The following question appeared in "the Ethicist " column of the New York Times Magazine. "Some knowledge about hypothermia comes from brutal Nazi medical experiments conducted on prisoners of war. Considering the data came from the destruction of their lives, are there ethical issues when modern-day scientists use it? Could it be considered a form of collaboration with the Nazis? Or does the origin of the data matter if the data is useful? Declaring the data off-limits could lead to preventable deaths, while using the data seems coldheartedly clinical." What is the Jewish response to this seeming dilemma?

 

            In this verse from Leviticus (10:3), Moshe speaks to Aaron just after the tragic death of Aaron’s two sons.  It is difficult, if not impossible, to understand the meaning of Moshe’s words.  But Aaron’s response is far more profound: “And Aaron was silent.”  To whatever extent Moshe was attempting to make sense of the tragedy, in truth, there was nothing to be said, no sufficient meaning to be found, and so, Aaron was silent.

            In the shadow of the Holocaust, we are all, as Aaron was, stunned into profound silence.  Any attempt to justify even one iota of the Holocaust is not only impossible but offensive.  Therefore, let us not, for even a moment, entertain the notion that any scientific benefit that could come from Nazi data brings meaning to the suffering of the victims. 

            At the same time, were we to turn our backs on scientific data that might benefit others without sufficient justification, that would be a wrong of its own.  And while one might argue that respect for the victims is sufficient justification to declare all benefit from Nazi material to be off limits, I do not think the victims would be honored by our declining to help others in need.  Therefore, to the extent that the Nazis’ data on hypothermia is scientifically useful (the point is debated in the medical community), we have a serious ethical question to answer. 

            This particular question has been ably addressed by Rabbi J. David Bleich in Contemporary Halakhic Problems Volume 4 (pp. 218-236).  The most relevant rabbinic text on this question is Babylonian Talmud Pesahim 25a-b.  There we are told of the statement of Rabbi Yohanan that anything may be done for purposes of healing, aside from idolatry, adultery, and bloodshed.  The Talmud understands this statement to refer to healing a condition that involves mortal danger.  That dangerous illness may be healed through anything but idolatry, adultery, and bloodshed is noted in Mishneh Torah Yesodei HaTorah 5:6 and Shulhan Arukh Yoreh Deah 155.  Additionally, even where there is doubt involved in a matter, we err on the side of saving a life (pikuah nefesh).  For example, even if it is unclear whether an illness is life-threatening, the Sabbath may be violated to treat the person (Mishneh Torah Shabbat 2:1, Shulhan Arukh Yoreh Deah 128:10).  While one might argue that Nazi experimentation is a case of “bloodshed,” which may not be used even for lifesaving purposes, I agree with Rabbi Bleich’s analysis (p. 222ff) that while one may not perform an act of bloodshed in order to save a life, the ex post facto use of the results of such acts is not prohibited.  Similarly,        Rabbi Bleich (pp. 227-231) discusses and rejects certain other arguments that are elicited to prohibit use of Nazi data (for instance, the prohibition of deriving benefit from a cadaver) arguing that while scientific pursuits (e.g. certain autopsies or medical study) may be forbidden, there is no source to prohibit the use of knowledge derived from such pursuits.

            Rabbi Bleich (pp. 231-233) elicits other Talmudic sources that seem to approve of the use of scientific information derived from illicit means, including, for instance, the students of Rabbi Yishmael who studied the body of a woman executed by the king in order to determine the number of organs in the body (BT Bekhorot 45a); the report of observations of dead bodies made by Abah Shaul during his career in burial (BT Niddah 24b); and the story of Cleopatra’s experimentation on handmaidens who were sentenced to death, which is discussed as a possible source for whether or not a fetus’s gender is determined by the fortieth day of conception (BT Niddah 30b).  In the Cleopatra case, Rabbi Bleich notes that the rabbis debated the scientific validity of the experimentation, but not the permissibility of using the resulting data.  Although these cases may be enlightening on the permissibility of garnering scientific information from cadavers, it is not clear to me that any of these situations were understood to be the result of immoral acts.  Rabbi Bleich seems to read the Cleopatra story as indicating that Cleopatra condemned these women to death for the purposes of experimentation.  It seems to me, however, that the story indicates that women already condemned to death were particularly executed on the fortieth day after conception for these scientific purposes.  While I would consider such experimentation to be immoral, and I imagine the rabbis would feel the same, this particular point is not raised by the Talmud and I want to be careful not to project my own sense of morality onto this text.

