A nurse working for the Third Reich: Eva Justin, RN, PhD

Abstract

Eugenics underpinned the Nazi race theories which saw the murder of over 10 million people from "undesirable" groups, including Sinti (referred to in Nazi times as "Gypsies"), during the Holocaust. Eva Justin, from Dresden, completed a doctoral dissertation which examined a group of Sinti children of St Josef's Home in Mulfingen, Germany. She aimed to prove the racial inferiority of these children; her work was done with no informed consent, and the children were sent to Auschwitz after her experiments. The study was supported by senior Nazis, supervised by Nazi "scientists" and examined by committed Nazis. We argue that her work was biased, poorly designed, and ultimately unethical, but was in keeping with methods of the emerging disciplines of anthropology and racial hygiene, in Germany and other countries, at the time. It is not possible to say that her work caused the children to meet their deaths (of the 39 children she included, only four survived); however, she did reinforce the Nazi racial theories. It is unfortunate that one of the first nurses in the world to receive a PhD did so through research attempting to prove that a group of children were "racially inferior" in support of National Socialism.

Full text

Journal of Medical Biography
2018, Vol. 26(4) 259–267
!The Author(s) 2016
Article reuse guidelines:
sagepub.com/journals-rmissions
DOI: 10.1177/0967772016666684
journals.sagepub.com/home/jmb
A nurse working for the Third Reich:
Eva Justin, RN, PhD
Susan Benedict
1
, Linda Shields
2
, Colin Holmes
3
and Julia Kurth
4
Abstract
Eugenics underpinned the Nazi race theories which saw the murder of over 10 million people from ‘‘undesirable’’ groups,
including Sinti (referred to in Nazi times as ‘‘Gypsies’’), during the Holocaust. Eva Justin, from Dresden, completed a
doctoral dissertation which examined a group of Sinti children of St Josef’s Home in Mulfingen, Germany. She aimed
to prove the racial inferiority of these children; her work was done with no informed consent, and the children were sent
to Auschwitz after her experiments. The study was supported by senior Nazis, supervised by Nazi ‘‘scientists’’ and
examined by committed Nazis. We argue that her work was biased, poorly designed, and ultimately unethical, but was in
keeping with methods of the emerging disciplines of anthropology and racial hygiene, in Germany and other countries, at
the time. It is not possible to say that her work caused the children to meet their deaths (of the 39 children she included,
only four survived); however, she did reinforce the Nazi racial theories. It is unfortunate that one of the first nurses in the
world to receive a PhD did so through research attempting to prove that a group of children were ‘‘racially inferior’’
in support of National Socialism.
Keywords
Nursing, Nazi, Holocaust, history, ethics, Gypsy, children, Sinti
Introduction
1
Nursing as a profession first started to educate nurses
to the doctoral level in the 1950s in the United States of
America and later in other countries.
2
The role of
nurses in the Nazi era has been ignored until recent
times,
3,4
but is now receiving the attention it deserves.
This includes their roles in research.
In the early 1940s, there were very few doctorally
prepared nurse researchers anywhere in the world.
Eva Justin was an exception and earned her PhD by
researching ‘‘racial hygiene’’ with Dr Robert Ritter, a
prominent scientist in the Third Reich. It is useful to
examine her life and career as exceptional in terms of
academic achievement during that time, as questionable
in terms of scholarship, and as problematic in the
exploitation of children who were members of one of
the Nazis’ persecuted groups, designated by the
National Socialist government as ‘‘racially inferior.’’
Using both primary sources including her personnel
file from the city of Frankfurt am Main, her doctoral
dissertation, and her ‘‘de-Nazification’’ documents
and relevant secondary sources in both German and
English, this paper examines Eva Justin’s actions,
and in particular her work with the Gypsy children of
Sankt Josefspflege (St Josef’s Home) in Mulfingen, in
south central Germany.
Justin was born in 1909 in Dresden, trained as a nurse
in Tu
¨bingen, graduating in 1934,
5
and became a member
of the German Red Cross and the Deutsche Arbeitsfront
(DAF) (German Workers’ Front) (Justin, Lebenslauf,
no page number, Lebensschicksale artfremd erzogener
Zigeunerkinder und ihrer Nachkommen).
