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November 2, 2017 at 12:54 pm Comments (0)

The Holocaust: Coercion was not Collaboration

Second International Scholar Workshop, May 7-11, 2017

Coercion is Not Collaboration

Ethics and Agonizing Decisions

Professor Naomi Baumslag, M.D., MPH
It is essential, in the interests of historical accuracy and objectivity, to recognize that coercion is not collaboration. The definition of collaboration varies and who is to judge how one can deal with oppression when your family is threatened. Some physicians committed suicide rather than violate the Hippocratic oath, while others were murdered.
Jewish prisoner doctors worked under incredibly harsh circumstances in brutal, inhumane confinement, which made it next to impossible to honor the Hippocratic oath by doing no harm and they saved lives to the best of their ability.
Doctors were coerced under extreme, life-threatening conditions. There was nothing voluntary about their status, nor was there an option for them to refuse to cooperate. Prisoner doctors had to make agonizing decisions and risk their lives. With sparse or no medical supplies and under unsanitary conditions, the doctors improvised ways to work around the constraints to try and save lives. They swapped charts to save healthy patients so that a prisoner who was at death’s door replaced one who could live. They recorded typhus cases as influenza. In the ghetto they ran a medical school and called it a sanitation school, as the Germans’ fear of typhus was so great. They diluted drugs, altered chart measures and where possible did less harm than they were instructed to. For example, if told to remove ovaries, they removed only one. Doctors performed abortions on pregnant women to save their lives because the Germans ordered pregnant Jewish women to be killed and Jewish doctors performed abortions unbeknownst to their Nazi supervisors.
There is ample evidence that Jewish doctors saved lives and took risks with their own lives to do so. Some even committed suicide, or refused to follow orders and were murdered. Many worked with the Resistance. Tragically, the Jewish prisoner doctors often had nothing to give their patients except some words of comfort. There were many Jewish doctors who strove to the best of their ability and managed to practice medicine under brutal Nazi coercion.
The following three little-known physicians and their actions and sacrifices under great risk underscore the efforts of a few that we know of.

Dr. Moses Brauns
Dr. Moses Brauns was a respected physician, epidemiologist and head of the Kovno ghetto’s sanitation and contagious disease department of the Jewish Council.On Oct 4th 1941 a reinforced squad of German police – 50 men and 100 Lithuanian participants – boarded up the small infectious disease hospital and burnt it, with 67 doctors, staff, and patients inside.
The burning of the infectious disease hospital and all the inmates made it imperative to avoid reporting cases or rumors of typhus in the ghetto. Dr. Brauns recognized that the greatest danger of typhus came not from lice but from the Germans’ attitude towards the disease. When cases were found it was it imperative to hide their existence, to delouse and isolate them and their families.
In October 1942 German soldiers with typhus returning home from the front were washed and treated in the Kovno ghetto. The Lithuanian Health authorities had Jewish workers wash and clean the soldiers, but vaccinated only the Lithuanian workers. When several of the Lithuanian workers contracted typhus a commission of Lithuanian doctors, suspecting typhus in the ghetto, came to inspect the ghetto hospital, and wanted to know how many typhus cases there were among the Jewish workers. Unbeknownst to them at the time of their visit, there were 29 cases of typhus, but they were not discovered because they were being nursed at home. The commission continued to search for cases, but found none. Dr. Brauns fought typhus while hiding it from the Germans and Lithuanians who might otherwise have destroyed the ghetto and inmates. His patients were given extra food rations, soap, and firewood for heat and were nursed at home. He secretly visited them twice a day. The home nursing had been handled so well that even ghetto inhabitants didn’t suspect there was typhus in the ghetto (personal interview with survivors). A total of 70 cases were diagnosed. These cases were not recorded and the cause of three deaths from the disease was falsified in the official report to the ghetto health committee. The visiting Lithuanian commission asked Dr. Brauns, an expert on typhus, to explain why there were no cases of typhus in the unvaccinated Jewish workers. Dr. Brauns replied that this was because the Lithuanian workers were vaccinated with a live lice preparation whilst incubating the disease. Dr. Brauns, by hiding the typhus cases, risked his own life, his family’s lives, his reputation as well as the lives of everyone in the ghetto. Dr. Brauns was a hero.

Dr. Ludwig Fleck
SS doctors assigned to concentration camps tended to be medically inferior with strong Nazi ties and personally self-serving. At the same time, prison doctors participated in the Nazi experiments unwillingly. Some prisoners survived to report what had occurred in their presence and to provide details of courageous acts of resistance.
Many of the prisoner doctors in Buchenwald concentration camp were experts in their field and came from well-known institutes. One such doctor was Dr. Ludwig Fleck, an accomplished scientist and philosopher, previously of the Lemburg Institute. When he was in the Lvov ghetto in 1942 he was faced with typhus in seventy percent of the inmates. As there were no vaccines or other resources available to them, he developed a typhus vaccine out of the urine of typhus patients.
In contrast to other doctors and researchers, Dr. Fleck demonstrated a superior ethic by first vaccinating himself and his family with the trial vaccine. He then vaccinated a group of 500 ghetto volunteers, as he had found his vaccine to be effective. As the vaccine was effective, he then used it for ghetto patients. When the Germans saw a report about his vaccine and asked him if it would be good for them. Even though he said it was made from Jewish urine, they arrested him and moved him and his family to Auschwitz and then to Buchenwald to Block 50 to make typhus vaccine for the troops.
Block 50 was a special isolated typhus vaccine development unit. When Fleck arrived in Buchenwald he discovered that the typhus vaccine being produced by Drs. Cielpielowski (in charge of the vaccine production block) and Professor Waitz was ineffective. To tell the authorities would have meant their certain death. So, unable to tell the authorities, the prisoner doctors continued the production of the ineffective harmless vaccine for the Wehrmacht, which was sent to the soldiers on the front and made a new vaccine, which was used for the Resistance.
Fearing sabotage and not trusting the prisoner workers, the Germans required control samples to be sent to the Pasteur Institute to be checked. However, with the help of the desk clerk who did the paperwork of the vaccine production unit, Fleck and his fellow prisoner doctors sent their high-quality, effective vaccine samples instead of the ineffective vaccine for testing. The tests proved positive, thereby allowing the ineffective vaccine to be sent to the front. As an act of sabotage, approximately 600 liters of the ineffective vaccine were produced and sent to the front and 30,000 soldiers were injected with this useless vaccine. At the same time, 69 liters of the effective serum were made for the prisoners and for the Resistance (Cohen and Schnelle).
Fleck had a wife and son in the concentration camp and had to be careful that the authorities were never aware of his resistance activities. Other prisoner doctors in the vaccine production unit were also in such a situation. Fleck, together with two other doctors, Dr. Cielpielowski (who was in charge of Block 50 vaccine production, Buchenwald) and Prof. Waitz falsified results, sabotaged vaccine production, and organized undercover resistance in the laboratory. Dr. Fleck was an extraordinary brilliant physician who under bestial circumstances managed to survive without compromising himself.

