needs, beyond that, we are a waste of space.
gabby
Posts: 31 | From US | Registered: Nov 2006
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quote:Originally posted by gabby: Screw the rest of us, we are worthless to the all-powerful. We only exist to contribute to "their" needs, beyond that, we are a waste of space.
gabby
All too correct. regardless the situation will be what it will be. Those in power or those who can pay for it themselves will get enough abx treatment for lyme. Soon Bb will be resistant to even these lucky few.
Secretly I think these top people have their own well informed network of doctors who can cure this and other diseases. The whey (colustrum?) and silver tetraoxide stories come to mind.
The real sin comes with the total neglect and even prosecution of all potential "cures" simply because their masters are unable to profit off it/us. As an aside I like some of the changes I've seen and am somewhat encouraged...only time will tell.
----------------------------------------------------- Does the government fear us? Or do we fear the government? When the people fear the government, tyranny has found victory. The federal government is our servant, not our master!
Thomas Jefferson
[ 05. January 2007, 01:50 PM: Message edited by: brentb ]
Posts: 731 | From Humble,TX | Registered: Feb 2005
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