Lectures in Berlin at the Charite and in Hannover

The public hospital in Berlin is the Charite. They have an exhibit on the history of modern medicine. The exhibit had a lot of interesting specimens from individuals who suffered various diseases. One of the great contributors to the development of anatomy, Virchow, was a professor at the Charite. He performed about 800 dissections a year and was among the earliest physicians to champion the dissection of victims of disease as a key to finding the cure.
While we were at the Charite we also heard from the current head of Complimentary Medicine, Dr. Witt. I was mostly interested in her explanation of how insurance companies determine if certain forms of complimentary medicine should be covered. The data that they examine to make this decision is not necessarily designed to remove the placebo effect. They focus on the difference in recovery between patients who receive, for example, acupuncture and patients who don't. If the improved level of recovery justifies the cost of the procedure, the insurance companies are often inclined to support it.
The following day in Hannover was spent talking to Dr. Kriestein, a nephrologist. It was especially interesting hearing him talk about the health care system in Germany. Though many Americans assume that all our problems will disappear as soon as we have universal health insurance, there are still in truth many challenges a health system has to face, some of which are indirectly caused by state sponsored health care. In Germany, for example, doctors had no concerns about the cost of a procedure and would blow away large amounts of money on patients with very trivial problems. German health care has recently gone through some reforms, as this has threatened to slowly consume the entire country's wealth. While patients still rarely see bills in Germany, doctors making a better effort now at being economical in their practice. One reform I found interesting is the addition of a small copayment for drugs in Germany. Dr. Kriestein was a proponent of this, because he found that a very large difference between Americans and Germans was that Americans actually knew about the drugs they were taking, what they did, and would generally take them as instructed. Germans, however, seemed to devalue their medicine, having little knowledge of them, how they worked, and were irregular in taking them. In his opinion, the copayment has alleviated this problem as well as some of the issues health care has had in balancing its check book.
The next day was also in Hannover, and we spent the morning in lecture with Dr. Wasser talking about the Doctor Trials at Nuremburg. He explained that after the chief war criminals were tried, there were 12 additional trials held only by Americans in order to try various other Nazis for war crimes. The doctor trials prosecuted 22 men and one woman, mostly doctors, for crimes against humanity, using as evidence records of their experiments and testimonies from survivors of the experiments. The defense claimed that, yes, you can prove that we did these things, but you can not demonstrate that these are crimes against humanity. Scientists have experimented on animals to the benefit of humanity, and we were doing just the same.
The prosecution then set out to prove that among physicians and scientists there was an understood standard for how humans could and could not be treated in experiments. Interestingly, some of the prosecution's expert witnesses were outspoken proponents of animal experimentation. The case laid down in common law what is now sometimes known as the Nuremburg Code, a guideline for the humane treatment of subjects in an experiment. The most well known of these points is the necessity of informed consent.