Bioethics @ TIU

The U.S.’s Hubertus Strughold Award

Posted December 2nd, 2012 by Cody Chambers

The Wall Street Journal recently reported on the controversy surrounding the Hubertus Strughold Award given by the American Space Medicine Association.  Strughold was head of the Luftwaffe’s prominent Aeromedical Research Institute during World War II and likely oversaw experimentation on prisoners at Dachau.  This probably included the notorious hypothermia or “cold experiments,” which may have laid the foundation for his work in space medicine for the U.S. government.  Strughold was one of many scientists who were part of the “intellectual reparations” paid to the U.S. following the war, a program known as Operation Paperclip (for information on Paperclip, link here for the Jewish Virtual Library article).  Strughold would go on to become the “Father of Space Medicine” and have an award named in his honor in 1963.

Among the reports filed by the Nuremberg Trials, there is both a numbering of Strughold among those involved in experimentation at Dachau and a record of his denial of involvement on “grounds of medical ethics.”  So, there is still some debate on his legacy as a medical researcher.  However, the story of Hubertus Strughold, with its origin in Germany and its meanderings in the United States, may offer us useful lessons in ethics.  This case may bring to light something that could be the Achilles heel of American culture and, in turn, American medicine.  There often seems to be a tendency among us to partition our lives in such a way as to avoid culpability.  Strughold never had any political involvement in the U.S. during his lifetime and was probably viewed simply as an “intellectual asset,” a source of data much like a laptop.  It’s the data were after in the long run, so as long as there is a consent form on file with a signature at the bottom, we move ahead.  Of course, that’s not the case at all.  Ethics involves human beings; and not only the human being that is the patient but the human being that is the researcher or the physician.

The Space Medicine Association has no page for the Hubertus Strughold Award on its website, but it does have a page with an interesting quote by Wernher von Braun: “Man is not made for space.  But with the help of biologists and medical doctors, he can be prepared and accommodated.”

 

 

 

13 Responses

  1. planeDoc says:

    Dr Strughold was the director of the Reich Ministry of Aviation’s Research Institute for Aeronautical Medicine (Luftfahrtmedizinisches Forschungsinstitut des Reichsluftfahrtministeriums) which was a military institution.

    The epileptic children used in the altitude chamber at Dr Strughold’s institute came from Goerden, from the psychiatric hospital. The researchers Ruhenstroth-Bauer and Nachtsheim were both civilians and thus had to ask the director before using the chamber and they had to inform him about their research program. Ruhenstroth-Bauer and Nachtsheim had contacted Strughold for assistance in conducting the low-pressure experiments and Dr Strughold allowed them to use one of the vacuum chambers in his institute. Does anyone on this blog believe that some civilians would simply use the wartime military facility without prior permission? One can imagine many preparations that would be necessary to coordinate the inter-facility collaboration.

    The military institute would have provided the specially trained military personnel needed to operate the mechanical systems to change the air pressure in the chamber to simulate high altitude conditions, such as less dense oxygen for the children to breath. The researchers had previously experimented on rabbits and had experience with various age ranges of rabbits who experienced convulsions in the altitude experiments.

    The children did not experience seizures, thus the experiment was considered a failure by the researchers. They wished for younger children to match the most susceptible age group of rabbits but such children were not at the psychiatric hospital.

    At this point it might be interesting to reflect what the children might have been thinking about their experience. While some might say that hypoxia is euphoric, the circumstances under which they were housed, brought to the military institute and placed in the chamber, and returned to the hospital would not have been ‘fun’. They exposure would have had absolutely no therapeutic value for children with seizure disorders and the endpoint of the experiment was to induce a seizure in the susceptible children.

    This information in German was available in 2003, and in English in 2008. The book cited in other posts on this blog is available for inter-library loan.

    Think back to other comments on this blog where other unethical examples, influenza vaccine, Dr Salk, etc, as well as prevailing attitudes of the 1930s-1940s are mentioned by Dr Strughold defenders to account for such actions and to indicate that present day standards did not apply back then.

    That is probably why during Operation Paperclip, the at-that-time insignificant experiment (deemed unsuccessful) using children went unnoticed. But since 2003 the fact of such an unethical action has been exposed, and the Strughold Award has given annually since 1963.

    Why not stop issuing such an award with such a dubious past history behind the person, for whom the award is named? Because he did not much for US space medicine during the Cold War? Because our national security benefited from the infusion of his and the other 700 persons brought over by Operation Paperclip?

    Well, that utility expired when we landed an astronaut on the moon, and with the dissipation of the Cold War with the ex-USSR.

    In light of the 1943 experiment on psychiatric epileptic children should we in the present continue to give a prestigious eponymous award with the rationale that, while the experiment is/ was unethical, it was appropriate during those times?

