The Nazi Doctors: Medical Killing and the Psychology of Genocide

by Robert Jay Lifton

Nazi doctors did more than conduct bizarre experiments on concentration-camp inmates; they supervised the entire process of medical mass murder, from selecting those who were to be exterminated to disposing of corpses. Lifton (The Broken Connection; The Life of the Self shows that this medically supervised killing was done in the name of "healing," as part of a racist program to cleanse the Aryan body politic.

After the German eugenics campaign of the 1920s for forced sterilization of the "unfit," it was but one step to "euthanasia," which in the Nazi context meant systematic murder of Jews. Building on interviews with former Nazi physicians and their prisoners, Lifton presents a disturbing portrait of careerists who killed to overcome feelings of powerlessness.

He includes a chapter on Josef Mengele and one on Eduard Wirths, the "kind, decent" doctor (as some inmates described him) who set up the Auschwitz death machinery. Lifton also psychoanalyzes the German people, scarred by the devastation of World War I and mystically seeking regeneration. This profound study ranks with the most insightful books on the Holocaust.

Genres: History, Nonfiction, Psychology, Holocaust, World War II, War, Medicine

561 pages, Paperback

First published January 1, 1986

About the author

Robert Jay Lifton was an American psychiatrist and author, chiefly known for his studies of the psychological causes and effects of wars and political violence, and for his theory of thought reform. He was an early proponent of the techniques of psychohistory.

Reviews

[Mario the lone bookwolf · Rating 5 out of 5]

Important memorial against transfiguration and oblivion of the frighteningly fast metamorphosis of the standard rule of law to dictatorship.

The doctors are the main topic of this nonfiction book, but the underlying, always actual problem of group dynamics is even more disturbing. The most mentionable thing about the doctors is the fact that they constructed, against the Hippocratic oath, sick theories that justified and relativized their atrocities with the explanation of a higher end goal, the final solution on the way to breeding the master race for their thousand-year-long German Third Reich. Within shortest time medicine and the motivation to cure and heal turned to doing vivisections and test any kind of chemical or biological agent on humans.

A work that makes stunned and disturbs, whose explosive content is omnipresent in the form of constant ethnic, religious or political conflicts in different parts of the world. Disputes, with the inherent potential of culminating in mass expulsions and genocide within a tight time, that doesn´t even open the reader the option to see the indescribable atrocities as a unique, but above all past and in this form unimaginable repeatable breach in civilization.

After all, one does not want to see how rapidly society can convert, that norms and values can be turned 180 degrees, neighbors, friends and family members made into people of second grade and soon, as a logical step, no longer worth living. It is difficult to understand how it could escalate so quickly, from clichés and prejudices against a group of people to active rejection and avoidance of these, up to the first physical attacks, the enrichment at their expense and the final material erasure within a decade. Sure the lap out of that this creature crept is still fertile, but only a small part of the population was for it.

Habit and conditioning, of which we are often unaware because we delude ourselves in the illusion of being openminded and not manipulated, belonging to the community but seemingly free and independent in our actions, play a crucial role in all dimensions of cruelty.
As long as it is considered socially taboo and unacceptable to slaughter one's neighbor, a healthy coexistence, apart from the profoundly human group constraints, class differences and prejudices, is relatively quickly possible. On the other hand, if the norm changes, as illustrated in the book explicitly by the genocide, the actors adapt their worldview to the new circumstances and put together justification mechanisms to deceive themselves.

In the beginning, the mass murder is still relatively tricky to perform, the aversion to the slaughter of men, women, children, infants, the sick and old that doesn´t accord to the previous indoctrination is still there, and so there are resistances. Although only in the spirit, not in actings.
But it becomes more and more professional, people exchange their knowledge and killing tips, experiment with the best angles of fire and hit points on the bodies of victims, how to stack corpses for optimal utilization of space, whether first mothers or children should be killed to not to be too cruel, how often one should change the overheated rifles to avoid damage, how to distribute the logistical tasks, how to keep the victims quiet for as long as possible under false pretenses and many other details.

The theory and practice of horror, learning from ever-higher stacked piles of corpses to make them grow faster and more efficiently. With the days and weeks, it becomes routine to shoot thousands of people, the sadistic troopers are pushing to work as executioners the others take their respective positions as transport driver, warden or guard and at some point, horror has become standard.
Some justify having to do their job, while others are concerned about the safety of their own family at home or in general. They see potential mothers of enemies in little girls, in infants already growing adolescents, with whose extinction they believe to make an essential contribution to the final solution. For the leadership ranks it is sufficient to reassure themselves repeatedly of the ideological superstructure and the correctness of their instructions, while the average soldiers who are directly exposed to the bloodbath need additional illusions to be sure of the rightness of their actions.

For example, first having the mother shot by another soldier, and then immediately killing her child, with the explanation that now that the mother is dead, it would be a poor orphan, and it would be humanity to prevent it from growing up without a mother. This is exemplary for the fundamental logic of all analytical approaches that are introduced by the perpetrators.
If one looks at the current geopolitical situation and the many smoldering, potentially at any time escalating conflicts with potential for rapid deployment to devastating fires, one has to take the veil from the eyes and admit that something like learning ability compared to the thesis "history repeats itself" has the worst possible cards.

Moreover, it makes a striking difference whether a group or a whole nation is going to make a war out of elemental hardship, hunger, misery, menace, oppression and desperation to ensure survival and defend against an aggressor, and as a result, atrocities happen. Or, alternatively, whether, for no good reason, human rights violations are born of incitement, agitation, demagogy and propaganda and committed by hitherto sovereign, prosperous states.

The despicable results may be the same in both cases, only the moral legitimacy of the perpetrators is it a bit sicker and more obnoxious. To let it happen without real cause or threat from the outside and to actively participate in it just because it is possible.

Other books that show the perfidy of manipulation in action are

https://www.goodreads.com/book/show/4...
https://www.goodreads.com/book/show/2...

A wiki walk can be as refreshing to the mind as a walk through nature in this completely overrated real-life outside books:

https://en.wikipedia.org/wiki/Nazi_hu...
https://en.wikipedia.org/wiki/Unit_731
https://en.wikipedia.org/wiki/Unethic...
https://en.wikipedia.org/wiki/Human_s...

https://en.wikipedia.org/wiki/Psychol...
https://en.wikipedia.org/wiki/Media_m...
https://en.wikipedia.org/wiki/Psychol...
https://en.wikipedia.org/wiki/Propaga...

The infographics show does a great job on topics like this:
https://www.youtube.com/watch?v=B7SJK...
https://www.youtube.com/watch?v=D4nPx...

[William2 · Rating 5 out of 5]

Fascinating. Not for the faint of heart. Martin Amis used this as background for his novel Time's Arrow.

[Lobstergirl · Rating 4 out of 5]

"National Socialism is nothing more than applied biology," said Deputy Party Leader Rudolf Hess at a 1934 meeting. Robert Jay Lifton, professor of psychiatry and psychology, examines the role medical doctors played in the Nazi genocidal project. From its beginnings, with the sterilizations of the unfit, the "euthanasia" of mentally defective or handicapped children, followed by adults, to its apotheosis in Auschwitz with the medical experiments of Josef Mengele and others, and the attempt to eradicate the "diseased" Jews from Germany and its conquered territories to cure the ills of the Nordic race through therapeutic mass killing, doctors were central to Nazi ideology and practice.

This is a work of both history and psychology. In addition to mining historical archives and testimony, Lifton intervewed surviving Nazi doctors and surviving prisoner doctors. His interest was in discovering how doctors, in a profession charged with healing, came to be medical killers. For some, the ideology of viewing Jews as the disease of the national body was sufficient rationale. (Of course, not just Jews, but also Gypsies, Poles, Russians and others were marked for extermination.) Eduard Wirths, the head doctor at Auschwitz, saw himself as part of a moral crusade, making life better for the prisoners, controlling typhus outbreaks, eliminating diseases. One of the achievements he was proud of was reducing the death rate among Auschwitz prisoners; Wirths felt he was doing God's work in preserving Jews in this way.(*) For most Nazi doctors there was a bizarre distancing between their roles and the facts of extermination.

Most doctors, in order to become killers, needed to engage in a process Lifton calls doubling: splitting oneself in two, into an Auschwitz self and a non-Auschwitz self, so the killer could coexist with the healer, or the official who made gas chamber selections on the ramp with the loving husband and father. Doubling entailed numbing oneself to the exterminating side of Auschwitz, aligning oneself with the "healing" side, compartmentalizing the horrors from the rest. Doubling was crucial to the whole genocidal project.

(*) This of course reminded me of another jarring example of someone claiming to be doing God's work, Lloyd Blankfein, CEO of Goldman Sachs, during the financial crisis.

[iva° · Rating 5 out of 5]

nema tog horora koji bi mogao nadmašiti ovo.

