Court. No. 1
Q From the evidence submitted, it can be seen that you were particularly excited at the time; even Kogon, who had only heard of the matter, spoke of a particularly violent discussion here; now why were you so excited as to make such an impression on the witness.
A The subject of this whole discussion was a matter of absolute fundamental principle to me in my profession, of course, this excited me greatly.
Q What did you know about the type of the experimental subjects?
A I know that Gildemeister had told me at our first meeting and what Conti had corroborated, what Ding again fenfirmed, in this public argument of the subject in that these were criminals condemned to death. Then I was also told by these in Buchenwald, who had not fallen sick, that they had been through typhus, to which they attributed their immunity, in ?cahit before they had been condemned.
Q Mr. President, I might say that Moahit was the pre-trial prison in Berlin, a prison known to every person in Berlin. There is a section of Berlin called Moahit and if someone says that he was sent to Moahit, that of course means he was sent to this pretrial prison.
Why did you make this such a principle problem; you as a doctor and as a research man knew that medical experiments not without danger had previously been carried out on criminals condemned to death?
A. You are now asking a question of decisive importance regarding my motives in this whole matter; and General Taylor in his opening statement on page 55 of tho German record demanded, and I quote:
"It is our duty to expose with crystal clarity the ideas and motives that lead the defendants to do what they did," I agree with the Chief of Counsel.
This is one of the most important questions, and consequently I should like to answer this question here in some detail.
I shall state my own opinions and also what I know of my own experience about the motives of other scientists who are today dead and cannot answer for themselves.
You asked why I protested against the experiments on human beings. Of course, I know that such experiments had been carried out but several clear considerations helped to determine my attitude.
First of all the concept of the criminal condemned to death. This, of course, in the last analysis is a purely emotional reaction. For tho jurist and many people who are accustomed to thinking in formal terms this may perhaps be a more simple question. When a man is condemned to death by law, then for them this is an order, and that is the way it must be The jurist concerns himself with the legal phases. He has a heavy responsibility to carry in making decisions. But the matter is settled and the judgment must be carried out. I am not a jurist, and my attitude is somewhat different. I have been around far enough in the world to know hew extraordinarily wavering and relative concepts of law are.
They differ not only from country to country and from people to people, but within the same country they can change dramatrically in a short time. This is true in normal peaceful times and all the more true in politically fomenting times or war times. Often times a man is punished for a crime which ether thousands or persons regard as an act of heroism, and there is something else to be added here, and I said when I answered that those were criminals condemned to death, namely, that it was a fundamental professional question. For me in my profession as a hygienist and researcher into the question of immunity, I have already said here how we normally proceed in order to test a now vaccine. The tolerance is tosted on human beings because that is something that simply cannot be ascertained in the animal experiment. Of course, you can find exceptions. Bieling's affidavit states such an exception, where the protective value of the vaccine is tested by infecting the human being, but those are only exceptions; and so far as I could survey the whole field, those were exceptions which happened exclusively abroad and I, as a hygienist and immunity researcher did not want that this practice to become common in Germany. I foared such would establish a precedent. Of course, I also was perfectly aware of the crucial position in which we found ourselves with regard to typhus vaccines, but I shall clarify this when I discuss the technical side of the experiments, whereas now I am discussing the ethical aspects. I was afraid that if this method were undertaken in the question of typhus vaccines, that very soon there would be a demand to apply it also to other vaccines or other problems.
I am a specialist and know this field well enough, and I know what enormous advantages a research worker would have if we were perfectly at liberty to carry, out human being experiments, but here, as the advantage was evident to my reasoning, nevertheless my emotions revolted against it. I was acting on the principle of 'principe is abstat', and if one does not combat such tendencies in the very beginning they got out of hand. That was the second point. And then thirdly there was a purely practical consideration. From 1921 I worked in experimental medicine in many countries and I know with what prejudices my profession is beset. In wide public circles we are cursed out as torturers of animals, because our field of immunology has to work in animal experiments. Otherwise, we cannot work at all. If then in addition to this prejudice there should be brought also the much more serious charge of human being experiments then that would throw my profession even deeper into the sediment. Then there is a fourth psychological point. Mr. McHaney, in discussing Professor Hippko's attitude toward the breathing experiments,said and I quote:
"If Hippko know that those were criminals concerned to death then everything was in order and he need have no scruples."
