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US Primary Care Doctors Greediest on Planet Earth (NYT 8/9/11)

Posted in Uncategorized by ce399 on 14/09/2011

Doctors are paid higher fees in the United States than in several other countries, and this is a major factor in the nation’s higher overall cost of health care, says a new study by two Columbia University professors, one of whom is now a top health official in the Obama administration.

“American primary care and orthopedic physicians are paid more for each service than are their counterparts in Australia, Canada, France, Germany and the United Kingdom,” said the study, by Sherry A. Glied, an assistant secretary of health and human services, and Miriam J. Laugesen, an assistant professor of health policy at Columbia.

The study, being published Thursday in the journal Health Affairs, found that the incomes of primary care doctors and orthopedic surgeons were substantially higher in the United States than in other countries. Moreover, it said, the difference results mainly from higher fees, not from higher costs of the doctors’ medical practice, a larger number or volume of services or higher medical school tuition.

Such higher fees are driving the higher spending on doctors’ services, the study concluded.

Ms. Glied, an economist, was a Columbia professor before President Obama named her assistant health secretary for planning and evaluation in June 2010. She said the paper, based on academic research, did not reflect the official views of the administration or the White House.

But the journal said the findings suggested that, as policymakers struggle to find ways to restrain health spending, they might consider doctors’ fees. Doctors have generally been excluded from recent cost-cutting proposals because under existing law, Medicare, the federal insurance program for older people, will reduce their fees by 29.5 percent on Jan. 1. In addition, many states have frozen or reduced fees paid to doctors treating poor people under Medicaid.

The study examined fees paid by public programs and private insurers for basic office visits and for hip replacement surgery, and found that Americans were “very low users of office visits and relatively high users of hip replacement surgery.”

“Fees paid by public payers to orthopedic surgeons for hip replacements in the United States are considerably higher than comparable fees for hip replacements in other countries,” the authors found, “and fees paid by private insurers in the United States for this service are double the fees paid in the private sector elsewhere.”

For primary care office visits, the gap between fees paid by Medicare and by public programs in other countries was smaller. But the study found that private insurers paid more for such services here than in other countries.

“U.S. primary care physicians earn about one-third more than do their counterparts elsewhere,” mainly “because a much larger share of their incomes is derived from private insurance,” the study said.

Ms. Laugesen and Ms. Glied said that among primary care doctors, those in the United States had the highest annual pretax earnings after expenses — an average of $186,582 in 2008 — while those in Australia and France had the lowest earnings, $92,844 and $95,585.

“Among orthopedic surgeons, those who had the highest annual pretax incomes, net of expenses, were in the United States,” with an average of $442,450, the study said. In Britain, which ranked second, the comparable figure was $324,138. Annual pretax earnings of orthopedic surgeons in the other countries were less than $210,000.

Medical students often cite higher pay as a reason for choosing to become specialists, and the researchers said the income gap between primary care doctors and orthopedic surgeons was larger here than elsewhere.

“In the United States, primary care doctors earned only about 42 percent as much as orthopedic surgeons earned,” the study said. “In Canada, France and Germany, in contrast, primary care doctors earned at least 60 percent as much as orthopedic surgeons earned.”

“High physician fees in the United States may reflect the cost of attracting skilled candidates to medicine in a society with a relatively more skewed income distribution,” the study said.

http://www.nytimes.com/2011/09/08/us/08docs.html?_r=1&pagewanted=print

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Science and Inhumanity: The Kaiser-Wilhelm/Max Planck Society

Posted in Uncategorized by ce399 on 08/09/2011

William E. Seidelman MD
Science and Inhumanity:
The Kaiser-Wilhelm/Max Planck Society
First Published in: If Not Now an e-journal Volume 2, Winter 2000
http://www.baycrest.org/journal/ifnot01w.html

Revised February 18, 2001.

