c. Selection from the Argumentation of the Defense

_EXTRACT FROM THE CLOSING BRIEF FOR DEFENDANT GEBHARDT_

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_The Sulfanilamide Experiments_

Of all medical experiments forming the subjects of the indictment, the experiments for testing sulfanilamides were undoubtedly the most directly connected with the war. The problem of wound infection is one with which every nation at war must concern itself especially in modern warfare. This problem is not only one of great importance to the life and health of the individual wounded soldier, but it may have a decisive effect on the strategical position and on the outcome of the war itself through the resultant gaps in the ranks. Already the First World War showed that the majority of soldiers do not die on the battlefield itself and that in most cases death is not the direct result of a wound, but that the heavy losses must be attributed to infection of wounds received. These experiences have been confirmed in the Second World War and the special conditions prevailing in Russia and the climatic conditions due to the winter there have shown even more than in the First World War that wound infection was a medical and tactical problem of the highest importance for the troops and their health. As regards details, I refer to statements made in this connection on the witness stand by several defendants in these proceedings.

Consequently, it could not come as a surprise that in this war, too, efforts were made to deal with wound infection not only by using surgical measures, but that a way was sought to prevent the formation and spreading of bacterial infections or at least to confine them within reasonable limits by using chemical preparations.

Such efforts seemed the more called for as the war in the East not only meant an immense strain on the resources in material and personnel in general, but also in view of the fact that especially the supply of the army troops and the Waffen SS with medical officers and, above all, with trained field surgeons became more and more difficult. Had it been possible to assist the field medical officers at the front and at the main dressing stations with a reliable and effective chemo-therapeutic preparation against bacterial wound infection, progress of vast importance would have been achieved.

On the other hand, however, it was impossible to overlook the fact that the introduction of a chemo-therapeutic preparation which did not operate safely involved a certain amount of danger to an effective medical care of the wounded and consequently to the war potential of the wounded and consequently to the war potential of the German Wehrmacht and its striking power. In his lecture on the chemo-therapy of wound infection as delivered before the First Conference East of the Consulting Specialists on 18 May 1943, which I submitted as part of the report dealing with this conference, (_Gebhardt, Fischer, Oberheuser 1, Gebhardt, Fischer, Oberheuser Ex. 6._) Professor Dr. Rostock referred to the great danger of chemo-therapy, i. e., the possibility “of making negligent physicians careless in the surgical aspect of wound dressing, since they may place a certain trust in chemo-therapy.”

This warning was all the more in order since, at that time there was not only complete uncertainty as regards the effects of sulfanilamides, but also because there was a divergence in opinions as to the efficacy of this preparation. It has been clearly shown by the evidence that, in spite of close observation of the effects of sulfanilamides in peace time and in war, it was impossible to answer this question. Opinions were very much divided. While some were convinced of the efficacy of these preparations in connection with wound infections, and ascribed extraordinarily good results to them, others were of the opinion that these chemical preparations could at the best be used as a supplement and that if used by themselves, they did not have the properties to prevent bacterial infection resulting from combat wounds. With regard to the details I refer to the statements of the defendants Karl Brandt, Handloser, Rostock, Gebhardt, and Fischer and to Gebhardt Exhibits 6, 7, and 10 as submitted by me during the hearing of the evidence.

In this respect, it is highly interesting to review the scientific discussions of the consulting specialists as contained in the report on the First Conference East on 18 and 19 May 1942. (_Gebhardt, Fischer, Oberheuser 1, Gebhardt, Fischer, Oberheuser Ex. 6._) These discussions which took place prior to the sulfanilamide experiments comprising the subject of the indictment give a true picture of the situation as it was at that time with regard to the efficacy of sulfanilamides.

In this respect we are able to distinguish three sharply defined groups. In the group which rejected the chemo-therapeutic treatment of wound infection, Geheimrat Professor Sauerbruch was the leader. He emphatically voiced the opinion that these chemical preparations tend to obscure surgical work and to lead to perfunctory treatment. He requested that the preparations should be critically tested, that is to say, the test should be made by surgeons experienced in general surgery.

In the other camp there were surgeons who claimed to have obtained extraordinarily favorable results in the chemo-therapeutical treatment of bacterially infected wounds. Among them was Dr. Krueger, the Berlin professor of surgery, who claimed to have observed a favorable effect of sulfanilamide in as many as 5,000 cases.

