Abstract
More than 20 years after the failure of socialism in the German Democratic Republic (GDR), even conservative politicians and journalists are starting to ask themselves whether there might have been a point to the way in which Karl Marx had criticized capitalism after all. Years of wholesale disparagement of Marxism may indeed give way to a more nuanced assessment today. At stake are the philosophical contributions of the GDR, which are worth recognizing despite socialism’s overall failure. This essay seeks to explore such contributions, as exemplified by the field of ethics in its application to medicine.
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Notes
- 1.
When, on the other hand, East German developments were discussed, their achievements were placed under an implicit question mark, owed to the spirit of the age, as typified by the title of a recent study Medical Ethics in the GDR: Valuable Experience or Inherited Burden? (Bettin & Gadebusch Bondio, 2010).
- 2.
- 3.
Theodor Brugsch, a professor of internal medicine who had been boycotted by the National Socialist student movement and been expelled from the university, now became vice president of the central administrative body for popular education (“Volksbildung”). He was entrusted with human resources management (in particular hiring contracts) at the universities of Berlin and Halle (Steiger & Flaschendräger, 1981, pp. 195ff).
- 4.
Some parts of Stalin’s ‘History of the Communist Party of the Soviet Union (B), Short Curriculum’ (Central Committee, 1943) became obligatory readings, along with several essays by Lenin. Only minimal snippets from Marx and Engel’s writings were included.
- 5.
Here Marx and Engel’s critique of ethics as an instrument for legitimizing bourgeois ways of life and production was decisive. As of 1956, it became a disputed matter whether ethics should be considered as integral to Marxist philosophy, as an ingredient part of historical materialism, or as a discipline in its own right (cf. Luther, 1997).
- 6.
The quote goes back to J. Tandler’s speech before the League of Nations in 1929.
- 7.
In Halle, the lecture series began in 1962 with the title “Social and conceptual problems of modern medicine.” The faculty allotted 30 hours to this subject for students in their eighth term.
- 8.
In 1975, the 100th anniversary of the birth of Albert Schweitzer was commemorated, among other activities, by orienting these competitions around subjects related to his life and writings. In this way, even a dissertation about Schweitzer was completed (Hoffmann, 1990). Similarly, related themes were proposed in preparation for the 100th anniversary of the Halle physiologist and president of the academy of science Leopoldina, Emil Abderhalden (1877–1950). This medical scholar had established an extended social service in Halle and had issued a journal on ethics between 1922 and 1938. At age 70, he had published his Thoughts of a Biologist about the Creation of a Community of Nations and for a Lasting Peace. All of this offered rich material for interested students.
- 9.
In 1967, the author of this essay co-edited a book entitled The Hippocratic Ethos. Among other contributions, it assembled diploma theses that had been developed in the context of a research project. Among the subjects were the development of the Hippocratic Oath, the social role of German physicians’ associations (“Ärztevereine”) and courts of honor, physicians’ moral and legal professional obligations, the position of physicians during times of social unrest (on the physicians’ strikes of 1919), the moral evaluation of experimentation on human subjects, the role of SS physicians in Auschwitz, and the significance of the Hippocratic Oath in socialist societies. Another important contribution was a bibliography of works on Hippocrates in German, especially on his oath. The first edition of this book (1525 copies) was soon sold out almost completely (Luther & Thaler, 1967).
- 10.
Cf. the 1969 “First All-Union conference on problems of medical deontology” held in Moscow.
- 11.
This oath which all medical students at the GRD’s medical faculties delivered on receiving their diploma included the following commitments, “With a high sense of obligation in view of society and its members, in close cooperation with the German Democratic Republic, my fatherland, I promise to fully devote all my knowledge and ability to the bodily and psychic well-being of man as well as to the healing and prevention of illness, to be ever prepared to offer medical help, to conscientiously fulfill my medical tasks, to be attentive to the patient, to care for him and to preserve the physician’s secret, to ever improve on my medical knowledge and capacity, to contribute through my work to the development of medical science and practice, to use all advantages offered by socialist society to the full, to consult with colleagues in the interest of the patient, never refusing to offer advice and help to them, to preserve the noble traditions of the medicine of my country and to develop these further, and to be guided in all my actions by the high vocation of the physician and his responsibility for the people and the socialist state.”
