How Should Unethical Legacies in Medical History Be Handled?

In 2021, Congress ordered the Defense Department to look into renaming military bases, ships, and anything else that was named in honor of Confederate figures. The Naming Commission recommended changing the names of nine Army bases and Navy ships.

Even more recently, my college dormitory at Boston University, Myles Standish Hall, was renamed “610 Beacon Street” — its physical address. Standish provided military muscle for the Pilgrims and notoriously ambushed and slaughtered Native Americans at a supposedly peaceful summit.

In recent years, there has been a growing movement to reevaluate and often rename medical programs, buildings, statues, and other honors that bear the names of physicians and professionals whose past actions or beliefs are now considered unethical or harmful. This mirrors the broader societal shift towards acknowledging and rectifying practices considered racist, sexist, discriminatory, and dehumanizing.

But is this trend justified? It can be difficult to draw the line between condemning unethical behavior and recognizing valuable contributions when looking back in time. Additionally, such actions could lead to a slippery slope where historical figures are judged solely by contemporary standards, potentially leading to the erasure of important aspects of history. Thus, some institutions have instead chosen to keep the names of certain individuals in question but add plaques or exhibits that provide a fuller context, acknowledging both their achievements and ethical failings.

Let’s look at a few instances where a naming overhaul felt warranted to those in charge.

One prominent example is the legacy of J. Marion Sims, MD, often referred to as the “Father of Modern Gynecology.” Sims developed pioneering surgical techniques in the 19th century, but his methods included performing experimental surgeries on enslaved African American women without anesthesia and without their consent. Such practices, viewed through the lens of contemporary ethical standards, are deeply troubling. As a result, a statue of Sims was removed from Central Park in New York City in 2018.

Similarly, the name of Thomas Parran Jr., MD, a former Surgeon General, has come under scrutiny. Parran played a significant role in public health advancements, but he was the intellectual inspiration of the infamous Tuskegee Syphilis Study. Due to his involvement, the University of Pittsburgh renamed Parran Hall, which previously housed the Graduate School of Public Health. The American Sexually Transmitted Diseases Association (ASTDA) renamed the Thomas Parran Award as “The ASTDA Distinguished Career Award.”

The legacy of Hans Asperger, MD, an Austrian pediatrician after whom Asperger syndrome was named, has also been reexamined. Recent historical research has uncovered Asperger’s complicity with Nazi eugenics policies, including his involvement in the euthanasia of disabled children. This has led to a reconsideration of the use of his name in medical diagnoses. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) eliminated Asperger’s disorder, which is now subsumed under the general heading of autism spectrum disorder.

Several other esteemed physicians have had their names removed from an award or edifice. Joseph DeJarnette, MD, had his name taken off a Virginia mental health facility in 2001 after it was discovered he had championed Nazi eugenics policies and supported increased sterilization efforts in the U.S.

More recently, the “Father of Space Medicine” fell to earth when allegations of the involvement of Hubertus Strughold, MD, in Nazi concentration camp medical experiments earned greater credibility. The controversy caused the Space Medicine Association to end the annual presentation of an award given in Strughold’s honor. His name was dropped from a plaque on a building façade, and his portrait was removed from a gallery at Ohio State University.

These efforts are part of a broader movement within the medical community and society at large to critically assess the legacies of historical figures whose contributions to science and medicine are overshadowed by their unethical actions or beliefs. Renaming programs, buildings, and statues is seen not only as a way to rectify past wrongs, but also as a means to ensure that the names honored in public spaces reflect values of equity, justice, and respect for all individuals.

Promoting moral standards is the key outcome of this process. Reexamining legacy helps identify practices and individuals whose actions may not meet today’s ethical standards, encouraging a shift towards honoring those who have made positive contributions without ethical compromises. By revoking reverence for those whose actions are deemed unethical by modern standards, the medical community reinforces the importance of integrity and ethical behavior within the profession.

Fostering diversity, equity, and inclusion is also achieved through this critical reassessment. Reexamining legacy allows for the recognition of previously overlooked contributions from diverse and marginalized groups, promoting a more inclusive and accurate historical narrative. Addressing and correcting past biases through revoking reverence helps create a more equitable environment that respects the contributions of all individuals, regardless of their background.

The educational impact of this process is significant. Reexamining legacy — and providing context for various acts of renaming — provides an opportunity to educate current and future medical professionals about the complexities of medical history, including both its achievements and ethical failings. Revoking reverence works to incorporate ethics in medical school curricula.

Restoring public trust is another vital benefit of reexamining legacy and revoking reverence. Transparent reassessment of historical figures and practices builds public confidence in the medical profession’s commitment to ethical standards. By taking a stand against unethical behavior, the medical community can demonstrate that the profession holds itself accountable to the highest standards.

While prominent figures may have made significant contributions to the medical field, their actions and beliefs must be scrutinized in light of their impacts on vulnerable populations. By reexamining legacy, revoking reverence, and instituting corrective measures, the medical community can uphold its commitments to equity and ethical inquiry.

Arthur Lazarus, MD, MBA, is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia. He is the author of several books on narrative medicine, including Medicine on Fire: A Narrative Travelogue and Narrative Medicine: Harnessing the Power of Storytelling through Essays.