[Jessica · Rating 5 out of 5]

I got my hands on this book after my Mom helped a librarian friend clean out the Stillwater High School library's non-fiction section. Since they're just going to toss the books anyway, she often sets aside any Third Reich related materials for me. I think they do this weeding because non-fiction becomes out of date so quickly, and library's use the average copyright date of their materials to gauge how up to date their collection is. In any case, after reading the book I felt that the HS could have probably kept this one!
Even though it was published in the 1980s, this book was a very interesting glimpse into the psyches of the Nazi doctors who worked in the death camps. Dr. Mengele is, of course, the most famous of these but I particularly liked the fact that he was just one of many in this book. Though he has become "THE angel of death," the horrible truth is there were many.
Another little acknowledged fact is that many doctors that worked in the camps were prisoners, who lead a somewhat double life - they were forced to aid the Nazis in their medical experiments as well as medicalized killing, but many tried to help their patients as well. This hierarchy lead to many complicated and profound relationships between doctors, Nazi and prisoner. This was an aspect Lifton went into that I hadn't seen in my other Nazi medicine related readings, at least not in the same depth.
One of the things I liked best about this read was the fact that Lifton constantly invoked the Hippocratic oath, and asked his interviewees to discuss their relationships with this sacred responsibility to heal, both inside the Third Reich, and afterward the war.
Ultimately, I feel like this scholarship takes an approach I haven't found in my other Nazi reads, and I enjoyed it's depth and sensitivity towards both the victims and the perpetrators. I would highly recommend it to anyone as interested in the psychology of "everyday" Nazis as I am.

[William2 · Rating 5 out of 5]

Fascinating. Not for the faint of heart. I wonder if Martin Amis knew of this book when he wrote his novel, Time's Arrow.

[Valerie]

There are several points that get to the crux of this book. One is from the preface; Lifton, having interviewed both Nazi and prisoner doctors, was asked by one of the prisoner doctors "Were they monsters?" "No" he replied, "They were human beings." The prisoner doctor opined that it would've been simpler if they were monsters--but the book makes plain that it's not so simple.

Another critical point deals with a prisoner doctor who is sent to escort a child through the camp. He felt eyes on the child from all around, and said that he felt very proud, as if he were escorting the president of the Republic. "There is only one president, and there was only one child."

Lifton is a past master in describing human behavior in extreme circumstances. He's one of the creators of the term 'post-tramatic stress disorder'. An important insight that he brings out in his research is that there's no such thing as 'the mind of a killer'. All of us are potential killers, and it's critical to be able to recognize and resist the socialization that causes such tendencies to be expressed.

[Katherine Addison · Rating 5 out of 5]

This is an astounding book. On a second reading, I am, if possible, even more impressed by Robert Jay Lifton than I was the first time. He takes on an enormous question--how did doctors under the Nazis come to participate in the genocide of the Jews?--and not only does he answer it, but the bulk of his research is interviews with surviving Nazi doctors.

The idea makes my skin crawl, and I'm not Jewish. Robert Jay Lifton is.

So one of the things I admire in this book is Lifton's courage and honesty. His courage to do the interviews, and to do them honestly. He didn't pretend to his subjects that he validated their experience, or that he forgave them, but at the same time, he listened to them, and again and again, he struggled--and struggles in the writing of the book--for empathy:

... it felt strange and uncomfortable to hold out even minimal empathy (and even with full awareness of the clear distinction between empathy and sympathy) for participants in a project so murderous, and one aimed specifically at my own people, at me. If I never fully resolved the matter, I managed it by understanding my empathy to be in the service of a critical rendition of those doctors' psychological actions and experiences. (Lifton 501)

Demonizing the Nazis doesn't help (although in the case of Hitler and Himmler, it's well nigh impossible to avoid); making them inhuman and unique merely prevents us from understanding how and why they did what they did. They were human beings; that doesn't make their crime less. Arguably, it makes it greater: you can't blame an inhuman evil for being inhuman and evil. Only humans can be blamed for their failures in humanity. One of the things that Lifton's persistent emphasis on empathy reveals is in fact the contradictions in the selves of the Nazi doctors, the fact that they did struggle with their killing mission.

Now, they resolved those struggles in ways that allowed them to keep killing--and that in fact may be the central question of this book. What makes doctors kill, and kill professionally--that is, as doctors?

The answer is complicated, but here is the nutshell version I'm carrying away with me:

1. Ideology (I also get this from something Solzhenitsyn says in The Gulag Archipelago, 1918-1956: An Experiment in Literary Investigation, Books I-II:
Ideology--that is what gives evildoing its long-sought justification and give the evildoer the necessary steadfastness and determination. (Solzhenitsyn 173)

He goes on to cite the Nazis specifically.) Nazi ideology, with its emphasis on the race (the Volk) over the individual, and its sacralization of biological racism, presented the idea that killing the Jews (inhuman, evil, deadly) was in the service of "curing" the Aryan race. (One Nazi doctor described the Jews as a "gangrenous appendix"--lovely, huh?) Nazi ideology also elevated the doctor to the status of race hero (an idea few doctors in Weimar Germany were equipped to resist), and in general mobilized the romantic idea of the hero, of the glorious life or death struggle: if killing all these Jews is hard, well it should be! You must make sacrifices for the Volk.

Notice, please, just whom that sacrifice consists of.

So Nazi ideology first of all glorified death and killing, glorified struggle and sacrifice, and neatly reversed the polarity of genocide: not killing, but curing. And it was assisted at every point by the pre-existing German anti-Semitism; even Germans who were opposed to killing the Jews believed that they were a dangerous problem for Germany.

2. Psychology. Lifton talks a great deal about a psychological process he calls "doubling": the creation of a second self, in this case, an Auschwitz self. (He emphasizes that doubling is far from unique to Nazis:

Doubling is part of the universal potential for what William James called the "divided self": that is, for opposing tendencies in the self. [...] the potential for doubling is part of being human, and the process is likely to take place in extremity, in relation to death.

But that "opposing self" can become dangerously unrestrained, as it did in the Nazi doctors. And when it becomes so, as Otto Rank discovered in his extensive studies of the "double" in literature and folklore, that opposing self can become the usurper from within and replace the original self until it "speaks" for the entire person. Rank's work also suggests that the potential for an opposing self, in effect the potential for evil, is necessary to the human psyche: the loss of one's shadow or soul or "double" means death. (Lifton 420)

In fact, as Lifton notes, prisoners in Auschwitz, especially physicians, also went through doubling. They had to, in order to survive.

The Nazi doctors' doubling, though, was not a survival mechanism in that way. It is clear that it was possible for Nazis of all kinds not to participate in genocide. But the vast majority of them did not make that choice. They chose instead to create an Auschwitz self.

The Auschwitz self makes selections, does experiments (almost all of them hideously cruel, some of them lethal, and most of them ludicrously bad science, like Mengele's "experiments" in changing the eye-color of brown-eyed blond children by injecting methylene blue into their irises), is hard and unempathic and efficient, leaving the prior self essentially dormant, except for interactions with family and pets--and weirdly, sometimes, with prisoners. The Auschwitz self is also formed by the transferal of attention (my phrase): instead of thinking about the thousands of people you're killing on a daily basis, you think about how to make the gas chambers operate more efficiently, or you think about the technical problem of disposing of all those bodies when you've outstripped the processing power of the crematoria. And by selective loyalties: instead of recognizing your common humanity with your victims, you focus on your duty to support your SS comrades in their own trial.

And thus black becomes white; evil becomes good. The Holocaust becomes possible.

[Rosanna · Rating 5 out of 5]

Ci ho messo un anno e più per leggere questo libro. Così corposo, così complicato, così tremendo.
Libro durissimo. Durissimo prendere atto che non esiste il Male senza l'Uomo, per quanto sia comodo pensarlo come entità a se stante. Durissimo prendere coscienza che esso è un limite valicabile, in ogni tempo e da ognuno di noi. Durissimo pensare che ci siano persone, che fanno Popolo, che si spogliano della propria umanità per diventare piccole particelle del Male, al suo servizio, senza rientrare in se stessi un solo attimo per chiedersi 'che cazzo sto facendo'. (Mi scuso, ma non lo capirò mai).
Arrivata a Mengele, confesso, ho smesso. Per mesi. Tutte quelle immagini e quei pensieri dovevano smettere di agitarsi in me, che trasformo tutto in sogno notturno.
Poi ho ricominciato a leggere della 'divinità del male', di Mengele, accogliendo la teoria dell'autore che ne scandaglia motivazioni e comportamenti e ne rifiuta la leggenda che attorno a lui si creò e che persiste ancor oggi, riducendolo a uomo.
Le mie conclusioni, scritte di getto, sono misere in fondo: furono, tutti loro, esseri mediocri che fecero danni enormi e non solo ai loro tempi, ma anche ai nostri giorni e in futuro ancora.
Per evitare questi danni occorre leggere, studiare, partire a ritroso da oggi e vivisezionare ciò che fu, per ritrovare gli uomini che fecero, lasciando i dinosauri ai bambini dell'asilo.
Dobbiamo, con studio e spirito critico, evitare che Malvagità, opportunismo, Odio, Sadismo e Piacere connesso a tutto ciò, avvengano ancora.
Non dirò altro, sono troppo piccina.
Vorrei solo citare i capitoli della terza parte di questo libro, intitolata 'La psicologia del genocidio':
- Lo sdoppiamento: il baratto faustiano
- Il sè di Auschwitz: temi psicologici nello sdoppiamento.
- Genocidio.
E non si pensi che sia solo analisi psicologica ciò che fa l'autore, psichiatra lui stesso, ma il suo è uno sguardo che abbraccia individuo e Storia cercandone in fondo, al fondo, il significato più profondo oppure l'Anima.

