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Before the war, Jews had built some of Germany’s best hospitals, and Jewish physicians and nurses also held top positions in government-run facilities, Martin says. Nevertheless, “doctors and nurses were the first to turn in their Jewish colleagues, who were rounded up and killed,” she says. “Jewish hospitals were looted, confiscated, or burned to the ground for total annihilation.”
After the war, nurses almost never expressed remorse for collaborating, Martin says. “They could’ve had dissociation and armor toward suffering, or believed their victims would die anyway, or thought they wouldn’t want to live,” she says. But these rationalizations and issues are rarely addressed in nursing curricula.
“This is not relegated to history, long ago and far away,” Martin notes. “We need to be attentive to patterns that are repeated today. We’re hearing so many things about so many places, such as Bosnia and Rwanda. Wherever there’s war, global conflict, or ethnic cleansing, there are doctors and nurses as collaborators, resisters, or witnesses. We must be vigilant about getting co-opted as agents of the state, and maintain our ethics.”
‘Banality of evil’
“Prior to these events, these nurses weren’t obviously horrible people,” says nurse sociologist Mary Lagerwey, RN, PhD, associate professor of nursing and chair of the Institutional Review Board at Western Michigan University in Kalamazoo, Mich. “Most were ordinary, not that different from nurses today, and not without ethics training — it was a required course. Each of these nurses had the chance to say no, yet there was very, very little resistance.”
Author Hannah Arendt once spoke of the “banality of evil,” represented by the ordinariness of the Nazis’ bureaucratic dispatch of millions of lives. That banality easily describes the several common “defenses” that Lagerwey found in her review of trial transcripts. Many nurses said killing patients was a kindness they did gently, despite proof to the contrary.
“One nurse convicted in 1946,” Lager wey notes, “said he ‘was kind to all patients — you can ask anyone.’ The American prosecutor said, ‘But they’re all dead.’”
Others epitomized the “just a nurse, following orders” defense, Lagerwey says. At the trial for the Hadamar facility nurses, who killed 15,000 mentally ill German patients, “public health nurses said, ‘I only brought them to the hospital,’ and the head nurses said ‘I only handled medications and keys.’”
Another head nurse who participated in hospital killings testified she asked her priest how Germans could win the war while committing such crimes. “She was distraught by what they did, but not enough to stop, which makes it more appalling,” Lagerwey says. “She showed continued willingness to do what she knew was wrong.”
Nurses should understand their professional and personal vulnerabilities, she says. They must acknowledge their responsibility and accountability, maintain values consistent with ethical behavior, think critically about their orders and the larger picture, and be wary of the corrupting power of hierarchies.
“People are capable of atrocities in difficult situations,” Lagerwey says, warning that some hospital nurses abuse their power by humiliating or harming others. And until recently, nurses have whitewashed and hidden their horrible wartime behavior.
“The profession failed, not just individuals,” she says. “We can’t ignore it. Never again.”
Wendy Bonifazi, RN, CLS, APR, is a senior staff writer for Nursing Spectrum .
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