I believe that this statement of Mr. McHaney completely misunderstands the psychological factors that play a role in this problem. I have already said that perhaps the jurist's attitude toward this is different. The jurist has the heavy professional responsibility of putting into execution the death verdict, or as prosecutor , he has the responsibility of requesting such a verdict, but once that has happened, the matter is closed so far as he is concerned, and then the matter applies, fiat justitia.
The very ethical researcher who is interested only in scientific knowledge, night also come to the conclusion that once a sentence has been passed, he may fool indifferent as to whether the man is hanged or whether he is killed in a medical experiment, but for a man who is not a research fanatic, very essential considerations of another sort play a role. In Buchenwald I myself saw the serious state of illness of the control persons who had not been vaccinated, and I was under that impression. After Holzloohner passed on the froozing experiments, I happened to speak with Professor Holzlochner, at Nurnberg. From his paper I could not clearly see the connection. Consequently,after his lecture I checked into this matter and saw what an enermous spiritual burden was placed on Professor Holzlochner by having to go through this experience, because even a person condemned to death is a human being. He can suffer pain and now return to Hippko, I know his personality and completely understand his attitude. How I can quite understand that if he found out the details from Hippko's report and from the other reports as to how such experiments took place, that that could have been quite enough for him to withdraw the permission he had previously given, not knowing what was going to go on.
And then there is the fifth point, and you can say about this; This is professional egoism and has nothing to do with ethics, but as a motive it also plays a role. Only the most important of experiments are carried out on human beings.
Many research persons, even after the State has given it's permission for them, will attempt to evade carrying then out, simply because they are not willing to take the spiritual burden upon themselves of doing such experimentation. Thus the danger a rises at the most important part of the research, that it should fall into the hands of the purely research fanatic, and he is not tho happiest representative of our profession. You could say that this is not an ethical consideration but it is a consideration nevertheless, how old this problem of the research fanatic is in research. medicine can be soon from Hell's book which the witness Liobrandt quoted from here, a prosecution witness, and on page 557 it says, and quote:
"If a doctor devotes himself to research he is more or less inclined to regard the patients from this point of view, is all too prune to use a patient who is trusted to him for the solution of a scientific problem and thus it happens that he puts the interest of the sick person in the second place. This conflict between the medical profession and the requirements of science has already been treated in French literature where the doctor sacrificed his patient to the interest of science."
Thus we see that the problem of the research fanatic is by no means a new one because those words I have just quoted were written in 1900.
THE PRESIDENT: At this time the Tribunal will be in recess, Counsel may finish after the recess.
(Tho Court adjourned for tho noon recess)
AFTERNOON SESSION (The hearing reconvened at 1330 hours, 21 April 1947.)
THE MARSHAL: The Tribunal is again in session.
GERHARD ROSE - Resumed DIRECT EXAMINATION (Continued) BY DR. HEINZ FRITZ (Counsel for the defendant Rose):
Q. Professor, before the recess you quoted a passage from the book by Moll. Would you please continue to answer this important question?
A. I spoke above all of the considerations which influenced the doctor in the problem of experimentation and I have mentioned the problem of the research fanatic and the danger which he implies for our profession. In consideration of this entire problem, aside from the doctor performing the experiment, there is a well-known historical example. When the Oriental method of variolation was introduced in Europe, not a vaccination with cowpox, King George the First ordered that the procedure be tested on six criminals who had been condemned to death. The legation Doctor Maitland, who was in charge of carrying out this experiment, refused to perform the operation, not for any ethical considerations for the fate of the experimental subjects, but for the personal consideration that he might be considered an assistant of the hangman if this experiment should be unsuccessful. The refusal was brought about by fear of damage to his own reputation. Maitland did not want to get into touch with the hangman.
I spoke of the research fanatic before but I do not want to be misunderstood. I do not want you to think that I consider every doctor who accepts an assignment for human experiment an unfeeling, cold, research fanatic. That would be unjust. I know too many research workers in various nations personally who conducted experiments on volunteers and on non-volunteers. I, therefore, know quite well what mental conflicts result from such work for such a man and understand what an enormous burden he feels himself when he takes on such a task. The prosecution and the Tribunal as jurors are in the fortunate position of never having been in touch with such a conflict, although their profession too involves serious responsibility.
