Introduction: How did it go so wrong?

Nazi doctors, nurses, scientists, and public health officials voluntarily and enthusiastically conducted inhumane and unethical human subjects research. They were empowered by eugenics, which was an acclaimed worldwide movement long before Hitler co-opted it for his own purposes. German eugenicists emulated American policies such as the world’s first involuntary sterilization laws, defended their anti-miscegenation policies by citing US treatment of its black citizens, and received philanthropic and moral support from American eugenicists. At the Nuremberg Doctors’ Trial, which produced the landmark Nuremberg Code, defendants cited unethical American experiments. Germany was the most medically advanced nation at the time, and many nations sent their research trainees to study in Germany. American medical schools emulated Germany’s system of medical education. Nonetheless, much of the world has accepted myths that the German researchers were mad, incompetent, isolated, or sadistic ideologues who could not ethically justify their actions. Since acceptance of these myths has greatly diminished serious consideration of the implications of Nazi experiments on human subjects research after the Holocaust, an effort is made to dispel them. This chapter also provides the historical background for the essays by our distinguished authors and challenges the reader to study and reflect upon how medical ethics failed during the Third Reich.