* The Kaiser-Wilhelm-Institute of Psychiatry, Munich

* The Kaiser-Wilhelm-Institute of Brain Research, Berlin-Buch

* The Kaiser-Wilhelm-Institute of Anthropology, Human Genetics and Eugenics, Berlin-Dahlem

* Present day Max Planck Society

One hundred years ago this past December a German scientist by the name of Max Karl Ernst Ludwig Planck gave a lecture in Berlin to the German Physical Society. Planck’s lecture would change the world forever. Entitled “On the Law of the Normal Distribution of Energy” the lecture marked the birth of quantum physics. Quantum physics established a basis for the later development of nuclear physics, the laser and the computer. It is the foundation of the modern technological world extending from nuclear energy to the transistor radio.

Max Planck was to become the most influential scientist in Germany. For 26 years (1912-1938) he was permanent secretary of the mathematics and physics sections of the Prussian Academy of Sciences. It was Planck who brought Albert Einstein to Berlin in 1914. Planck, who was awarded the 1918 Nobel Prize in Physics for his 1900 discovery, became the president of the Kaiser Wilhelm Society (1930-1937), the prestigious and influential organization established in 1911 by the German government and industry for the promotion of research.

After World War II the Kaiser-Wilhelm Society asked the aged Planck to again undertake the presidency of what had become a badly damaged organization. Planck also agreed to allow the Kaiser-Wilhelm Society to take on his name; thus today’s Max Planck Society which assumed its new name in 1948, one year after Planck’s death at age 89.

Planck’s achievements and distinctions and influence did not protect him from tragedy. His first wife died in 1909. His eldest son was killed in World War I. Each of his twin daughters died in childbirth. Erwin, the only surviving child of his first marriage, was executed by the Gestapo for purported links with Hitler’s would be assassins.

Planck was admired not only as a great scientist but also as a moral and courageous individual. He criticized Hitler’s racial policies to Hitler’s face. Rather than flee Germany Planck remained in an attempt to salvage what was left of German physical sciences. And in the 9th decade of his life he agreed to again become president of Germany’s preeminent research organization (1) (2) (3) (4).

While Planck the person is regarded with honor the same cannot be said of the organization that continues to bear his name.

Established in 1911, The Kaiser-Wilhelm organization spawned some of the most prestigious and influential scientific and academic institutes in the world. Kaiser Wilhelm institutes encompassed such scientific and academic disciplines as physics, chemistry, biology, cell biology, psychiatry, neuropathology, genetics, anthropology, metallurgy, and law. Many of the Nobel Laureates of the past century were associated with Kaiser-Wilhelm institutes. Between its founding in 1911 and 1948 the Kaiser-Wilhelm organization supported 35 institutes in Germany and other countries (5). The international esteem of the Kaiser Wilhelm institutes is reflected in the support it received from the Rockefeller Foundation. The Rockefeller Foundation made major contributions to the construction of the Kaiser Wilhelm institutes of brain research (Berlin-Buch) and psychiatry (Munich). It also provided financial support to other Kaiser-Wilhelm institutes adversely affected by World War I and the ensuing depression (6). In addition to capital funding for construction the Rockefeller Foundation supported research at the Munich psychiatric institute and twin research at the Kaiser Wilhelm Institute of Anthropology, Human Genetics and Eugenics at Berlin-Dahlem (7).

Ironically, the three Kaiser-Wilhelm institutes that were beneficiaries of Rockefeller largesse were to eventually play important roles in the development, implementation and exploitation of the racial programs of the Third Reich including murderous experiments and the exploitation of the dead. Kaiser-Wilhelm scientists joined with the Nazi state in pursuit of the goal of improving the people’s health (Volksgesundheit), the major emphasis being on eugenic and racial purification. The resulting collaboration between science and the Nazi state not only legitimized the policies and programs of the Hitler regime it resulted in the exploitation and mutilation and murder of untold thousands of innocent victims by physicians and scientists associated with some of the world’s leading universities and research institutes. The participation of scientists associated with the Kaiser-Wilhelm Society enhanced the credibility of the Nazi state’s program of scientific terror and murder (8).

