Austrian and Czech neuroscience becomes “coordinated” under National Socialism

The Austrian neuroscience consolidation came swiftly and terribly on “non-Aryans.” Austrian anti-Semitism was arguably even more virulent than in Germany. And laws had already escalated in Nazi Germany to the point that Jewish physicians at most could only treat other Jews as derogatorily called “sick treaters”; these laws were instantly applicable in “annexed” Austria, with no stepwise progressive disfranchisement. Even “Aryan” neurologists who were thought to be unsympathetic to the Nazi movement were dismissed shortly after the “annexation.” The Vienna university neurology clinic was taken over primarily by SS neurologists who had been “illegal” Nazis before the annexation and were extremely dedicated to the Nazi cause. At least one, Walther Birkmayer, spoke of expanding the sterilization law to other hereditary conditions not stipulated already by the law. At least nine racial or political neuroscientist replacements, including directors of institutes, led to racial hygiene consequences, including execution of sterilization and euthanasia programs.

Neuroscience becomes “Aryanized” at the Kaiser Wilhelm Institutes in Germany

The Kaiser Wilhelm Institutes (KWI) in Germany were supposed to be bastions of internationally renowned science, but were just as easily “coordinated” under National Socialism in Germany as the universities and public hospitals and clinics. The KWIs for brain research in Berlin and Munich, even partially founded by a Jew in the case of the latter, became primary sites for research related to the Nazi “euthanasia” programs. The transition from physiologic to pathologic research at each institute, facilitated by replacement of dissident neuroscientists with more loyal and ethically pliable neuroscientists, such as Spatz and Scholz, helped to set the stage for euthanasia research. Illustrated in this chapter is the fact that at least seven replacements of non-Aryans or dissidents at various levels significantly facilitated the coordination of the KWIs. One of these, Marthe Vogt, was not actually a dismissal, but a voluntary emigration from Germany in rejection of the Nazis.

Setting the stage for mass murder and human experimentation

With Hitler’s 1933 power seizure, the fate of roughly 9000 political and racial “enemy” neuroscientists was sealed. In the “Gleichschaltung,” or coordination of German neuroscience, step-wise legal and professional sanctions occurred against “non-Aryan” neuroscientists at every university neurology department in Germany. These were either dismissed within the first months of the Nazi takeover or by the passage of the 1935 Nuremberg Laws. Sometimes the dismissed neuroscientists were forcibly removed by colleagues and sometimes they were arrested and imprisoned for trumped-up charges. Even private neurologists were forbidden from seeing insurance panel patients. Half of all German doctors joined the Nazi party, eager to take the positions vacated by their Jewish and communist comrades. The German neurology and psychiatry societies were merged to facilitate Gleichschaltung and Nazi influence on the specialties. And flourishing research and clinical programs were halted and then replaced by the racial hygiene agenda of the Nazi state.

Introduction

Despite knowledge since the postwar period and the efforts of neurologist Leo Alexander, the neuroscience community has been slow to recognize its involvement in the racial hygiene policies of the Third Reich. Part of this has been denial, but part of it protective of past perpetrators. However, since the popularization of medicine in the Nazi era in the 1980s, the fall of the Berlin Wall making previously unavailable patient data in the 1990s, and some astute articles in the neurology literature, neuroscience in the Nazi era has emerged as a scientific topic. Pioneering works by Shevell and Peiffer highlighted the unethical involvement of even famed German neuroscientists such as Julius Hallervorden. In the 2000s a growing body of literature has begun to show common threads between the exile of persecuted neuroscientists and the rise of increasingly destructive policies toward neurologic patients, and the exploitation of these patients for scientific research.

“Beautiful mental defectives” and “lovely idiots”

Some German and Austrian neuroscientists, instead of condemning the patient murder, actually saw a great opportunity in the euthanasia programs. The opportunity was for scientific research on a scale that would never have been possible without the murder programs. The brain parts of these murdered “beautiful defectives” would be used during and long after the war in scientific publications, largely containing mere pathologic descriptions or regarding hereditary causes of neurologic disease. Brain transfer networks existed based on individual scientific interests of neuropathologists at various German institutes; thus, a symbiotic relationship can be seen in the neuroscientists’ desire for scientific material and research funding, which fueled and further intensified the killers’ desire to eliminate patients. The lack of humanity and ethics by Hallervorden, Ostertag, and others regarding this indirect collaboration in killing is striking, as is their lack of repentence or informing future generations about the unethical provenance of the “material.”