- 12.
It was only in 1981 that insight into such limits was accepted in the Soviet Union. Here another All-Union conference for medical ethics and deontology, which the author could attend, marked the transition to a more encompassing philosophical approach to objectives, goals, means, and consequences of medical practice. (The papers of this conference appeared in 1983 as Medizinskaja Etika i Deontologija).
- 13.
This cooperation encompassed many years of membership in the Council for Medical Science (“Rat für Medizinische Wissenschaften”) at the GDR’s Ministry of Health Care (“Ministerium für Gesundheitswesen”), as well as continued efforts to promote interdisciplinary exchanges between medicine and the humanities in numerous medical faculties of the country.
- 14.
It is characteristic of that country’s internal contradictions that a particularly relevant work by the dramatist Berthold Brecht, who otherwise enjoyed the status of an official ambassador of communist culture, was never mentioned by the authorities. This work, Me-ti, the Book of Turnarounds, had appeared in 1975, and it offers terse insights concerning the fact that in a well-ordered society, where everyone has work and can earn his living, any special ethics is unnecessary. His implied association of the practice of moralizing with an economy of scarcity must have been so embarrassing that the whole work was shushed up. Even during the Karl Marx year of 1983, when official conferences addressed Brecht’s relationship to Marx, no one cared to talk about Brecht’s take on ethics. I myself heard about it only in 1990, and from a West Berlin Marxist, to boot.
- 15.
The author had the privilege of participating as an invited speaker at numerous international conferences. The contacts established at these occasions extended all over Western Europe and to the USA. The invitation to join the Hastings Center as a free member, to become a member in the European Society for Philosophy of Medicine and Health Care, and to become a guest member in the German Academy for Ethics in Medicine offered welcome opportunities for scholarly exchange.
- 16.
Quite generally, therefore, it was characteristic of the GDR that unpleasant and complicated moral issues, since these could not be addressed by ethicists, were relegated to artists. But only after the demise of socialism did those many further books and films become known, which had been locked up as “top secret” in governmental safes.
- 17.
The lecture series in Halle mentioned above engaged guest presentations from the directors of the clinics of anesthesiology and intensive care, gynecology, psychiatry, radiology, internal medicine, of the institute for biology, for social hygiene, and the district doctor.
- 18.
During those years, the lecture series was attended by 100 to 150 students. This is a very high number, especially if one compares it to similar courses offered in West Germany (where, of course, participation was voluntary!) (Luther, 1994, p. 105).
- 19.
The primary place where moral problems could be addressed in the GDR was the arts. Authors like Chingiz Aitmatov, Erwin Strittmatter, or Christa Wolf presented an unofficial and informal forum where critical moral concerns could be somewhat more openly discussed than within the academy, where every deviation from the official Marxist-Leninist party line was immediately sanctioned.
- 20.
It is worth noting that within the GDR, the diaconic or charitable institutions of the two large churches enjoyed considerable freedom of operation, because their contribution to health care (especially in view of the handicapped) was indispensable for the country. The churches owned their own healthcare institutions and enjoyed some autonomy in this area.
- 21.
“Philosophers merely interpreted the world in various ways. The challenge is to change the world.”
- 22.
A similarly strong interdisciplinary cooperation among clinicians from intensive care medicine, gynecology, radiology, and neonatology, with representatives of medical law and experts for medical statistics and information processing had been secured by the author for his book on medical ethics during the 1980s.
- 23.
In Halle, two students shouldered the task of supplementing their diploma theses (which later developed into dissertations) by anonymous surveys concerning the views students held about their ethics instruction, especially in view of care for seriously ill and dying patients. Responses showed an overwhelming majority of positive votes for the need of ethics instruction as well as for the helpfulness of the information received. Major criticism, on the other hand, concerned the lack of practical relevance from the ethics instruction they had in fact received (Purps & Hammerschmidt, 1990).
- 24.
In the FRG, despite numerous efforts as for example in Tübingen, no C-4 or C-3 professorship in ethics of medicine had as yet been instituted. Instruction in physicians’ professional ethics was offered mostly by historians of medicine, theologians, or clinicians.
- 25.
Unfortunately, technical reasons (1989 was the year in which the GDR ceased to exist) made it impossible to publish the papers of this conference. Only some initial theses and a short report could appear in the journal Humanitas (Günther & Luther, 1989, p. 9).
