The European Journal of Public Health Advance Access originally published online on April 27, 2006
The European Journal of Public Health 2006 16(3):229; doi:10.1093/eurpub/ckl038
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Editorials |
Russian medicine and the Nuremberg trials
Vasiliy Vlassov** Russian Branch of the Nordic Cochrane Centre, PO Box 13, Moscow 109451, Russia
Correspondence: Vasily Vlassov, Russian Branch of the Nordic Cochrane Centre, PO Box 13, Moscow 109451, Russia, tel: +7 095 4824210, fax: +7 095 4824312, email: vlassov{at}cochrane.ru
Ten years ago, on the occasion of the 50th anniversary of the Nuremberg trial of Nazi physicians, many international journals devoted special issues to the history of this trial, and to the subsequent rise of biomedical ethics and regulation of human participation in biomedical research. Surprisingly, not one article was published in Russian professional journals. Searching MEDLINE will give you 282 articles on ‘Nuremberg AND trial’ but just one in Russian, describing the experience of Soviet physicians testifying in Nuremberg.1 Why is the medical profession in Russia—the country where people and politicians use to say that the USSR defeated fascism—not interested in the lessons of the Nuremberg trial?
First of all, the documents of the Nuremberg trials were not published in the USSR, despite the fact that full publication was agreed by the Coalition. Only excerpts were published, and Soviet propaganda distributed Stalin's words that the verdict of the Nuremberg trials was not severe enough. Full publication was dangerous to the regime, because some crimes of the communist government were disclosed during the trial, for example the fact that Stalin killed thousands of Polish citizens, mostly officers, at Katyn but that his propaganda accused Germans for this crime. Only after the fall of the Soviet power did the Russians learn the terrible details of this massacre. Staff and students of Tver Medical Academy learned that in the rooms of the basement of their main building thousands of Soviet and Polish people were killed by NKVD/KGB who owned the building these years.
In some Soviet ‘scientific’ texts about the Nuremberg trials, the trial of Nazi doctors was not mentioned at all.2 Because documents of the trial were not published, the Nuremberg Code was not published till 1986.2 As a result of the isolationist policy of the Communist regime Soviet physicians were not informed about the emergence of the World Medical Association and the Helsinki Declaration which was developed from the Nuremberg Code. The regulation of human experimentation in Russia was and still is in a primitive state. Till the present day, journals publish reports describing ethically unacceptable research. In all medical research and teaching institutions medical scientists do research without prospective ethical review. Only in some institutions medical dissertations are reviewed by ethical review boards, but usually retrospectively, before presentation to the Dissertation Council. Ethical review boards, where they are formed, are not independent and have no real voice to approve the study.
Probably, the most important reason to hide the Nuremberg trial and Code from Soviet physicians was to make physicians morally blind in relation to experiments they were appointed to do. We know something about human radiation experiments in the USA and the UK,3 but we know nothing about similar experiments in the USSR. After the Perestroika we learned that Soviet physicians for decades secretly studied the health of people who live in an area in South Ural which was contaminated by radioactive wastes after a nuclear disaster. We learned from witnesses that the Soviet state used prisoners and military personnel for testing of lethal toxins and other weapons.4 We may be quite sure that the Soviet state has experimented with radiation on human subjects. But probably we never will learn the truth.
The unethical practice of medical research is not the only inertia of Soviet time. The medical profession, as well as the rest of society including the media, is still under a lot of pressure. Government documents are kept secret for an indefinite period of time, and even many documents that were declassified in the short period of Perestroika are now secret again. In December 2005, dozens of Chechen children from one school were hospitalized because of an unknown disease. After two weeks the disease was declared ‘mass psychosis’ and information about the outbreak was classified. Chechnya is absent from the national TV and press coverage, because the government declared that ‘war is over’, and all negative news was filtered out. All authoritarian regimes tend to improve not their health care systems, but their public health statistics. When SARS emerged in China the government underreported the number of cases. When in mid-summer of 2005 cases of bird flu were reported from regions along the Transsiberian railway, they were reported as having been transmitted by migrating birds, which do not migrate at this time. Till 2005 the Russian government denied the AIDS epidemic in Russia, only negligible funding for treatment was provided, and even only a small proportion of HIV positive women received antiretroviral therapy before delivery.
Recently, M. McKee called for action in Tajikistan, where a totalitarian leader destroyed the national system of health care.5 Authoritarian regimes continue to be a major danger for world health. They do not want to learn from the past, they try to beautify it.
References
1 Tomilin VV. Participation of Soviet forensic physicians in investigating crimes committed by the fascists (in Russian). Voen Med Zh 1985;6:39–42.
2 Lebedeva NS. Preparation of the Nuremberg trial. Moscow: Nauka: Insitute for World history AS USSR; 1975 (in Russian). Available at: http://vivovoco.nns.ru/vv/books/lebedeva/content.htm. Accessed 16 February 2006.
3 Faden RR, Lederer SE, Moreno JD. US medical researchers, the Nuremberg doctors trial, and the Nuremberg Code. A review of findings of the Advisory Committee on Human Radiation Experiments. JAMA 1996;276:1667–1671.
4 Birshtein VYa. Experiments on human beings—not only in Nazi Germany. In Yudin BG, editor. Bioethics: principles, rules and problems. Moscow: Editorial URSS, 1998:192–210. (in Russian).
5 Rechel B, McKee M. Human rights and health in Turkmenistan. Available at: http://www.lshtm.ac.uk/ecohost/projects/health-turkmen.htm.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||