Nurses and the sterilization experiments of Auschwitz: a postmodernist perspective

The medical experiments conducted on non-consenting prisoners of Nazi concentration camps during World War II necessitated the codification of principles to protect human subjects of research. Auschwitz was the largest and one of the most infamous of the camps and the site of numerous 'medical' experiments. This historical study uses primary source documents obtained from archives in England and Germany to describe one type of experiment carried out at Auschwitz - the sterilization experiments. The purpose of these experiments was to perfect a technique in which non-Aryans could be prevented from reproducing while still being able to work as slave laborers. These narratives regarding the sterilization experiments at Auschwitz are remarkable in that they contain previously undocumented information regarding the voluntary and involuntary involvement of nurses. Following these narratives, a discussion of ethics in relation to the Holocaust is presented with a specific focus on the work of Agamben. Implications of the Auschwitz narratives for the application of codes of ethical principles and contemporary nursing are discussed from a postmodernist perspective.     

Ethics seminars: physician complicity in the Holocaust: historical review and reflections on emergency medicine in the 21st century, part II.

Part I of this seminar in ethics reviewed the participation of German physicians and the German medical establishment in carrying out Nazi policies and listed eight moral failures that could be attributed to doctors during the dark period of history known as the Holocaust. The collective acts that occurred during this period have, arguably, become a benchmark for abject ethical collapse on the part of mankind. Part II contemplates a variety of contemporary issues through the prism of the Holocaust. This article reviews and categorizes ethical pitfalls encountered by physicians during the Nazi era and examines them in relationship to several current issues. It also focuses on ethical concerns and challenges that confront contemporary emergency practitioners, some of which have parallels, though certainly not direct comparators, in the Nazi era.     

Ethics seminars: physician complicity in the Holocaust: historical review and reflections on emergency medicine in the 21st century, part I.

Individual physicians as well as the medical establishment were complicit in a wide range of activities carried out by the Nazis during the period that encompassed the Holocaust. This article examines these activities and lists eight moral failures attributable to physicians of this era. The accompanying article reviews the ethical pitfalls encountered by German physicians during the Nazi era and examines them in relationship to current issues. It also explores the role of professionalism then and now. In particular, ethical issues presently confronting emergency physicians are examined through this prism.     

Nurses' participation in the Holocaust: A call to nursing educators

This year marks the 75th anniversary of the liberation of Auschwitz. The number of people able to provide first-person accounts of the atrocities of the Holocaust is dwindling in numbers. Prior to the mass extermination of Jews at Auschwitz and other extermination camps, nurses actively participated in the execution of tens of thousands of mentally, physically, and emotionally ill German citizens. Nursing educators must ensure that nursing students not only know about the Holocaust, but that they know that ordinary nurses were directly involved in the identification of vulnerable humans to be killed, and actually murdered them. Social, economic, and political pressures existed enabling the Nazi regime to involve nurses in this way. Similarly, social, economic, and political pressures today have the potential to encourage nurses to act in ways that violate personal or professional values. This paper provides four learning objectives that can be incorporated into existing nursing curricula to ensure that nurses do not forget how and why nurses in Germany came to murder more than 10,000 people in their care. With the passage of time comes the risk that the legacy of the Holocaust will be forgotten, nursing educators must participate in preventing that from happening.     

The National Socialist Sisterhood: an instrument of National Socialist health policy

When Adolf Hitler (1889–1945) came to power in 1933, the new Nazi government focused the German health system on their priorities such as the creation of a racially homogeneous society and the preparation of war. One of the measures to bring nursing under their control was the foundation of a new sisterhood. In 1934, Erich Hilgenfeldt (1897–1945), the ambitious head of the National Socialist People's Welfare Association (Nationalsozialistische Volkswohlfahrt), founded the National Socialist (NS) Sisterhood (Nationalsozialistische Schwesternschaft) to create an elite group that would work for the goals of the National Socialist German Workers' Party (Nationalsozialistische Deutsche Arbeiterpartei, NSDAP). Hilgenfeldt proclaimed community nursing as a priority for NS Sisterhood nurses. Catholic and Protestant sisters, who were traditionally dedicated to community nursing, were to be gradually replaced. However, other competing priorities, such as hospital service for the training of junior nurses and work in conquered regions, as well as the lack of NS nursing personnel, hampered the expansion of community nursing. The paper also addresses areas for future research: everyday activities of NS nurses, the service of NS Sisterhood nurses for NSDAP organisations such as the elite racist paramilitary force SS (Schutzstaffel, Protective Squadron), and involvement in their crimes have hardly been investigated as yet.     