- 26.
Since the publisher was not able to keep the schedule and was altogether closed in 1990, work on these projects had to be resumed later. The book on nursing could appear only in 1995 (Hoppe et al., 1995).
- 27.
Up to the moment when the new director of the Institute for the History of Medicine, Prof. Neumann, was appointed, Dr. habil. V. Schubert-Lehnhardt was in charge of the department.
- 28.
Information about selected publications by the author, as well as a list of the diploma and doctoral theses he supervised, are available in Schubert-Lehnhardt, 2002, pp. 105 ff.
- 29.
See, for example, the formulation used for the problem of informed consent, which was addressed in the lecture series on medical ethics and started at the medical faculty in Halle around 1976: “Problems involved in patient information and guidance (“Führung”) of patients (especially of cancer patients).”
- 30.
- 31.
Engel’s views are characteristic: “... health is not a given state but... it requires an active acceptance of life, an aim in life, the co** with the processes of life, and a high valuation of the purpose of life. Ethics as moral theory is concerned with the societal and individual orientation to values. It should investigate those conditions that stimulate the thoughts and attitudes which allow one to combine the right course of action with one that is meaningful for the individual. Ethics must help to abolish the concept that the individual ‘chooses’ whatever lifestyle he likes: It must reveal the deeper social relationships between the conditions of life, lifestyle, and health. Ethics also has to recommend value orientations that derive from the requirements of socialist society” (cited in Luther, 1989b, pp. 294 f, see also Marx & Engels 1975, vol. 20, pp. 106, 87).
- 32.
- 33.
In his book on ethics in medicine (Luther et al., 1986, p. 11), the author had extended this claim about the possibility of a rationally grounded account of the good to the issue of patient well-being. While conceding that new diagnostic and therapeutic resources required greater attention to the patient’s subjectivity and personality, nevertheless, he emphasized that “patient well-being and his true interest cannot be determined by recourse to his own subjectivity, or emotional responses, but must be accessed primarily on scientific grounds.”
References
Baust, G., Keck, A., Löther, R., Rapoport, S. M., & Spaar, H. (Eds.) (1977–1989). Medizin und Gesellschaft. 36 Vols: (1977–1984) Vols. 1–22. Jena: Gustav Fischer Verlag. (1985–1989) Vols. 23–36. Berlin: Verlag Volk und Gesundheit (also distributed as ʽBeihefte’ of Zeitschrift für ärztliche Fortbildung. Berlin: Akademie für Ärztliche Fortbildung der DDR).
Bettin, H., & Gadebusch Bondio, M. (Eds.). (2010). Medizinische Ethik in der DDR: Erfahrungswert oder Altlast? Papst Publishers.
Central Committee of the Communist Party of the Soviet Union. (1943). History of the communist party of the Soviet Union. London: Corbett Publishing.
Chartschew, A. G., & Miller, R. (Eds.). (1976). Ethik. Philosophisch-ethische Forschungen in der Sowjetunion. Deutscher Verlag der Wissenschaften.
Eberle, H. (2002). Die Martin-Luther-Universität in der Zeit des Nationalsozialismus 1933–1945. Mitteldeutscher Verlag.
Eichhorn, W. (1965). Wie ist Ethik als Wissenschaft möglich? VEB Deutscher Verlag der Wissenschaften.
Fletcher, J. (1974). The ethics of genetic control. Doubleday.
Gillon, R. (1986). Philosophical medical ethics. Wiley & Sons.
Günther, E., & Luther, E. (1989). Was schafft Geborgenheit? Zu einigen Resultaten des Ethik-Symposiums zum Thema: Information – Wahrheit – Geborgenheit (11. bis 13. Dezember 1988 in Bad Kösen). Humanitas, 4(9).
Hahn, S., & Rieske, B. (1980). Das Arzt-Schwester-Patient-Verhältnis im Gesundheitswesen der DDR. Gustav Fischer Verlag.
Hoffmann, A. (1990). Friedensideen Albert Schweitzers und sein Engagement in der Anti-Atom-Bewegung der 50er und 60er Jahre. Martin-Luther-Universität Halle-Wittenberg.