            Rabbi Bleich, admitting that his proofs might be rejected, concludes by falling back on the rule mentioned earlier, namely, that we should err on the side of saving lives.  He writes that use of "information obtained by immoral means . . . must nevertheless be regarded as legitimate for purposes of pikuah nefash unless there is clear and convincing evidence to the contrary.  Any and all measures must be utilized for purposes of preserving life unless there exists clear evidence predicated upon talmudic sources indicating that some measure must be abjured."

            While I agree with Rabbi Bleich’s conclusion, one other note of caution must be sounded (also discussed by Rabbi Bleich p. 234 ff), which is whether using data derived form unethical experimentation might encourage future scientists to act in unethical manners in the future.  Perhaps scientists who might otherwise feel that “the ends justify the means,” might decide otherwise if they knew that the results of unethical scientific procedures would not be utilized.  Indeed, sometimes otherwise acceptable behavior is to be eschewed when it might set a dangerous precedent (an example might be ma’arit ayin, where an otherwise acceptable act is forbidden because its appearance might mislead others).  Although one can hardly imagine that a person capable of participating in the type of experimentation performed by the Nazis will be deterred based on how a moral scientific community might shun the results, no doubt there are lesser acts of immorality that might be deterred by an absolute ban on the use of on information garnered by immoral activities.  Nonetheless, I do not believe that this concern is sufficient to tip the balance away from erring on the side of potentially lifesaving activity.

            In conclusion, using scientific data garnered by Nazi experimentation is consistent with our general bias toward lifesaving activity.  Because I do not see the use of this information as being a violation of the dignity of the victims or as being too great an incentive toward future immoral acts, I would encourage the use of this data to the extent it could be used to save lives.

          This issue has been addressed extensively by leading Orthodox rabbis. Many point to the rabbinic law that one may not gain any benefit from an object used to administer capital punishment, and must therefore bury it, as well as the law that one may not gain any benefit from a corpse. While relevant for our discussion, these laws only prohibit benefit from the object or corpse itself, not the information that is obtained from them.  Similarly, despite rabbinic prohibitions against performing autopsies, there is no prohibition against utilizing the information gained from them once it has been learned. Indeed, the Talmud records much information that resulted from viewing cadavers or even immoral experiments (see for example the discussion in Nida 32b of the knowledge gained from Queen Cleopatra’s abortion experiments).
          Another oft cited source is Maimonides’ explanation of the rabbinic praise for King Hizkiyahu’s decision to get rid of an ancient book of cures “Sefer HaRefuot.” Maimonides argues that King Hizkiyahu destroyed this work, despite the value Judaism places on medical knowledge, because it contained modes of treatment that the Torah does not allow for use in healing (i.e., idolatrous or illicit behaviors). Maimonides explains that we may utilize the knowledge gained from these procedures, but are forbidden from actually taking part in them themselves, as he writes, “one may learn in order to analyze and teach. However, when people destroyed their path and began to cure themselves through these means, he removed the practices and hid them away.” According to this approach, we may not take part in forbidden practices   – such as idolatry, for example - even for the sake of healing or saving a life. But once such procedures have been done, we may study the results in order to figure out how to apply the knowledge gained in a permitted manner.  Furthermore, we know that it is axiomatic in Judaism that in order to save a life, almost all means must be exhausted.

          Some scholars have expressed concern that utilizing such information may encourage more immoral studies and may seem to imply a certain degree of acceptance of such methodologies. Others advocate using the knowledge gained, but not citing the immoral source in order to deter future such experimenters, similar to King Hizkiyahu’s decision to hide the book of cures. On the other hand, it is argued that most of the Nazi experiments were so grotesque that we need not be concerned that anyone will try to replicate them or that we are not sufficiently deterring others from them. Others argue that making use of Nazi-obtained data, while still condemning the Nazis and their method of obtaining this data, at least allows us to ensure that these individuals did not die in vain. However, others feel that those people who were martyred because they were Jewish, in sanctification of God’s name, did not die in vain, regardless of whatever medical knowledge can be gleaned from their lives. The debate goes on and on and there is no simple solution.

