Hi, I’m Art Caplan at the Division of Medical Ethics at NYU School of Medicine. I had a horrific, terrifying, disturbing phone call some months ago. I got a call from a surgeon who had been asked a question about the use of data from unethical sources.
Many, many years ago, during World War II, an anatomist named [Eduard] Pernkopf did work on bodies sent to him from concentration camps and came up with what is one of the amazing medical wonders of the world: the Pernkopf anatomical atlas.
People agree that it is a unique resource that is astounding in terms of its accuracy and detail. I don’t think anything has ever been able to rival this book. However, it is built directly on from the bodies of victims of Nazi terror and murder. So, the question comes up as to what we should do with Pernkopf’s atlas.
Regarding the question that I was asked, there was a surgeon in the middle of an operation on the leg of a patient. Apparently, she could not find a particular nerve that she wanted to move or handle in some way. She said the only place to find the detail she was looking for was by accessing Pernkopf’s atlas. She’d seen it in medical school, and she knew that it would help her if she looked at this particular volume to get some guidance.
She also felt that if she didn’t do this delicate operation properly, the patient would lose his leg. There was a lot of quick phoning around to determine whether you can use information that was immorally acquired in order to try to benefit a patient.
I’ve thought about this issue over the years. It comes up with the use of data from concentration camp experiments, the Tuskegee study on African American men in the south that guided much of our understanding of syphilis, and many other instances where immoral experiments produced data of value.
In this case, you’re going back and immediately accessing this atlas in a very real way. You may want to later explain yourself to your peers, the patient, or the patient’s family. It’s a very tough call.
My argument is that yes, you can use the atlas if the stakes are high—saving a life, saving a limb—if you have a very important goal in terms of benefiting an individual patient or a group of patients and if there’s no other resource to find the information you need. You also should acknowledge in any writing or papers that you used something that was immorally generated—in this case, the atlas.
You should not credit Pernkopf or any of his associates for the atlas. Instead, say that you had to look at this atlas built on concentration camp victims from 1946. Do not give credit or reward to anyone associated with the generation of the book.
At the end of the day, I would not want to see lives lost or people severely disabled because of fear of justifying immorality. We have to be very careful about what is done, how it’s reported, and how it’s presented when we [use this information].
I think the goal of saving lives and preventing disability justifies even the use of some of the most horrifically generated information that has ever been obtained by medical science.