To the third group belonged the surgeons, bacteriologists, and pathologists who took the view that nothing definite could be said as yet as to the effects and the efficacy of sulfanilamides as agents in the fight against bacterially infected wounds and that further tests along these lines would have to be made.

Thus it can be said that after the experiences of the Russian winter campaign of 1941-1942, the fight against bacterial wound infections, and the question of the efficacy of the sulfanilamides had become a military-medical and medical-tactical problem of the first importance, about which opinions differed widely. A solution of this problem was the more urgent as an answer had to be found quickly, and on the other hand the fact was not to be disregarded that the experiences gained during nearly 10 years of peace and war in clinics as well as in laboratories were insufficient to answer this question.

_The Order for the Execution of these Experiments_

The evidence has shown that the order to ascertain the effectiveness of the sulfanilamides by experiments on human beings was given directly by the Head of State and Supreme Commander of the Wehrmacht. Hitler’s order was not at first submitted by Himmler to the defendant Gebhardt, but to Dr. Grawitz, Reich Physician of the SS and police.

However, the evidence showed further that another circumstance arose which from the point of view of time at least caused the order for these experiments to be given, viz, the death of the Chief of the Reich Security Main Office, General of the Waffen SS Reinhardt Heydrich, who in May 1942 was assassinated in Prague. For the details I refer to the testimony of Gebhardt in the witness box on this matter. Heydrich’s death is connected with the experiments themselves only insofar as, at that time, the charge was leveled that Heydrich’s life could have been saved if sulfanilamides, and especially a certain sulfanilamide preparation, had been administered to the wounded man in sufficient quantities. The whole problem of sulfanilamide therapy came to the fore once more in this one case, and then in such an obvious manner that the Head of State himself gave the order to clarify by way of all-out experiments the question which for a long time had been of general importance for the fighting troops at the front.

Within the scope of this evaluation of evidence, it is irrelevant to enter into the details which resulted in the experiments being carried out by the defendant Gebhardt himself. Against the strict order of the Reich Physician SS Grawitz, Gebhardt carried out the experiments not by deliberately inflicting bullet wounds but by causing an infection while observing all possible precautionary measures.

It was further shown by the evidence that the experiments were started with 15 habitual criminals who had been sentenced to death and who had been transferred from the concentration camp Sachsenhausen to Ravensbrueck. In view of the fact that this part of the experiment is not a subject of the indictment, it seems to be unnecessary to enter into this matter. It should, however, be kept in mind that at the conference on 1 June 1942, at which the conditions for the experiments were determined in detail—the defendant Gebhardt has described this conference in detail and I am referring to this—it was understood that the experiments should be carried out with the male habitual criminals who had been sentenced to death and who were to be pardoned in case of survival.

_The Experimental Arrangements for the Sulfanilamide Experiments_

It was shown by the evidence that the experiments for testing the effectiveness of the sulfanilamides were carried out in three groups. The first group included 15 men (habitual criminals). This group has nothing to do with the charges of the indictment and it is therefore superfluous to enter into this matter more closely.

The second group included 36 female prisoners who had been members of the Polish Resistance Movement and who, for this reason, had been sentenced to death by the German court martial in the General Government. This second group was divided into 3 subgroups of 12 experimental persons each. As to the particulars of the provisions for the experiments, I refer to the testimony of the defendants Gebhardt and Fischer in the witness box. Contrary to the first group, contact substances were used in this second group to accelerate the process of infection. The contact substances were inserted into the open wound together with the germs. Sterile and pulverized glass and sterile wood particles were used as contact substances. These contact substances took the place of earth and uniform particles and were to produce war-like conditions for the wounds, without, however, producing at the same time the general dangers created by infection of the wound by earth and parts of clothing.