The Kaiser-Wilhelm-Institute of Psychiatry, Munich

The Kaiser-Wilhelm Institute of Psychiatry in Munich had been established in 1917 as the German Institute for Psychiatric Research by the eminent psychiatrist, Prof. Emil Kraepelin. A major benefactor of the Munich institute was the American-born Jewish philanthropist, and at one time a patient of Kraepelin’s, James Loeb (9). The Munich psychiatric institute became the first and foremost psychiatric research institute in the world. In 1924 the institute joined with the Kaiser-Wilhelm research organization. The building of the new institute, which opened in 1928, was the first major construction project of the KWG to be financed by a grant from the medical division of the Rockefeller Foundation (6).

Kraepelin, who had been professor of psychiatry at the University of Heidelberg, had assembled a stellar group of clinicians and researchers including the psychiatrist/neurologist Alois Alzheimer and the neurohistologist, Franz Nissl (10). They were subsequently joined by the Swiss-born psychiatrist/geneticist Ernst Rüdin. Alzheimer, Nissl and Rüdin joined Kraepelin when he moved from Heidelberg to Munich in 1903. In 1909 Rüdin succeeded Alzheimer as senior physician at the Munich psychiatric hospital. In Munich, Rüdin led the Genealogical/Demographic research department of the Kraepelin Institute. The focus of Rüdin’s research was on the inheritance of psychiatric disorders. His 1916 paper on that subject is considered a classic that continues to be cited in the literature on the genetics of schizophrenia (11). In 1928 Rüdin became director of a “greatly expanded” genealogical department of what had become the Kaiser-Wilhelm Institute of Psychiatry. In 1931 he ascended to the leadership of the world’s preeminent psychiatric research institute (12). Rüdin built on Kraepelin’s relationship with the Rockefeller Foundation and James Loeb. His research was well endowed with funding from Rockefeller and the Loeb estate. Loeb, who died in 1933, had been a generous supporter of the institute from its inception. As his final gift, Loeb bequeathed $1,000,000 to the Munich institute (13).

After Hitler’s rise to power, Rüdin became an active supporter of the eugenic and racial hygiene policies of Hitler’s regime. He was an intellectual leader of the Nazi program of enforced eugenic sterilization entrenched under the 1933 Sterilization Law. He was honored twice by Hitler for his contribution to German eugenics (14).

The 1933 Sterilization Law established diagnostic categories for enforced sterilization. Two of the categories were for psychiatric conditions first characterized by Kraepelin and investigated by Rüdin, namely schizophrenia and manic-depressive disorder (15). An estimated 400,000 German citizens qualified for sterilization under the law. This goal was achieved (16).

The Kaiser Wilhelm Institute of Psychiatry under Rüdin became a major academic eugenic center during the Hitler period. It was to the psychiatric institute that doctors and the courts turned for an “expert” opinion on eugenic matters. It can be assumed that Rüdin, as an architect of the sterilization law did not support appeals against sterilizations ordered by the court. Rüdin was such an avid proponent of eugenic sterilization that his colleagues nicknamed him “Reichsfuhrer for Sterilization (17).”

In 1935 the Rockefeller Foundation withheld funding for genealogical and demographic research at the Munich institute. In 1940 the executors of the Loeb estate also ceased payment to the institute. Desperate for support Rüdin turned to the SS terror organization for salvation. In 1939 the world’s first and foremost psychiatric research institute came under the influence, if not the control, of the SS and its research organization, the notorious Ahnenerbe (7).

The Kaiser-Wilhelm-Institute of Brain Research, Berlin-Buch

The 1933 Sterilization Law to which Rüdin contributed and in which the KW Psychiatry Institute participated established the basis for the Nazi programs of selection and eugenic and racial purification. These programs included the killing of handicapped children and the T-4 Aktion for the murder of adults in psychiatric institutions (18) (19).

The T-4 killing program was exploited by Professor Julius Hallervorden of the KWI for Brain Research as an opportunity to augment the neuropathological collection of brain material in one of, if not the, world’s foremost institutes for brain research. The founding director of the institute, Professor Oskar Vogt, had been dismissed by the Nazis and replaced by Professor Hugo Spatz (20). Hallervorden was subsequently appointed by his friend Spatz with whom he had already achieved fame through the identification of a congenital neurological condition known as ‘Hallervorden-Spatz Disease (21).’

