The Legacy of Nazi Medicine in Contemporary Mental Health Ethics: Comparing three decades of debates in Germany and Israel, 1990-2020 (LANE)

Research Background

The crimes of National Socialist medicine, most notably the systematic murder of psychiatric patients under the so-called "euthanasia" program and the broader apparatus of eugenics, mark a foundational rupture, in turn affecting modern medical ethics. Yet the legacy of Nazi psychiatry is not confined to historical remembrance; it continues to function as a normative reference point in contemporary bioethics and mental health ethics debates.

Modern bioethics provides moral orientation for healthcare professionals, patients, and health policy. Strikingly, the relationship between bioethics and Holocaust memory has never been systematically examined. This joint German-Israeli project addresses that gap. By comparing mental health ethics debates in Germany and Israel between 1990 and 2020, we investigate how perceptions of Nazi atrocities have shaped the emergence and development of bioethical thinking in two societies for whom this history carries profound but distinct meaning. The project thus brings together the history of medicine and empirical bioethics.

Research Topics

The project addresses two central research questions:

1. What image of the patient has informed mental health ethics – particularly the concepts of informed consent and patient autonomy – and on which formal regulations, informal assumption and historical references is that image based?
2. What are the ethical imperatives that guide research on mentally incapacitated persons, or patients with severe mental illness (e.g. dementia research and placebo-controlled clinical trials) and how are they influenced by collective memory of a traumatic past?

To address these questions, the project employs a mixed qualitative methodology:

1. Critical discourse analysis is applied to bioethics publications, scholarly literature, reports, and policy documents on psychiatric ethics published between 1990 – 2020, in Germany and Israel. Particular attention is paid to how references to Nazi medicine and the Holocaust emerge in debates surrounding psychiatric research and treatment.
2. Experts’ interviews: semi-structured in-depth interviews with psychiatrists, ethicists, and legal professionals in both countries, analyzed using content analysis.

By systematically comparing ethical debates across two societies for whom this history carries distinct but profound significance, the project is aimed at developing a cross-cultural, theoretically informed understanding of how historical memory and cultural context shape the development of bioethical discourse in psychiatry.

Research Aims

• To reconstruct and compare, on an empirical basis, implicit and explicit discourse patterns in the ethical governance of psychiatric research and novel treatments in Germany and Israel, and to assess the impact of the Nazi medicine legacy on these debates.
• To investigate how historical memory, professional self-understandings, and cultural contexts shape contemporary conceptions of patients, autonomy, and vulnerability in psychiatry
• To combine historical, social scientific, and ethical approaches in order to contribute to a historically informed understanding of contemporary bioethical debates
• To critically examine how the liberal and individualistic approach in mental health ethics, developed as a normative response to Nazi ideology, has functioned as a dominant framework in Germany and Israel, and to draw lessons for future research ethics and ethics education.

Results / Outreach

Publications

• Korecky, K. and Schicktanz, S. (Forthcoming). „Psychiatrieethik in Deutschland seit 1970 und die Aufarbeitung nationalsozialistischer Medizinverbrechen“, Ethik in der Medizin.

Organized international workshops (selection) 

• "Rethinking the Legacy of Nazi Medicine and Debating the Future of Psychiatric Bioethics", International Project Workshop, Ben Gurion University of the Negev, Beer Sheva. July 14-15, 2024. Full program see here.
• "Rethinking Mental Disease and the Birth of Bioethics in the Shadow of the Holocaust" International Project Workshop, Chair for Science Studies, ETH Zurich, April 24-25, 2024. Organizers: Hagner, M. and Zalashik, R.  Full program see here.

Presentations in academic conferences (selection)

• Korecky, K., Rimon-Zarfarty, N. and Schicktanz, S. “The Ethics of “Never Again”
  History and Structure of Psychiatric Ethics in Postwar Germany”. Nahariya Conference on Medicine and the Holocaust. June 12, 2025.
• Schicktanz, S. "The Legacy of Nazi Medicine in Bioethics: A Conceptual Reconstruction of Contemporary Psychiatric Ethics". 4th Annual Conference of the Research Center for Medical Humanities, University of Innsbruck.  December 6, 2024

Public Outreach (selection)

• Korecky, K. and Schicktanz, S. "The Legacy of Nazi Medicine in German Psychiatric Ethics. Results of a Narrative Interview Study“. Wednesday Lecture Series on Biopsychosocial Medicine Department of Psychosomatic Medicine and Psychotherapy University Medical Center Göttingen. May 14, 2025.