[Brett C · Rating 3 out of 5]

This book accounts for the Nazi takeover of the medical sector in Third Reich Germany and then goes into the medical implementations/experiments in the concentration camps. Full of information.

[Erik Graff · Rating 4 out of 5]

Lifton, a psychiatric physician and teacher himself, has written a host of books, many of them treating of the threat of nuclear war, all of them with a decided ethical concern, a concern which can be related to what Freud termed the 'thanatos' or death instinct. How does it happen, he asks, that people can become so destructive, so evil?

While treating of early Nazi extermination practices (f.i., of the disabled and infirm), most of this book concerns itself with Auschwitz, that enormous complex of camps and industrial concerns run by the S.S. for the purposes of production, profit and industrialized mass murder. Most specifically, it's about the doctors serving the camp and the medical aspects of the camp's management. These medical professionals include not only the regular German physicians but also their assistants, many of them themselves imprisoned M.D.s, many of them Jews, some of them the former mentors of their captors.

Much of Lifton's work in preparing this study was in interviewing these doctors, often quite extensively. How did they see their transition from being healers to becoming murderers? What were the higher purposes of their work and how did they reconcile the tenets of their Hippocratic oaths to 'do no harm' with their oaths to Adolf Hitler? And how, most importantly, can one objectively account for such extraordinary hypocrisy?--this being the point of his efforts.

[peg · Rating 4 out of 5]

I'm not sure how one decides how to rate a book on such heinous crimes. I can't say that I enoyed it or that I would go about waving the book in the air recommending it to others. What I can say is that this author offers a well-researched historical account of the genocide movement which began and advanced insidiously during the pre-war era and reached epic proportions during WWII. The questions raised in The Nazi Doctors are not dissimiliar to the issues we debate when considering capital punishment,physician assisted suicide,genetic engineering,mercy killing and the like. However, the latter are discussions for another day.

[Ellie Midwood · Rating 5 out of 5]

I read this a few years ago for research purposes but as it turns out, I never wrote a review for it. This study is absolutely fundamental for understanding the phenomena of medical killing and the psychology of the nazi doctors performing euthanasia and graduating to becoming the main perpetrators in the Auschwitz genocide. After conducting multiple interviews with the surviving nazi doctors, Dr. Lifton completed an unparalleled study that allows a rare glimpse into a psyche of a healer turned killer following the nazi indoctrination and succumbing to its pseudo-scientific goals and methods. By explaining how the idea of “healing” the German nation by turning it against “the enemy” - the Jews - gradually led to an experimental phase (euthanasia T4 program) and later, to the actual industrial scale annihilation of millions, Dr. Lifton paints a truly terrifying picture of a similar transformation that the nazi doctors were undergoing. Explaining their coping mechanisms from a psychiatrist’s POV, Dr. Lifton explains how seemingly decent men could turn into sadistic monsters experimenting on human beings as though they were guinea pigs and performing selections on the Auschwitz ramp under the pretext of the medical - and ideological - necessity. Some adapted astonishingly quickly and even thrived in the hell of Auschwitz (Dr. Mengele); the rare few refused to have anything to do with the atrocities and tried their best to remain healers. But each doctor underwent a similar transformation, the doubling as Dr. Lifton calls it, in order to preserve their psyche and protect it from self-destruction as the sense of guilt would be far too overwhelming. I could go on and on about this study, but you really should read it for yourself to truly appreciate its historical and scientific value. A must-read for anyone who wishes to understand the Holocaust and the doctors’ role in it.

[Edward Champion · Rating 5 out of 5]

This is one of the most harrowing and disturbing books I've ever read. It took me about a week and a half to get through -- and I was only able to pick at it intermittently by reading other books -- but it is a deeply important volume on the true evil carried out the Nazis. Robert Jay Lifton -- who is Jewish himself -- tracked down a remarkable number of surviving Germans, both the doctors and the prisoners, and has masterfully documented how the genocidal impulses sprung from the Aktion T-4 program, in which anybody declared "feeble" was gassed by carbon monoxide (Hitler specified the gas), starting in an abandoned prison in Brandenburg, and carried out to the terrified mechanized slaughter of Jews, Gypsies, gays, and anybody too weak to work in the camps. But within Auschwitz, there were further horrors than genocide. There was Block 10, where the whistling butcher Dr. Josef Mengele (whom Lifton REALLY unpacks here -- the sections on Mengele are a brilliant psychological examination) carried out experiments on children, twins, and various other horrific "tinkering" that I could not possibly write here on Goodreads to secure a master race. Aside from Lifton's heavy lifting on the systemic mechanisms of genocide, he has also confronted many of the "doctors" who cosigned onto these hideous experiments. At the time of these interviews (the 1970s and the 1980s, it appears), many of them were STILL defending Mengele and the ghastly mission. One Dr. B even tells Lifton that one cannot judge Auschwitz unless one was there, while simultaneously remaining in denial about the evil that was committed. If you are somehow unconvinced that fascism represents the worst political system that humankind has devised, I urge you to read this book. I cried. I was unsettled. I nearly vomited at some of the descriptions. But one cannot walk away from this book having even a remote strain of sympathy for those who gleefully signed on for the Nazi ideology. This is a vital read, but read it only when you are ready.

[Hugh Cameron · Rating 5 out of 5]

A fascinating and chilling study into the political perversion of one of the worlds most noble professions. How roaring rhetoric, distorted doctrine and deep resentment combined to convince an institution established to save life, embark on a quest to destroy those very same lives they had sworn to protect. A chilling reminder of what happens when a warped ideology infects a health care system- picture a demonic and twisted NHS, where the object is not to save life but to destroy it. Picture a logic so skewed, that it treats a whole race of people as less than human. It is only through that lens that these atrocities could have taken place, and this book serves as a stark reminder of how low we can go. The true horror of the book’s focus is not blood and gore, but the ease of which, prejudice, left unchecked, can manifest into something much darker, birthing false ideologies on an industrial scale whose sole purpose is the destruction of human life. Essential reading.

[Edward · Rating 5 out of 5]

For anyone who wants to understand a little bit about how a society can become so comfortable with 1.2 million abortions in the US every year (over 42 million worldwide every year), this is a must-read. Many of the steps used by the Nazis to channel the medical profession into killing millions can be seen in what the pro-aborts have done. I'll plan to write more about this on my blog (http://speaking4life.com), please check it out.

[Andrea Hickman Walker · Rating 2 out of 5]

I wanted to like this book, but I found it surprisingly dry and uninteresting. It's a topic that fascinates me, so I'm really surprised that I had to force myself to read this, and eventually just gave up.

[Frank Hermens · Rating 3 out of 5]

3.5 stars really…. Overall the book has some interesting insights with the chapter on the term “doubling” to be one if them. I did find the build-of the different chapters to be a bit random.

