Theme 5 Bodies and the body politic: life, death and organ transplantation Tissues and treatments: organ transplantation

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Theme 5 Bodies and the body politic life, death
and organ transplantation Tissues and
treatments organ transplantation

• HI269
• Week 18

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Transplantation Medical Miracle?
A verger's dream Saints Cosmas and Damian
performing a miraculous cure by transplantation
of a leg Andrés Sánchez de Oña c. 1484-1510
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"Felix, the eighth pope after S. Gregory, did do
make a noble church at Rome of the saints Cosmo
and Damian, and there was a man which served
devoutly the holy martyrs in that church, who a
canker had consumed all his thigh. And as he
slept, the holy martyrs Cosmo and Damian,
appeared to him their devout servant, bringing
with them an instrument and ointment of whom that
one said to that other Where shall we have flesh
when we have cut away the rotten flesh to fill
the void place? Then that other said to him
There is an Ethiopian that this day is buried in
the churchyard of S. Peter ad Vincula, which is
yet fresh, let us bear this thither, and take we
out of that morian's flesh and fill this place
withal. And so they fetched the thigh of the sick
man and so changed that one for that other. And
when the sick man awoke and felt no pain, he put
forth his hand and felt his leg without hurt, and
then took a candle, and saw well that it was not
his thigh, but that it was anotherSaints
Cosmas and Damian practised medicine and surgery
without payment according to their legend, and
were therefore represented to the lay public as
medical ideals. In this Spanish altarpiece they
are shown in the full finery of academic doctors
as they perform their miraculous operation. The
painter shows only one bone running through the
limb below the knee-joint, whereas empirical
research reveals that there are two, the tibia
and fibula. This not uncommon fallacy may be
derived from the fact that in classical antiquity
the same word (tibia) was used for both the
larger bone in the leg and for the leg as a
whole Wellcome Library Catalogue
http//catalogue.wellcome.ac.uk/recordb1203821,
accessed 32/02/09
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Transplantation Medical Murder?
Heidi Cartwright, Brain in a Bowl
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Transplantation Medical Monstrosity?
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Bodies and Identities Parts and wholes

• Human bodies imbued with social meanings
• Bodies not regarded as either vessels or
  integrated wholes, but as simultaneously both
  partially dualistic, but also partially
  ensouled
• So where does identity and personhood lie in
  this complex entity?

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The German context

• Ideas (and ideals) of the Volk (people) ,
  Volkscörper (body of society/body politic) and
  Volksgemeinschaft (nation as an integrated
  community/ extended family)
• Post WWI, rapid urbanization combined with loss
  of a generation of healthy young men, and
  economic despair ? concerns about racial
  degeneration (not just in Germany)
• Policy responses mirror Progressivist thinking
  elsewhere (eg. USA), but with a greater emphasis
  on state and professional involvement and Social
  Darwinism Rassenhygiene, Sozialhygiene, and
  Volkshygiene.
• Emerging disciplines like anthropology anxious to
  contribute to national drive to identify
  undesirables scientifically
• Good fit with rapid growth of medical
  specialization and search for medical role in
  governance

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The German context

• National Socialism builds on this foundation
  national identity is tied to the physical bodies
  of its citizens, and social/national wellbeing is
  tied to physical vitality and regeneration
• In combination with common EuroAmerican
  preoccupations of the day eugenics, fears of
  race suicide, racism, and rising status of
  science this allows for the scientific
  definition of lebensunwertes Leben, and the
  ideological stance that such lives must be
  subjected to medical and scientific
  categorization, control, limitation, and
  elimination.

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• So how did Germany go from national regeneration
  to the death camps? Hogle argues for three linked
  factors
• Myth of a superior national biological and social
  body
• Redefinition of all other bodies as essentially
  different and lesser as not fully human
• Development of social and technological means
  for converting such lesser material into useful
  substances for the greater national good
• Note the central place taken by medicine and the
  sciences in this progression

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Resistance
Petition of Bishop of Limburg to the Reich
Minister of JusticeConcerning Killing of
Patients at the State Hospital for the Mentally
Ill at Hadamar13 August 1941 About 8
kilometers from Limburg there is an institution
which had formerly served various purposes and
of late had been used as a nursing home this
institution was renovated and furnished as a
place in which euthanasia has been
systematically practiced for months Several
times a week buses arrive in Hadamar with a
considerable number of such victims. School
children of the vicinity know this vehicle and
say" There comes the murder-box again." After
the arrival of the vehicle, the citizens of
Hadamar watch the smoke rise out of the chimney
and are tortured with the ever-present thought,
of the miserable victims, especially when
repulsive odors annoy them, depending on the
direction of the wind. The effect of the
principles at work here are Children call each
other names and say," You're crazy you'll be
sent to the baking oven in Hadamar." Those who do
not want to marry, or find no opportunity, say,"
Marry, never! Bring children into the world so
they can be put into the bottling machine!" You
hear old folks say, "Don't send me to a state
hospital! After the feeble-minded have been
finished off, the next useless eaters whose turn
will come are the old people." All God-fearing
men consider this destruction of helpless beings
as crass injustice. The official notice that
N. N. had died of a contagious disease and that
for that reason his body has to be burned, no
longer finds credence, and such official notices
which are no longer believed have further
undermined the ethical value of the concept of
authority.
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Nazi Medicine on trial Nuremberg

