gms | German Medical Science

Frank Schneider (ed)

Psychiatry under National Socialism – Remembrance and Responsibility

Springer Verlag, Heidelberg

year of publication: 2011, 77 pages (including DVD),

German/English € 9,95

On 26^th November 2010 around 3000 psychiatrists rose up for a minute's silence in the great hall of the International Congress Centrum in Berlin. What they had heard before, was deeply impressive and memorable to the audience. Professor Frank Schneider, president of the German Society for Psychiatry, Psychotherapy and Neurology (DGPPN) asked the psychiatric victims and their relatives of the Nazi era for forgiveness to an extent as only a few German Doctors done before. He spoke of shame, of nearly 70 years of speechlessness and of the request for forgiveness, which come far too late. Unfortunately, there was every reason for these formulations. The described ethical failures and crimes of psychiatrists during the "Third Reich" were basically known to the majority and were frightening enough. But it was followed by a detailed description of the "second crime" of the postwar years, until to the second half of the 20th Century. After years of psychiatric prescribed and performed forced sterilizations, the murderous "Euthanasia" killing actions on children, adults and old people, illegal eugenic racial hygiene research on mentally ill patients and the forced emigration, or killing of Jewish psychiatrists, this dark chapter of psychiatric history was not finished after the end of the war. The following decades were marked by personal continuities (including honorary memberships of the DGPPN for 2 referees to the "euthanasia" campaign), the denial of complicity and lack of recognition of guilt. To date, the victims are not explicitly accepted as official victims of national socialistic prosecution by the Federal Republic of Germany, which leads to lack of compensation. In this decision psychiatrists are also implicated. The institutional and personal guilt and involvement of psychiatrists and their professional association (including the then President) was admitted in detail by Professor Schneider and frightening examples were shown. Thus, the address ended logically in a comprehensive admission of guilt and a formal apology to all victims of crime and their families.

In a second part of the event it was tried to provide a forum to the victims, but because of the long distance to the historical events it was only possible by the report of relatives. So, a son of a psychiatrist who emigrated to Israel from Dessau reported how his father built up a neuropsychiatric clinic in the new country under toughest conditions and later treated the severely depressed Lebanese Prime Minister with electroconvulsive therapy with such a success that he was able to sign the Lebanese declaration of war to the German Reich in the beginning of 1945.

The most impressive contribution came from a niece of a forcibly sterilized and eventually murdered psychiatric patient. She reported from a personal, naturally high emotionally point of view about her family-related traces and about the short life of her aunt (murder at age 24) and linked this with thought-provoking appeals to the attending physician. It became clear that the decades of silence, denial and looking away in the society and in professional circles was also common practice of memory in the families of the victims.

For those who attended this event had a unique and collective opportunity to deal with the power and abuse potential of this medical specialty. For absent interested people the Springer-Verlag (Heidelberg) published a 70-page booklet in which all the speeches and some impressive pictures are recorded. Attached is a DVD by which the whole event can be tracked in German and English language and which contains additional readings of historical letters from doctors, patients and relatives.

However, this is not a simple document of memory at a memorial event. Independently of this event the affordable and easy to read book offers a comprehensive introduction to this piece of history, which is important for all physicians working on the psychiatric field. If you works as a doctor with mentally ill patients you often feel the power that you possesses. Who wants to deal responsibly with this power, benefits of becoming repeated aware of all facets of their possible misuse, and that includes also the historical facet. Therefore this book is more than suitable.

Of particular note is, that this work offers both, an emotional and a scientific approach to the subject. The introduction contains expressions like bewilderment and that there are no words to express the facts. On the other hand, the book reported about the the first research results of the scientific committee of the professional society, which currently investigate this dark chapter of German history of psychiatry. Especially as doctors we can not afford, only to be stunned by these atrocities, but must also face to the tradition of scientific research. Even if the results are unpleasant. The numerous current references in the speech manuscript of Prof. Schneider offer a good opportunity to review the issues if there is further interest. A high degree of emotionality and science must not contradict each other and appear to be an adequate access to this topic especially for later born generations.

The speeches are surprisingly topical. Whether it's the fact that the slow processing of the history is described, which continues still, whether through new bioethical questions that demand a historical awareness and today again require a personal stance on ethical issues in professional life.

A forcibly sterilized former psychiatric patient gives readers on page 61 on their way:

So this book finds a good place right next to the commonly used reference books as admonition to focus in daily work always on the dignity of the individual patient more than on social values. Precisely, the unobstructed view of the people to be treated seems to be a protective factor for the abuse of power. So, especially among those physicians in private practice there where individuals who are not display one possible hereditary disease at the relevant offices, which would be resulting in forced sterilization. One reason for that may be that there, outside of the clinics, the contact with the patient was more direct and immediate.

The above-described moment of silence is also captured at the end of the book in a double-sided photography and seems necessary to the reader at this point after the harrowing, wise and mature-making lines on the sides before.

The author declares that he has no competing interests.