Students attending the Fellowships at Auschwitz for the Study of Professional Ethics at a library in Charité–Universitätsmedizin Berlin, where several specimens, including casts of body parts of some famous scientists and skulls of people from Namibia during German colonization, were displayed.
For many pursuing a path in medicine, a fellowship is an opportunity to learn and hone specialized skills in their chosen subspecialty. But medical education encompasses so much more than just medical skills and knowledge—compassion and ethics are just as important for a physician during medical training.
A group of students and graduates from the Icahn School of Medicine at Mount Sinai got to explore those values more deeply at the Fellowships at Auschwitz for the Study of Professional Ethics (FASPE), a two-week program in Berlin, Germany, and Krakow, Poland, exploring ethical atrocities committed in medicine in the past and opportunities for improvement today.
“The immersive experience it offers, allows participants to learn about some of the professional responsibilities of physicians,” says Rosamond Rhodes, PhD, Professor of Medical Education and Director of Bioethics Education at Icahn Mount Sinai.
When guided by humanitarian commitment, medicine can achieve great things, but when doctors lose sight of the profession’s fiduciary responsibility, horrors can come from it, says Dr. Rhodes. Students benefit tremendously from learning about critically important pieces of history in medicine, she adds.
Over the years, seven people from Icahn Mount Sinai have participated in the fellowship. Browse the slideshow and read from three recent fellows on their accounts of the program, and how it has reshaped their perspectives.
Anish Kumar is currently on a Scholarly Year project—a yearlong research training—at RubiconMD, a New York-based digital health company that aims to improve access to specialty care. Professional interests include how clinical medicine and artificial intelligence intersect and resulting ethical questions, and using digital technologies and policy solutions to improve access to health care for LGBTQ+ and limited-English-proficiency patients.
As part of the FASPE program, our group had the opportunity to visit the Charité–Universitätsmedizin Berlin, a university hospital and medical school in the center of Berlin. Here, we traced the steps of pioneers of medicine, where figures like Rudolf Virchow and Carl Wernicke elucidated concepts that have become integral to modern clinical practice. But it was in these same hallways where academics contributed to and benefited personally from the atrocities of the Nazi regime, gaining easy access to human subjects and cadavers for their research efforts.
Our cohort visited a facility in Brandenburg, Germany, that was part of the Aktion T-4 campaign, in which medical professionals selected patients with serious illness or disability for systemic execution. Many of these clinicians were swayed by arguments that caring for such patients was excessively resource-intensive and that these patients represented “life unworthy of life.”
I was horrified to learn that doctors had signed up their own patients to be killed—a realization made even more chilling by witnessing the remnants of a gas chamber prototype that was used, which eventually became the notorious killing machines used to execute mass murder in concentration camps. I saw that rank-and-file physicians had been compelled to corrupt their core ethical values and murder their own patients, all in the name of public health.
In discussing how to memorialize the remains of victims of the Holocaust and Germany’s colonial campaigns in West Africa, we confronted challenges around the use of human specimens in research without consent. Having previously worked with digital forms of clinical data and understanding its growing ubiquity in health care technologies, I was struck by similar implications that are increasingly posed by digital data. Inspired by my experiences at Charité, I am currently writing an opinion piece arguing that certain forms of medical data should be considered “digital specimens” and that their use in research should be regulated in similar manners to physical samples.
I realize that part of my duty as a physician is to stay vigilant and speak out against claims that blindly dismiss the importance of an individual patient in alleged deference to the greater good. I am grateful for the opportunity to participate in FASPE and to walk away with a new vocabulary, refined perspective, and a deeper confidence in my ability to recognize and engage with the inevitable ethical dilemmas that will face me as a physician.
Krishna Patel is currently on a Scholarly Year project, and started a 501(c)(3) nonprofit called Health and Education Alliance, supported by Mount Sinai’s Diversity Innovation Hub Fellowship. The nonprofit builds partnerships between health care organizations and school districts to maximize access to health care and education opportunities through holistic community centers.
Before arriving in Berlin and Krakow for the two-week fellowship, I found myself grappling with a lot of excitement but also some element of concern. Having lacked any prior ethics background and knowing I would be in a cohort of folks with much more knowledge than me in this domain, I couldn’t help but worry about how I might be judged. However, I am so thankful to say that all of the other 41 fellows, who challenged me to break down and realize my own biases and weaknesses, were among the kindest, most insightful group of people I have had the pleasure of meeting.
In particular, it turns out that spending entire days in close proximity with everyone at historical sites, where some of the greatest horrors in history have been memorialized, is one of the best ways to bring people together, albeit in a way that I could not have comprehended prior to this experience.
I found myself able to make myself vulnerable in sharing my thoughts and being transparent when discussing the fellowship’s fundamental themes, namely: what is inside us that makes us prone to becoming perpetrators or complicit in flawed systems, despite our most noble intentions?