6
Little is
known about her personal life other than that she
remained single and adopted two children, Hannelore,
born 16 January 1940 and Beate, born 30 June 1941.
7
After graduating from her nursing program, she worked
in the Tu
¨bingen Youth Center Clinic where she met
Robert Ritter, then head physician at the clinic. When
1
Medical University of South Carolina, Charleston, SC USA
2
Charles Sturt University, Australia; The University of Queensland,
Australia
3
James Cook University, Australia
4
Independent Translator, Houston, Texas, USA
Corresponding author:
Linda Shields, School of Nursing, Midwifery and Indigenous Health,
Charles Sturt University, Bathurst, NSW 2795, Australia.
Email: lshields@csu.edu.au
Benedict et al. 259

Ritter was transferred from Tu
¨bingen to the Race
Hygiene and Population Research Office at the Reich
Health Agency in Berlin-Dahlem in 1936, he immedi-
ately arranged for Justin’s transfer to the same agency
and is reported to have kept Justin as his ‘‘mistress.’’
8
From 1936 until 1945, she was employed as a research
assistant in the criminal health division of the agency.
9
Nazi racial policy and the Gypsies
Nazi racial policy was founded in the ‘‘science’’ of eugen-
ics which was widely adopted not only in Germany but in
the US and throughout Europe as well. The term ‘‘eugen-
ics,’’ meaning a good birth, was introduced by Francis
Galton, a cousin of Charles Darwin, in 1883. Eugenics
was defined as a science studying heredity and developing
a stronger race. Positive eugenics was the encouragement
of the transmission of positive traits through ‘‘racial
purity’’ whereas negative eugenics discouraged the trans-
mission of negative traits through decreased fertility
including sterilization of individuals believed to have
these traits. The term ‘‘Rassenhygiene’’ (racial hygiene)
was introduced in 1885 by the German eugenicist, Dr
Alfred Ploetz in his book ‘‘The Excellence of Our Race
and the Protection of the Weak.’’ In this, Ploetz presented
the view that the protection of the ‘‘weaker’’ members of a
society threatened the overall quality of a race.
10
This
view concurred with that of Galton expressed in
‘‘Hereditary Genius,’’ published in 1869, where Galton
stated that ‘‘the incompetent, the ailing and the despond-
ing’’ were threats to society because their children would
be sick, miserable, and poor.
11
In the early 1900s, German anthropologist Eugen
Fischer became a leader in eugenics and carried out
much of his research in the African country of
Namibia (known then as German Southwest Africa).
Between 1904 and 1908, up to 100,000 Herero and
Nama people were subjected to observation, measure-
ment, incarceration, and murder in what, in many
ways, became a blueprint for the Nazi era. Fischer pub-
lished his findings in 1913 in a book entitled ‘‘Die
Rohoboter Bastards und das Bastardisierungsproblem
beim Menschen’’ (The Rehoboth Bastards and the
Problem of Miscegenation among Humans). In this,
in addition to objecting to marriage between blacks
and whites, Fischer objected to those who were colored,
Jewish, and Gypsy mixed race people, known as
Mischlinge (‘‘cross breeds’’).
12
An important link is established here between the early
days of eugenics and the ultimate fate of the Sinti children
studied by Eva Justin. First, Fischer specifies Gypsy
mixed race people as being objectionable, as did Robert
Ritter later. Also significant is the fact that Eugen Fischer
became the mentor of Dr Josef Mengele, the Auschwitz
physician who experimented upon many Gypsy children
and who, in fact, ‘‘liquidated’’ the Gypsy population of
Auschwitz by sending them to the gas chamber.
Like the Jews, the Roma and Sinti were targeted by
the National Socialists as being racially inferior. In add-
ition to aspects of race, Gypsies were regarded as being
prone to participating in criminal activites.
13
In the
autumn of 1935, Gypsies, like the Jews, were subjected
to the Nuremberg Race Laws and the ‘‘marriage
health law’’ which forbade marriage between Gypsies
(and other ‘‘inferior’’ races) and Germans.
14
Beginning
in 1936, Nazi policy mandated the rounding up of
Gypsies and sequestering them in Gypsy camps.