To them I must explain this whole aspect of the problem of medical experiments on human beings. It would be useless to take examples from this trial. An impartial explanation of the real state of affairs would be very difficult with the persons involved in this trial. I shall take as an example an experiment which must be discussed anyway because it forms the scientific basis and the immediate predecessor of the one for which I am held responsible here. This is the first experiment for the development of vaccination with living bacteria, living plague bacteria. If you later read the corresponding document you will see that these experiments were conducted on criminals, on criminals condemned to death who were not volunteers. You will be able to read how the worker, the scientist, Proceeded, step by step, in this experiment with very small quantities of living bacteria, gradually increased the amount until he had reached the amount necessary for vaccination.
6l85 A (continued) If he then concludes the series of experiments with the conditions as astonishing as it may seem, with these large doses, caused no serious consequences.
And, if the fact that his experimental subjects had fever up to 4O he does not call that a serious reaction. That may seem to laymen a cynical remark but whoever who knows this field of work and whoever knows this scientist personally knows what amount of bitter worry and concern was borne by this man through weeks and months that his theory might be proved false and that the persons might fall ill of plague and die of it. Now this experiment which was conducted forty years ago is justified by its success today. On that is based modern protective vaccine against plague with living avimulent plague bacilia. But, there is another series of experiments conducted by the same man, also on criminals condemned to death. This time the experimental subjects had had to sign an agreement that they submitted to the experiments. These were experiments to determine the cause of beri-beri. For this purpose the disease had to be caused artificially by inadequate nutrition. It was possible to produce the disease and it is described in great detail how through long weeks the symptoms of this serious disease developed - paralysis, painful neuritis, serious heart ailments appeared which finally led to the death of one experimental subject and the person was dissected a half an hour after death. For the person who does not know the disease Beri-Beri it is difficult to imagine the spiritual burden on the doctor who for weeks must observe and nurse these experimental subjects and must record all the details of the symptoms of the disease which he himself has caused by his own measures. This experiment was successful in so far as it was possible to produce a typical disease in a large number of experimental subjects, but the experiment did not have scientific success. The answer as to what factor was the real cause of the disease was not found because the experiment was uneven in its course. Even the consolation of justification by success was lacking in this experiment to the doctors who carried it out, to the Government authorities who approved it, and to the persons who were subjected to it.
What burden this experience is on the doctor a layman cannot understand. The question immediately results, "What is the reason for a person voluntarily assuming this burden or accepting it when it is given by order of the Government authority?" It would be a cheap answer to find the motive or ambition for research fanatism. I know the real reason in this case. I know the man and the conditions under which he worked. The driving force was alone a feeling of duty and responsibility - the the feeling of responsibility to the millions of natives for whose health he was responsible that were doing by hundreds and thousands from this terrible plague and the hundreds and thousands that were suffering terrible pain from this Beri-Beri disease. The knowledge of having to help these people and still with the state of knowledge at the time being powerless. That was the reason to look for new means to take such a burden on himself and expecting other people to submit to such suffering. The experiments which I have been speaking about wore carried out by Professor Richard P. Strong. He was Public Health officer in Manilla at that time, later professor at Harvard University in Boston and Chairman of the Medical Society for Tropical Medicine. I hoped that the prosecution would not attempt to dismiss the work of this highly respected research worker with the words, "There are criminals everywhere". I ask you to believe me that Strong was a man of greatest feeling of duty and responsibility and of the highest ethics and if the Prosecution does not believe that he can consult his expert, Professor Alexander because he is a doctor from Boston and he probably knows Strong even better than I do. But, I ask you to believe me - that in ethics and motives of most German doctors who consented to take over the collaboration in such experiments were not so enormously different from those of their foreign colleagues in the same situation. There are three dead German professors in the dock today - President Gildemeister, Eppinger of Vienna, and Professor Holzloehner of Kiel. Because they are dead they are even more exposed to the defense and criticism before the Tribunal than we who at least have the opportunity to defend ourselves.