[YHC · Rating 4 out of 5]

Ending my 2017 with this book seems negative, but i just want to remind myself how weak our kindness could be altered due to different circumstances.
It was a very heavy book to read, also quite thick with many chapters of case studies.
I think the prefaces say the points about human rationalized their behaviors even though it's apparently wrong.

the evil of banality is everywhere.
below i copied preface to keep
.........................
本书的顺序如下：在这篇前言的后一部分，将谈谈我总体的心理学方法， 我的那些访谈，以及相伴而来的道德问题；然后，我将介绍基本的纳粹理论和 医学化屠杀的做法。在正文第一部分中，我将考察从强制绝育到医学直接杀 人——它被虚伪地称为“安乐死”——的一系列做法，德国医学界的纳粹化使 其成为可能，而这种“安乐死”延伸至集中营，则将医学杀人行为推向了高潮。 第二部分在本书中篇幅最大，它关注奥斯维辛。【6】奥斯维辛作为一种制度的 进化；纳粹医生在火车站坡道上的大规模筛选，在集中营内的小规模筛选，尤 其是在医疗区的筛选；在这个屠杀计划中那些纳粹医生的社会化；囚犯医生 为幸存和坚持做一个医治者而进行的斗争——尽管这要依赖纳粹医生；使用 石炭酸注射的屠杀；在奥斯维辛囚犯身上做的那些试验，以及这些试验与纳 粹生物医学原则的关联。第二部分后面的内容还包括对3个纳粹医生的个案 研究：一个是恩斯特·B，他可以展示一种纳粹式正派的矛盾性（the ambiguity of Nazi decency）；另外两个案例分别是：约瑟夫·门格勒，一个意识形态狂热 者的心理行为，以及原来称为“好人”的爱德华·维尔特，正是他设置了奥斯维 辛的整部医学杀人机器。
在第三部分，我探讨了由纳粹医生直接引发的一些心理学原理，尤其是 双重自我的角色转换，也就是第二个自我的形成；这个自我相对自主，使得一 个人能够参与邪恶。然后，我转向了纳粹种族灭绝的一些普遍原则，它们或许 能够应用于其他形式乃至于所有形式的种族灭绝。最后，全书以一篇带有某 种个人感触的后记而结束。
访谈
从一开始起我就有一个假设，也是我25年的研究中一直坚持的，即：了解 纳粹医生，最好的途径就是与他们交谈。访谈成为这个研究的实际核心。然 而，我也知道——甚至在早期工作开始之前就知道，我必须用大量的阅读和 对所有问题的深入探讨来补充这些访谈，不仅要了解其他人对纳粹医学行为 的观察，而且要了解整个纳粹时代，了解德国的文化和历史，了解遭受迫害尤 其是因反犹主义而受害的整体模式。
从一开始，就这个时代的每个方面，我向专家们请教，请教历史学家、社 会科学家、小说家和剧作家（他们中有些人是集中营的幸存者），内容涉及：理 解纳粹政权及其行为的方式，阅读材料，图书馆，审判档案，各种信息来源，访 谈哪些人等等。有了这种基础性的帮助，我就能动身上路了。我早期的旅行 是：1978年1月去了德国，5月和6月又去了以色列和波兰。从1978年9月到1979 年4月，我一直住在慕尼黑，在这期间完成了大部分访谈，主要是在德国和奥 地利进行访谈，也再一次去了波兰和以色列，还去了法国、英国、挪威和丹麦。 1980年1月，我又到以色列和德国做了更多的工作；同年3月，我去澳大利亚访 谈了3位奥斯维辛幸存者。我从【7】来没有如此频繁地旅行过，也没有做过如 此投入和如此痛苦的心理调查。
我访谈了三类人。核心的一类包括29位男性，他们在很大的程度上相当 重要地卷入了纳粹医学，其中28人为医生，1人为药剂师。在这28个医生中，5 人在集中营工作过（3人是在奥斯维辛），他们或是作为党卫队医生被派去，或
是参与了医学试验；他们中6人与“安乐死”（直接的医学杀人）项目有关，8人 参与了纳粹医学政策的制定和纳粹医学意识形态理论的开发和实施，6人担 任过其他重要的医学职务，这使得他们卷入了肮脏行为和意识形态冲突；还 有3人主要是在军方医学界，这使他们接触到（或者是导致他们寻求保持距离 于）东欧战线背后纳粹对犹太人的大规模屠杀。
我访谈的第二类人共有12人，均是有一定知名度的前纳粹非医学专业人 员，有律师、法官、经济学家、教师、建筑师、管理人员和纳粹党官员。我的目的 是调查纳粹时期一般专业人员的经历，以及他们与意识形态的关系，从而获 得对医学及相关政策的背景了解。
第三类人就大为不同了。他们是80个前奥斯维辛囚犯，都在奥斯维辛医 疗区工作过，其中一半以上是医生。他们多数是犹太人（我在美国、以色列、西 欧和澳大利亚访谈他们），但也包括两个非犹太人群体的成员：一是波兰人 （我在克拉科夫、华沙和伦敦访谈他们），一是前政治犯（主要是在西欧各地， 尤其是维也纳访谈他们）。我关注他们与纳粹医生及奥斯维辛医疗政策打交 道的经历，以及他们当年对这一切的观察。
就前纳粹的那两类访谈对象而言，尤其是纳粹医生，访谈安排委实不易。 我从一开始就很清楚，要接触他们，最好是通过一些在他们社会中有声望而 又同情这项研究的德国人来介绍。我曾被正式聘为保罗·马托斯克（Paul Matussek）医生领导的马克斯·普朗克精神病理学和精神治疗研究所（Max Planck Institute for Research in Psychopathology and Psychotherapy）的研究员， 这对我找人颇有帮助。我的第一个任务是确定在纳粹政权中有声望的前纳粹 医生。我的助手协助我，通过书籍、渊博的学者、传闻和大量的地址检索来找。 当一个名字和地址被确定后，马托斯克教授会给此人写一封正式的信，此信 是他与我两人仔细斟酌过的。信里介绍我是一位杰出的美国精神病学研究 者，正在进行一项关于国家社会主义（National Socialism，即纳粹主义。——译 者注）时期德国医生的“压力与冲突”的研究，并提到我此前对广岛和越南所
进行的研究，强调我会严格保密，希望收信者能与我充分合作。如果对方有积 极的回应，我就会自己写一封短【8】信，说我希望尽可能准确地理解那个时代 发生的事情。
接到这些信的人无疑都明白，“压力与冲突”其实是一些更为恶性事件的 委婉表述。但是，基于他们各自不同的心理原因，约有70%的人同意见我。有 些人觉得，他们应该对一位外国“同行”有礼貌，而且此人还是一位在本国医 学界有巨大声望的人介绍来的。另外，纳粹时代已经过去了这么长时间，这让 他们中的一些人把它当做是一件自己现在能开口的事情。而且，这样做也给 他们一个机会来确定一种后纳粹的身份。在与他们的接触中，我形成了一个 印象：这些前纳粹医生中，许多人内心深处藏着愧疚与羞耻，他们不能去接近 这些，也就是说，是一种静默的自我谴责的无意识或麻木状态。这种未公开承 认的感觉，一直有一种说出来的需要。
然而，他们处理这种感觉的方式又常常与自我谴责背道而驰。在我面前， 这些纳粹医生基本上都称自己是正派人，是想在恶劣环境中尽可能做好事的 人。他们想从我这里得到对他们自己这种观点的证实。而且，作为老人——他 们中最年轻者已近60岁，大部分人已近70岁或者更老，有一人已91岁了—— 他们处在一个喜欢“回顾”自己过去的人生阶段，想在死亡将要到来之前找到 自己这一生的意义和能够传下去的东西。
他们中的一些人，希望有人倾听，他们想说一些事情，这些事情大部分是 从未说过的，尤其是从未对他们周围的人说过。然而，他们中没有一个人—— 我访谈的这些前纳粹医生中没有一个人——对自己所做之事，对自己曾是邪 恶的一部分，有清晰的道德评估。他们可以颇为详细地考察事件，甚至以一种 令人吃惊的坦率来谈论、来体察感觉——但他们几乎都是以第三者的方式。 从道德层面来说，叙述者没有出现。
我不得不考虑真相与非真相的许多层面。在见每一个纳粹医生之前，我