    The following references make for an interesting classroom exercise. Drs Eckart, and Schmuhl have published condemnations of Dr Strughold and were quoted in the WSJ article.

    Dr Roth contributed a chapter regarding the aviation medicine research atrocities in the book by Dr Eckart.

    Jonathan Moreno has published a book with passages that refer to Dr Strughold and the controversies also.

    Wolfgang U Eckart (ed.), Man, medicine,and the state: the human body as an object of government sponsored medical research in the 20th century, Beitr€age zur Geschichte der Deutschen Forschungsgemeinschaft, Band 2,
    Stuttgart, Franz Steiner, 2006, pp. 297,

    Hans-Walter Schmuhl — citation: Grenzuberschreitungen. Das Kaiser-Wilhelm-Institut fur Antropologie, menschliche Erblehre und Eugenik, 1927-1945 (2003)

    The National Library of Medicine has the book in English (Kaiser Wilhelm Institute for Anthropology, Human Heredity, and Eugenics, 1927-1945: crossing boundaries). (2008)

    Moreno, Jonathan D. 2000. Undue risk: secret state experiments on humans. New York: W.H. Freeman.

    This information is available on other public forums as well.

  2. planeDoc says:

    The English and German versions of the publication can be partially viewed online at Google. The URL below will take you to the English version.

    Dr Strughold is listed on pages 330 and 333.

    http://books.google.com/books?id=LeQusx57mpkC&q=strughold#v=onepage&q&f=false

    The Kaiser Wilhelm Institute for Anthropology, Human Heredity, and Eugenics …

    By Hans-Walter Schmuhl

    Springer, Jan 1, 2008 – 467 pages

    The historical study documents in the Google online version on page 333 that the experiments were done 17 September, 1943 in Prof. Strugholt’s [sic] vacuum chamber. This statement is a from the experimentalists, named and reference given in the quote. I recommend that followers of this blog read it for themselves. The book is available in most University Libraries as well as NLM.

    So much for a chamber that just happens to be near where Dr Strughold works and is the head of the facility. The unethical experimenters refer to it as Dr Strughold’s. They say “We would have to be able to test epileptic children of 5-6 years of age, but this is not possible at the moment because this age group in not present at Görden”. (358 reference)

    What do the bio-ethicists on this blog think?

    A rather interesting assignment for a classroom debate.

    • Jon Holmlund says:

      Oh, I do find your arguments persuasive, planeDoc. As a commenter here, if I have been reticent to weigh in on Dr. Strughold personally it is only because I am reluctant to do so without spending more time on the specifics (such as reading the entire book you recommend) than I am able to commit at present. Based on what I have read I would have a hard time exonerating him.

      My earlier comments were intended to point out that we ought not hide behind the clearly unethical examples of the Nazis, and ignore other severe breaches of ethics in our time, or oversimplfy questions of complicity, which are not always clear-cut and, I think, not morally equivalent in all cases. (See my upcoming post of Dec. 11.)

      The studies in children are unethical on their face, as far as I can tell. In response to Mr. Sandel, we certainly do judge the ethics of past research in retrospect. The recognition of past breaches is what has driven the current regime of human subject protection, which is reasonably robust, but which requires constant vigilance–in content and application. (The necessary safeguards are of course greater for vulnerable populations such as children.) It will not do to say that Dr. Strughold (or the people at his institute) were just following common practice at the time, just as it would not do to apply the same rationalization to Tuskeegee or Guatemala.

      • planeDoc says:

        Yes I also agree, the comments apply to all such ethical breaches. I will look for your post Dec 11.

      • planeDoc says:

        The references I just posted deal with the many documented medical abuses and unethical lapses, and the Strughold component is a very small part of the many examples.

        The emphasis of all the references from my other post is on the State sponsored (including USA) medical research that was clearly unethical or just plain sadistic.

        The persistent thread of eugenics, State utility, and racism permeates many of the examples.

        Sir Ronald Fisher, described by some as the father of modern statistics and experimental design, was also an ardent eugenicist, favoring forced sterilization and other attempts to ‘improve’ the human genome.

        He was knighted and received personal acclaim and honors.

        Needless to say we do not hear about honors in his name being presented to the best statistical minds for their work.