In the same year, Dr Robert Ritter became director
of the Race Hygiene and Population Biology
Research Office, which was a part of the Reich
Health Office in Berlin-Dahlem. It was Ritter’s research
that classified Gypsies according to their physical char-
acteristics, health, genealogy, criminal activity, and
other factors.
15
This research attempted to provide a
‘‘scientific’’ basis for the concentration of the Gypsies
in camps and later their extermination.
Upon starting his new position in Berlin, Ritter
declared that there was not ‘‘a single useful study about
the Gypsies living in Germany’’ and it was essential ‘‘to
supply the documentation for the radical measures
expected to go into effect soon.’’
16
Thus, Ritter sought
to provide the ‘‘scientific’’ basis for the sterilization,
deportation, and elimination of the Gypsies. He cham-
pioned the hypothesis that the Gypsies were ‘‘inferior’’
and, in a complete abrogation of good scientific principle
(which requires that hypotheses are for testing and
cannot be made to fit a preconceived idea), sought the
data to support this hypothesis.
Ritter’s goal was to register and assess all Gypsies
living in Germany. His work was regarded as important
to the Nazi notion of the ‘‘racial inferiority’’ of the
Roma and Sinti population and, along with Justin,
received significant funding for the research. A particu-
lar goal of their research was to do genetic testing on
‘‘Gypsy cross-breeds, etc.’’
17
The name of their study
was ‘‘One breed of people - medical and genetic exam-
inations of the ten generations of descendants of hobos,
crooks, and robbers [‘Ein Menschenschlag – a
¨rztliche
und erbgesundheitliche Untersuchungen u
¨ber die durch
zehn Geschlechterfolgen erforschten Nachkommen von
‘‘Vagabunden, Jaunern und Ra
¨ubern’’’].
18
Ritter was able to obtain a list of ‘‘vagabonds’’ from
Munich which contained 19,000 names. From
Karlsruhe, he obtained a similar list with 5000 names.
He and his research team, including Eva Justin, began
by visiting Gypsy camps and measuring the physical
features of the residents and obtaining their personal
histories. They were able to access the populations
by learning the Romani language and bringing small
gifts such as candy (sweets); sometimes they even
260 Journal of Medical Biography 26(4)

posed as missionaries.
19
In addition to their visits to
Gypsy camps, they visited Gypsies imprisoned in con-
centration camps.
20
Their research gathered strength as
a decree was issued in Himmler’s name on 8 December
1938 entitled ‘‘Combating the Gypsy Plague.’’
21
The
regulation for the analysis of the ‘‘racial-biological
assessments of the Gypsies’’ was decreed on 7 August
1941 and consisted of the following categories:
1. Z (Zigeuner)—a full-blood Gypsy
2. ZMþ(Zigeuner-Mischling)—predominantly Gypsy-
blooded mixed breed
3. ZM (Zigeuner-Mischling)—Gypsy mixed-breed
4. ZM- (Zigeuner-Mischling)—predominantly German
blood
5. NZ (Nicht-Zigeuner)—non-Gypsy
By spring 1942, 30,000 Gypsies and ‘‘mixed-breed’’
Gypsies had been registered.
22
Ritter’s own bias is seen in the following quotes:
It would be best to gather and categorize those families
in yards from where the police should put them into
enclosed colonies. There, a family life would only be
allowed after previous sterilization of those persons still
able to reproduce. ... The primitive human being won’t
change and cannot be changed ...Instead of imple-
menting punitive actions we need to establish facilities
which are able to prevent further creation of primitive
asocials and criminals from crook families by means of
gender separation or castration.
23
Ritter and his team of other physicians and district
nurses found that many of the Gypsies were not racially
‘‘pure’’; that is, many had intermarried. This became
particularly significant on 16 December 1942 when
Reichsfu
¨hrer-SS Heinrich Himmler ordered the deport-
ation of all Gypsy ‘‘mixed breeds’’ to Auschwitz con-
centration camp.
Families are supposed to be deported as complete
as possible, including all children who are not eco-
nomically independent. If there are children who have
been institutionalized in public welfare facilities or
otherwise, their reunification with their clan is to be
arranged prior to the arrest if possible. The course
of action is similar for Gypsy children whose parents
are deceased, housed in concentration camps or other
facilities.
