Der Nervenarzt
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Historical Article
[Psychiatry during National Socialism: historical knowledge, implications for present day ethical debates].
This contribution is a synthesis of the results of historical research on psychiatry during the Nazi period and some implications for present day debates in medical ethics. The focus is on three issues: the relationship between physicians and the state, the impact of eugenically and economically motivated health and social policies for psychiatry (e.g. forced sterilization, patient killing/euthanasia) and psychiatric research. Three myths are deconstructed: 1) that medical atrocities were imposed from above by Nazi politicians on apolitical physicians, 2) that mass sterilization and patient killing had nothing to do with contemporary state of the art of medical reasoning and practice and 3) that ethically unacceptable research on psychiatric patients had nothing to do with the contemporary state of the art of biomedical sciences. It is argued that the findings on these issues of Nazi medicine are not specific to Germany and the period between 1933 and 1945 but they were the extreme manifestations of some potential problems implicit in modern medicine in general.
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Neurology and psychiatry deal with diseases of the (central) nervous system. Historically neurological disorders are related to a proven organic basis, whereas psychiatric disorders are mainly defined by the phenomenology and course of the symptoms. ⋯ For major brain disorders - such as dementia of the Alzheimer type - close collaboration between both disciplines is developing in diagnosis, therapy and care. Due to common neurobiological research topics, educational programs, medical training and the challenges of assuring appropriate care to patients with brain disorders, further cooperation between neurology and psychiatry is expected and necessary.