As a future physician who is currently in the midst of a Scholarly Year, where much of my work focuses on improving health care and education inequity for underserved neighborhoods and families with special needs, I have been unable to stop myself from ruminating on this question since the conclusion of the fellowship. It is no secret that both health care and education, especially in the United States, are flawed systems—to say the least—yet how can this be reconciled with the vast majority of individual agents, including teachers, nurses, doctors, and aides who devote themselves to a career of helping others during times of high need and vulnerability?
Truthfully, I still do not have the best answer to this question. However, without FASPE, I would never have been able to come away with the ethical framework to engage in self-introspection and evaluate my own biases and shortcomings as much as possible. Moreover, I do not believe I would have the courage or even the words to articulate some of my frustrations, which have encouraged communication with people I speak to for my Scholarly Year work in my hometown, Pittsburgh.
I could not be more grateful for my FASPE experience and I’m optimistic it will stay with me throughout the remainder of my professional career. It reinforces the notions that as physicians who have the great privilege of having roles and rights in patients’ lives not otherwise granted to most other professions, there is always more that we can advocate for as a collective profession to minimize harm and hold ourselves accountable.
Esha Bansal, MD, MPH, is currently a resident physician in internal medicine at Hospital of the University of Pennsylvania. Professional interests include reducing preventable morbidity and mortality through population health research and public policy, particularly in cardiovascular disease, and advancing gender equity by designing equitable, sustainable health interventions that reduce sexual and gender-based violence for women and girls worldwide.
While visiting important historical sites through FASPE, I was struck by the complexities of memorializing large-scale events of human suffering. Early in the fellowship, we visited the Grunewald train station, a major deportation site for the Jewish community of Berlin during World War II. Over time, several commemorations of the violence enacted at the Grunewald train station had been installed by diverse groups, simultaneously reinforcing and contrasting with one another to bring a piece of this history into the present and future.
In my work as a physician, this experience compelled me to consider the ethical challenges of addressing histories of collective harm and health-related trauma in underserved communities. In particular, this lesson from FASPE shaped my career interests in gender equity and preventive health. Inspired by “A Woman in Berlin,” an important post-World War II literary work by a German journalist, I wrote an essay arguing that past and present incidents of mass sexual violence should be proactively acknowledged as medical and public health crises with genocidal attributes.
At the conclusion of the fellowship, our cohort visited the Auschwitz-Birkenau Memorial and Museum in Oświęcim, Poland. Standing in the physical space where millions of people were exterminated was a powerful, humbling experience. This moment moved me to make my own contribution to the ongoing work of addressing medical and public health professionals’ complicity in mass crimes—including the genocides of World War II, in which Nazi physicians participated freely and voluntarily. I later wrote a commentary article calling attention to the unmet obligations of the medical and public health professions to address femicide, a severe and highly prevalent form of gender-based violence, as a global health problem.
Participating in FASPE reinforced my belief that as physicians and public health professionals, we must seek accountability for our profession’s role in perpetuating harm. I am grateful that FASPE offered me the intellectual framework, personal experiences, and practical skill set to begin my own professional ethics journey.
Anish Kumar is currently on a Scholarly Year project—a yearlong research training—at RubiconMD, a New York-based digital health company that aims to improve access to specialty care. Professional interests include how clinical medicine and artificial intelligence intersect and resulting ethical questions, and using digital technologies and policy solutions to improve access to health care for LGBTQ+ and limited-English-proficiency patients.
As part of the FASPE program, our group had the opportunity to visit the Charité–Universitätsmedizin Berlin, a university hospital and medical school in the center of Berlin. Here, we traced the steps of pioneers of medicine, where figures like Rudolf Virchow and Carl Wernicke elucidated concepts that have become integral to modern clinical practice. But it was in these same hallways where academics contributed to and benefited personally from the atrocities of the Nazi regime, gaining easy access to human subjects and cadavers for their research efforts.
Our cohort visited a facility in Brandenburg, Germany, that was part of the Aktion T-4 campaign, in which medical professionals selected patients with serious illness or disability for systemic execution. Many of these clinicians were swayed by arguments that caring for such patients was excessively resource-intensive and that these patients represented “life unworthy of life.”
I was horrified to learn that doctors had signed up their own patients to be killed—a realization made even more chilling by witnessing the remnants of a gas chamber prototype that was used, which eventually became the notorious killing machines used to execute mass murder in concentration camps. I saw that rank-and-file physicians had been compelled to corrupt their core ethical values and murder their own patients, all in the name of public health.
In discussing how to memorialize the remains of victims of the Holocaust and Germany’s colonial campaigns in West Africa, we confronted challenges around the use of human specimens in research without consent. Having previously worked with digital forms of clinical data and understanding its growing ubiquity in health care technologies, I was struck by similar implications that are increasingly posed by digital data. Inspired by my experiences at Charité, I am currently writing an opinion piece arguing that certain forms of medical data should be considered “digital specimens” and that their use in research should be regulated in similar manners to physical samples.