24
German Gypsies who were ‘‘racially pure’’ as well as
those consistently employed had a permanent residence
and/or those who had served in the military were
exempt from this deportation. All remaining Gypsy
individuals over 12 years of age who were not deported
were ordered to be sterilized.
25
Of those who were sent
to Auschwitz, 19,000 died of starvation or disease or
were killed in the gas chambers.
26
Eva Justin’s research
The so-called Homing Decree issued by the Wu
¨rttemberg
Secretary of the Interior on 7 November 1938 called for
the relocation of Gypsy and ‘‘Gypsyish’’ children from
their homes to St. Josef’s Home, a Catholic orphanage,
in Mulfingen. Many of these children were taken from
their families by police who arrested the parents and sent
them to concentration camps such as Buchenwald for
men and Ravensbru
¨ck for women. It was these children
who were the subjects of Justin’s research and they were
kept in the orphanage until she completed her doctoral
degree at the University of Berlin.
27
Justin had not had a traditional university education
and Ritter did not have a university appointment; how-
ever, she was admitted to the University of Berlin in
1939.
28
Thus, her admission to PhD candidacy was
entirely in recognition of the importance to the Reich
of the research on Gypsies, one of the populations tar-
geted as ‘‘inferior.’’ Justin’s admission was supported by
Eugen Fischer, a renowned proponent and researcher of
racial hygiene (previously described for his ‘‘research’’ in
Namibia), as well as three leaders of the Third Reich:
Hans Reiter of the Reich Health Office, Herbert Linden
of the Reich Ministry of the Interior, and Paul Werner,
Deputy Chief of the Central Office of the Reich
Detective Forces.
29
Ethnologist Richard Thurnwald,
known as one of the founders of racial hygiene, spon-
sored, that is formally recommended, Justin’s enrolment
into a doctoral research program.
30
The title of Justin’s
dissertation was Lebensschicksale artfremd erzogener
Zigeunerkinder und inhrer Nachkomen (‘‘Life fates of
alien-raised Gyspsies and their descendants’’).
31
(The
dissertation is available in German online).
32
Although many public foster care authorities and per-
sonnel pointed out the ‘‘inferiority’’ of Gypsy and
‘‘Gypsyish’’ children, according to Meister
33
this was
not the attitude held by the nuns and personnel of the
St. Josef’s Home. There, teachers and caregivers enabled
the children to ‘‘live as complete equals in their commu-
nity.’’
34
The children of St. Josef’s Home became the sub-
jects of Justin’s doctoral research project because the
foster home was instructed by the authorities to ‘‘support
the scientist and to give her any information desired.’’
35
The children were initially spared deportation to
Auschwitz, possibly at the request of Ritter, so that
they could be Justin’s research subjects. In the introduc-
tion to her dissertation, Justin clearly indicated her bias:
May this study in accordance with his [Ritter’s] beliefs
also be a small contribution to the solution of the
Benedict et al. 261

asocials problem and may it offer our lawmakers fur-
ther background for the upcoming eugenic regulation
which will prohibit the continued infiltration of the
German Volk by inferior, primitive genetic material.
36
For six weeks, Justin lived at St. Josef’s Home.
She stated
I observed all Wu
¨rttemberg Gypsy children who had
been removed from their parents. They are raised under
relatively favorable conditions together with jeniche
37
children and a small fraction of German children in the
welfare system. I conducted psychological tests and
observed in particular their reactions to the upbringing
alien to their species.
38
The questions that Justin was attempting to answer—
albeit with the aforementioned bias—were ‘‘To what
extent are these primitives able to adapt? And to what
extent can we even – especially in our own interest –
integrate them?’’
39
Given that Himmler had already
ordered the deportation of the Gypsies to concentration
camps, the second question seems rhetorical at best.
Meister interviewed a former teacher at St. Josef’s,
Johanna Naegele, who recalled Eva Justin’s visits to
the home where Justin, who gave herself the title of
Versuchsleiterin (Examiner-in-Chief) (VL),
40
critically
observed the children and discussed them with the
nuns and teachers. According to the teacher, Justin
regarded the children as ‘‘nothing but ‘research objects,’
thus a mere means to an end.’’