Hallervorden’s main collection point for specimens was the euthanasia killing center in the town of Brandenburg. At Brandenburg the victims were assembled in a large room disguised as a shower where they were asphyxiated with gas. Hallervorden is known to have been present for some of the killings and to have removed the victims’ brains shortly after their murder. Many of the Brandenburg victims came from the nearby large psychiatric hospital known as Görden. Hallervorden had a neuropathology facility on the grounds of the Görden hospital where specimens were prepared and sent to the Kaiser-Wilhelm institute in Buch (22) (23) (24) (25). Beginning in 1944, and for a number years after the war, the Kaiser-Wilhelm brain research institute and its neuropathological collection were moved from Berlin (via Giessen) to a permanent location near the University of Frankfurt and a newly constructed facility now known as the Max Planck Institute for Brain Research (26). The misbegotten specimens acquired by Hallervorden remained in the collection of the Max Planck Institute until 1990.

The provenance of the Frankfurt brain specimens was not revealed until the late 1980’s. This revelation occurred around the same time there were similar disclosures involving the Institute of Anatomy of the University of Tübingen. At first Max Planck officials denied the existence of the Hallervorden collection (27). The entire collection of brain specimens in the collection of the Frankfurt institute was buried in two adjoining gravesites at the Forest Cemetery in Munich. Munich was chosen as the burial site because it is the home of the Max Planck Society (28). It was also revealed at that time that the Max Planck Institute of Psychiatry had in its collection brain specimens from children murdered in the child “euthanasia” program. These specimens came from children murdered at Eglfing-Haar; a psychiatric institution near Munich (29).

The Kaiser-Wilhelm-Institute of Anthropology, Human Genetics and Eugenics, Berlin-Dahlem

The third Kaiser Wilhelm institute implicated in the crimes of the Third Reich is the Institute of Anthropology, Human Genetics and Eugenics in the Berlin suburb (and Kaiser Wilhelm Society campus) of Dahlem. The official opening of the institute in September of 1927 occurred in conjunction with the first international scientific conference to be held in Germany after the end of World War I; the 8th International Congress on Heredity. The founding director was the noted anatomist/anthropologist Prof. Eugen Fischer. Fischer’s interest was in the anthropology of natives of African territories colonized by Germany. With the arrival of the Hitler regime Fischer declared “the institute is completely and wholly prepared to assume the tasks of the current government (30).” And it did. Indeed, according to the Max Planck Society’s own accounting, the activities undertaken by institute scientists on behalf of the Nazi state “… reflected the conviction of most of the researchers, who believed that they might thereby come closer to achieving the racial hygiene goals they shared (30).”

A major proponent of the racist goals of the Hitler state was an institute scientist from Tübingen, Freiherr Dr. Otmar von Verschuer. Verschuer was a noted expert on the genetics of twins. His early twin research at the Dahlem institute was funded by Rockefeller (7). In 1936 Verschuer was called to Frankfurt to head the newly established Institute of Genetics and Racial Hygiene at the University of Frankfurt. The largest institute of its kind, the Frankfurt institute was responsible for the compulsory medical curriculum on eugenics and racial hygiene. Institute staff provided expert opinions to the court on decisions under the 1933 sterilization law and the Nuremberg racial laws (race having being made a medical diagnosis). Verschuer’s first assistant in Frankfurt was a medical student Josef Mengele. Mengele had recently received his PhD from the same university as had Max Planck, the University of Munich.

Verschuer exploited his position as a noted geneticist to expound his racist/anti-Semitic views which included “a new total solution (Gesamtlösung) of the Jewish problem.” In a 1942 editorial published in a journal he edited (Der Erbarzt) Verschuer called for a “final solution” (endgültige) to the Jewish question. In the second edition of his textbook on race hygiene (1942) he repeated his provocative statement, “The political demand of our time is the new total solution (Gesamtlösung) of the Jewish problem (31).”