  3. Martin Sandel says:

    It is evident those quoting the children study did not actually read it. First, yes, it is unethical to use human subjects without consent – there is no denial of that. But we also must realize we are living in 2012 and we are putting research practices of 60 years ago under the microscope of our current ethical standards. While Strughold had nothing to do with the children’s study (it was conducted by an entirely different institute who borrowed a chamber for part of one day that happened to be on the grounds where Strughold worked) those that did were applying ethical standards not dissimilar to the work of Dr. Jonas Salk, Tuskeegee syphilis studies and others done in the U.S. Incidentally, if you read the original German article, you find that the researchers did NOT take the children to the altitudes they previously subjected the rabbits to. I don’t agree with trying to judge somebody 60 years after the fact when we don’t even know he was there that day. We don’t even know if some chamber technician said, “Sure, you can borrow the chamber tomorrow – we’re not using it” and maybe even the department head didn’t know about it, let alone the chief of the research institute. Why do we as humans jump so quickly to suspecting evil and foul play, based simply on our own interests and passions, without even reviewing all available facts?

    • planeDoc says:

      So basically you are comfortable with the experiment that was to try to induce seizures in children, not only nothing of therapeutic value to them, which failed only (in your words) because the experimenters did not use severe enough experimental conditions. Whereas in the words of the experimenters they only regretted not having children of a more suitable age to compare with the relatively younger rabbits, who did suffer convulsions.

      You then also need to make all the other assumptions that this was done without the knowledge of the head of the institute, basically a Friday lark. Altitude chamber operation now as then requires a fair bit of coordination of people and resources to utilize. Especially if used for research and not training.

      It is preposterous that that the experiments were done in secret at Dr Strughold’s institute without his knowledge. He could just as easily have been in attendance. However even if not physically present, he would still be responsible, then as now for his actions.
      I note you only rationalize the unethical experiment, you do not in any way condemn the activity.
      The author of the study (in German) Dr Schmuhl does condemn Dr Strughold for his complicity in the experiment, and does so again in the WSJ article. The alternative explanation you offer is not part of the original paper, in any language.

      The apologists are avoiding the fact that the history is completely aligned against the idea of a heroic research mission to improve mankind, overseen by Dr Strughold in his Institute of Aviation Medicine in Berlin during the War years.

      Since the Strughold award is offered annually, in the present era, it is subject to the ideals, morals and ethics of the current era. Dr Strughold, a brilliant scientist, was somewhat successful in partitioning his work life to avoid most culpability for his service to the Nazi government. But as this 2008 study reveals most clearly, this effort has not been completely successful.

      Shame on the poster for not condemning the use of children from a infamous psychiatric hospital (Dr Mengele, the Angel of Death) in the altitude chamber that they refer to as Prof Strughold’s vacuum chamber.

      They were treating the children somehow? They had any regard for the childrens’ welfare? The endpoint was to cause a seizure, what if one of the children would have suffered status epilepticus. Your point is they had proper medical staff in attendance to treat any unfortunate (but wished for) seizures?

      Any ethical lapses in the US or other countries with respect to medical research are also justifications for what Dr Strughold or others using his facilities did during the war?

      Dr Strughold can retain the various honors and distinctions that people and organizations gave him over his life.

      Change the name of the award, certainly a more suitable title for the highest award from the Space Medicine Association is available.

  4. Jon Holmlund says:

    With regard to the specifics about Dr. Strughold, I do not claim detailed knowledge–nor did Cody appear to pass judgment on him specifically. What the WSJ article should do is prompt us to reflect on what Cody did–to wit, the risk in human subject research of regarding informed consent mechanically, overlooking basic ethical issues or grossly midjudging them. Certainly the 20th century history of bioethics is replete with notorious examples. And my point was not about Dr. Strughold personally, but about how to regard data from frankly unethical research–of which the Nazis were indeed amply guilty.

    And yes, vaccine research performed without properly obtained and documented informed consent is unethical (read: morally wrong, worthy of condemnation), regardless of the stature of the researcher.

    Willowbrook, Tuskeegee, Guatemala, the Third Reich….