Hoppe, E., Körner, U., Luther, E., & Nitsche, A. (1995). Ethik. Arbeitsbuch für Schwestern und Pfleger. LAU-Ausbildungssysteme GmbH.
Hörz, H. E., & Wilke, U. (Eds.). (1985). Ethik. Deutscher Verlag der Wissenschaften.
Jung, F., Klaus, G., Mette, A., & Rapoport, S. M. (Eds.). (1961). Arzt und Philosophie. Humanismus Erkenntnis Praxis. Verlag Volk und Gesundheit.
Kästner, I., & Thom, A. (Eds.). (1990). 575 Jahre Medizinische Fakultät an der Universität Leipzig. J. A. Barth Verlag.
Körner, U., Seidel, K., & Thom, A. (Eds.). (1981). Grenzsituationen ärztlichen Handelns. Gustav Fischer Verlag.
Luther, E. (1982). Philosophisch-ethische Aspekte des ärztlichen Handelns. Das deutsche Gesundheitswesen. Zeitschrift für Klinische Medizin, 37, 770–773.
Luther, E. (Ed.). (1983). Beiträge zur Ethik in der Medizin. 2500 Jahre ärztlicher Eid. Gustav Fischer Verlag.
Luther, E. (1984). Ethik in der Medizin – Ergebnisse, Standpunkte und Aufgaben in der DDR, Das deutsche Gesundheitswesen. Zeitschrift für Klinische Medizin, 39, 1649–1653.
Luther, E. (Ed.). (1986). Ethik in der Medizin. Verlag Volk und Gesundheit.
Luther, E. (1988). Die Entwicklung der Wissenschaft in der Medizinethik bis 2000. Ministerium für das Gesundheitswesen. Manuscript printout.
Luther, E. (1989a). ‘Medizinische Ethik im Lichte des Marxismus-Leninismus.’ In D. Rössler & H. D. Waller (Eds.) Medizin zwischen Geisteswissenschaft und Naturwissenschaft. Drittes Blaubeurer Symposion vom 30. September – 2. Oktober 1988. (pp. 132–142). Attempto Verlag.
Luther, E. (1989b). Medical ethics in the German Democratic Republic. Journal of Medicine and Philosophy, 14, 289–300.
Luther, E. (1991). Paternalismus und informed consent – ethische Konzepte in der medizinischen Diskussion. In V. Schubert-Lehnhardt (Ed.), Ethik in der Medizin und Biotechnologie (pp. 52–69). Wissenschaftliche Beiträge der Martin-Luther-Universität.
Luther, E. (1994). Ethik-Unterricht in der Medizin. Erfahrungen aus der Martin-Luther-Universität Halle-Wittenberg (1962–1992). Ethik in der Medizin, 6, 105–108.
Luther, E. (1997). Ethik im Sozialismus. In W. F. Haug (Ed.), Historisch-kritisches Wörterbuch des Marxismus. Vol. 3. col. (pp. 895–897). Argument Verlag.
Luther, E. (1999). Selbstbestimmt sterben? Marxistische Blätter, 6, 32–45.
Luther, E. (2001). ‘Chancen und Risiken der Patientenautonomie.’ Presentation given at a public discussion of the “Enquete Commission of the German Parliament” at Jena University. Manuscript printout.
Luther, E. (2002). ‘Medizinische Ethik im öffentlichen Entscheidungsprozess.’ In V. Schubert-Lehnhardt (Ed.) Medizin-Ethik – quo vadis? Versuch einer Antwort. Protocol volume of the Colloquium in honor of the 70th birthday of Prof. Dr. sc.phil. Ernst Luther. (pp. 41–57). Verlag Storbeck.
Luther, E. (2008). Abwicklung oder bewußtseinsbildendes Bedenken? In E. Beleites (Ed.), Menschliche Verantwortung gestern und heute. Beiträge und Reflexionen zum nationalsozialistischen Euthanasie-Geschehen in Thüringen und zur aktuellen Sterbedebatte (pp. 73–79). Landesärztekammer Thüringen.
Luther, E., Baust, G., & Körner, U. (Eds.). (1986). Ethik in der Medizin. Wissenschaftliche Beiträge der Martin-Luther-Universität Halle Wittenberg.