For that very reason I feel obligated to speak for these gentlemen today although at the time when they were doing their work I was definitely opposed to them. From two of these men I know from their own mouths that they - that is Gildemeister and Holzloehner - were influenced by feeling as doctors their duty to prevent disease and distress that they did not accept their part lightly and without responsibility. But personally Professor Gildemeister said that to me in our conversation. I do not know however about Professor Eppinger from his own mouth since I never spoke to him but I know As personality enough so that I may include Am in this statement as well.
MR. HARDY: Your Honors, I submit that the defendant is going outside of the scope of this case before the Bar and the examination discontinue along these lines and come back to the issue of this case. I didn't object to him giving the example of Professor strong even though the Tribunal has ruled that such evidence will be taken up at a later date. I think that we have gone far enough along these lines and request the Tribunal to instruct defense counsel to continue As examination on the issues.
THE PRESIDENT: The defendant has taken the stand as a witness in his own defense. He is entitled to testify to any facts which he believes should be placed before the Tribunal for that defense which he has. But, matters of argument should not be introduced by the witness. His counsel may argue the case and draw knowledge from the examination which he thinks would be pertinent and which he thinks would help the Tribunal. But, the testimony of the witness should be limited to facts which in As opinion bear upon As defense.
A May I remark that I believe that here I was giving absolutely factual testimony on behalf of these men because Chief of Counsel in As introduction spoke - expressly demanded that the motives of the defendants be presented here in all clarity. My motives were influenced by my experiences and work abroad. And I wanted to explain here to what extent my considerations, my decisions, in this question were influenced by my own personal approval.
MR. HARDY: Your Honors, the Prosecution true is interested in finding out motives of t he defense. We are more interested in finding out the motives of Professor Rose had in being implicated in these matters but we are not interested in the motives of Gildemeister and Eppinger and others. We are only interested in the motives of the 23 defendants in the doct at this time.
THE PRESIDENT: The Tribunal permitted the witness to proceed so far but as to matters of extraneous argument by analogy to what other doctors he has known have done is not particularly pertinent to this case and counsel may argue in brief any matters which are deemed pertinent as legal argument but the witness should limit himself more to facts with his own defense.
A May I add just one sentence perhaps that, of course, I did not intend in my statements to include Dr. Rascher and Ding. If he didn't say that I am in the diary - that seems the statements were interrupted, they might be distributed to that effect. Then formulated list of various reasons which occasioned me to protest experiments even on criminals condemned to death. I would not want this enormous charge to be layed on our profession. In addition to all that we have to bear without it. As hygienists we spend our lives among human misery and among experimentation. We are sent to places from where other people flee. It is a matter of course for us to risk our own lives from being exposed.
I don't know how many doctors and assistants in the more than fifty years of the Robert Koch Institute have died there from infections acquired in the laboratory. Certainly more than twenty. There is no memorial tablet in their honor. Such a sacrifice is given silently. It is simply among the ethics of our profession and therefore one will probably understand my desire to preserve at least my honor.
Now, to conclude this whole consideration of the ethical aspect a few words about the volunteering of the experimental subjects, and in an experiment dangerous to life what this means to the doctor performing the experiment. I am by no means so one-sided researcher that I would not realize that the question plays a very important role from the legal point of view, but from the medical point of view I may emphasize that there is a very definite group of experiments which includes, for example, the typhus experiments in Buchenwald, the yellow fever experiments in Cube, the sub-cooling experiments of Holzloehner in which the doctor in general, including myself, must consider it immoral to take volunteers. The spiritual burden on the doctor conducting the experiment is, in such a case, intolerable, He does not have the right to accept an offer of suicide. Such experiments, in my opinion, are admissible only if the person who holds the state authority determines the persons from among the group of persons who have forf????? their lives through committing deeds against society. That I, for my person, reject this method altogether I already stated publicly years ago. The prosecution has already admitted this as a fact. I am not saying this for the first time here in the court room. In the interests of my profession as a research worker and for the medical profession I desire for all future that human society and those who hold state sovereignty shall not impose this bitter duty on us.