In 1942 Verschuer succeeded Fischer as Director of the Dahlem institute. Verschuer as institute director took advantage of the endgültige to exploit helpless human beings captive in Auschwitz to pursue his research objectives including the study of twins. Verschuer took advantage of the appointment of his former Frankfurt assistant, Dr. Dr. Josef Mengele (PhD, MD) to Auschwitz where Mengele served as an agent of the institute and as his, Verschuer’s, research assistant. Jews and Gypsies (Roma) in Auschwitz were studied, murdered, dissected and their body parts sent by Mengele to Verschuer in Berlin. Specimens included eyes of hapless victims who happened to have eyes of a different color (known as heterochromia of the iris) (32).

Studies carried out on Auschwitz victims included an examination of their blood for certain elements that were believed to be formed in response to infection. Verschuer’s institute lacked the capacity to do the required blood testing. The blood of the Auschwitz victims was sent to the neighbouring Kaiser-Wilhelm Institute for Biochemistry headed by the Prof. Adolf Butenandt. The tests themselves were performed at the biochemistry institute by Dr. Günther Hillmann (31). The institute director, Butenandt, was a pioneering biochemist who discovered the male and female hormones in humans. His work, for which he received the Nobel Prize for Chemistry in 1939, led the way to many modern therapies including the birth control pill (33).

Verschuer fled Berlin toward the end of the war. There are no surviving specimens or documentation from the Dahlem institute. It is believed that Verschuer had those destroyed. Soon after the end of the war accusations were made against Verschuer concerning Auschwitz research. A committee of Kaiser-Wilhelm scientists was formed to review the case against him. The committee report, which was not made public, was critical of Verschuer’s wartime activities and made it impossible for him to be re-appointed to a university position (31).

Butenandt, in addition to directly or indirectly assisting Verschuer with his studies on the blood of Auschwitz victims, helped restore Verschuer’s postwar standing in the scientific community. Butenandt was the member of a committee that re-examined the Verschuer case. Despite the evidence, the new committee concluded that Verschuer was not a Nazi, was not a race fanatic, was tolerant with his collaborators and that he did not know what went on in Auschwitz. The committee stated that “von Verschuer has all qualities which destine him to be a researcher and teacher of the academic youth (31).”

Having been exonerated by his colleagues, Verschuer went on to assume the position of professor of genetics at the University of Münster and the director of that university’s genetics institute. In that position Verschuer became the most prominent geneticist in (West) Germany. He died in 1969 (32).

Present day Max Planck Society

As the preeminent scientific and research organization in Germany, it is not surprising that Kaiser-Wilhelm scientists and institutes were involved in the eugenic and racial programs of the Third Reich. What is perplexing is the difficulty the present day Max Planck Society has had in confronting its own history. Despite the evidence linking scientists and researchers of the Kaiser- Wilhelm/Max Planck (KW/MP) Society with the crimes of the Third Reich, it has taken the KW/MP Society over a half a century to begin an examination of its own history. In spite of the documented involvement of KW/MP scientists and researchers in various nefarious scientific activities during Hitler’s regime, the organization has yet to formally apologize for the suffering and death inflicted by its scientists and researchers on untold numbers of innocent human beings. Hiding under the veneer of academic and scientific objectivity, officials suggest that an apology would be premature and should await the completion of the much belated investigation that would document exactly what the Max Planck Society should apologize for (34) (35) (36). It is expected that this investigation will be completed in 2004.

Evidence of the complicity of Kaiser-Wilhelm/Max-Planck scientists has been in existence for over a decade. That evidence documents activities that include the scientific legitimization and advancement of eugenics and racial hygiene by the Kaiser-Wilhelm Institute of Psychiatry (Rüdin) and the Kaiser-Wilhelm Institute of Anthropology (Eugen Fischer, Fritz Lenz, Otmar von Verschuer); the exploitation of the euthanasia killings to acquire brain specimens of the murdered victims by the Kaiser-Wilhelm Institute of Brain Research (Hallervorden); and genetic research on Jews and Roma (Gypsies) in Auschwitz by the Kaiser-Wilhelm Institute of Anthropology (Verschuer/Mengele).