Kombinationsarzneimittel aus Paracetamol plus Acetylsalicylsäure: Nutzen und Risiken

According to the German Drug Law of 1976 the present status of scientific knowledge regarding the benefit/risk-ratio of combination analgesics was reevaluated and is summarized taking the fixed combination of paracetamol plus acetylsalicylic acid as an example. The extensive discussion of the responsible committee for reevaluation of drugs B-3 (Neurology/Psychiatry) at the German Federal Institute of Health (Bundesgesundheitsamt) led to the following results as viewed by the involved members: - the fixed combination has its pharmacological rationale (secure detoxification, even with high single doses; (over)additive analgesic effect in experimental models. - the benefit of the fixed combination is given by a potentially lower liver toxicity as proven with experimental models and by an (over)additive efficacy in cancer pain or headache. - combination-specific risks surpassing the ones of the single substances are not recognizable. This holds particularly true also for the risk of analgesic nephropathy being presented elsewhere [19]. Even though the clinical efficacy has been proven only in few specific studies the evaluation of the benefit/risk-ratio appears to be positive regarding the not recognizable combination-specific risks. The combination is recommended for acute use.     

Nursing in Nazi Germany.

German nursing did indeed change during the Nazi period. There were external changes, in terms of the improved social status of nursing, the tightening and unification of professional nursing organizations, the laws affecting nursing, and the politicization of the profession. Articles written by nurses at the time and more recent interviews suggest that there were internal changes as well. It appears that at least a portion of German nurses accepted the National Socialism reinterpretation of professional nursing ethics and humanitarian principles in the assumption that through their obedience they were doing good. This historical research points to clear lessons for contemporary nurses. Nurses in Nazi Germany were under the illusion that they were remaining true to their professional ethics, unaffected by the social change around them. This apolitical professional consciousness made it possible for the profession to be subsumed as a part of the larger political system. I believe that we must be clear that nursing never takes place in a value-free, neutral context; it is always a socially significant force. This means that we cannot simply observe what is taking place around us but must take a stand and get involved, helping to shape sociopolitical developments. I also believe that we must deal with the history of our profession, especially its darkest hours, so that we may remain sensitive to any signs of inhumanity. We must call into question traditional principles, such as obedience, and replace them with professional competence, professionalism, and creative self-consciousness. And not least, we have a moral obligation to the millions of victims of National Socialism, even if it only means that, through historical research, we assure that they are not forgotten. By taking responsibility for this part of our history, we can become more sensitive for the future, with eyes and ears open for all social injustices.     

Assessment, education and placement: an integrated approach to vocational rehabilitation

Taking into account that a great number of people in the Netherlands are considered incapacitated for work, reintegration activities are becoming increasingly important. Thus far, no studies have been conducted in the Netherlands to investigate the long-term effectiveness of vocational rehabilitation programmes. This study assessed the long-term effectiveness of the programmes of three vocational rehabilitation centres. The centres relate their success to the proportion of trainees participating in the competitive labour market. The centres provide integrated programmes in certified occupational training and personal skills training. After five years, 80% of the trainees are working in the competitive labour market. In addition, their personal skills have improved. Within 4 to 7 years the decrease in social security costs of reintegrated employees will outweigh the total costs of the vocational training programme.     

A frequent polymorphism in the coding exon of the human cannabinoid receptor (CNR1) gene.

The central cannabinoid receptor (CB1) mediates the pharmacological activities of cannabis, the endogenous agonist anandamide and several synthetic agonists. The cloning of the human cannabinoid receptor (CNR1) gene facilitates molecular genetic studies in disorders like Gilles de la Tourette syndrome (GTS), obsessive compulsive disorder (OCD), Parkinsons disease, Alzheimers disease or other neuro psychiatric or neurological diseases, which may be predisposed or influenced by mutations or variants in the CNR1 gene. We detected a frequent silent mutation (1359G-->A) in codon 453 (Thr) of the CNR1 gene that turned out to be a common polymorphism in the German population. Allele frequencies of this polymorphism are 0.76 and 0.24, respectively. We developed a simple and rapid polymerase chain reaction (PCR)-based assay by artificial creation of a Msp I restriction site in amplified wild-type DNA (G-allele), which is destroyed by the silent mutation (A-allele). The intragenic CNR1 polymorphism 1359(G/A) should be useful for association studies in neuro psychiatric disorders which may be related to anandamide metabolism disturbances.     

