With lessons from the Holocaust, medical students consider health care ethics

PROVIDENCE, R.I. [Brown University] — By the time the students arrived at Auschwitz-Birkenau, they were prepared — they had read texts about the Holocaust, spoken with a survivor, viewed Berlin’s memorials and toured the halls where the Nazi regime planned its “euthanasia” and Final Solution campaigns to murder millions. But for Hyunwoo June Choo and Alexa Kanbergs, standing on the grounds of the Nazi killing center transformed merely knowing of these historical events into feeling them, vividly and palpably.

Monday, June 26, was a lovely summer day in Poland, Kanbergs recalled. She was struck by how the buildings of Birkenau, where Nazis gassed as many as 6,000 Jews a day to death, stood in juxtaposition with the beautiful surrounding landscape and the ubiquitous sounds of chirping birds.

“I viscerally felt something when I went to that site,” said Kanbergs, a third-year Warren Alpert Medical School student from Portland, Ore. “We had been reading about it, but you are removed from it because you are just learning about it. Then when you actually visit, it makes it a lot more real.”

Choo, a fourth-year medical school student from Los Angeles, was similarly struck. Organizers of the two-week program that had brought them to Germany and then Poland, the Fellowships at Auschwitz for the Study of Professional Ethics, had told them that “place has power.” In a huge camp built for the sole purpose of genocide, the meaning was clear.

“The entire week, we had been building up to this point,” Choo said. “We went to where the leaders had planned and strategized how to exterminate large masses of people. When I was actually there, I was just standing aghast at the expanse and the sheer vastness of this institution. Everything was deliberate. Everything was calculated.”

The Fellowships at Auschwitz program teaches medical, legal, business, journalism and divinity students to consider the ethics of their future professions in the context of the Holocaust’s catastrophic moral failings. Choo and Kanbergs had applied to the competitive fellowships out of a desire to transcend and therefore contemplate the day-to-day experience of their medical training.

“In medical school as students, we’re sort of thrown into wards and hospital systems and we see things — a lot of injustices play out on individual bodies,” Choo said. “We don’t really have the time or space to think through the systems behind a lot of the social circumstances that bring a patient in front of us. What this program allowed us to do was to think about ethics not as this lofty, abstract idea, but as something grounded in history.”

The point is not that inequities and injustices in the U.S. health care system have equivalence with the Nazi regime’s meticulously planned policies of mass murder, Kanbergs said. Instead, the point is to learn how to recognize and sustain clear moral vigilance in systems that produce injustice, regardless of its scale or whether it was intended.

“I don’t ever want to take away from the events that happened in the Holocaust and say that this is the same situation,”  Kanbergs said, “but I think about prisoners a lot, and I think about how we incarcerate individuals of color. I see these parallels with how we strip the rights of individuals and target certain classes of individuals. As physicians, we are put into these systems that allow for that to happen.”

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