The Max-Planck Society has publicly acknowledged its moral responsibility (in the absence of any preceding investigation) for the exploitation of the “euthanasia” murders to acquire the brains of the victims (37). The connection between Verschuer and Josef Mengele has been well known since it was first reported by Professor Benno Müller-Hill in 1984 (38). In the words of a German social scientist published over a decade ago, “In fact, through Verschuer the institute (Kaiser Wilhelm Institute of Anthropology) was to become directly connected with the murderous ‘experiments on humans’ at Auschwitz. Even though this connection was never substantiated in a court of law, evidence accumulated over the years leaves little doubt (39).”

Despite this evidence, the Max Planck Society appears to be demonstrating signs and symptoms of disordered memory and conscience. This disorder of memory is exemplified by the Society’s own 1998 descriptive history of the Berlin institutes of the Kaiser Wilhelm/Max Planck Society. Despite the previously mentioned honest accounting of the anthropology institute during the Hitler period, the monograph disputes the wording of a commemorative plaque on the building that formerly housed the anthropology institute. According to the 1998 document, “The text of the plaque, which was revised many times, however, falsely suggests that the concentration camp doctor Josef Mengele was a member of this Kaiser Wilhelm Institute. He did, however, send blood and organ samples for testing. The statement that the staff of the institute made an ‘active contribution to selection and murder’ by virtue of issuing professional opinion, seems exaggerated, however (30).”

The formal examination of the history of the Max Planck Society was undertaken one year after the publication of the aforementioned deceiving statement. In 1999, the Max Planck Society established an “autonomous” Presidential Commission (“History of the Kaiser Wilhelm Society in the National Socialst era”) (5) (36). With two co-chairs and nine members (one from the United States and one from the United Kingdom), and a staff of resident and visiting researchers, the Commission has embarked on a major research program encompassing:

* The organization, policy and administration of the Kaiser-Wilhelm Society.
* Racial hygiene, genetic, medical and psychiatric research in Kaiser-Wilhelm Institutes.
* Military Research: war-related and applied science in Kaiser-Wilhelm Institutes under the supervision of the Four-Year-Plan and the war economy.
* Osforschung (research on the east) and Lebensraumforschung (research on living space) at Kaiser Wilhelm Institutes in the context of expansionistic and occupation politics.

One commission researcher, Prof. Volker Roelcke of the University of Lübeck, has documented that Ernst Rüdin provided intellectual and financial support for murderous experiments on children performed by the Heidelberg psychiatrist, Julius Deussen (35). Another commission researcher, Robert Proctor, has been given access to the archives on Professor Adolf Butenandt which show that ” Butenandt was aware of and supported a research project involving blood samples from Auschwitz in an unsuccessful effort to find disease-fighting proteins specific to race (36).”

There is no question that the Presidential Commission will add greatly to the body of knowledge of the history of science and medicine during the Third Reich. However, the issuance of an explicit apology on the basis of what is already known should in no way prejudice the research into what is not yet known. The half-century of delay into documenting its own history is of itself deserving of a public apology. The moral imperative is emphasized by the fact that the Max Planck Society today encompasses 81 institutes embracing such areas as human development, criminal law, and foreign and international private, public and social law. The Max Planck Society is now more than an organization for basic or applied scientific research; it is also an organization with an explicit moral mandate to study the human condition. In so doing, it also has a moral responsibility for its own actions, and those of its members, past and present. What the Max Planck Society appears to continue to ignore, or avoid facing, is the fate of the victims, those who perished and those who survived. Given the fact that 59 years will have elapsed between the end of the Third Reich and the end of the mandate of the “Presidential Commission,” few of the survivors will still be living. If a formal apology should be forthcoming few, if any, will be alive or capable of receiving it. By the time the Max Planck Society has recovered its own institutional memory, there will be few survivors who remember.