I realize that part of my duty as a physician is to stay vigilant and speak out against claims that blindly dismiss the importance of an individual patient in alleged deference to the greater good. I am grateful for the opportunity to participate in FASPE and to walk away with a new vocabulary, refined perspective, and a deeper confidence in my ability to recognize and engage with the inevitable ethical dilemmas that will face me as a physician.
Krishna Patel is currently on a Scholarly Year project, and started a 501(c)(3) nonprofit called Health and Education Alliance, supported by Mount Sinai’s Diversity Innovation Hub Fellowship. The nonprofit builds partnerships between health care organizations and school districts to maximize access to health care and education opportunities through holistic community centers.
Before arriving in Berlin and Krakow for the two-week fellowship, I found myself grappling with a lot of excitement but also some element of concern. Having lacked any prior ethics background and knowing I would be in a cohort of folks with much more knowledge than me in this domain, I couldn’t help but worry about how I might be judged. However, I am so thankful to say that all of the other 41 fellows, who challenged me to break down and realize my own biases and weaknesses, were among the kindest, most insightful group of people I have had the pleasure of meeting.
In particular, it turns out that spending entire days in close proximity with everyone at historical sites, where some of the greatest horrors in history have been memorialized, is one of the best ways to bring people together, albeit in a way that I could not have comprehended prior to this experience.
I found myself able to make myself vulnerable in sharing my thoughts and being transparent when discussing the fellowship’s fundamental themes, namely: what is inside us that makes us prone to becoming perpetrators or complicit in flawed systems, despite our most noble intentions?
As a future physician who is currently in the midst of a Scholarly Year, where much of my work focuses on improving health care and education inequity for underserved neighborhoods and families with special needs, I have been unable to stop myself from ruminating on this question since the conclusion of the fellowship. It is no secret that both health care and education, especially in the United States, are flawed systems—to say the least—yet how can this be reconciled with the vast majority of individual agents, including teachers, nurses, doctors, and aides who devote themselves to a career of helping others during times of high need and vulnerability?
Truthfully, I still do not have the best answer to this question. However, without FASPE, I would never have been able to come away with the ethical framework to engage in self-introspection and evaluate my own biases and shortcomings as much as possible. Moreover, I do not believe I would have the courage or even the words to articulate some of my frustrations, which have encouraged communication with people I speak to for my Scholarly Year work in my hometown, Pittsburgh.
I could not be more grateful for my FASPE experience and I’m optimistic it will stay with me throughout the remainder of my professional career. It reinforces the notions that as physicians who have the great privilege of having roles and rights in patients’ lives not otherwise granted to most other professions, there is always more that we can advocate for as a collective profession to minimize harm and hold ourselves accountable.
Esha Bansal, MD, MPH, is currently a resident physician in internal medicine at Hospital of the University of Pennsylvania. Professional interests include reducing preventable morbidity and mortality through population health research and public policy, particularly in cardiovascular disease, and advancing gender equity by designing equitable, sustainable health interventions that reduce sexual and gender-based violence for women and girls worldwide.
While visiting important historical sites through FASPE, I was struck by the complexities of memorializing large-scale events of human suffering. Early in the fellowship, we visited the Grunewald train station, a major deportation site for the Jewish community of Berlin during World War II. Over time, several commemorations of the violence enacted at the Grunewald train station had been installed by diverse groups, simultaneously reinforcing and contrasting with one another to bring a piece of this history into the present and future.
In my work as a physician, this experience compelled me to consider the ethical challenges of addressing histories of collective harm and health-related trauma in underserved communities. In particular, this lesson from FASPE shaped my career interests in gender equity and preventive health. Inspired by “A Woman in Berlin,” an important post-World War II literary work by a German journalist, I wrote an essay arguing that past and present incidents of mass sexual violence should be proactively acknowledged as medical and public health crises with genocidal attributes.
At the conclusion of the fellowship, our cohort visited the Auschwitz-Birkenau Memorial and Museum in Oświęcim, Poland. Standing in the physical space where millions of people were exterminated was a powerful, humbling experience. This moment moved me to make my own contribution to the ongoing work of addressing medical and public health professionals’ complicity in mass crimes—including the genocides of World War II, in which Nazi physicians participated freely and voluntarily. I later wrote a commentary article calling attention to the unmet obligations of the medical and public health professions to address femicide, a severe and highly prevalent form of gender-based violence, as a global health problem.
Participating in FASPE reinforced my belief that as physicians and public health professionals, we must seek accountability for our profession’s role in perpetuating harm. I am grateful that FASPE offered me the intellectual framework, personal experiences, and practical skill set to begin my own professional ethics journey.