Sunday, June 12, 2016

Nuremberg & Thalidomide: The Good The Bad & The Ugly.

It is not really the first time we visited a place that has a rather haunting history. St. Petersburg is one such place especially when one re-visited the whole sordid saga of the murder of the small children of the Russian Tsar family.

Now we are starting our high school reunion on our river cruise. The journey starts at Nuremberg. All of us of course remember the Judgment at Nuremberg. I decided to watch it again. The principle that just because your boss told you to do things in a certain way did not absolve you from the greater humanitarian aspect of what you do. This is most important for doctors and if you think we have shied away from the Nuremberg era, think again. In one way or another, those that dare speak out against what management in our beloved NHS does were met with some of the worst fates unimaginable in any democratic society.

Nuremberg of course was the famous setting for one of Wagner’s well known Operas, Die Meistersinger von Nürnberg which was in 2011 performed at Glydnebourne for the first time ever to much international acclaim. 

But Nuremberg was sadly linked to one of the worst drugs disaster of our time. This was uncovered by none other than Newsweek.

As they opened a new Waitrose across from my clinic, I find myself shopping there most days after work. It was one of those de-roling activity that is important after a whole day being involved in the mad of sad world of child psychiatry. John Barnes in Swiss Cottage was the first local store that was very close to the Tavistock Clinic where I trained. It was there that I saw the wooden escalator that my father reminisce about of the ones in Shanghai in the 40s. John Lewis and Waitrose remained my favourite haunt for all these years.

One day, at one of the specially designed check outs, sat a girl on a special raised mechanical chair was a girl with arms a quarter the size of ours and a few minute fingers. Yes, a Thalidomide victim doing a proper check out job.

Yes, we tried our best not to notice and our best not to treat her any differently as we well know that that is what she would want. I raised my hat to Waitrose for treating her like any of their partners. That is how the world should be.

But I never knew that there was any link between Thalidomide and Nuremberg. O.K. I knew Thalidomide was developed by a German Company, Grünenthal.



Newsweek

Adding to the dark shadow over the company, it is increasingly clear that, in the immediate postwar years, a rogues’ gallery of wanted and convicted Nazis, mass murderers who had practiced their science in notorious death camps, ended up working at Grünenthal, some of them directly involved in the development of thalidomide.

 What they had to offer was knowledge and skills developed in experiments that no civilized society would ever condone. It was in this company of men, indifferent to suffering and believers in a wretched philosophy that life is cheap, that thalidomide was developed and produced.

Perhaps the best known of Grünenthal’s murderous employees was Otto Ambros. He had been one of the four inventors of the nerve gas sarin. Clearly a brilliant chemist, described as charismatic, even charming, he was Hitler’s adviser on chemical warfare and had direct access to the führer—and committed crimes on a grand scale. As a senior figure in IG Farben, the giant cartel of chemical and pharmaceutical companies involved in numerous war crimes, he set up a forced labor camp at Dyhernfurth to produce nerve gases before creating the monolithic Auschwitz-Monowitz chemical factory to make synthetic rubber and oil.

In 1948 Ambros was found guilty at Nuremberg of mass murder and enslavement and sentenced to eight years in prison. But four years later, he was set free to aid the Cold War research effort, which he did, working for J. Peter Grace, Dow Chemical, and theU.S. Army Chemical Corps. Ambros was the chairman of Grünenthal’s advisory committee at the time of the development of thalidomide and was on the board of the company when Contergan was being sold. Having covered up so much of his own past, he could bring his skills to bear in attempts to cover up the trail that led from the production of thalidomide back through its hasty trials to any origins it may have had in the death camps.



Dr. Kelsey is honored by President John F. Kennedy in 1962. (Courtesy of FDA)


The tragedy was largely averted in the United States, with much credit due to Frances Oldham Kelsey, a medical officer at the Food and Drug Administration in Washington, who raised concerns about thalidomide before its effects were conclusively known. For a critical 19-month period, she fastidiously blocked its approval while drug company officials maligned her as a bureaucratic nitpicker.

Freedom of Speech: Truth & Thalidomide!



Case 5 – The Truth about Thalidomide Given the lack of a constitution enshrining free speech, we do need some protection against frivolous libel actions and injunctions which try to prevent the truth from being revealed. Otherwise the truth about thalidomide would never have been told.

“Thirty-eight years ago,” he wrote, “I sat through days of hearings by the Law Lords deliberating on whether I and the paper I edited were guilty of contempt in 1972-3 in campaigning for justice for the thalidomide families. All five Law Lords voted to ban publication of our report. Only a 13-11 victory in the European Court of Human Rights removed the gag order” – and thus, I add, enabled The Sunday Times to expose one of the great scandals of that time, and subsequently win compensation for the families with young children born damaged or deformed, often without legs or arms, because their mothers had taken the drug, thalidomide, which was marketed as a mild sedative that would relieve morning sickness in pregnancy.                                                                                             Telegraph

Luckily, the 
European Court eventually ruled for The Sunday Times:

“The newspaper then decided to fight the injunction on its investigation into the origins and testing of the drug. The case went right through the British legal system and up to the European Court of Human Rights, which decided that the injunction violated the right of ‘freedom of expression’. The full story of thalidomide could eventually be told in 1976, revealing that both Grünenthal (the maker) and Distillers had not met the basic testing requirements of the time.”



I mentioned thalidomide also because in 2002 Gordon Brown, the then chancellor, attempted to tax the benefits payable through the Thalidomide Trust.

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