41
Indeed, Justin ‘‘strongly
opposed the upbringing (of the Gypsy children) which
was ‘alien to the species’ identical to that of the children
who had been living at the home for years’’
42
Justin, the VL, described one of her visits to the
children:
When the VL visited with the Gypsy children they were
initially very shy, reserved and tight-lipped. When she
observed one of them for just a few moments, the child
disappeared from her view like a weasel. She tried to
strike up a conversation with two of the older children,
Zweigerli and Dudela. At first this was not successful.
Except for a whispered ‘‘yes’’ or ‘‘I don’t know’’ they
would not reply anything. When the VL then addressed
them in their language, they laughed insecurely and
embarrassed. They did not remember much of it,
most words they had forgotten because they were
only allowed to speak German in the facility. But the
words they heard for the first time again after two years
were familiar, they were theirs. While the older one,
Dudela, more limited in her intellectual and mental
constitution, remained unsure of the new situation
and only slowly came to trust the VL, the intelligent,
lively 14 year-old Zweigerli came to trust her within a
few minutes. The mask of the well-trained student came
off and the little Gypsy regained his naive security
quickly ...
They adored roundels. They got lost in the rhythm of
the song and in the play of the bodies; so much that
they didn’t notice the observer with the feared camera
anymore. Maila had put a white flower in her hair,
which slowly came undone from her tight braids. The
12 year-old school girl had become a wildly dancing
bayadere. ‘‘Gypsy blood’’ the caretaking nuns said,
smiling embarrassed, as if to apologize, without being
able to distance themselves entirely from the lure of this
genuineness and harmony. That’s when the child saw
her audience. She blushed, her face took on a closed-off
expression and she then only continued dancing in a
detached, almost clumsy manner.
43
Although Justin’s description is interesting, it seems
devoid of the scientific content ordinarily expected in a
doctoral thesis or dissertation today. Particularly puz-
zling—and without apparent scientific merit—was her
potato-harvesting competition in which Justin observed
the children and compared German, Gypsy, part-
Gypsy, and Yeniche (jeniche) children for rapidity in
harvesting potatoes, describing their efforts as ‘‘lame,
diligent, somewhat superficial, steady, very orderly,
eager, inconsistent, and exceptionally honest.’’
44
To
consider her assessment standards, how does one oper-
ationalize such terms as ‘‘lame’’ or evaluate ‘‘exception-
ally honest’’?
In addition to her potato-harvesting competition,
Justin measured the heads of the children, noted their
eye color and photographed them. She gave them prizes
for winning in athletic games. In contrast to the nuns of
St. Josef’s Home who encouraged the children to be
orderly and clean, Justin encouraged them to climb
trees and ‘‘run wild in the woodlands as if they were
primitives.’’
45
From these behaviors, Justin concluded
that the children’s morals were ‘‘even worse’’ than
those who had remained with their parents and nomadic
tribes. She concluded that assimilation made no differ-
ence and that the only solution was to sterilize all of
them, including most of those who were ‘‘half-Gypsy.’’
46
Eugen Fischer, Director of the Kaiser Wilhelm
Institute for Anthropology (1927–1942),
47
and leading
Nazi ‘‘racial scientist’’ was instrumental in facilitating
Justin’s PhD from the University of Berlin. She ‘‘sup-
posedly studied anthropology, genetic psychology, race
hygiene, criminal biology, and ethnology – although
she could not provide evidence of a methodical pro-
gram of study when she registered for [i.e. submitted]
her doctorate in 1943.’’
48
The title of Justin’s dissertation was ‘‘The Fates of
Alien-raised Gypsy Children and their Progeny’’
(Lebensschicksale artfremd erzogener Zigeunerkinder
262 Journal of Medical Biography 26(4)

und ihrer Nachkommen) and attempted to document the
‘‘limits of educability’’ of the Gypsy children.
49
Justin
concluded that the Gypsy children ‘‘could not ever
become socially well-adjusted adults even if they were
removed from their families and sent to special schools,
and that they too must be sterilized.’’
50
Justin success-
fully completed her oral examination on 24 March 1943.