• Half of the German medical profession joined the
  Nazi party from 1933-45 only those who faced
  discrimination under Nazi policies actively
  protested them.
• The Nuremberg trials detailed the nature of Nazi
  medical experimentation on death camp inmates,
  presented evidence of those experiments, and
  crucially, judged not only individuals but the
  profession and science of medicine in the Nazi
  era.
• A. High Altitude ExperimentsB. Freezing
  ExperimentsC. Malaria ExperimentsD. Mustard Gas
  ExperimentsE. Ravensbrueck Experiments on
  Sulfanilamide Other Drugs
  
  F. Ravensbrueck Experiments on Bone,
  Muscle, and Nerve Regeneration and Bone
  TransplantationG. Sea-Water ExperimentsH.
  Epidemic JaundiceI. Sterilization ExperimentsJ.
  Typhus (Fleckfieber) and Related ExperimentsK.
  Poison ExperimentsL. Incendiary Bomb
  ExperimentsM. Jewish Skeleton Collection
• Conclusion of the Prosecutions Opening
  Statement I have now completed the sketch of
  some of the foul crimes which these defendants
  committed in the name of research. The horrible
  record of their degradation needs no underlining.
  But German medical science was in past years
  honored throughout the world, and many of the
  most illustrious names in medical research are
  German. How did these things come to pass? I will
  outline briefly the historical evidence which we
  will offer and which, I believe, will show that
  these crimes were the logical and inevitable
  outcome of the prostitution of German medicine
  under the Nazis.

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Post-War medical reform and regulation

• Nuremberg trials and establishment of the
  Nuremberg code (next slide)
• Personhood laws incorporated directly into the
  Basic Law of 1949, formalizing ideas of human
  dignity and protecting bodily integrity of the
  living and the dead and heavily regulating the
  removal of tissue from either
• The worth of persons is inviolable
• Everyone has the right to life and bodily
  integrity
• Virtually no medical involvement in promoting
  organ or tissue donation, or in debates with
  opponents of organ/tissue donation and
  experimentation.
• SO after privileging the interests of the Volk
  and Volkskörper over those of individuals under
  national Socialism, Germany now privileges
  individual rights most highly.

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THE NUREMBERG CODE from Trials of War Criminals
before the Nuremberg Military Tribunals under
Control Council Law No. 10. Nuremberg, October
1946April 1949. Washington, D.C. U.S. G.P.O,
19491953. Permissible Medical Experiments The
great weight of the evidence before us is to the
effect that certain types of medical experiments
on human beings conform to the ethics of the
medical profession generally. All agree,
however, that certain basic principles must be
observed in order to satisfy moral, ethical and
legal concepts 1. The voluntary consent of the
human subject is absolutely essential. 2. The
experiment should be such as to yield fruitful
results for the good of society, unprocurable by
other methods or means of study.... 3. The
experiment should be so designed and based on
reliable data animal experiments that the
anticipated results will justify the performance
of the experiment. 4. The experiment should be
so conducted as to avoid all unnecessary physical
and mental suffering and injury. 5. No
experiment should be conducted where there is an
a priori reason to believe that death or
disabling injury will occur... 6. The degree of
risk to be taken should never exceed that
determined by the humanitarian importance of the
problem to be solved by the experiment. 7.
Proper preparations should be made and adequate
facilities provided to protect the experimental
subject against even remote possibilities of
injury, disability, or death. 8. The experiment
should be conducted only by scientifically
qualified persons. .... 9. During the course of
the experiment the human subject should be at
liberty to bring the experiment to an end... 10.
During the course of the experiment the scientist
in charge must be prepared to terminate the
experiment at any stage, if he has probable cause
to believe that a continuation of the
experiment is likely to result in injury,
disability, or death to the experimental subject.
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Compare
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• http//adweek.blogs.com/adfreak/2008/11/dont-let-t
  he-giant-maggot-eat-your-corpse-.html

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Explaining German attitudes towards the body

• Hogle puts forward two theories. either of which
  could explain German views of the sanctity of the
  body
• Reactions to Nazi atrocities and utilitarian
  attitudes towards the bodies of the lebesunwertes
  leben national guilt/shame fear that the
  world is watching and will condemn, etc.
• Blut und Boden Romantic notions of the body as
  emblematic of the nation, of purity, etc. Note
  German attitudes towards other sources of
  impurity eg. bio-engineered food, environmental
  pollution etc.

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Seminar Medicine gone mad Nazis, Nuremburg,
and national identity

• Have German responses to the revelations of
  Nuremberg and the post-war era created a
  distinctive German medicine, or merely
  reinforced differences that were already embedded
  in German culture?
• Why is it shocking that medicine and medical
  professionals participated fully in the
  Holocaust, turning some bodies into commodities?
• And to what extent are suspicions of organ
  transplantation specific to Germany?

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REMINDER Papers are due NEXT WEEK, no later than
4PM Monday, to my Pigeonhole outside the History
Main Office. Remember to include a coversheet,
to double space your paper, and to submit it
online as well as to me in hard copy!