I know that that is merely my personal opinion, and history teaches that at all times and in many states the decision was different and that there have always been morally high doctors who believed they were fulfilling their duty by carrying out such experiments. On various opportunities when I dealt with problem I presented these considerations which I have presented here during half an hour are, in effect, contained in the one sentence with which I involuntarily reacted when Gildemeister, for the first time, told me, and I therefore repeat this sentence. "If this method becomes the fashion, then we turn over all immunology to the hangman and open a special execution department here in the Institute." This feeling was the decisive one in this problem. In my statements I emphasized the spiritual burden on the doctor who mast conduct this experiment. I have spoken very little of the victim of the experiment, for the simple reason that the whole problem lies with the doctor and arises from the suffering of the victim to whom the sector conducting the experiment is nearest, and this sympathy with the victim of the experiment is such a matter of course for a accent doctor that would not even mention it if I did not see the danger that, because of the failure to mention this point of view, one might later distort my statements.
Q. Is tne view of the problem of dangerous experiments on human beings which you have just propounded the general opinion of all doctors?
A. Certainly not. Otherwise experiments on human beings would not be as common as they actually are.
It would not be approved by the state.
Q. You quoted from Moll's book about medical ethics. does this work actually have the fundamental importance for the medical profession which the witness Leibbrandt ascribed to it?
A. That is certainly not the case. Doctors, if they are Germans who think about medical ethics certainly know the book, but among other doctors there may be perhaps two among a hundred who know it.
Q. And now do you feel about the contents of this book?
A. It is undeniable that the author tries to demonstrate a very high ideal of the medical profession but the book also snows very clearly that he is aware that in practical life things are very often different from what he demands as an ideal. Besides, the cook was published forty-five years ago and, of course, is obsolete on many points today.
Q. How do you feel about the point of view expressed in the book about experiments on human beings and on animals?
A. Fundamentally, Moll writes what is a matter of course for everyone, out in this field it is very definitely shown that the book is influenced by its time. Moll considers immunization against typhus and against plague as experiments on human being - as an unadmissible experiment. Ten years after the publication of the book these methods were generally used, He also expresses objections to vaccinations against diphtheria and against tetanus. Today, failure to carry out these measures can; under certain circumstances, be legally prosecuted. But the central purpose of this trial Moll does not deal with at all.
The question of whether the state has the right to force individuals to submit to medical experiments and to order doctors to conduct such experiments. One might bring one sentence from this boom into this connection. On page 500, Moll says that the research scientist has no right for executive such as the government claims. At this time he rejects experiments by a doctor on his own initiative, but he obviously permits experiments with state approval. In his long statements, Moll repeatedly objects to experiments on patients, particularly experiments on hopelessly ill patients which, in the past century, was so common, so wipe-spread that there was a special technical expression for it. It w s c lied "the experiment on the corpus vile". Even today this experiment has not disappeared completely from literature. From the document which Dr. Servatius submitted here we have seen that the Military Government itself apparently still considers this experiment permissible. At only one point does Moll approve of a government approved experiment. That is the well-known leper experiment by the American Dr. Arning on a murderer condemned to death, and Moll admits that others could have a different opinion. Whether it is worthy of a doctor to perform such an experiment - here the point of view of medical ethics of a doctor is repeatedly the prevailing one, not that of the victim, and of the voluntariness. Moll comes to the conclusion that voluntariness under such conditions could not be ethically recognized. That is on page 538 of the book which Leibbrandt quoted. Also Moll objects to the validity of such declarations of voluntariness which are often included in publications of medical work.
He proves that they are quite generally untrue. First of all, because of the incapacity of the experimental subjects for coming to any judgment because of the Influence exerted by the authority of the doctor and fear of consequences of refusal. But the decisive point is that Moll is speaking only of experiments on patients and not on experimental subjects determined by the government. to that extent the quotation of Mr. Leibbrandt was not applicable to this trial.
Actually Moll knew about state experiments. The smallpox vaccines on criminals, orphans, soldiers, were known, Moll deals with the transfer of venereal disease to patients, and knew the experiments conducted by order of the French Government. He must have known of Huffgen's experiments with plague vaccine carried out in prison in Bombay. That all happened before the publication of his book. If he does not comment on this problem at all I can only conclude that he approved State approved experiments. He emphasized repeatedly that the War does not have the right of execution, that is up to the state.
Q What do you know about the opinions of the doctors who consider state approved experiments on human beings admissible?