Examiners were Eugen Fischer, Richard Thurnwald,
Robert Ritter, and Wolfgang Abel and, interestingly,
the oral examination was held in Ritter’s home.
51
Why
these highly placed Reich scientists would accept this
study as a favor to Robert Ritter is at least partially
explained by Justin’s letters of recommendations from
prominent Nazis including Hans Reiter (President of
the Reich Health Office), Herbert Linden (Hitler’s
Reich Deputy for Sanatoriums and Hospitals and a
prominent figure in the Nazi ‘‘euthanasia’’ program),
and Paul Werner (Deputy of the Central Office of the
Reich Detective Forces).
52,53
Despite ‘‘not meeting basic
scientific standards,’’ Justin’s dissertation was awarded
by the University of Berlin on 5 November 1943 and
published in Spring 1944.
54
Shortly after completing her research, the perilous
bombing of Berlin by Allied forces compelled Justin
and Ritter to move to Fu
¨rstenberg, not far from the
women’s concentration camp at Ravensbru
¨ck. They
worked as assessors at the ‘‘Jugendschutzlagern’’ (youth
protection camps) at Moringen and Uckermark camps
for males and females, respectively, where their racial
theories began to be put into practice. Ritter arranged
the camps according to racial status, and between
February and October 1944 he and Justin signed 1320
reports about persons’ racial status.
55
These reports
decided the fate of the young prisoners, which included
forced sterilization, and transfer to Auschwitz or
Ravensbru
¨ck.
The fate of the Gypsies
Upon completion of Justin’s doctoral degree, the 39 chil-
dren who had been her research subjects were sent to
Auschwitz-Birkenau on 9 May 1944.
56
The deportation
process for the Gypsy children began in January of that
year when officers from the Criminal Investigation
Department came to St. Josef’s home to finalize the
deportation order for every Gypsy child; however, the
officers were told to not let ‘‘the Gypsyish person know
that their arrest was impending.’’
57
Children were ques-
tioned alone, without the presence of any of the home’s
staff who were not informed of the reason for the inter-
views. Afterward, the children laughingly described
the fingerprinting procedure to the staff saying that
‘‘the men had made their fingers black and pushed
them on paper.’’
58
It was only in March 1944 that the
staff were told that all Gypsy children would have to be
deported to a Gypsy camp and there was nothing they
could do other than prepare the children. Staff decided
to tell the children that they would soon be going on a
big trip to visit their parents in a Gypsy camp. The
smaller children were excited at the prospect of seeing
their parents, but the older ones were more doubtful.
One girl asked ‘‘Why do we have to go to a camp? We
can’t just work like our parents since we are still so
little.’’ A 16-year-old girl cried ‘‘Why do I have to die?
I’m still so young!’’
59
Days elapsed before the actual deportation, and
the staff of St. Josef’s attempted to keep the children’s
lives as routine as possible. Classes continued and, even
though they were too young, children were prepared for
Holy Communion by the community priest. On the
Sunday before their deportation, all the Gypsy children
celebrated their first Communion.
61
On 9 May, very
early in the morning, a postal bus collected the children,
accompanied by the Mother Superior and their teacher,
Johanna Naegele, who were both allowed to accom-
pany them part of the way.
60
The children and the
two staff members were transferred to a prisoner-
train, and they questioned why the train had barred
windows and was accompanied by police. During the
many waits in transit, the children recited the poems
they had learned for the Mother Superior. At the
Crailsheim train station, Naegele and the Mother
Superior had to leave the children who continued on
to Auschwitz.
61
Auschwitz (including Birkenau, also known as
Auschwitz II), the Reich’s largest concentration camp,
had a section, BIIe, especially designated as the Gypsy
Camp (Zigeunerlager). It was completed in February
1943 and consisted of 32 residential barracks, barracks
for washrooms and toilets, two barracks for kitchens, and
even a kindergarten and a nursery.
62
Upon special order
of Himmler on 16 December 1942 (the so-called
Auschwitz-Erlass) and based upon the instruction to
apprehend Gypsies living in the Third Reich, over
20,000 Gypsies (10,097 males and 10,849 females, includ-
ing babies born in Auschwitz) were housed in the
Zigeunerlager. The first of these arrived on 26 February
1943, even before the completion of construction.