The esteemed scientist after whom Germany’s foremost scientific organization is named would probably have been very distressed had he been aware of the behavior of scientists associated with the organization that now bears his name. Given his own example of moral recititude he most likely would have been dismayed by the behaviour of the leadership of that organization which for over one half century after the end of the war demonstrated moral amnesia and paralysis in addressing the questions of its own history and moral responsibility.

The word “quantum” when first used by Max Planck referred to an infinitesimally small measure of change at the level of the atom. The collective impact of those infinitesimally small changes have changed the world forever. “Quantum” as adjective refers to a significant quantity. The future impact of the heretofore tepid efforts of the Max Planck Society will depend on that organization’s ongoing commitment to an honest historical examination of the role of German science and medicine during the Hitler period and after. The Max Planck Society has a moral obligation to set an example for German academia and industry in urging those universities and industrial concerns such as the chemical and pharmaceutical companies who wittingly and unwittingly joined in the programs of scientific terror and have yet to reveal the truth. That truth requires a proper objective and full examination of the archives and other historical records and collections of the universities and companies that share the same moral responsibility as the Kaiser-Wilhem/Max Planck Society for the design, implementation and exploitation of some of the worst crimes in the history of humankind.

On the basis of current evidence the Max Planck Society should make a full and public apology to the surviving victims and the families of the deceased for their suffering at the hands of scientists of the Kaiser-Wilhelm/Max Planck Society. The Max Planck Society should undertake, together with institutions providing care to Holocaust survivors, a study of the impact of the Holocaust and the trauma of experimentation and scientific abuse on the surviving victims. In contradistinction to the research undertaken in pursuit of state defined Volksgesundheit, this research would be based on the goal of improving the quality of life of the surviving victims; an effort to which the Max Planck Society should become party. As Germany’s (and one of the world’s) leading scientific and research organization, the Max Planck Society should explicitly address the issue of the moral responsibility of science based on its own tragic history and example.

Max Planck, having come from a family of theologians would have probably been acquainted with the source of the title of this journal (If Not Now an e-journal) which is taken from The Ethics of the Fathers by the great sage Hillel. The complete aphorism of Hillel is an admonition that applies to the society that continues to bear Max Planck’s name:

If I am not for myself who will be for me? But if I am only for myself, what am I? If not now when?

Notes

1) Overbye D. Celebrating a Century of Confusion and Triumph. New York Times. Dec, 12, 2000 p. D2 & D4.

2) Zeiliger A. The Quantum Leap. Frankfurter Allgemeine Zeitung. English-language internet edition. December 15, 2000.
http://www.faz.com/IN/INtemplates/eFAZ/archive.asp?rub={B1311FD3-FBFB-11D2-B228- 00105A9CAF88}&doc={52775327-D1F3-11D4-B99E-009027BA226C}

3) http://www.britannica.com/bcom/eb/article/5/0,5716,115045+2+108525,00.html

4) http://www.nobel.se/physics/laureates/1918/planck-bio.html

5) Wirsing B. Opening the archives (letter) Haaretz Magazine. August 4, 2000, 2.

6) Macrakis K. The Rockefeller Foundation and German Physics under National Socialism. Minerva 27: 1989, 33-57.

7) Weindling P. Health, Race and German Politics Between National Unification and Nazism 1870-1945, Cambridge: Cambridge University Press, 1989.

8) Seidelman W. The Legacy of Academic Medicine and Human Exploitation in the Third Reich. Perspectives in Biology and Medicine. 43(3):2000, 325-334.

9) Chernow R. The Warburgs: The Twentieth Century Odyssey of a Remarkable Jewish Family. New York: Random House, 1993.

10) Shorter E. A History of Psychiatry: From the Era of the Ayslum to the Age of Prozac. New York: Wiley, 1997.

11) Rüdin E. Zur Vererbung und Neuentstehung der Dementia praecox, Vol. 1 of Studien über Vererbung und Entstehung geistiger Störungen. Berlin: Springer, 1916.

12) Weber W. Ernst Rüdin, 1874-1952: A German Psychiatrist and Geneticist. American Journal of Medical Genetics (Neuropsychiatric Genetics) 67:1996, 323-331.

