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Modern medical terms are still named after Nazi doctors. Can we change it?

The views expressed are those of the author and are not necessarily those of Scientific American.

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In 1977, a group of doctors began a campaign to change the name of an inflammatory arthritis after discovering it was named after a Nazi doctor who planned and performed gruesome forced human experimentation that killed thousands. In one of these experiments, for example, Hans Conrad Julius Reiter inoculated Buchenwald concentration camp inmates with the microbe causing typhus, resulting in the deaths of over 250 people. The inflammatory arthritis then known as “Reiter’s syndrome,” the group of doctors suggested, should change its name to “reactive arthritis.”

That was in 1977. In 2000, Dr. Daniel J. Wallace and Dr. Michael Weisman published a paper rekindling old requests to remove Reiter’s name from the syndrome. Shortly after, the patient advocacy group Spondylitis Association of America voted to approve the name change. In 2003, a group of rheumatology journal editors decided against continued use of the eponym in their journals. The official retraction from the doctors who originally proposed the eponym came in 2009.

Sadly, the story is still not over.

The campaign to remove Reiter’s name should not actually have been morally ambiguous. Medical eponyms are meant to honor individuals who contributed to the field. Torture and murder are not things we wish to honor. After the war, a profound ethical debate sprung from the question of what to do with discoveries that came about from forced experimentation on human beings without their consent. But the question of the medical eponym does not fall into that category. Up for debate was not whether we should keep or discard useful medical information obtained through grossly immoral means. All medical information discovered would still be known. All that was asked is that the result was not named to reward a criminal. As the physicians who wrote the retraction summarized their reasoning:

“Medicine is a moral enterprise. Physicians serve to promote the welfare of their patients. Hans Reiter was a Nazi war criminal responsible for heinous atrocities that violated the precepts of humanity, ethics, and professionalism. We see no acceptable rationale to preserve any professional memory of Reiter within our medical culture, except as a symbol of what our societal values obligate us to reject.”

The difficult part, it turned out, was not making the moral call but implementing it. The New York Times reported on the Reiter scandal in 2000, writing: “The precise steps needed to get rid of an eponym are unclear and vary with who uses them.” A 2005 analysis found that medical journal use of the eponym without mentioning its disfavored used dropped from 57% in 1998 to 34% in 2003. One interpretation is that these figures are encouraging; use of the eponym, after all, is decreasing. But considering that the campaign to change the name began in 1977, is a less than 50% drop over the first twenty years really such tremendous progress? Moreover, the study showed that change in the US was particularly slow, with US authors more likely to use the eponym than authors in Europe.

Since then, other medical eponyms tied to Nazi crimes have surfaced. The “Clara cell,” a type of cell lining the airways to the lungs, was named after Max Clara, an “active and outspoken Nazi” who made his discovery using tissues from murdered Third Reich victims. Then there is Friedrich Wegner of the vessel disease “Wegener’s granulomatosis”: Wegener joined the brownshirts eight months before Hitler seized power, joined the Nazi party in 1933, worked in “close proximity to the genocide machinery in Lodz,” and was wanted as a war criminal.

As a medical student in 2012, here is what I have learned. I have heard “reactive arthritis,” but I have also learned about “Reiter’s syndrome.” I have learned about the Clara cell, without any qualification of its tainted name. I have learned about Wegener’s granulomatosis: this one was given with a qualification of its tainted history, but then in group discussion, the eponym was the norm. Immediately after doctors used it, it stuck with the students.

What this shows is that even an official retraction is not enough to change terminology that is deeply engrained. First impressions set the tone. Changing language takes more than official notification. It takes proactive, universal involvement. It takes a decision, and sticking to it. It takes a community, setting an example.

So, here is my humble request to doctors: please introduce these terms without their Nazi affiliations. If a tainted term has had another one substituted, please, just use the newer term. You can mention its former name and reasons for discontinued use, so that students may still recognize it if others refer to it. But from there after, make the newer term the norm. The norms of language follow from how terms are introduced.

Hans Reiter, responsible for the torture and murder of thousands of innocent people, was able to work and enjoy life until the age of 88. His crimes against humankind can never be erased. The least we can do is erase any praise of him and others like him. Saying their actions were deeply antithetical to the values of modern medicine is an understatement.

It takes a community to shape language. For the victims, and to make a statement against human rights abuses, I hope we can make it happen.

Ilana Yurkiewicz About the Author: Ilana Yurkiewicz is a fourth-year student at Harvard Medical School who graduated from Yale University with a B.S. in biology. She was an AAAS Mass Media Fellow, and her work has appeared in the New England Journal of Medicine, Aeon Magazine, Science Progress, The News & Observer, and The Best Science Writing Online 2013. She has an academic interest in bioethics, currently conducting ethics research at Harvard after previously interning at the Presidential Commission for the Study of Bioethical Issues. She is going into internal medicine and is also interested in quality and systems improvement. Follow on Twitter @ilanayurkiewicz.