Adina Blady Szwajger
In September 1942, a 22-year-old Jewish senior medical student, Adina Blady Szwajger, who served as a nurse in the Warsaw Ghetto hospital gave lethal doses of morphine to several elderly patients and about 15 infants and children. She did this to spare them certain death at the hands of the Nazis, when she heard screaming downstairs as the German and Lithuanian guards were taking the sick from the wards and ruthlessly throwing them out. (Yodaiken R.E.)
Through her dedication and love, Swajger gave her patients a dignified death and denied the German murderers the satisfaction of slaughtering her charges at their leisure. (Yodaiken).
It is very important to examine the source of this coercion. It was exerted from the highest levels of influence—the pharmaceutical industry IG Farben, the German Hygiene Institute, various Nazi health and science research centers and medical schools searching for a vaccine against typhus. Much of the impetus behind the experimentation came from the IG Farben pharmaceutical conglomerate, Bayer, BASF and Hoechst, which were responsible for most of the coercion of poorly trained SS and German doctors, who in turn coerced and exploited prisoner doctors to run their dirty experiments on their untested drugs. All of this was to increase their profits. More attention needs to be paid to these unpunished criminals in these centers.
The coercion was apparent as early as 1939, but experimentation on native colonial populations in Namibia (then called German South West Africa) by German doctors and scientists in Germans medical and public health training centers actually began before that. It simply continued from 1939, with German doctors and the German pharmaceutical and drug industry experimenting on Jews with vaccines and drugs in the Csyste Hospital in the Warsaw ghetto (Baumslag). George Nauck, a pathologist in the Hamburg Hygiene Institute, had a typhus research unit in the Warsaw State Institute and Dr. Robert Kudeche tested vaccines on Jews. These Nazi doctors forced staff of Csyste Hospital in the Warsaw ghetto to test sulphonamide drugs in typhus cases for IG Farben, including a toxic drug called Uliron, which caused blueness (cyanosis) and death. According to Roland, German doctors threatened the Jewish doctors with punitive actions if they refused to cooperate as instructed. Nauck filmed the subjects and autopsied the dead.
The experimentation to find a typhus vaccine continued in the concentration camps, especially Auschwitz and in Buchenwald, where there was the special isolated typhus unit in Block 50, where they made and experimented with vaccines and many as-yet-untested drugs.
In conclusion, better ways of enforcing ethical codes and rules on experiments need to be devised. It is not enough to simply leave it to the health profession. It needs to be broader. An independent consumer oversight committee with the ability to enforce ethical laws and human rights is urgently required and continues to be relevant in today’s pharmaceutical industry and its ongoing financial ties with doctors and institutes.


Baumslag N. Murderous Medicine; Nazi Doctors, Human Experimentation and Typhus. Chapter 3. Jewish doctors struggle to conceal typhus and save lives, pp85-125. Praeger Press, 2014.

Cohen R.S. and Schnelle T. Cognition and Fact materials on Ludwik Fleck, Dordrecht: Reid D. Publishing Co, pp19-29, 1986.

Fleck L. Specific Antigenetic Substances in Urine of Typhus Patients, Texas Reports on Biology and Medicine 6: pp169-172, 1947.

Baumslag N. and Shmookler B. Typhus Epidemic Containment as Resistance to Nazi Genocide, pp39-48; in Grodin M. Jewish Medical Resistance in the Holocaust. Berghahn, New York, 2014.

Kogon E. The Theory and Practice of Hell. Berley Books New York, 1980

Lifton RJ. The Nazi Doctors: Medical Killing and the Psychology of Genocide,

Siegel S. Treating an Auschwitz Prisoner-Physician: The case of Dr. Maximillian S.; Holocaust and Genocide Studies, 28, NO3 pp450-481, 2014.

Siegel S. Changing Circumstances, Shifting Approaches; Jewish Prisoner Physicians in Nazi Concentration and Forced Labor Camps. Lecture Vienna Wiesenthal Institute for Holocaust studies, 2015.

Tory A. Surviving the Holocaust; The Kovno Ghetto Diary, pp141-143, Harvard University Press, Cambridge MA, 1990.

Yodaiken R. Moral Dilemmas Faced by Jewish Doctors During the Holocaust. Paper presented at the Medical Resistance During the Holocaust Conference, YIVO, New York, 1996.