Narrative inquiry into life experiences of refugee women and men

BACKGROUND: Africa is the site of many refugee camps, and non-governmental agencies are often responsible for providing programmes and services to improve refugees' quality of life and health in temporary encampments. Rwanda hosts three refugee camps as a result of the 1994 genocide. AIM: This research examines meaningful life experiences as narrated by women and men Congolese refugees residing in a refugee camp in Rwanda. METHODS: Two in-depth interviews were conducted with 15 refugee men and 14 refugee women. Content in the research text was analysed separately by gender. FINDINGS: Women's experiences revealed themes of leaving the good life behind, worrying about their daughters, feeling ambivalent about marriage and lacking hope. Men's experiences revealed themes of leaving the good life behind, having no peace in the heart and fearing the future. CONCLUSIONS: Listening to refugee voices in narrated life experiences provides an opportunity for non-governmental organizations to create programmes and services that pertain closely to refugees' life experiences.     

Hahnemann's legacy: The rise and fall of Bryonia alba

When Hahnemann published the provings of Bryonia alba in the first edition of the Materia Medica Pura, he knew exactly which species of Bryonia he had been using. After his death, the plant gradually came to be replaced with another species of the same genus, with no distinction made and the second species practically unproven.Today, Bryonia dioica, a practically unproven species, is widely sold as ‘Bryonia’, and customers are not informed about this inadmissible exchange. Hahnemann made it very clear that every plant species is unique and cannot be exchanged for any other.Today, Bryonia dioica, a practically unproven species, is widely sold as ‘Bryonia’, and customers are not informed about this inadmissible exchange. Hahnemann made it very clear that every plant species is unique and cannot be exchanged for any other.At the same time his improvements to the manufacturing process, based on experience, have not been adopted by pharmaceutical firms, nor in the German Homoeopathic Pharmacopoeia (GHP). Instead, they have been adopting less labour intensive methods, though these have not been properly validated.     

The perceptions of nurse teachers regarding the preparation for their role in Project 2000 programmes.

This paper discusses the findings related to the perceptions of nurse teachers regarding the preparation for their role in Project 2000 programmes. Data were collected by utilising three rounds of a Delphi survey with a panel of experts made up of Grade 2 nurse teachers. The panel of 201 respondents was obtained from 25 of the 28 colleges of nursing and midwifery that had implemented Project 2000 between September 1989 and April 1991. The profile of the respondents revealed that 68% work in general nurse courses, 18% in mental health, 8% in mental handicap and 6% in child care. Over half of the respondents hold a degree related to health care and over a quarter are studying for one. The findings suggest that the nurse teachers working in Project 2000 programmes consider their teacher preparation course an important means of preparation for the activities within their role. Degree and diploma courses are also considered important along with additional professional qualifying courses and subject related courses. What did not appear evident was any preparation for the many specific activities they carry out apart from teaching. Experience came out strongly as an important means of preparation for all the activities. Staff development programmes were said by 52% of respondents to be organised within their colleges and perceived by many as an important means of preparation.     

Improving the pharmacokinetic and pharmacodynamic properties of a drug by chemical conversion to a chimera drug.

The purpose of the present study is to investigate a new concept which involves the conjugation of two drugs having different pharmacological activities which is termed a 'chimera drug (mutual prodrug)', in drug delivery optimization using a chemical modification approach. The conjugates of FP, an NSAID, with histamine H(2) antagonists were synthesized, in order to investigate the reduction in gastric damage by NSAID, and their pharmaceutical, pharmacokinetic and pharmacological properties were examined. The limited data obtained herein indicate that the chimera drug composed of FP and PPA was effective in reducing gastric damage by FP, with no changes in its biopharmaceutical properties, compared with the conventional prodrugs such as ester-type prodrugs.     

International Vision and Strategy for Drug Regulatory Authority: The PMDA's International Vision

The past several years saw various countries' drug regulatory authorities (DRAs) internationalizing their activities in response to the rapid globalization of pharmaceutical affairs. This is the second surge of internationalization, coming after the first in the 1990s, when the International Conference on Harmonisation (ICH) and the Global Harmonization Task Force were founded. For maximum effect, a DRA needs to carefully strategize its international activities. The significance of international master plans is discussed in relation to the recently published International Vision of Japan's Pharmaceuticals and Medical Devices Agency (PMDA).     