都要尽我所能来了解他。访谈之后，我还要用其他来源得到的材料来比较和 交互核对那些细节和解释，这些来源包括对其他前纳粹医生和非医学专业人 员的访谈；对前囚犯和受害者的访谈，尤其是那些曾在奥斯维辛做过医生者； 以及关于纳粹医学行为的各种形式的书面讲述，尤其是战后较早出现的材 料；另外就是大量的书籍和文件，包括审判记录和能够得到的日记与信件。对 于有意的说谎或（更为常见的）扭曲，对于记忆上的问题，这些额外信息全都 有必要。我们讨论的这些事情发生���20世纪30年代、40年代甚至更早之前，持 续的忘却，以及精神麻木的表现等，会与为自己辩护的扭曲混合起来。不过， 我也遇到了生动和精确的回忆，有着令【9】人吃惊的客观与自我揭露。在进行 解释性判断的过程中，我必须把所有的信息结合起来；（在这个过程中），最终 我却更多地了解访谈过的那些纳粹医生，以及作为整体的他们。
对纳粹医生的访谈，他们中的大部分人，我都谈过两次或者更多次，用时 4个小时或更多。不过，这也因其个人的方便和他们对本研究的重要性而有所 不同。有些人我只见了一次，而有一个人的访谈只进行了半个小时就结束。与 其他人的访谈时间则长得多，有几人是数日长谈，时间长达20或30小时。绝大 部分访谈都要用到翻译。如同我过去的工作，我能够培训几个固定的助手来 做翻译，这种翻译马马虎虎可以对付快速直接的交流。虽然有局限，但访谈时 有翻译在场，却好几次帮了大忙：当纳粹医生感觉不舒服或矛盾时，翻译的缓 冲使其能够较为从容地处理那些高度紧张之事，而不是马上直接处理，所以 不会形成冲突意味很强的交流。这些交流所呈现的紧张感，并不亚于我直接 用英语（受访者英语流利）的少数几次访谈。这两类访谈无一例外，德国医生 们都同意我录音，所以我就有了访谈的准确记录，能够依据德文原文来做后 续的工作。
这种研究方法有一个带点讽刺意味的因素：耶鲁人文学科研究委员会 （Yale Committee on Research with Human Subjects）要求（美国研究界通常也 遵守）：访谈者要得到访谈对象的“知情同意”，也就是说，我要得到这些纳粹
医生的“知情同意”，而这个要求本身来自纽伦堡医学审判（Nuremberg Medical trial），所以它正是我所访谈的医生们或其助手自身行为带来的结 果。这种人情味的要求，看起来完全正确。所以，在见面之前与这些医生的通 信中，我就申明一些原则，包括保密、他们有权利提出任何论题或问题、可以 在任何时候停止参与某次访谈或整项研究等。这些原则用书面形式写下来， 我请每个医生在上面签字，有时是在第一次访谈的开头或结束时，有时则是 在第二次访谈时，或者是通过邮件告知（依据我的估计而定，也就是说，确保 在当时的情形下，提问不会加剧已有的压力，不会形成干扰）。
在我访谈的医生中，有两人曾经因他们的纳粹行为受过审判，另有一人 服过很长的徒刑。他们中很多人在战后都被拘禁长达数年，但没有正式审判。 不过，整体而言，他们并不是医生中最能辨认出来的犯罪群体，而【10】后者的 成员，要么在纽伦堡审判和随后其他审判中被处死，要么数年前由于自然原 因已去世，其中绝大多数人在犯罪之时都有较高的官阶。但是，如同我下面会 讲到的，我也见到了一些人，他们有着邪恶、有时是蓄意谋杀的行为。
我决定在与这些医生最初的通信中不提自己是犹太人。有些人显然怀疑 我是犹太人，但没有人直接问我。在这项工作临近结束的一次访谈中，一个医 生在谈到某件事时，提到《时代》杂志上的一篇文章，那篇文章描述了我这项 研究，提到我是犹太人这个事实。他油滑地提到了我们两个民族的“悲剧历 史”。这加深了我的一个印象：如果我一开始就强调我的犹太身份，那么在访 谈中，这个信息就会被歪曲，会限制对方的回答，也会导致更多的前纳粹医生 拒绝见我。不过，无论讲与不讲，我的犹太身份在每次访谈中都会以某种方式 明显显露出来，这无疑体现在我的方式之中，而德国医生一方的意识中也会 多少感知到。
就访谈内容的顺序而言，我首先简要介绍研究的目的、方法和基本规则， 包括非正式地提到我对访谈进行录音的做法。在得到一个医生的同意开始之 后，我会问一些关于他当下情况的事实性问题，但基本上是开始让他回溯其
教育背景，尤其是医学教育的背景。由于与后面的问题相比，这些经历没有那 么多的情感内容，他就能够形成一种相对自由的谈话模式，能够与我进行某 种医学对话。我常常也要求他描述纳粹时代的早期对他医学学习和工作的影 响，对他整体生活的影响。然后，我往往会询问更多的家庭和文化背景，此后 才是详细考察他在纳粹年代做过和经历过的事情。医生们知道，这才是我前 来的目的，许多人积极地谈论起这些经历。关于感觉和冲突、想象和梦境、愿 望和自我评判的那些详细问题，他们不怎么有准备；但是，在访谈过程中，这 些医生也开始在这些方面透露了许多。如同我在其他研究中访谈过的那些人 一样，在鼓励之下，这些医生会很好地进入到访谈的一种混合模式：一方面是 有重点的探究，另一方面则是自然的联想。
这些访谈的气氛各有不同，从不安到热忱都有。有时会出现高度默契，但 通常又会出现紧张、各种形式的疏离，以及我和纳粹医生各自对基本对立存 在的重申。我随后会较多谈到这些医生表达的世界观；但普遍而言，他们大多 数人已经采纳了一种典型的二战后保守的政治和社会立场，【11】其中包括对 纳粹行为过分的批评，但支持德国社会中相对的独裁因素，对于今天年轻人 可能会走到哪一步，他们也有某种不安。访谈中，偶尔会出现一闪而过的对纳 粹时代的怀旧，对一个生活有热情有意义的时代的怀旧，不管这个时代带来 了什么样的冲突。
这么说吧，对面坐的，是我认为属于迫害阵营那一边的人，所以我的那种 陌生感从未被克服。我努力要进入他们的心理世界，这样做时我一直有某种 困窘和羞愧。有些时候，当我发现自己对其有了好感，被其人性所吸引，这些 感觉就更复杂了。所以，我的核心冲突是：我通常将心理访谈视为本质为友好 程序的感觉，以及对这些受访者难以友好的感觉，这二者之间的冲突。我总是 在这样的冲突中工作。我经常有一种冲动，想用攻击性的道德对峙使自己摆 脱这种冲突。大多数时候，我抑制住了这种冲动。尽管我的心理探究可能类似 于这样一种对峙，我的观点无疑也很鲜明，然而，还是有必要保持一种区分，心
理探究而非道德对峙，才能得出我想要的关于行为和动机的信息。我后来认 识到，想要保持我做这个工作的专业身份——这一点对我很重要，这个区分 也是必须的。甚至可以确切地说，对于我而言，心理探究就是道德对峙的一种 形式。不过，我也必须补充说，有过一些片刻，我不但是想要对峙，而且想要控 诉——用某种攻击的方式——那个坐在我对面的人。尽管有所有的这些感 觉，我还是体会到，而且继续体会到有一种责任，要对这些前纳粹医生公正，也 就是说，尽我所能，做出确切和深入的整体评估。
在那些奥斯维辛幸存者中，访谈的气氛就完全不同了。他们所有人（只有 一人是例外，他因与我交谈这些事情而感到心烦意乱）马上参与进来，和我们 共同努力，探讨纳粹医生，探讨医生们在奥斯维辛和其他地方所做的事情。在 这两个方面，这些原来的囚犯被证明是极为难得的观察者。这种情况完全不 令人吃惊，我的个人身份与那些犹太幸存者医生极为接近。他们之中的许多 人，其家庭、社会和种族背景与我自己的差别不大，他们原来所在的地方与我 祖父母的老家很近。我禁不住把他们的苦难与我自己的优裕生活进行对比。 访谈回来之后，我确实有眩晕之感，有时几乎落泪。不过，我也访谈了来自波 兰和欧洲其他地方的非犹太医生，他们中许多人由于想要帮助犹太人而被送 往奥斯维辛。然而，这种普遍的同情中也有一个例外，我与一个反犹主义的波 兰医生有一场痛苦却富有启示的访谈，此人与纳粹有过密切合作，在本书的 后面我将讨论他。
这些访谈，不同于我以前那些研究项目做过的任何访谈。在这些访【12】 谈中，我体验到了各种各样的情感，从愤怒、焦虑到厌恶，都有；就对幸存者的 访谈而言，有钦佩、共同的痛苦、愧疚和无助之感。我有时希望，要是自己从未 开始这个研究多好。我做了关于奥斯维辛的噩梦，有时梦见我的妻儿身陷其 中。这个研究启动的初期，这样的噩梦经常出现，我告诉了一位幸存者朋友。 他看着我，眼睛里没有特别的同情，或许有少许的认可。他温和地对我说：“好 吧，现在你可以做这个工作了。”这帮助了我。