A I have already said in my protest against Ding's lecture I Id not find any uniform approval agreement. If you will look at the record of this meeting you will find a sentence there which escaped the attention of the Prosecutor, but which clearly shows, for a participant in the meeting, that he was opposed to these experiments, and it proves that there was discussion about it. On page 111 there is a sentence, "Such experiments are necessary." This sentence refers to the discussion and this statement is proof that the listeners, the auditors, believed since Ding had issued them this that the experimental subjects were criminals condemned to death. Otherwise, there would not have been anyone in public meeting who would have expressly approved such experiments. Certainly not the person responsible for this sentence, whose life achievement in the service of humanity and his international reputation could protect him from openly participating in any action not in the interest of humanity. Besides I have answered this question already in my fundamental statement.
DR. FRITZ: Mr. President, this remark was made by Professor Uhlenhuth. This is in Rose Document 38, in Volume III. I have already submitted this document as Rose Exhibit 10. They are the copies of the report of the third meeting on page Mi of the Document book, last paragraph, page 111 of the original. Professor Uhlenhuth is speaking of the typhus experiments.
On page 45, first paragraph, the second line from the end there is the sentence which the defendant Rose has emphasized, "Such experiments are necessary." This sentence shows that admissibility was discussed at the meeting on the basis of Professor Rose*s protest. All these statements about admissibility were stricken out of the statement of Schreiber, but this statement of Professor Uhlenhuth was forgotten.
Q What do you know about the reasons for this protest being ignored, and the typhus experiments being carried out in spite of it?
A They are in part contained in the explanation which Conti gave, but the result is the experiment from the situation prevailing at the time. In the winter of 1941-1942 we were at the beginning of an enormous typhus epidemic. It was clearly to be seen that it would be serious. What typhus means during wartime or how many human victims it means, every doctor knows, not only hugienists, and every layman knows that who looks at Cincer's book, the American typhus works, "Men, Lice and History." That is typhus experiments during the last war In view of the new type of warfare it was not interrupted in the winter, where obvious at that time the use of vaccines therefore was of importance. Recognizing value, there was only one vaccine, the Weigl vaccine from lice intestines, and with this experiment in Buchenwald proved that our judgment which seemed based on the experience of 10 to 15 years was mistaken. We all believed that this vaccine protected against infection. In Buchenwald we saw that this was not true. But one thing was certain, in the case of this lice vaccine that it would be impossible ever to produce it in an adequate amount. In the Weigl procedure every louse must receive an injection separately in the rectum. The intestine of each louse must be separated separately. For one dose of vaccine you must get from 50 to 1185 louse intestines. One louse needs several meals of blood daily. The louse can be fed only on human beings. There is no other means of feeding lice in the laboratory. Even an infected louse can only feed on human beings. We therefore need in the laboratory hundreds of people who do nothing except let themselves be bit by lice.
That makes it clear even to laymen what difficulties there are in this procedure. Naturally, there are other difficulties. If one breeds millions of lice then there are epidemics among the lice. Then suddenly the millions of lice are dead. But I don't want to go into details. In reality it is even more difficult than I have described. But now at the very beginning of the war we have new procedures that have been developed among vaccine specialists, and were developing our opinion about the value of these procedures, different meanings like black and white, but in the concentration of those vaccines there was no clarity at all. The responsible men of the health service, like Conti, for example, were making a difficult digest, effecting the life of thousands and tens of thousands of human beings, and the decision had to be made instantly. Typhus would not wait. The epidemic was there and was calling for victims, hundreds every day. The opinions of the specialists did not give any help to the definite authorities. The specialists disputed each other and did not know what was right, but one thing was certain if a false decision was reached, if a wrong decision was reached this mistake meant the death of thousands or tens of thousands of human beings. It was said here once on the witness stand that experiments on human beings to determine the value of typhus vaccine was not necessary, because an enormous epidemic would have offered the best opportunity to test the vaccines in practice without any experiment. Such a statement can be made only by a person who has no idea whatever about what testing of vaccine and epidemiological evaluating of vaccines means. First of all, what is testing? In practice it means nothing but that large groups of people are vaccinated with various vaccines, and then another group is left without vaccination, and then one waits to see how many people fall ill, and how many die in the various groups. That is the normal procedure in normal times. It cannot be done without death. On the contrary one need merely look at the statistics on such epidemiological evaluations in order to know what numbers of deaths there are. If after some period of time, after several years perhaps, the statistics are set up, then I can determine Vaccine-A was excellent.