This shocking first-hand account of the monstrous behaviors of Nazi physicians by Vivien Spitz should be required reading for all medical, dental, nursing, and public health students and faculty. Time is better spent reading this book than filling out HIPAA forms and other well-intentioned but even less effective tools designed to protect patients' interests. Spitz was a 22-year-old court reporter during the doctors' trials at Nuremberg following World War II. In Doctors from hell: the horrific account of Nazj experiments on humans, she recounts in vivid, objective detail the horrific human experiments conducted by 20 so-called physicians and medical assistants in Germany under the direction of the Nazis. The human experiments included "high-altitude" experiments in which concentration camp inmates were forced, without oxygen, into high-altitude chambers that duplicated conditions at up to 68,000 feet; removal of sections of bone, muscle, and nerves, including whole legs removed at the hips to transplant to other victims; artificial wounding and exposure to mustard gas; wounding of two limbs and treatment of one but not the other with sulfanamide antibiotics; intramuscular injection with fresh typhus; and collection of skeletons from 112 live Jewish inmates who were killed and defleshed. When you read this account, do not skip past the critically important foreword by Fredrick R. Adams. It is Adams who helps put this horror into a modern and deeply disturbing context for us. Adams carefully documents how Nazi doctors shaped much of their human experimentation program after similar studies conducted earlier in the United States. He notes that "Germans lagged behind their American colleagues in implementing the eugenic endorsements of doctors." Adams writes that as of 1995, Mississippi's eugenic sterilization law allowing for compulsory sterilization of "the socially inadequate" was still in force. Indeed, Germany's sterilization law, passed in 1933, came 26 years after the state of Indiana's. What lessons have been learned from the medical experimentation horrors of the Nazis? Today, in my own field of cardiology, I am aware of clinical studies now ongoing, particularly in the areas of gene therapy and cell-based therapy, for which there are inadequately convincing animal data, yet patients are being subjected to experimentation that puts them at great risk. What chance do patients have, even the most well informed, when an arrogant and egotistically driven physician tells them that they are going to die unless they submit themselves to an unproven treatment? Are the patients told the truth - that we don't have a lot of options, and this is an unproven therapy that will likely to do more harm than good, but we need to experiment on you? As one reads Spitz's beautifully written and fully documented account of the Nazi medical atrocities, one searches to understand the why and how. One clear motivation for the anti-Semitism among German doctors was the potential for personal and professional gain. For example, as Adams writes, "dismissal of Jewish scientists from the Kaiser Wilhelm Consortium provided dozens of openings for professional promotion and opportunities for advancement in addition to usurping the reins and funds of research grants." How far have we come? Can the worldwide community of physicians who did little or nothing in the 1940s afford to sit silently when modern-day leaders call for the same kind of ethnic cleansing so carefully and effectively practiced by German physicians 60 years ago? As the shocking tale concludes and becomes numbing, the reader must ask what lessons there are for us today. The health care industry, in the parlance of our times, has become a dangerous driver of the kinds of abuses that were made famous by the Nazi doctors. Too much emphasis and reward is given to those who discover new treatments for patients. Thus, the driving force for some becomes the clinical trial that leads to FDA approval of the next blockbuster drug. Have we lost sight of the moral and ethical compass that was also absent among the German doctors during World War II? Is all the excess, glory, and fortune jeopardizing the very important and necessary rights of patients to truly informed consent? We pride ourselves in having come so far and learned so much in the past 60 years about how to respect patients' rights, but when a giant company like Merck tries to hide data about a blockbuster drug because it may be harming some patients, we must ask ourselves - how far have we come? One of the tenets of Judaism is to bear witness, not to forget, but rather to remember and learn from the past, to never let it happen again. As health care providers, we have a moral duty to first read Spitz's alarming book and then to speak out to question and to hold our colleagues to a higher moral standard to ensure that there is no sequel to Doctors from hell. —The Journal of Clinical Investigation; January 4, 2006

As a court reporter at the Nuremberg trails from 1946 to 1947, Vivien Spitz became one of the first people to learn of the atrocities committed in Nazi Germany.. Spitz chose to be assigned to the trials of Nazi doctors and this experience at age 22 changed her life “significantly and forever” (p.10). The Nuremberg War Crimes Trials were the first international criminal trials in history. The book helps us to imagine what is must have been like to hear of these exercises in sadism as she did from the mouths of both perpetrators and victims. Spitz notes that there were no legal precedents in place for dealing with carefully orchestrated barbarism on a national scale. As a result she was what the SHOAH Visual History Foundation has termed “ a witness to history”. The trials essentially ushered in a new era in which terms such as “crimes against humanity” and “genocide” became necessary. Another landmark of history that was precipitated by these particular trials was the Nuremberg Code which established guidelines still in place today for medical research involving human beings. Spitz is clearly interested in both documenting the past and in using it as a cautionary tale in the present. From 1987 to 2004 she has been involved in Holocaust