Psychiatry during National Socialism: Historical knowledge and some implications

The contribution is a synthesis of the results of historical research on psychiatry during the Nazi period. Three issues are focused: the relationship between physicians and the Nazi state; the impact of eugenically and economically motivated health and social policies for psychiatry (forced sterilisation, patient killings/”euthanasia”); and psychiatric research. Three widely share assumptions are fundamentally challenged by the historical evidence: (1) that medical atrocities were imposed from “above” by Nazi politicians on apolitical physicians; (2) that mass sterilisations and patient killings had nothing to do with contemporary state of the art medical reasoning and practice; (3) that ethically unacceptable research on psychiatric patients had nothing to do with contemporary state of the art biomedical sciences. It is argued that the structural findings on these issues of Nazi medicine are not specific to Germany and the period between 1933 and 1945; rather the underlying features were the extreme manifestations of some problematic potentials implicit in modern medicine in general.