  5. Rusty Skills says:

    The WSJ article was an example of careless (and therefore unethical) journalism. Strughold’s record was reviewed multiple times over the years by multiple agencies and ZERO evidence was found to implicate him in those unethical experiments. In fact, among documents investigated by the US State Department, it was found that Strughold voiced opposition to the Luftwaffe Surgeon General regarding the use of prisoners in medical research. This was immediately following his attendance at a scientific conference in 1942 where he learned of this practice. Prosecutors at Nuremburg concluded there was no evidence to warrant any further investigation of Strughold; his presence at the trial was as a witness, testifying on the behalf of the character of various scientists. He was not a member of the Nazi party, and neither were any of his staff – which was actually quite unusual for German physicians and scientists during World War II. There was even evidence that Strughold refused to return the “heil” sign. The Dachau experiments were conducted entirely by the SS; Strughold was with the Luftwaffe. In fact, for those that know their history, you realize that the SS and Luftwaffe didn’t even get along with each other. The research conducted on children was conducted by the Institute for Brain Research, not by Strughold. The borrowed a pressure chamber one day in September, 1943 – something he may not have even known. The WSJ article also makes it sound like he was in charge of the biggest research institute in Germany at the time, but he was only head of one of many similar facilities across the country. It is quite ironic that the WSJ article concludes with the Proctor quote, “You can’t whitewash history,” when the goal of the article seems to attempt to do just that. The evidence shows Strughold was an honest and ethical scientist who unfortunately due to timing found himself in the middle of Nazi-run Germany; he led a distinguished and accomplished career as the “Father of Space Medicine” following his patriation to the US after World War II as part of OPERATION PAPER CLIP. It is unethical to second guess the thorough investigations that were previously conducted, and make attempts to trash the reputation of an accomplished individual who contributed to our ability to explore space and walk on the moon. After all, do we trash the reputation of physicians and scientists who contributed to development of the atomic bomb in the US – a bomb which killed and tortured hundreds of thousands, including women and children? Do we trash the reputation of Jonas Salk (who developed the first polio vaccine), who used non-voluntary subjects from a Michigan mental institution while investigating influenze in 1941? Let’s not apply our holier-than-thou 2012 attitude and apply it to a very different time, attempting to judge those who went before us and trying to rewrite history – especially when all the evidence shows a complete lack of cupability.

    • planeDoc says:

      None of those investigations looked at the 1942 study of children with seizure disorders, from a psychiatric institute, that were placed in the hypobaric chamber at the German Institute of Aviation medicine, headed by Dr Strughold, to see if seizures would arise from the high altitude exposure. The WSJ cites the author of the study, and the study (in German) is easily available. That information was uncovered in just the past decade. Thus the wartime investigations, and those that followed did not have access to the facts of this unethical study. The point of the article is not that Dr Strughold was personally present at Dachau or even in the altitude experiments, the point is that as a famous aviation medicine pioneer and the head of the institute that was involved in those medical atrocities, he bears some responsibility.
      To ignore the experiment on the children done at his institute is in fact a white-washing of history.
      The German Society of Aerospace Medicine, when provided the information in 2004, dropped their Strughold award. What happened to the paper trail of the existence of that experiment on the children since then?
      Why is it 8 years on and there are still people defending the responsible head of the institute that conducted such an unethical study?

    • planeDoc says:

      Here is the reference for the experiment where the children with seizure disorder were placed in the high altitude chamber at the Institute run by Dr Strughold to see if they could induce seizures in the children. It has been translated into English:

      Hans-Walter Schmuhl — citation: Grenzuberschreitungen. Das Kaiser-Wilhelm-Institut fur Antropologie, menschliche Erblehre und Eugenik, 1927-1945

      The National Library of Medicine has the book in English (Kaiser Wilhelm Institute for Anthropology, Human Heredity, and Eugenics, 1927-1945: crossing boundaries).

      Re-reading the WSJ article of 1 December 2012 I note that there is no denial of Dr Strughold’s accomplishments. There is however a reasonable question raised regarding how he and others compartmentalized their association with the Nazi war machine, for which they served and were honored with distinction.

      Their utility to the USA in a space race with the Russians in the Cold War is long past the need to look past their associations with the Nazi government.

      The author of the historical analysis was quoted by the WSJ reporter and a prominent German physician-historian is also quoted in the WSJ article to substantiate the concerns.

      After all the only question being posed to that Association is Will you change the name of the award to something or someone else? There is no claim disputing Dr Strughold’s many accomplishments after the war, there is without doubt a cloud over the continued use of his name (eponymous award) on an award given out each year.

      I think case closed … new award. That is not controversial in the least.

      The Werner von Braun quote on the Space Medicine Association website is disturbing since von Braun held SS officers rank, was a member of the Nazi party, and his rocket factories employed 10s of thousands of slave laborers.

      • Hi there planeDoc,
        I am a journalist and author.

        Having interviewed Prof. Schmuhl about his work and this matter, I see your comments as spot on. Might we have a brief chat? I would like quote something you wrote. Wanted to clarify.

        Thank you,

        Annie Jacobsen (anniejacobsen@mac.com)

  6. Jon Holmlund says:

    The WSJ article was well worth noting. In addition to Cody’s points, we might add the question of whether concerns about moral complicity make it unethical even to cite the Nazi research. My understanding is that there is a pretty strong current in bioethics saying that it is. I’m sympathetic with that position; it’s not ethical to build one’s research on prior, grossly unethical research. Where would a rigorous application of that have left space medicine? I’m not sure. And what of stem cell research as it advances along lines more ethical than those requiring creation or destruction of human embryos specifically for research purposes? The CBHD website includes a good article by Dr. Orr on the subject of addressing moral complicity: http://cbhd.org/content/addressing-issues-moral-complicity-when-where-why-and-other-questions.

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