Luther, E., & Thaler, B. (Eds.). (1967). Das hippokratische Ethos. Untersuchungen zu Ethos und Praxis in der deutschen Ärzteschaft. Wissenschaftliche Beiträge der Martin-Luther-Universität Halle-Wittenberg.
Marx, K., & Engels, F. (1975). Marx-Engels Werke. Dietz Verlag.
Mayer, G. (Ed.). (1962). Über das ärztliche Berufsethos in der sozialistischen Gesellschaft. Verlag Enzyklopädie.
Mayer, G. (Ed.). (1963). ‘Philosophische Probleme der ärztlichen Ethik.’ Wissenschaftliche Zeitschrift der Karl-Marx-Universität Leipzig: Mathematisch-Naturwissenschaftliche Reihe. Special vol. I.
Mayer, G. (Ed.). (1964). ‘Sozialismus und ärztliche Pflichten.’ Wissenschaftliche Zeitschrift der Karl-Marx-Universität Leipzig, Mathematisch-Naturwissenschaftliche Reihe. Special vol. IV.
Mayer, G. (Ed.). (1965). Medizin und Philosophie – Arzt und Gesellschaft, Wissenschaftliche Zeitschrift der Karl-Marx-Universität Leipzig. Mathematisch-Naturwissenschaftliche Reihe. Special vol. V.
Mette, A., Misgeld, G., & Winter, K. (Eds.). (1958). Der Arzt in der sozialistischen Gesellschaft. Akademie Verlag.
Ministerium für das Hoch- und Fachschulwesen der DDR (Ed.) (1976). ʽCurriculum für das Grundstudium in Medizin an Universitäten und anderen höheren Lehranstalten.’ Manuscript printout.
Mitscherlich, A., & Mielke, F. (Eds.). (1989). Medizin ohne Menschlichkeit. Dokumente des Nürnberger Ärzteprozesses. Fischer Bücherei.
Purps, A. & Hammerschmidt, St. (1990). Die berufsethische Ausbildung der Medizinstudenten unter besonderer Berücksichtigung der Betreuung Schwerstkranker und Sterbender. Diss. Martin-Luther-Universität Halle-Wittenberg (Manuscript).
Rupieper, H. (Ed.). (2002). Beiträge zur Geschichte der Martin-Luther-Universität 1502–2002. Mitteldeutscher Verlag.
Schubert-Lehnhardt, V. (Ed.). (1991). Ethik in der Medizin und Biotechnologie. Martin-Luther-Universität Halle-Wittenberg, Bereich Medizin, Abt. Ethik und Geschichte der Medizin.
Schubert-Lehnhardt, V. (Ed.) (1992). Grundfragen medizinischer Ethik. Ernst Luther zum 60. Geburtstag; Ethik zwischen Anspruch und Wirklichkeit. Martin-Luther-Universität Halle-Wittenberg, Bereich Medizin, Abt. Ethik und Geschichte der Medizin.
Schubert-Lehnhardt, V. (Ed.) (2002). Medizin-Ethik-quo vadis? Versuch einer Antwort. Protokollband zum Ehrenkolloquium anläßlich des 70. Geburtstages von Prof. Dr. sc.phil. Ernst Luther. Verlag Storbeck.
Schweitzer, A. (1971). Das Problem der Ethik in der Höherentwicklung des menschlichen Denkens. In R. Grabs (Ed.), Gesammelte Werke in fünf Bänden (Vol. 5, pp. 143–159). Union Verlag.
Steiger, G., & Flaschendräger, W. (Eds.). (1981). Magister und Scholaren. Professoren und Studenten deutscher Universitäten und Hochschulen. Urania Verlag.
Thielicke, H. (1970). Wer darf leben? Goldmann.
Thielicke, H. (1979). Wer darf sterben? Grenzfragen der modernen Medizin. Herder.
Wahl, D. (1978). Ethische Probleme der Wissenschaft. Akademie Verlag.
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Luther, E. (2022). The Development of Doctors’ Ethics Into Medical Ethics in the German Democratic Republic and Its Impact on Medical Education. In: Delkeskamp-Hayes, C. (eds) From Physicians’ Professional Ethos towards Medical Ethics and Bioethics . Philosophy and Medicine, vol 140. Springer, Cham. https://doi.org/10.1007/978-3-030-78036-4_4
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