July 5, 2023

In 1985, Leo Alexander,one of the most important psychiatrists to grace America, died at age 79 of cancer.   He was author of the Nuremberg Code and trial aide and medical consultant to the Nuremberg Tribunal that tried 23 Nazi physicians for war crimes including inhumane experiments and murders of prisoners and concentration camp detainees.  His New York Times obituary elaborates:

A medical investigator for Secretary of War Robert P. Patterson and an aide to the chief counsel at the Nuremberg war crimes trials, Dr. Alexander wrote the (Nuremberg) code after studying the actions of German SS troops and concentration camp guards.

He said they were ”on the whole meek and overpolite fellows who committed inhuman crimes because they found themselves suspect by their superiors.”

Dr. Alexander at the Nuremberg Trials

Leo Alexander was a Jew, son of a prominent Viennese physician, born in 1905, and lived an idyllic life in a mansion frequented by the glitterati of Vienna. He grew up and became a physician, graduated from the University of Vienna Medical School, then went to Frankfurt, Germany  for advanced studies in neurology and psychiatry.  He was in Asia doing a medical project when the Nazis imperiled Jews in Austria and decided to emigrate to the United States in 1933, holding positions at Worcester State Hospital, Boston City Hospital, Harvard Medical School and Boston State Hospital before becoming associate professor of neuropsychiatry at Duke Medical School in 1941. He volunteered and became a Medical Officer in the US Army during WWII. 

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Dr. Alexander was engaged as an aide/consultant to the post war Nuremberg Tribunal, charged with trying Nazi physicians accused of war crimes.  A summary shows that he had only a short time to investigate war crimes of Nazi physicians, so he criss-crossed Germany to investigate activities of German Wehrmacht physicians and SS troops in human experiments and other atrocities that killed or dramatically injured the subjects.  His work was invaluable and revealed a level of evil that is hard to grasp—human experiments that were so horrific as to be incomprehensible.   

Nonetheless in a short time Alexander succeeded in finding out the nature of the unprecedented cruelties that otherwise might have been unknown, cruelties by a nation that at the time had a claim to represent the most scientificly and culturally advanced nation on earth.  The German Reich instead gave us Dachau and Buchenwald, pogroms and genocide beyond imagination, human experiments that revealed an evil beyond any conception.

Alexander was ideally suited to do the investigation, and he found the magnitude of the horrific human experiments.  The conduct discovered was ghastly.  Experiments supervised by Nazi physician monsters were performed for freezing water survival (resulting in death) and high altitude injury (also deadly).

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Rasher also ran tests on potential blood coagulators, and whenever he needed a fresh vial, he’d simply shoot someone in the abdomen. Other doctors forced Dachau prisoners to chug salt water for days, or exposed them to nerve gas, or gashed their legs open and ground wood fragments and glass and bacteria into the wounds to simulate battlefield injuries. Still other doctors managed widespread sterilization programs to prevent the “unfit” from breeding. Far from acting alone, Alexander found, Rascher was immersed in a web of vile medical research.

Eventually Alexander wrote a 1500-page report for the trials in 1946 and 47.  By the time the trials were done, some of the accused had been acquitted.  One of the reasons was that no international laws or codes of conduct had been violated; for example Jews and other prisoners under the Third Reich enjoyed no legal rights or protection.  Prisoners scheduled for death had no rights.  Worse still, some Nazi doctors who supervised experiments on inmates were invited to the United States and handed plum research contracts through a secret military recruitment program called Operation Paperclip.

Alexander’s dogged efforts, however, did expose the atrocities and inspired him to promote the idea of a code of conduct that became the Nuremberg Code a guide for all research on human subjects and a milestone in the history of medical ethics. Few people today know of the man behind the code—much less the story of how his disappointment and frustration inspired it. Although Alexander couldn’t ensure justice in his own time, he at least helped secure the rights of those who came after.

Dr. Alexander wrote a wonderful and compelling monograph for publication in the New England Journal of Medicine, and in that monograph he described his discoveries and explained how Germany, German Medicine, and the German population were influenced by the Nazi regime to abandon traditional compassion and consideration of humanity for new values: Hegelian utility, as opposed to tradition medical ethics, and treatment of those considered useless eaters — those who were politically disturbing or racially and ideologically offensive and oppositional or uncooperative — as not deserving of rightsm therefore eligible for extermination or human experiments.

You have to read his essay linked above to get his extraordinary explanation for how a sophisticated and advanced German populace was turned from moral civility to savagery. 

Dr. Alexander provides a supplement in his essay that shows how the physicians of the Netherlands refused the Nazis’ demnands and stopped the savagery, refused to be a part of it, and stood for humane and considerate medical principle, even under the threat of occupation and the hammer of the SS.  

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Alexander on the SS and Criminalizing a Society

In the 1948-49 issue of Criminal Law and Criminology Dr. Alexander provided another extraordinary monograph on his observations of societal disintegration and devolution into criminality by the action or inaction of citizens. Titled “War Crimes and Their Motivation: The Socio- Psychological Structure of the SS and the Criminalization of a Society,” it begins:

War Crimes are crimes committed with group approval. In this way they are similar to gang crimes, and different from crimes committed by single individuals in ordinary society. The main approving and instigating group in Germany during the Nazi regime was the SS which was the most important political organization in Nazi Germany.

SS stands for Schutz-Staffel, which, translated, means “protective squadron.” No totalitarian state can function without an SS-like organization. It is therefore important for us to know all we can about the SS, to understand its motivation and how it worked, what its strength was and what its weaknesses were; and it is the duty of sociologists, psychologists, and psychiatrists to study these facts and to make them generally understood.