Rival research programmes and their influence on nursing practice

In most forms of industry, there is an explicit link between research and development and subsequent technological processes. New discoveries can alter the direction or trajectory of technological progress. In this respect, health care is no different to any other form of industry. There are several theories of science which attempt to explain this link and predict its behaviour. According to Lakatos (1978), rival research programmes may co-exist, whilst Brouwer (1990) suggests they may vie with each other to alter the direction of technological progress. Presently, there are at least two research programmes which are competing to capture the activities of nurses. These are: the Health Care as Industrial Process programme, generating guideline driven nursing, and use of care pathways to maximize throughput plus labour substitution to minimize costs; and the Health Care as Therapeutic Interaction programme, focused on the management and delivery of the fundamental aspects of nursing care, and the use of emotional labour and psychological care to enable patients to cope and make sense of their situation. Ideally, the direction of practice should reflect both of these valid research programmes, with nurses as the staff best placed to integrate medical technology with humanity. Arguably, it is the Industrial Process programme which is currently dominant, at the price of decreased quality of care, and loss of the health benefits of therapeutic interaction. Greater effort is needed, in terms of research to reduce the apparent 'invisibility' of emotional labour, and education of nurses to boost therapeutic interaction skills. In order to re-direct the trajectory, managers should acknowledge and accommodate aspects of therapeutic interaction in service re-engineering, and use quality assurance tools which may accurately detect and monitor therapeutic interaction by nurses.     

Importance of in vivo pharmacology in research and development

The pharmaceutical industry, with its well structured research, is now an area where the in vivo pharmacologist has a well recognised role. After a period of relative loss of interest related to the belief of the 'all in vitro', the impressive development of molecular biology, genomics, proteomics, and now metabonomics has surprisingly revived the absolute necessity for the pharmaceutical industry, within its R&D (research and development) teams, to give the responsibility to in vivo pharmacologists for the following: validating new targets; phenotyping transgenic animals; determining the activity and potency of molecules, as well as exposing their potential unwanted pharmacological activities; contributing to the characterisation of pharmacokinetics and metabolism; participating in numerous other research and development activities such as the preparation of submission of files to authorities.     

PROPERTIES OF THE CAUSATIVE AGENT OF A CHICKEN TUMOR : IX. THE EFFECT OF AQUEOUS EXTRACTS OF CHICKEN TUMOR I ON YEAST NUCLEIC ACID

1. Aqueous extracts of Chicken Tumor I cause a disintegration of yeast nucleic acid. 2. Two enzyme activities, a polynucleotidase and a phosphatase, are demonstrated. 3. These activities are distinguished by different reactions to an environment of hydrogen, different optima of hydrogen ion concentration, and different rates of activity. 4. Adsorption with aluminum hydroxide Type C removes substances inhibiting the polynucleotidase activity. 5. There is a rough proportionality between the polynucleotidase activity and the tumor-inducing power of different fractions of extracts of Chicken Tumor I. 6. There is a rough proportionality between the inhibition of polynucleotidase activity and the inhibition of the tumor agent. 7. The polynucleotidase activity of Chicken Tumor I is as great as that of spleen, slightly less than that of kidney and liver, but much greater than that of muscle. There are also qualitative differences.     

Relevance of medical rehabilitation in disease management programmes

Disease management programmes will increasingly be introduced in Germany due to the new risk adjustment scheme. The first disease management programmes started in 2003 for breast cancer and diabetes mellitus type II. German rehabilitation will have to face several challenges. Disease management programmes are strongly based on the notion of Evidence so that proof of the efficacy of a care giving task should be present. Verification of the evidence of the specifically German rehabilitation treatments must therefore be given. However, integration of rehabilitation in disease management programmes could lead to changes in the alignment of German rehabilitation. The essence of German rehabilitation, notably its holistic approach, could get lost with integration in disease management programmes.     

Similitude in modern pharmacology.

The principle of the similitude, the basis of homeopathy, has correspondences in the clinical studies of secondary effects of many modern pharmaceutical agents through the observation of the rebound effects of these drugs. Through clinical pharmacology, I proposed a model on which to base the scientificism of the homeopathic model. We have studied the effects of the drugs in the human body using pharmacological compendia and recent scientific works, confirming the mechanism of the homeopathic medicines' action through the verification of the primary action of the drugs and the consequent secondary reaction of the organism in hundreds of pharmaceutical agents. Treatment exploiting the "rebound" effect (curative vital reaction) may also be observed. This work suggests a research methodology to scientifically base the therapeutic principle of similitude.     

Nurse education and the labour market: an Israeli case study

The article explores the demand structure for nursing in Israel by analysing socio-demographic trends within the nursing-student population at one Israeli university. The main findings are that many of the new recruits to academic nursing programmes in the late 1990s came from two somewhat marginal sub-populations: immigrants from the Former Soviet Union (FSU) and Israeli Palestinians. The high, yet decreasing percentage of the former category and the rise in the latter are interpreted in terms of competing forces in the local labour market in general, and in the healthcare field in particular. The article points to possible links between the structure of nurse education (length of training, relative advantage of university graduates) and broader political processes that have taken place in the Israeli arena during these years.