13) “The German Eugenic Society,” Journal of the American Medical Association

14) Wistrich R. Who’s Who in Nazi Germany. London: Weidenfeld & Nicholson, 1982.

15) The Law for the Prevention of Hereditary Disease Offspring (Gesetz zur Verhütung erbkranken Nachwuchses) enacted 14 July 1933. Berlin: Reichsauschuß für Volksgesundheitsdienst Berlin, (Paris: Archives du Centre de Documentation Juive Contemporaine, Document #B15076).

16) Proctor R. Racial Hygiene, Cambridge, MA: Harvard University Press, 1988.

17) Stern K. The Pillar of Fire. New York: Harcourt Brace, 1951.

18) Burleigh M. Death and Deliverance: ‘Euthanasia’ in Germany 1900-1945. Cambridge; Cambridge, 1994.

19) Friedlander, H. The Origins of Nazi Genocide: From Euthanasia to the Final Solution. Chapel Hill: Univ. of N. Carolina, 1995.

20) Haymaker W. C‚cile and Oskar Vogt: On the Occasion of her 75th and his 80th Birthday. Neurology 1:1951, 179-204.

21) van Boagaert L. Hugo Spatz (1888-1969) in The Founders of Neurology, ed. Haymaker W. and Schiller F. Springfield, IL: Charles C. Thomas, 1970.

22) Alexander L. Neuropathology and neurophysiology, including electroencephalography, in wartime Germany. Combined Intelligence Objectives Sub-Committee G-2 Division SHAEF (rear) APO 413. National Archives. Washington D.C. Document No. l-170 cont’d. July 20, 1945.

23) Shevell, M. Racial hygiene, active euthanasia, and Julius Hallervorden. Neurology 42:1992, 2214-2219.

24) Peiffer J. Neuropathology in the Third Reich: Memorial to those Victims of National- Socialist Atrocities in Germany who were Used by Medical Science. Brain Pathology 1:1991, 125-131.

25) Jürgen Peiffer, Assessing Neuropathological Research carried out on Victims of the ‘Euthanasia’ Programme. Medical History Journal (Urban & Fischer) 34:1999, 339-356.

26) Neugebauer W, Stacher G Nazi Child ‘Euthanasia’ in Vienna and the Scientific Exploration of Its Victims before and after 1945. Dig. Dis. 17: 1999, 279-285.

27) Dickman S. Brain Sections to be Buried? Nature 339:498. June 15, 1989.

28) Seidelman W. Erinnerung, Medizin und Moral. Die Bedeutung der Ausbeutung des menschlichen Körpers im Dritten Reich. In Gabriel E. & Neugebauer W. (Hg.) NS-Euthanasie in Wien. Wien: Böhlau Verlag. 2000.

29) Kreutzberg G. Verwicklung, Aufdeckung und Bestattung: Über den Umgang mit einem Erbe. In Kerstig F., Teppe K., Walter B. (eds.) Nach Hadamar: Zum Verhältnis von Psychiatrie und Gesellschaft im 20 Jahrhundert. Paderborn: Ferdinand Schöningh; 1993.

30) Henning E. and Kazemi M. Dahlem-Domain of Science: A walking tour of the Berlin institutes of the Kaiser-Wilhelm/Max Planck Society in the “German Oxford”. Munich: Max Planck Society, 1998.

31) Müller-Hill B. Das Blut von Auschwitz und das Schweigen der Gelehrten. In Kaufmann D. Geschichte der Kaiser-Wilhelm-Gesellschaft im Nationalsozialismus. Bestandsaufnahme und Perspektiven der Forschung. Göttingen:Wallstein Verlag. 2000. 189-227. (English translation provided by B. M-H.).

32) Müller-Hill B. Murderous Science: Elimination by Scientific Selection of Jews, Gypsies, and Others in Germany, 1933-1945. Cold Spring Harbor Laboratory Press, 1998.

33) http://www.britannica.com/bcom/eb/article/1/0,5716,18591+1+18312,00.html?query=butenandt

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