The views expressed are those of the author and are not necessarily those of Scientific American.

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  1. 1. Derick in TO 9:46 am 11/16/2012

    I disagree. Changing the name is like sweeping history under the rug. The fact that a doctor named Reiter (among others) was willing to commit such atrocities in the name of science is something that no doctor should ever be allowed to forget. I think we should keep the names and use them as a teaching tool so this lesson is not forgotten.

    Ignoring history won’t change it, but it may doom us to repeat it. Genocide has not gone away, despite the world’s discovery and condemnation of the holocaust, and there remain today too many people who see others who are different from them as being somehow less than human. Until the scourge of racism is eliminated from humanity, we can ill afford to forget either our heroes or our villains. And that goes for doctors as much as the rest of us, if not even more so for the role they play and power they hold in the development of our society.

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  2. 2. metahominid 10:41 am 11/16/2012

    I disagree as well, many discoveries in the history of biomedical science have stretched and broken moral and ethical codes. I am in no way no condoning the actions of war criminals but it would be a disservice to future students of the craft.

    I am not aware of the depth of training or exposure to bioethics new doctors are given however I would believe that every lesson is one worth remembering. I do not believe the patients who benefit from their discoveries typically know. If they do, nor do I believe they in anyway, as with their physicians, honor the war criminals. They simply wish to be treated.

    In the short run you create unnecessary confusion, in the long run you attempt to whitewash history and may facilitate weakening the moral compass of the medical community if you don’t stop with them.

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  3. 3. Ilana_Yurkiewicz 11:23 am 11/16/2012

    @Derick in TO and metahominid, your comments raise the question: what is the best way to teach about historical crimes?

    Unfortunately, names are not used as teaching opportunities. They are simply ingrained as part of the lexicon. It is not as though we learn a word and then embark on a bioethics discussion. Rather, we use the Nazi terms, and the vast majority of us have no idea what they are named for.

    Indeed, we can never forget our villains: so let’s continue to write and teach about them. Let’s tell the story of the offensive name that is no longer in widespread use because of the villains’ crimes against humanity. Eponyms are a sign of distinction. The lessons are in the wrong places.

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  4. 4. curiouswavefunction 3:47 pm 11/16/2012

    Although having a medical eponym named after a mass murderer is painful, I too tend to agree with the commentators above; teaching about Reiter’s syndrome in class would be the perfect opportunity to tell students about Reiter and is the easiest way for them to remember what he did. The solution as you rightly indicated is to also teach the history when we teach the named syndromes or principles.

    The other argument of course is that no matter how unspeakable the crimes committed by these scientists may be, it still does not detract from the purely scientific value of their investigations. Otherwise similar logic may also apply to other fields of science; for instance, the Stark and Lenard effects, the Debye unit of dipole moment and the Geiger counter are all named after scientists whose allegiance to Nazism was either explicit or ambiguous.

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  5. 5. evelynjlamb 1:00 pm 11/17/2012

    I am a mathematician in a field named for Oswald Teichmüller, a Nazi. Ironically, one of the people who attached his name to this field was Jewish, and had to come to America in 1940 to get away from the problems in Europe. (He was born in Latvia, got into political trouble there, and went to the Czech Republic and France before coming to the US.) It’s frustrating to me and to many others in my field that we keep attaching Teichmüller’s name to areas of study that are increasingly unrelated to Teichmüller’s actual contributions.

    In some ways, the name is a teaching tool: people frequently bring this fact up when talking about Teichmüller theory, and I would not have known this specific example of Nazi mathematics without having his name attached to it. But it’s not like I really needed a teaching tool. I know about the Holocaust, I know Nazis were bad, and I know that Nazi ideology infiltrated many different aspects of society, including academia.

    For what it’s worth, people aren’t trying to be difficult when they stick his name on things. I think it’s a way to highlight the similarities between prior work and new work. “Oh, this new area that this paper is talking about can be thought of an extension of this other area I already know.” But dang, it’s annoying.

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  6. 6. JohnSmith57 1:22 am 11/20/2012

    The names are just names. Nobody is honoring anybody by using the name of a disease or tissue.

    There are plenty of things to get upset about in the world. Changing names that refer to Nazis should not be one of them.

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  7. 7. bucketofsquid 5:51 pm 11/20/2012

    Suppose some guy breaks into your house and violates you with a broom handle. Suppose you then discover that a new hospital is named for him. Would you, his brutally abused victim think that his name should be on the hospital?

    Personally I think it is reasonable to not honor a monster by naming anything after him. That isn’t whitewashing history, it is simply being a decent human being. Medical school isn’t the place to teach political history so ditch the names and use more accurately descriptive names.

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