然而，不管涉及什么样的痛苦，大多数时候我并不沮丧或过于心烦意乱， 实际上，在完成这个研究中，我体验到相当的活力。我沉浸在完成它所需要做 的各种事情之中，我在组织和完成这些访谈上进行精心的安排，我有一种必 须去完成的任务感。1979年春季，我回到美国，独自坐在书房，沉思并开始整 理自己所了解到的情况。那一刻，痛苦强烈地击中了我。我不再走动，我唯一 的任务是想象自己进入了奥斯维辛和其他屠杀中心——这是我一直想要的 状态。当然，一个人只能想象性地进出这样的地方，你不可能在它们里面待得 太久。让我工作后期增加幸福感的，是努力让这些材料获得一种表现形式。在 这样一个研究的过程中，由于希望去与邪恶进行斗争，与那些要为邪恶负责 的人进行斗争，希望让其畅所欲言，自律也就能够做到了。
心理解释的局限
心理研究一直有一种道德取向（moral enterprise），就如同道德判断不可 避免地包括了心理假定一样。比如，不妨想一想汉娜·阿伦特（Hannah Arendt） 对阿道夫·艾希曼（Adolf Eichmann）和“平庸之恶”（banality of evil）的著名评 判。（1）那个说法是作为整个纳粹项目的特点概括而说的。我所谈到的纳粹医 生作为人的普通性看来也进一步证实了她这个论断。不过，也并不完全如此。 纳粹医生是普通人，但他们所做之事却不平常。我在这项研究中会一再讲述 普通人如何进行恶魔行为。在这样做时——或者说下令这样做时，他们自己 也改变了。在完成他们行为的同时，他们自己已不再是普通人了。将心理学研 究与道德思考结合起来，我们就可以较好地理解邪恶的本质和这些人的动 机。
在这个研究中，我的目的是发现走向邪恶的心理条件。以这种方式来使 用心理学，必须避免一些特别的陷阱。每个学科都追求一种幻想，以为能理解 自己未能理解的东西，而深层心理学更容易陷入这种幻想，因为它【13】与科 学的关系很微弱，而且在与后者的关系中，常常处于被动防御。这里我想起了 一位讲法语的东欧幸存医生的警告：“教授喜欢去理解不可理解之物。我们这
些自己曾在现场的人，总是问自己这个问题，而且会一直问到生命结束之时， 但我们永远不会理解它，因为它就是不可理解的。”
这段话并不仅仅是谦虚，它更表明了一个重要的法则：有些事情是不可 能被我们充分理解的。我们最好是承认：一种局部的理解，一种理解的方向， 是任何方法能得到的最好结果了。这是对心理还原论的一种有说服力的否 定。将复杂事物拆分为一种单一而无所不包的解释，这样的方式除了将其一 扫而空，并不能阐释这些事物背后环环相扣的结构和动机。使用这样一种还 原论（或简化论），既牺牲了心理精确性，也失去了道德敏感性。
即使没有还原论，也还存在另外一个陷阱，即将“理解”作为道德评判的 替换。那句经常被引用的法国格言“能够理解一切，便能宽恕一切”（tout comprender c'est tout pardonner）就包含了这个法则。然而，我在这里必须说， 如果这样一种充分理解能够把道德与心理都包括在内，那么这句格言的后半 部分“宽恕”就不会有了。必须意识到这种替换的危险。始终意识到心理学工 作的道德情境，才能克服这种危险。
与社会和历史经验相联系，早期精神分析学家奥托·兰克（Otto Rank）在 一定程度上关注了若干这类道德问题，他把自己最后一部主要著作称为《超 越心理学》（Beyond Psychology）（1941）。（2）兰克长期以来执着于一些伦理原 则，他认为，弗洛伊德和其他人把这些原则从心理学工作中排除出去了，这主 要是因为心理学本身陷入了自己的科学意识形态中。兰克所言给我们的启示 是：这种“科学—心理学”的意识形态把奥斯维辛或它的党卫队医学从业者简 化为某种特别机制或某套机制，于是关于罪恶的问题就不再提出了。在这个 意义上，我们或许可以说，关注道德问题，我们未必总是需要完全超越心理学， 但的确必须持续关注大部分心理学所忽视的那些东西。即使我们在知识上做 得很好了——如同兰克那样，但心理学也只能解释那么多。就奥斯维辛和纳 粹种族灭绝而言，有大量的东西是我们不知不懂的，但我们必须尽我们所能 去了解。
一个人的心理模式或范式相当重要。我自己的心理范式脱离了弗洛伊德 经典的范式，包括生命的本能，自我防御，以及对生命延续的强调，或者说生与 死的象征。（3）我使用的这种范式包括当下和终极两个维度。当下维度指我们 直接的心理参与，包括联结与分开、完整与瓦解、运动与停滞的斗争。分开、瓦 解和停滞相当于死亡，是一些与关注死亡相关的体验；而联结、完整和运动的 经验则与活力、与生命的象征相关。【14】
终极维度则关注更多人的参与，一种在我们有限的生命中连接祖先和后 代的感觉。所以，我们就寻求一种不朽感，一种在我们的孩子、工作、人类影 响、宗教信念中继续活着的感觉，或者是去关注永恒的自然。靠着对超越的体 验，也能获得这种感觉，这种超越体验是一种极其强烈的心灵状态，时间和死 亡在此刻已经消失了，比如神秘主义的古典体验。
一个人必须关注这个终极维度——奥托·兰克将它称为“不朽系 统”（immortality systems）（4），这样才能开始去理解纳粹提出“千年帝 国”（Thousand Year Reich）的力量。要理解纳粹的那个“人民”（Volk）概念，也 是如此。这个词不仅指“民众”，而且对于许多德国思想家来说传递着这样的 意味：“一个有着超越‘本质’的民族群体的团结……（这）可以称为‘自 然’或‘宇宙’或‘神话’。然而，在每个实例中，它都融入一个人的内心深处，成为 一个人创造性、强烈的情感，个体性以及他与这个‘人民’其他成员一致性的 来源。”（5）我们或许可以说，“人民”体现了永恒的种族与文化实质的一种不朽 联结。这种联结就让我们接触到了纳粹的“革命的永生”（revolutionary immortality）（6）。
这个范式为研究者划出了界限，他们总是把辩护与分离混在一起：一方 面是清晰地表现一个人不可避免的道德倾向，而不是通过宣称绝对的道德中 立来“贩卖私货”；另一方面，在运用自己学科的技术和科学原则上，保持足够 的分离。我作为一个美国人、一个医生、一个精神病学家、一个犹太人和一个
人，对我们这个世界中那些毁灭力量的关注，以及我在伦理、社会和政治问题 的基本立场，我自己的辩护，就与以上这些有关。
不管有多么困难，在与那些令人惊愕的经历打交道时，要尽力去维持这 样一种辩护与分离的平衡，这正是马丁·布伯（Martin Buber）所称的“距离与 关系”。
医学化屠杀
在纳粹大屠杀中，可以说障碍已移除，边界已跨越：一方面是暴力意象和 对受害者的定期杀戮（比如杀害犹太人），而另一方面，在奥斯维辛和其他地 方进行系统的种族灭绝。这两者之间的界线已被跨越。在这个研究中，我的观 点是：杀人的医学化——治疗名义下的杀人——是前者走向后面这个可怕阶 段的关键所在。所以，纳粹事业的核心，是摧毁治疗与屠杀之间的界线。
对于奥斯维辛和其他死亡营的那些早期描述，主要集中于纳粹看守、 【15】官员和医生的病态残忍与邪恶。
然而，后来的研究者却认识到，单是病态残忍和邪恶，并不足以解释对数 百万人的屠杀。所以，重点就转向了屠杀的官僚机器。那些最早由马克斯·韦 伯（Max Weber）描述的无个人特征的、分离的官僚机构功能，被用到了大屠 杀之上。（7）关注这种麻木的暴力极为重要，它与我们将会看到的奥斯维辛所 有功能的程序化是一致的。
然而，这些关注就其本身而言并不够，必须看到，它们与一些幻想中的动 机有关联，这些动机与意识形态联结起来。另外则是一些特殊的个体心理机 制，让人们去杀戮。我所称的“医学化屠杀”，强调这些动机原则和心理机制，可 让我们了解奥斯维辛的加害者，尤其是纳粹医生，理解他们既是官僚机构杀 人的一部分，又是个体参与者，来考察其态度和行为。
我们可以从两个广泛的视角来理解医学化屠杀。首先是“外科手术”式方 法，即通过一种控制技术来使用高度致命性毒气，实现大规模杀人的方法。使 用这种方法，可以保持屠杀者与受害者之间的距离。对于纳粹来说，想要减轻 因屠杀而带来的心理问题（这些问题在纳粹档案中一再被记录），这种距离颇 为重要，那些在东欧面对面地枪杀犹太人的特别行动队队员（见本书159— 160页。英文原版页码，下同。——译者注）就出现了这些问题，尽管这没有阻 止他们枪杀140万犹太人。（8）