education using her status as a direct witness of events to challenge Holocaust deniers. Spitz felt strongly as a Christian of German ancestry that she had a particular obligation to address the issue of the Holocaust and this work is part of her ongoing commitment to education. “Doctors from Hell” begins with Spitz’s trip with the U.S military to war ravaged Nuremberg in October 1946. The bombed out city, which was without heat or clean water, came as a shock to her and she and the rest of the allied forces were greeted with hostility by its inhabitants. The descriptions of her life in Nuremberg which are interspersed throughout the book are a record of her own loss of innocence. This included her realization that the father of a friend had been the leader of the Chicago branch of the German-American Bund, a fascist group that supported Hitler’s actions in Germany. The Americans adopted a siege mentality while in Nuremberg eventually living in the Grand Hotel which was the hub of American life during this period. The social life and camaraderie Spitz experienced there was the only counterbalance she had to the tale of horror that unfolded each day in the court room. This hotel was bombed by German terrorists in 1947, but miraculously no one was injured, however the event reinforced the social distance between Spitz and the German population. The book is structured by the cases arraigned before the Tribunal made up of four American judges and indicting twenty Nazi doctors and three medical assistants. The experiments conducted by these doctors were committed upon prisoners of war without their consent. They included High Altitude, Malaria, Freezing, Poison and Sterilization experiments among others. Each chapter is devoted to one particular experiment and includes testimony from the trials, relevant photographs of victims and the doctors on trial. These sections are not for the faint of heart and depict the most barbarous acts imaginable. Almost as shocking as the actual acts is the complete lack of remorse shown by the defendants on the witness stand. Instead the accused, the majority of whom were highly educated doctors and surgeons, were resentful and defensive. Horrifyingly, one Gypsy man a victim of sadistic sea water experiments that left him permanently disabled, was questioned by a clearly racist defense council. This same man was harshly punished for attempting to stab the doctor who was responsible for his suffering and that of his fellow prisoners. In his own defense he stated, “ That man is a murderer. He has ruined by whole life.” Having read only extracts from these trials it is understandable that the author did not seek renew her contract at Nuremberg and returned to the United States in May 1948. Upon returning to America Spitz experienced reverse culture shock faced with a country seemingly untouched by the tragedy that she had just witnessed. Spitz was deeply affected by the “coordinated evil and hatred on an unprecedented scale perpetrated by a modern, civilized society of my heritage”(p.273). Plagued by nightmares she did her best to carry on with life marrying and having two sons. In 1972 Spitz was asked to act as a parliamentary reporter in Washington. During this period she became increasingly disturbed that no efforts had been made by non-Jews to commemorate the Holocaust. In 1980 she was present as a reporter for the bill that established the United States Memorial Council under the direction of President Jimmy Carter and Holocaust survivor and Chairman Elie Wiesel. In 1987 the next phase of Spitz’s work began when she became aware of a Holocaust denier in her hometown of Denver, Colorado. Spitz leapt into action unearthing transcripts and photographs that she had brought back with her from Nuremberg many years before. Since 1987 Spitz has spoken to more than forty thousand people all over the world in churches, universities, synagogues and law schools. She was also chosen to give testimony as part of Steven Spielberg’s SHOAH Visual History Foundation. As a result of her tireless efforts in Holocaust education in 2002 she was honoured as a “Righteous Gentile” by the University of Denver Holocaust Awareness Institute. “Doctor’s from Hell” is an extension of Spitz’s education work as it documents what she heard while covering the Nuremberg War Crimes Trials. As a person of conscience she was forced to grapple very early in her life with the most profound moral questions of our time. How could ordinary people sink to such levels of depravity? What are the implications of these actions for ethics? The foreword to this book by ethicist Fredrick R. Abrams M.D. situates the work in the context of contemporary issues. Abrams notes that unethical experiments performed without consent continued to occur in the United States after the writing of the Nuremberg code. Both he and Spitz emphasize the importance of individual conscience and societal vigilance. Spitz continues her mission to warn us that it is up to each person to ensure that they question all authority and “ not allow malignant evil to go unchallenged and unchecked” (p.293). The impassive faces of the Nazi doctors on the cover of the book and the testimony inside warn against what can happen if we do not. —Gillian McCann, Ph.D.; Women and the Holocaust

Written by skilled journalist Vivian Spitz, who counts being the youngest court reporter at the Nuremberg Trials among her many accomplishments, Doctors From Hell: The Horrific Account Of Nazi Experiments On Humans presents literal testimonies of Nuremburg war crimes trials specifically pertaining to murderous medical experiments performed on living people. A bleak, stark, and severe account; the dry yet thoroughly detailed testimony speaks for itself. Information concerning the conviction and sentencing of defendents is also included. The author offers closing chapters about adapting to a normal life after her role in bearing witness to unspeakable atrocities, including her encounters with poisonous and sometimes threatening Holocaust deniers. A straightforward primary source appreciable to scholars and lay readers alike, and a welcome contribution to Holocaust Studies and reference shelves. —Midwest Book Review