               In conclusion, while we must condemn these horrific practices and do whatever we can to ensure that they are never repeated, we may make use of the scientific knowledge gained from them, while remaining ever cognizant of the sanctity inherent in these holy people’s lives, and their deaths.

In 1988 Robert Pozos, Director of Hypothermia Studies at the University of Minnesota, sought to publish data compiled by Nazi scientists who used concentration camp inmates in Dachau as subjects on the effects of immersion in extremely cold water on human beings.  During World War II the Luftwaffe had a particular interest in knowing how long a downed pilot could survive in the cold North Sea before making any rescue attempt futile.  Forty years later, doctors had an interest in knowing how long a person who fell through the ice into a cold lake could survive before making any rescue attempt futile.  But Arnold Relman, then editor of the New England Journal of Medicine, rebuffed the request to publish.  Some later explained that the refusal to publish was justified on the grounds that it would have made Holocaust victims “retroactive guinea pigs.”  Whether or not data collected on the survival rates of emaciated and otherwise less-than-healthy subjects was useful was beside the point.  The debate began on whether any good could come from the results of what amounted to torture.   Some argued that using the data – as flawed as it might be – would make meaningful the deaths of the erstwhile victims.  This is an interesting moral argument but a halakhically irrelevant one.  From a halakhic perspective, the saving of human life is a nearly supreme value.  So while the actual experiments are condemnable, the results of those experiments ought to be used if a life might be saved.  Whether or not that would be the case will only be determined by the scientists who would study the data.  And to study the data means it must be open and available to study.  A review of the literature is accessible through an on-line article of David Bogod published in Anasthesia, the Journal of the Association of Anasthetists of Great Britain and Ireland, 18 November 2004.

We all rightfully recoil with a particular horror from anything associated with Nazi atrocities.  The original wrong was an evil act for which there is never any justification.  According to Jewish law, pikuaḥ nefesh (saving a life) takes precedence over all of the commandments except for three:  In order to save a life one may not commit murder, idolatry, or sexual immorality.  It is never acceptable in Jewish law and ethics to derive even the most brilliant and important life-saving information, even if it could save millions of lives, from the deliberate murder of even one person. 

 

However, the results of those horrific experiments now exist.  Not using the Nazi scientists’ results will not restore the victims’ lives.  Using the knowledge could, in fact, contribute to saving other lives, or at least to avoiding endangering other lives.  Doesn’t a scientist have a moral obligation to use all available knowledge to save a life? 

 

Let’s put this in the starkest possible terms.  If an emergency room physician has before her a person dying of hypothermia, and knows how to save that person’s life using particular knowledge that came from the Nazi experiments, should the physician use that knowledge?  Of course she should.  The immediacy of the situation, a clear case of pikuaḥ nefesh, makes it an easy call.  But what if the situation is not immediate?  Should scientists use that knowledge to design protective gear for astronauts and polar explorers whose lives might be endangered otherwise?  If you are tempted to say no, ask yourself:  If you were going to be wearing that gear, wouldn’t you want them to use it?  The knowledge is there.  Not to use it when it could save a life is wrong. 

 

However, there is no question that the knowledge is tainted.  It is hana’ah, “benefit,” from grossly immoral and illegal behavior.  The questioner is right to feel discomfort.  In all situations, therefore, where the knowledge is essential but life is not at stake, there should be an acknowledgement that it comes from a tainted source.  For example, the literature that accompanies the hypothetical protective gear should have a prominently displayed notice that it was produced using knowledge that came from Nazi medical experiments.  Any scientist who gives a paper or writes an article using the information should prominently feature the same notice.  Anyone who wins an award for research based on this knowledge should do the same when receiving the award.  In this way, using this knowledge will not become routine, nor the victims forgotten.  Indeed, not to use the knowledge for which these POWs were tortured to death would truly render their deaths meaningless.