Forced sterilization under the NazisPreventing people with neuropsychiatric disorders from polluting the German gene pool

The first negative eugenic measure passed by the Hitler regime in July 1933 was the forced sterilization law, which primarily targeted neuropsychiatric patients with “feeblemindedness,” schizophrenia, and epilepsy. Also included were Huntington’s chorea, bipolar disorder, and alcoholism, along with other congenital defects. The law was based on a prior Weimar Germany draft that was never enacted. Although Germany was late to enact a sterilization law, it was more rapidly implemented and executed than in other countries. In 12 years of the Nazi regime, 400,000 people were forcibly sterilized. The hypocritical execution of the law, supposedly foolproof because of the use of “hereditary health courts” and appeals courts, resulted in people of lower socioeconomic background being preferentially affected, and also in non-hereditary forms of diseases (e.g., symptomatic epilepsy) being included. Most in German neuroscience also seemed unconcerned with the 0.5% mortality rate of sterilization procedures, resulting in at least 2000 deaths.

Epilogue

In recent decades, there has been a more critical examination of the Nazi past within German and Austrian neuroscience. The Spiegelgrund euthanasia brains and brain parts in Vienna were finally buried by 2012 and victims were commemorated. More anonymous brain burials occurred in Munich and Tübingen in the early 1990s, which likely did not adequately commemorate victims and, furthermore, a recent comprehensive investigation of all brain specimens held by the Max Planck Society is underway. The Hugo Spatz Prize was renamed by the German Neurological Society, but the Heinrich Pette Prize still exists. This society and another have laudably conducted investigations leading to publications about Nazi-era neuroscience, but much work must still be done. Additionally, Hallervorden–Spatz disease has largely been renamed, but other collaborator eponyms remain in use and raise the question of what response the neuroscience community should take toward these, and toward experimental data from Nazi-era investigations.

Just “rabbits”

Neuropsychiatric patients were also subjected to various experiments during the euthanasia programs. The unethical experiments ranged from photography using restraints, to inducing hypoxic or hypercarbic states in epileptics to monitor electroencephalographic changes, to exposing children to hypoxia to induce seizures, to inoculating spinal fluid with monkey fluids to transmit a potential multiple sclerosis-causing viral agent, and tuberculosis experiments. These “expendable” patients were loaned from local mental institutions, and some died during the experiments. Results were published in scientific journals and continued to be cited as legitimate experiments long after the war. The individual scientists did not face any sanctions for the unethical experimental designs. Justifications given were that the patients were demented and couldn’t experience pain, or that the experimenter was in the vacuum chamber with the children. But the experiments violated 1931 Weimar guidelines and the Hippocratic Oath, even if formal ethical restrictions were not standardized at the time.

Hitler wages war on Europe, and on neuropsychiatric patients Neuroscientists introduce “euthanasia,” the ultimate negative eugenic measure

During the war, a more austere method of eliminating “useless eaters” was adopted by the Nazi state: killing patients. The concept of patient murder dated back to Hoche, a neuropsychiatrist, and Binding, a lawyer, and their 1920 book Permission for the Destruction of Life Unworthy of Life. Only in the totalitarian Nazi state, however, could an illegal secret action be authorized leading to the extermination of at least 275,000 neuropsychiatric patients. After about 70,000 patients were killed by gassings in the first phase (Action T4), the program was carried out on a smaller scale. The T4 medical director was a neuroscientist, at least 42.5% of the T4 assessors were neuroscientists, and among the T4 assessors were at least eight neuropsychiatry “Professor Doctors.” Killing methods included starvation, drug overdoses, and killing by painful pneumoencephalograms. It was the Nazi neuroscientists’ “devolution” from small initial ethical transgressions that resulted in patient murder.

“Three generations of imbeciles are enough”

Eugenic principles originated in the nineteenth century, along with the related subject of racial hygiene. Eugenics became popular globally, not just in Germany, and was seen as a solution to society’s problems of poverty, crime, and mental illness. Neuroscientists flocked to eugenics, but long before that they helped popularize scientific racism by espousing ideas about smaller skull sizes in so-called “inferior” races. Even famous neuroscientists of the nineteenth and early twentieth century became staunch eugenicists, including Forel, Möbius, Anton, Lundborg, Lennox, and Foster Kennedy. Thus, it isn’t surprising that leading up to the Nazi era, neuroscientists were some of the biggest proponents of forced sterilization and even euthanasia programs as negative eugenics measures to rid society of unwanted elements, including neurologic and psychiatric patients who were seen as “burdens.” Notably, not all neuroscientists believed in eugenic measures on these patients, with some calling for “exoneration of the feebleminded.”