A surgeon who refused to operate on an already anaesthetised man because he had a swastika tattoo should not be disciplined, said the German Medical Association last month. “I cannot operate on this man,” the 46-year-old surgeon told the patient’s wife. “I am a Jew.” He later explained that his principles did not allow him to operate on neo-Nazi sympathisers. He managed to quickly find a colleague who was willing to perform the operation on the man’s thyroid.

The wife demanded that the surgeon be deregistered, but the hospital declared “There has been positive feedback from the public praising the courage of the doctor.” Professor Jörg-Dietrich Hoppe, head of the German Medical Association, said that the surgeon had acted properly because he had referred the case to another doctor and had not jeopardised the patient’s care. “If it were an emergency that would be a different story,” Professor Hoppe said. “In an emergency he would have been obliged to perform the operation even if the patient was laced with swastikas.”

Claudia Wiesemann, director of the Institute for Medical Ethics and History of Medicine at the University of Göttingen Medical School, tried to put the case in perspective for the BMJ. She recalled that the World Medical Association’s 1948 Declaration of Geneva states:

“I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient.” However, she said, ultimately he did not endanger his patient.

Writing in the Journal of Medical Ethics blog, Iain Brassington, disagreed. The policy should be, in his opinion, hate the sin, and operate on the sinner.

“The Declaration says that race, religion, politics and all the rest of it have nothing to do with medical practice.  That means that Nazi medical practice would be condemned.  It doesn’t mean that Nazis would be excluded from treatment, even temporarily; there’s an ocean of difference (and not just moral: it’s ontological, too) between Nazi practices and Nazis.  The Geneva Declaration’s moral power comes from the fact that it extends moral protection even to the repugnant, while still condemning what they do.”

~ BMJ, Dec 17