From the rising costs of drugs, to the opioid crisis, to end of life care, there is no shortage of ethical challenges facing health professionals and patients in the United States, a nation mostly at peace. But what happens to medical ethics for people experiencing war or when nations engage in military counter-terrorism activities around the world?
The ethics of health professionals in war time is the theme of the University of Colorado’s 2019 Holocaust Genocide and Contemporary Bioethics (HGCB) program. The program will include nine events across all four CU campuses during the federally designated “Week of Remembrance of the Victims of the Holocaust,” April 29 to May 3. The CU Anschutz program will take place on April 30.
Keynote speakers are Zaher Sahloul, MD, director of the American Relief Coalition for Syria and past president of the Syrian American Medical Society along with Professor Leonard Rubenstein,JD, director of the Program on Human Rights, Health and Conflict at the Johns Hopkins Bloomberg School of Public Health and core faculty at the Johns Hopkins Berman Institute of Bioethics. He is also past executive director of Physicians for Human Rights.
Now in its fourth year, the HGCB program is one of the CU Center for Bioethics and Humanities most unique and anticipated series of outreach events. It looks at the complicity of Nazi health professionals in facilitating the Holocaust and how that tragic history influences health care ethics today.
This year’s program, Medicine and Morality in Times of War, will address timely issues such as international laws of war, medical neutrality, the care of refugees and asylum seekers, and health care issues faced by those living in active war zones.
Dr. Sahloul, a critical care pulmonologist in Chicago, has witnessed doctors in his native Syria committing war crimes. He has run multiple medical relief missions into Syria and along its borders to aid civilians and refugees. He has treated victims of gunshots, chemical weapons, and chronic disease. Sometimes he’s worked underground to decrease his chance of being bombed by a regime run by his former medical school classmate, Bashar al-Assad.
He describes al-Assad as being an “average and humble person” during his medical training.
"You never imagine that the person who used to be your classmate in medical school, will be able to do this type of war crimes against humanity," said Sahloul. He and al-Assad studied together at the University of Damascus, one of Syria’s top academic institutions. Hafez al-Assad, Bashar’s father, was president while they were students.
“At that time,” he said of his classmate, “they weren’t grooming him to be president. It was supposed to be his older brother.” When his brother Bassel was killed in a car crash, Bashar became president.
Professor Rubenstein has spent more than two decades engaged in research and advocacy concerning the protection of medicine and medical ethics in war.
“We have to come to grips with the implications of counter-terrorism policy for health care and respect for medical ethics,” he said. “Protections established after World War II are very much at risk today, not only by rogue regimes but by nations that claim to respect long-established norms yet put them aside in the name of counter-terrorism.”
The two keynotes will be joined by local expert Janine Young, MD, Denver Health’s Medical Director of the Refugee Clinic and the Human Rights Clinic. She works with many patients in Colorado who have been displaced by the Syrian Civil War and other conflicts in Latin America, Africa and Asia, including working closely with the Division of Quarantine and Migration at the US Centers for Disease Control and Prevention.
Dr. Young has spent her 20 year pediatric career working with immigrants and refugees providing direct clinical care, developing medical screening guidelines, performing research and advocating for undocumented immigrants.
“It is of utmost importance for all of us to continue to advocate for immigrants who have fled home countries that cannot adequately protect their citizens from war, persecution, and discrimination. We are a country of immigrants and Executive Orders banning refugees from select primarily Muslim countries, child separation/detention, and fast-track deportation/US entry bans without due process are all of tremendous concern.”
The HGCB program was developed a decade ago by William S. Silvers, MD, a Denver-based allergist/immunologist whose parents were survivors of the Holocaust. Silvers, with other physicians and community stakeholders, created the original program to inspire health professionals to remember the lessons of the Holocaust – a time when the world’s leading scientific and medical community lent its power and skill to a perverse political ideology where healers became killers.
In 2016, Dr. Silvers partnered with Matt Wynia, MD, MPH, who directs the CU Center for Bioethics and Humanities, and created an endowment to help support the program in the Center’s new home at CU Anschutz. The associated events and programming have nearly doubled each year since.
“As the program expands, we want to relate the content to health professionals and patients who are affected by areas of the world experiencing genocide, ongoing violence and political conflict and focus physicians on their moral compass to always protect the patient,” said Silvers.
In 2019, new partners such as the Center for Middle East Studies and the Center for Global Health Affairs at the University of Denver’s Josef Korbel School of International Studies join longer-term program supporters like the MB Glassman Foundation, JEWISH Colorado, the CU Program in Jewish Studies, and the Holocaust Awareness Institute at DU’s Center for Judaic Studies.
Nader Hashemi, PhD, Director of the Center for Middle East Studies, is excited to partner with Drs. Wynia and Silvers on the 2019 program.
“This program presents an excellent opportunity for the public to hear unique and first-hand perspectives on the challenges, dangers and obstacles that healthcare workers face during times of mass atrocities,” he said. “Including how the international community can play a more constructive role in advancing human rights and alleviating human suffering.”
Wynia said it is important to connect the present with the past to better protect the future.
“Nearly 80 years after German physicians and other health professionals were complicit in Nazi war crimes, health professionals continue to practice during times of war and political conflict. We face situations, even in this country, where health care professionals are asked to serve as agents of the state,” he said. “They serve in immigration detention centers or in collecting medical samples for use as evidence by law enforcement. Our mission is to take lessons from the Holocaust and create opportunities for education and community engagement around difficult issues facing health care and society today.”
This year’s program will also feature a dedication event for a sculpture series recently donated to the University. The “Witness to the Holocaust” sculptures were created by artist Devorah Sperber. They were donated by the artist and her mother, Hannah Sperber, to the HGCB program and the CU Strauss Health Sciences Library where they are now on display as part of the library’s permanent collection.
Meleah Himber, community outreach coordinator for the Center for Bioethics and Humanities, said Silvers’ inspiration in creating a program focused on the lessons and legacies of the Holocaust in bioethics today lends itself to the blending of art and science to better understand this history and its impacts.
She said it is an honor to receive the gift of the artwork from the Sperber family this year.
“The sculptures are compelling expressions of the very human consequences of some of the most inhumane acts,” she said. “They add an important emotional element to our program and help anchor it by creating an enduring physical reminder on our campus.”
Wynia noted that one of the primary missions of CU Anschutz is to train the health professionals of tomorrow to “practice with competence, compassion, justice and respect.”
“Having these sculptures on display in the heart of our library serves as a permanent, tangible reminder of our fundamental duty to protect our patients, regardless of when or where we practice,” he said.
The HGCB Program will take place from April 29 - May 3 across all four CU campuses. All events are free and open to the public. For complete schedule and to RSVP, visit the program website.
The CU Center for Bioethics and Humanities, located on the University of Colorado Anschutz Medical Campus, engages today’s and tomorrow’s health professionals and the community in substantive, interdisciplinary dialogue about ethical issues confronting patients, professionals and society.
Physicians for Human Rights carries out forensic documentation of war crimes and advocates for the protection of human rights of civilians, health workers, and others affected by war, genocide, and political conflict.