在对一个前德国国防军神经精神病医生的访谈中，我得到了这方面的直 接证据。此人治疗过很多特别行动队员的心理障碍。他告诉我，这些心理障碍 类似于普通部队的战斗应激反应心理障碍，包括严重的焦虑、噩梦、颤抖和很 多身体不适。但是，在他所称的这些“杀人部队”中，这些症状持续的时间更 长、更为严重。他估计，那些实际开枪者中，有20%的人患有这种心理上的呼 吸困难症状。这20%的人中，约有一半的人认为，自己的症状主要与自己所做 之事产生的“不愉快”有关，另一半则似乎对用这种方式枪杀人提出了道德质 疑。在枪杀妇女和儿童，尤其是儿童时，这些人出现了最大的心理障碍。许多 人在梦中体验到了犯罪感，其形式是自己受到各种惩罚或报应。于是，这些心 理障碍就导致纳粹去寻求一种“外科手术”式的屠杀方式。
不过，医学化屠杀还有另外一个方面，我相信这个方面是人们一直认识 不足的，即作为一种治疗必须进行屠杀。著名的幸存者医生埃洛·林根斯·赖 纳曾经引用过一个纳粹医生对他的回答，揭示了这种动机。埃洛指着远处的 那些烟囱，问纳粹医生弗里茨·克莱因：“你怎样把它们与你作为一个医生的 （希波克拉底）誓言协调起来呢？”【16】
克莱因的回答是：“我当然是个医生，我想保存生命。从对人类生命的尊 重出发，我从生病的身体上除掉坏死的赘余之物。犹太人就是人类身体上坏 死的赘余之物。”（9）
这样的医学意象其实应用更广。19世纪的土耳其（由于奥斯曼帝国的衰 退）就以“欧洲的病人”著称。希特勒之前的意识形态家和希特勒本人都把德 国一战后的混乱和堕落解说为“疾病”，尤其是雅利安种族之病。20世纪20年 代中期，希特勒在《我的奋斗》中写道：“这个时代已是病入膏肓，都腐烂了。任 何想要治愈它的人，首先就必须鼓起勇气，找到这种病的原因。”（10）对此的诊 断结果是种族主义的：那个唯一真正进行“文化创造”的雅利安种族，放任自 己被以犹太人为典型代表的“文化毁灭者”削弱，直至生存危险的境地。犹太 人是“种族污染”和“种族结核病”的代理人，也是寄生虫和细菌，在他们寄生的 那些宿主民族身上引发疾病、退化和死亡。他们是“永远的吸血鬼”“吸血蝙 蝠”“细菌携带者”“人身上的寄生虫”和“腐尸上的蛆”。（11）治疗必须是激进的， 也就是（如同一个学者所言）“切掉‘腐烂之处’，繁殖有价值的因素，让没有价 值之物枯萎死去……‘把各类被认定为没有价值和危险的人们全都消 灭’。”（12）
从强制绝育到直接的医学屠杀再到死亡营，在纳粹的这个顺序中，医学 隐喻与具体的生物医学意识形态结合在一起。这种生物医学意识形态的基本 原则是：对于一种致命的种族疾病而言，对于治愈雅利安种族而言，治疗的方 法就是杀掉所有的犹太人。
所以，法学家兼纳粹占领时期的波兰总督汉斯·弗兰克说：“犹太人是较 低的生命物种，是一种寄生虫，通过接触把致命的疾病传染给了德国民 族。”他在自己统治的地方屠杀犹太人时宣布：“现在，一个得病的欧洲将会重 新获得健康。”（13）这是一种意志的宗教，意志就是“一个无所不包的形而上学 原则”，（14）而纳粹的“意志”是对生死的完全控制。这种观点常常被称为“社会 达尔文主义”，但这个术语只能大致说明纳粹对自然“斗争”和“适者生存”的 强调。事实上，纳粹政权反对达尔文学说的大部分内容，因为进化论假定所有 种族是一个共同起源，它或多或少是民主的，因此它与纳粹关于雅利安固有
种族优势的原则相冲突。（15）
这种生物医学观，更具体而言，它是一种粗暴的遗传学意象，与更加粗暴 的优生学愿景（见本书23—24页）结合在一起。作为该宗教的大祭【17】司，海 因里希·希姆莱把领导的任务说成，“就像培育植物的专家，当他们想从一种久 经考验，但却因太多杂交而奄奄一息的物种中，培育出一种全新种类时，首先 就是要走遍田野，剔除不想要的植物”。（16）
所以，纳粹计划，并不是那么达尔文主义或社会达尔文主义，更多的是对 进化过程的绝对控制，控制生物学意义上的人类未来。纳粹广泛地使用了一 个达尔文学说的术语——“选择”。他们精心策划他们自己的“选择”，策划他 们的人类进化版本，在这个过程中，他们试图接管大自然的功能（自然选择）， 接管上帝的功能（赏赐的是耶和华，收取的也是耶和华）。
在这些版本中，纳粹不仅包含了中世纪神秘主义的反犹主义观点，而且 还容纳了较新的（19世纪和20世纪）“科学种族主义”的主张。危险的犹太人特 征与一些所谓的学科数据联系起来，于是，“人类学、优生学和社会思潮的融 合”构成了“种族主义的主流”。（17）对那些有学问的男性和女性来说，由此而 来的“种族的和社会的生物学”使得反犹主义的恶毒形式在智力上得到尊重。
可以说，这样的纳粹国家是一种“生物学统治”（生物学政体）。它的模式 是一种神权政体，在这个体系中，有一个在神圣特权的主张下产生的神圣秩 序，并由其祭司来统治该体系。这种神圣特权，是通过雅利安种族的净化和复 兴来进行治疗的特权：“一种死亡的机制，只能是为它自己而要求存在，必须 从它当中创造出一种活的有机体，其唯一目标是为一个更高的观念服务。”如 同在神权政体中一样，这个国家自身也只是为了实现神圣目标的工具。在纳 粹的生物学疯狂中，国家不过是一种手段，其目的则是要实现“德意志民族在 地球上的一种使命”，这就是，“汇集和保存这个［雅利安］民族中最有价值的 基本种族要素……，［并］将其提升到一种支配地位”。（18）不同于古典的神权
政体，在纳粹的生物学统治中，生物学祭司并不直接统治。很明显，统治者不 是生物学理论家，也不是医生们，而是希特勒和他那个圈子。（不过，这种差别 并非那么绝对。即使是在神权政体中，高度政治化的统治者也可能对祭司权 威发出不同的声音。）不管怎样，纳粹统治权威是以更高生物学原则的名义而 维持的。
这种生物学权威号召要明确地表达和实施“科学种族主义”，包括各种各 样的体质人类学家、遗传学家和种族理论家的工作，而医生不可避免地有了 一个独一无二的位置。医生在生死之界工作，他们与一种令人敬畏的光环联 系最紧，这光环是抗拒死亡——有时是致人死亡，它由原始巫师和巫医的光 芒而合成。作为巫师遗赠和当代神秘治疗技艺从业者的承载人，医生们最可 能被召唤，成为这种生物学的积极分子。
我已经提到，对纳粹医生参与医学化屠杀或生物学屠杀，我有研究的 【18】兴趣。我们会看到，他们的人体试验与这种屠杀过程相关，与纳粹整体的 生物医学愿景相关。
在纽伦堡医学审判中，医生们所受的审判只限于对杀人的参与，部分原 因在于，当时尚未认识到这种医学屠杀的全部意义。（19）
在奥斯维辛，纳粹医生主持了这个集中营100万受害者中大部分人的屠 杀。医生们进行筛选，站在坡道上对刚运来的囚犯进行筛选，其后又在集中营 和医疗区里继续筛选。医生们监督毒气室里的屠杀，并决定受害者何时死掉。 医生们实施了谋杀性的传染病传播——那些被送往毒气室的人感染了各种 传染病，有时医疗区的每个人可能也被传染。医生们下令、监督、有时还直接 杀害医疗区那些虚弱的病人，即将石炭酸注射到病人的血流或心脏中。与所 有这些屠杀相关的是，医生们还出示一种虚假的医学合法性：不管是处死奥 斯维辛的囚犯，还是杀害从外面带到这里的人，医生们都签署虚假的死亡证 明，列举假的死亡病因。对于如何最好地保持筛选的平稳进行，应该让多少人
活下来满足法本公司（I.G.Farben）对奴隶劳工的需要，怎样烧掉那么多、已经 对焚尸场设施造成巨大压力的尸体等，在这些方面，医生们积极地提供了建 议。
总之，我们或许可以说，医生们被赋予了奥斯维辛这个屠杀系统的许多 责任：筛选受害者，让这部身体和心理的杀人机器运转，对集中营的屠杀功能 和劳动功能进行平衡。虽然医生们不管理奥斯维辛，但他们为它增添了一种 堕落的医学光环。一位近距离看过这个过程的幸存者说：“奥斯维辛就像一场 医学手术”，“从一开始到结束，屠杀都是由医生来领导的。”
我们也许可以说，站在坡道上进行筛选的医生代表着一种奥米加点 （omega point，生态学家关于生物演替可能存在终点或顶极群落的猜想。—— 译者注），代表着死界与生界之间神秘的看门人，代表着一条最终的共同路 径：通过大屠杀来治疗的纳粹愿景。

