The Pernkopf Atlas
Steve, a recent graduate of a prestigious medical school, is working his first full shift as a surgeon at a rural hospital near his hometown. The first operation Steve is scheduled to perform is an emergency appendectomy. Appendectomies are common, and are generally considered safe and low-risk procedures. However, as is the case with any surgery, complications are still possible. Just before beginning the first operation of his professional career, Steve becomes nervous and disoriented, feeling the need to consult an anatomical reference book. The hospital staff provides Steve with an old copy of the so-called Pernkopf Atlas, originally published in 1937 by medical doctor and known supporter of the Nazi movement in 20th century Germany, Eduard Pernkopf. Steve, loosely aware of the history of this particular reference book, asks a nurse for another but is told that this is the only reference book available. Steve knows that without consulting the reference book, he is putting the patient at a higher risk. However, given the nature of the procedure, if Steve chose not to consult the Atlas, the increased risk would be a small one with any kind of complications remaining unlikely.
Like many anatomical reference books of its day, the Pernkopf Atlas was designed to be a detailed rendering of human anatomy for study and surgical practice. Almost 80 years later, the Pernkopf Atlas is still considered by many medical professionals to be one of the most detailed and anatomically correct reference books ever created. The Atlas itself has been out of print since 1994, but the drawings created by Pernkopf can still be found in current medical textbooks and original copies sell for many thousands of dollars. While doctors and educators get great use of the Atlas, its history is troubling for reasons beyond Pernkopf’s Nazi party affiliation. In 1998, Pernkopf’s former employer, the University of Vienna, conducted a study that found that during Nazi occupation the University had received the corpses of executed prisoners and political dissidents. Of the 800 drawings in the Atlas, at least half have so far been determined to be based on surgical experimentation on the bodies of those prisoners. While in the past, efforts were made to conceal the origins of the Atlas by airbrushing out insignias and removing references to the Nazi party, there is more effort today to come to terms with the resource’s history.
Those who might argue in support of using the Atlas could claim that to not use it would be to erase the suffering of the victims and that, while its origins are unfortunate, the medical benefits that it yields are enormous. In a recent survey, 69% of neurosurgeons indicated that they were comfortable using the Atlas, and 13% said they still use the Atlas in their practice. Additionally, some Rabbinic authorities have stated that while its origins are fraught it is permissible to use the Atlas as long as its history is made known. Those who might oppose Steve’s use of the Atlas could claim that, while there are benefits to using it, the drawings in the Atlas were obtained in such a morally reprehensible way that it is difficult to justify using it.
DISCUSSION QUESTIONS
Is it morally permissible for Steve to use the Pernkopf Atlas to inform his medical practice? Why or why not?
Is it permissible to commit morally impermissible acts in the service of some greater good, like the reduction of overall suffering? Why or why not?
How should we treat scientific advances made by repressive or totalitarian regimes?
References
[1] STAT, “The surgeon had a dilemma only a Nazi medical text could resolve. Was it ethical to use it?”
[2] Science, “The Dilemma of Pernkopf's Atlas”
[3] BBC, “Eduard Pernkopf: The Nazi book of anatomy still used by surgeons”
[4] BBC, “Eduard Pernkopf: The Nazi book of anatomy still used by surgeons”