As in the case of the first group, staphylococci, streptococci, and gas gangrene bacilli were used as agents. But the contention of the indictment that tetanus germs were also used is incorrect. On the contrary, the evidence has proved that the treatment of tetanus did not come within the scope of these experiments. There was all the less reason for this as it was realized long ago by German military surgery that the sulfanilamide preparations are not suitable for the effective prevention of traumatic tetanus. Here I refer to the directives for the chemo-therapeutical treatment of wound infection which were issued at the First Working Conference East of the Consulting Specialists in May 1943 (_Gebhardt, Fischer, Oberheuser 1, Gebhardt, Fischer, Oberheuser Ex. 6_)—that is prior to the performance of the sulfanilamide experiments charged in the indictment. In these directives it is expressly pointed out that the outbreak of traumatic tetanus cannot be prevented by means of the sulfanilamides and that tetanus anti-toxin has to be administered as usual.

During the presentation of evidence, only the witness Dr. Maczka maintained that tetanus was actually used in one individual case. This witness did not make her own observations of the case but drew conclusions based exclusively on the pathological picture presented by one of the experimental subjects according to her statements. In view of the fact that even according to the testimony of this witness tetanus bacilli were employed only in one individual case, the assertion of this witness can hardly be taken as a true representation of the facts, for if it had really been the intention of the defendant Gebhardt to determine the effect of sulfanilamides on tetanus too, one experimental subject would certainly not have been sufficient, and more experiments would have been necessary before a final decision regarding this question could possibly have been made.

The third group consisted of 24 experimental subjects who were not treated with any sort of contagion—unlike the procedure applied to the second group—but only had part of the muscle ligatured. The defendants Gebhardt and Fischer have given detailed evidence regarding these new experimental arrangements, how they originated, what considerations had to be regarded, and what part was played by SS Reich Physician Dr. Grawitz. With regard to these details I refer to the testimony of the defendants in the witness box.

The experimental subjects were treated with sulfanilamides as described by the defendants in the witness box. A few persons were not treated with sulfanilamides but were used as control subjects. But that did not mean that these persons were not treated at all. As the evidence has proved, all experimental subjects were treated, namely by surgical measures if the sulfanilamides did not prove effective against the inflammation. For this reason too the experimental subjects to whom sulfanilamides were applied, and where the inflammation did not pass away by itself, were given direct surgical treatment under observance of the generally recognized principles of surgery, particularly as developed in Germany by Gebhardt’s teacher Professor Dr. Lexer. This direct surgical treatment resulted in the scars which the court has seen on the experimental subjects questioned as witnesses. As explained by Professor Dr. Alexander, the expert produced by the prosecution, these scars are the result not of the bacteriological infection but of the operations performed in order to eliminate this infection. In the prosecution case, four experimental subjects were called to give evidence. In addition, the prosecution submitted a series of affidavits given by other persons used as experimental subjects. The statements of the four witnesses questioned in court coincide largely with the testimony given by the defendants Gebhardt, Oberheuser, and Fischer themselves in the witness box. For this reason alone it appears expedient and sufficient for the pronouncement of a just sentence and for the establishment of the true facts to base the sentence exclusively on the testimony of these four witnesses together with the statements of the defendants themselves. This is not only in accordance with the principle of direct and oral proceedings in court prevailing in any modern criminal procedure and which should not be departed from without urgent reason, but also such handling of the case seems suitable because the statements of the four witnesses are identical essentially so that they themselves, together with the statements given by the defendants, can be regarded as a safe basis for a finding—apart from one point which I shall go into later. In addition, the affidavits submitted by the prosecution not only differ in essential points from the statements made by the witnesses in court, but are inconsistent and contradictory in themselves as well. This is shown, above all, by the fact that in several of these affidavits contentions are quite obviously made which are not based on personal and factual observation, but have become known to these witnesses by hearsay. The affidavits, moreover, fail to represent the circumstances in clear chronological order, which makes the whole matter all the more doubtful, as it was proved by the evidence that in the Ravensbrueck camp experiments were obviously also performed by other physicians with whom the defendant in this case had no connection.

Considerable doubts also exist regarding the statements made by the witness Dr. Maczka. The prosecution has submitted two affidavits given by this witness as part of its evidence. When questioned in court, this witness could not maintain the most incriminating contentions which appeared in the two affidavits. Under these circumstances, the court has to consider whether it regards the statements of this witness as sufficiently reliable to enter into the judgment. I would answer this question in the negative, not only because she had to revoke the most essential points of her previous affidavits, but because a large part of her testimony was based not on her own observations, but either on information obtained from other prisoners or on conclusions drawn by her.

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