[Michael · Rating 4 out of 5]

In this book, Robert Jay Lifton sought to understand how people trained to heal and protect life became involved as perpetrators of genocide and the destruction of life. It remains significant as a book which ties together the early eugenics laws and operations to sterilize or euthanize undesirables with the ultimate development of mass killings on the Russian front and in the extermination camps. It also remains one of the most comprehensive analyses of the men who carried out the selections within the camps, and thus is an important historical contribution, which fortunately remains readily available more than twenty five years after its initial publication.

This is not to say that the book is without flaws, however, and history teachers considering it as a text will want to supplement it with more current research on perpetrators by historians, such as Ordinary Men: Reserve Police Battalion 101 and the Final Solution in Poland. Lifton was not a historian, and in his introduction he confesses his own limited ability in German, Polish, and other relevant languages. Although the book is based on interviews, it appears that Lifton did not adhere to accepted standards of oral history, acting more as a journalist or psychologist might in approaching the subject. In some sense, this is logical, as he was a psychologist who had published several popular works, mostly about recent traumatic events and their effect on the participants and victims. As such, he gives insight into the inner workings of perpetrators, and finds (as Browning would) that their responses to the situation varied. I’m not qualified to assess his use of the psychological concept of “doubling” to explain how perpetrators found it possible to live with themselves, but I tend to concur with his estimation that the concept of “lebensunwertes Leben” served as a justification for doctors in deciding to see “healing” the Volk community as a higher priority than protecting the individual lives of marginalized victims of the regime.

I read this book many years ago, at the outset of my interest in German history and fascism, and it served as a good place to explore some complex issues, following upon some rather more sensationalist works on the Third Reich. It is accessible for people with little background in history or psychology, and that is probably one key to its success, but it does not oversimplify or overstate its case. At the time I read it, I was particularly interested in its coverage of Joseph Mengele, who had been presented as a kind of movie-style villain figure in other works, and this gave a more complex sense of him, without trivializing the evil he committed. As Lifton quotes one of the camp survivors saying in the introduction, “it is demonic that they were not demonic,” but rather human beings committing acts of evil that live as a potential in each of us. Books such as this may help us ultimately find ways to prevent that potential from being expressed in the future.

[Anne Hawn · Rating 5 out of 5]

This book is so hard to read...not from the writing, but the events and the people who perpetrated them. I am finding that I can only read a few pages at a time. The book is extremely well researched with footnotes and an extensive bibliography. A great deal of it comes from actual interviews.

The extent of Nazi crimes is far more unimaginable that I could have ever thought and nothing is worse than doctors, who are trained to heal, turning into killers. The book deals with the SS doctors, German doctors, prison/inmate doctors and prison/inmate/Jewish doctors. I is also filled with the elaborate lengths the Nazis went to to cover up what they were doing to the world and to themselves.

As I continue to read this book, I am amazed at the amount of source material Lifton has used. The foundation of the book is interviews with the doctors, a few SS doctors, but mainly prisoners who were doctors. I am on the chapter on Mengele and it is one of the most extraordinary things I have ever read. I have read numerous books on Hitler and the concentration camps, but was left unsatisfied. No author could answer the question, "Why?" Why did seemingly normal people do such atrocious things?

The chapter on Mengele explains how he was able to compartmentalize his mind and do seemingly contradictory things. He would work hard to save a Gypsy from typhoid and then send him to the gas chamber later that week. In understanding the mind of Mengele, I finally began to understand some of these incredible events effected ordinary people. Make no mistake, Mengele was not a normal person. He had to have had a sadistic streak already, but, as the author says, he was “the right person at the right time and at the right place.” He saw himself as “healing” the German race and beyond that, healing mankind through genetic selection. He was an ideologue, as were the leaders of the party. They saw themselves as purging the race of man of the undesirables, which would lead to the “thousand year reich.” He was a demigod in Auschwitz and acted accordingly, but at times, he would be seen as honorable and courageous.

This is the book that I have always been looking for.

[dejah_thoris · Rating 5 out of 5]

A long, detailed, but necessary slog that has finally answered all my questions about how the Holocaust happened. (I might actually remove all the other survivor memoirs from my to-read list.)

Unfortunately, I'm seeing some of the same logic and behaviors surfacing today. For example, "The physician was to be concerned with the health of the Volk even more than with individual disease and was to teach them to overcome the old individualistic principle of 'the right to one's own body' and to embrace instead the 'duty to be healthy'". (page 30) Then there's the logic that extends a state's right to death for the its own good based on necessity of sending soldiers into battle. (page 46) Extending that logic further to battlefront triage where doctors must select those they can save served as the rationale for Jewish selections. (page 196)

Of course, the Nazis embraced euphemisms for killing under the guise of medical therapy, such as "special treatment". (page 150) Other psychological behaviors, such as the transfer of conscience to an "Auschwitz self" through a process Lifton refers to as "doubling", allowed doctors to commit immoral acts within an abnormal moral structure. (page 421) Doubling differs from disassociation because "What is repudiated is not reality itself--the individual Nazi doctor was aware of what he was doing via the Auschwitz self--but the meaning of that reality." (page 422) The mechanization of killing as a team effort as opposed to direct killing through shooting also helped share the feeling of culpability. (page 444)

Last but not least, Lifton warns professionals of every kind, not just doctors, "...have a special capacity for doubling. In them a prior, humane self can be joined by a 'professional self' willing to ally itself with a destructive project..." (page 464) The main force behind such susceptibility "...was his misplaced confidence in his profession and his professional self...." a.k.a. professional hubris. (page 464) Always question your own judgment!

Long review short, if you want to thoroughly understand the Holocaust, Lifton's book is a must-read. It'll take you awhile, but there's many more insights to discover.

[Razvan Zamfirescu · Rating 4 out of 5]

Spicuiri din recenzia finala care se gaseste pe blogul meu


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Nu există carte despre nazism care să nu fie înfiorătoare, însă studiul lui Robert Jay Lifton trece dincolo de limita ororii, în primul rând prin subiectul pe care-l accesează. Să vezi cum medicii renunță la jurământul de a salva vieți și încep să ucidă pe considerente nu doar politice ci chiar științifice conform normelor naziste, depășește orice capacitatea de înțelegere.

Robert Jay Lifton recunoaște că motivul pentru care a început să lucreze la acest volum a fost obsesia sa legată de medicii naziști și de dedicația cu care aceștia au aplicat principiul uciderii în numele vindecării. I-a cunoscut personal. I-a căutat și intervievat încercând să înțeleagă ce a fost în mințile luminate care trebuiau să ofere viață, nu să o curme. A căutat cu disperare explicații și, mai ales, păreri de rău. Nu mică i-a fost mirarea când a observat că unii medici nu prezentau nici o urmă de remușcare. Sistemul le-a intrat mult prea mult în suflet, sistem bolnav care i-a format, organizat, adunat sub o singură mână criminală și le-a schimbat modul de a vedea și aplica ce au învățat și studiat în școală.
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[Bruce Graham · Rating 5 out of 5]

In order to understand the operations of a medical system with total power over peoples' lives (can anyone remember Covid, the disease cured by Doctor Vladimir Putin?) I embarked on this book. It is harrowing, but also somewhat enlightening. One of the key motifs of the book is 'The Double"- the necessary mental adjustment in order to murder for 'health.' The concept was taken from Otto Rank, a psychologist who hasn't ranked as highly as Jung or Freud, but knew both of them.
Some considered Hitler a doctor, it seems, and thus the 'cleansing' of the German soul was considered a medical issue.

[Reet · Rating 3 out of 5]

This huge study, taken on by Lifton, must have been very painful in its execution. If you hated Nazis and Aryans before you read this, you will become enraged at their presumptuous impression that THEIR race was the only one that should survive in this world. Ugh. Anyone could be a target for murder: elderly, people with mental illness, homosexuals, Romanians, ...and Jews.

However, when you see Animals as sentient beings, instead of flesh on a plate, you are not as shocked by cruelty to humans as flesh-eaters are.

[Adrian Bodea · Rating 4 out of 5]

Este o carte foarte buna care prezintă psihologia si mentalitatea medicilor de la Auschwitz. Recomand aceasta carte celor care vor sa afle mai mult despre ce gândeau si aveau de suportat medicii. Cartea se axează mai mult pe prezentarea gândirii naziste si nu a acțiunilor

[Jeremiah Johnson · Rating 3 out of 5]

A terrifying description of what humans are capable of doing to one another. Lifton does a wonderful job of dispelling the Nazi Doctor's mythical reputation while dutifully and accurately recording the horrors they committed. Exhaustingly researched and full of eye-witness interviews from both "patients" and "doctors"; this book should be on the shelf of every primary school and university library in the world.

[Vasil Kolev · Rating 5 out of 5]

There's one thing that any author can learn from Lifton, and that's being as honest as possible with your readers.

Even though a Jew and even though he has some really personal feelings (which get in the way at some places) he paints a really good picture of everything and gives the reader the possibility to think for himself and to understand the issues.

Also, through the book you can't stop asking yourself "What would I do in this situation?"

[Emma Nebelung · Rating 5 out of 5]

Very interesting book!

"The Nazi Doctors: Medical Killing and the Psychology of Genocide" by Robert Jay Lifton offers a detailed exploration of the role played by medical professionals in the Holocaust.

Lifton's research and analysis provide a comprehensive understanding of the psychological and ideological factors that allowed Nazi doctors to justify and participate in such heinous acts; how doctors transformed from healers to killers under the influence of Nazi propaganda.

[Jackie · Rating 5 out of 5]

I've always been fascinated in what makes people become monsters, and this books details the chilling metamorphoses of several with all of their delusional reasons and lingering mysteries. This is a very, very difficult read--the horrors leap off the pages and gave at least me nightmares. But I still think this is a very important book and a valuable read.