63
Although marked as ‘‘asocials’’ by the black stars
sewn on their clothing, the Gypsies were treated differ-
ently to other prisoners. The Gypsies did not have their
hair shaved, nor did they wear camp uniforms, and they
were allowed to wear their few civilian clothes and live
as families. One family could occupy one bunk bed in
the barracks.
64
Even though the living conditions in
Auschwitz-Birkenau were horrific beyond description,
those in the Gypsy camp are widely acknowledged to
have been the worst. Prisoners were ravaged by conta-
gious diseases including typhus and noma
65
to the
extent that within six months of arrival over 7000 had
Benedict et al. 263

died. It was into this environment that the children of
Eva Justin’s research were sent.
On 2 August 1944, approximately 1400 Gypsies from
Auschwitz-Birkenau were loaded onto an empty freight
train and taken to Buchenwald concentration camp.
Their lives were saved because, on the same day at
Auschwitz, 2897 Gypsies from the family camp were
rounded up by armed SS men and taken by truck to
the gas chamber.
66
Only four of the children of Justin’s
research are known to have survived Auschwitz.
After the war, Justin worked as a youth psychologist
in the Frankfurt municipal health service. In October
1948, a large number of Gypsy survivors convinced the
public prosecutor of Frankfurt to open an inquiry into
the wartime actions of Ritter against the Gypsies.
As had been clearly stated at the time of his research,
and that of Eva Justin, their goal was to ‘‘provide sci-
entific and practical data for the measures taken by the
state in the areas of eugenics and racial hygiene.’’
67
The findings of this research led directly to the shipping
of Gypsies to concentration camps which many thou-
sands did not survive. After two years, the public pros-
ecutor closed the inquiry because of what he deemed to
be insufficient evidence, and his stated belief that the
Gypsies’ testimonies were ‘‘notoriously unreliable.’’
68
Ritter was ‘‘denazified’’
69
and went on to practice as
a psychiatric assessor in Frankfurt am Main, where
he continued to work with Eva Justin until his death
in 1951, having reached the position of Chief Medical
Councillor.
70
In 1959, an investigation was opened con-
cerning Eva Justin’s actions. She was accused by several
Gypsies as having ordered involuntary sterilizations
and deportations, many of which resulted in death.
After close to two years, the investigation was closed
and Justin was absolved of charges against her. The
prosecutor did determine that Justin’s assessments
had provided a basis for death or sterilization; however,
it was impossible to determine if she could have known
these were likely outcomes of her assessments. In add-
ition, the fact that she was ‘‘young and inexperienced,’’
strongly influenced by Ritter, and had ‘‘repudiated her
views on the Gypsy question’’ were also elements in the
decision.
71
Justin continued to work as a child psych-
ologist until her death in 1966. She was never punished
for her actions with the children of St. Josef’s Home.
72
The ethical aspects of Justin’s research
Germany was not completely devoid of ethical guide-
lines for conducting research at the time of Eva Justin’s
studies. In 1900, the Prussian Minister of Religious,
Education and Medical Affairs issued a Directive
about human experimentation. This Directive forbade
nontherapeutic research on minors.
73
In 1931, a Reich
Circular was issued which contained most of the points
of the subsequent Nuremberg Code.
74
Whereas Justin
was not a physician, her research was under the direc-
tion of a physician, Robert Ritter, who should have
been at least aware of the latter of these two documents.
Perhaps Justin did not consider her observations and
potato-harvesting evaluations as falling within the
domain of research but given that these observations
were for a PhD dissertation that seems unlikely.
However, even with the full knowledge that her obser-
vations were to be considered ‘‘research’’ in support of
Ritter’s attempt to find a ‘‘scientific’’ basis for his char-
acterizations of Gypsies, consent of the orphanage’s
administrators had been secured by government offi-
cials as previously described.
Eva Justin acted unethically on several counts, quite
apart from her attitude and beliefs (and subsequent
bias) as they related to Gypsies. Given the state of
knowledge in the 1920s and early 1930s, the prevailing
cultural norms in relation to marginalized groups, and
the dogmatic declarations as to genetic deficiencies and
the dangers to the German gene pool, a young woman’s
failure to recognize the speciousness of the arguments
or their political motivation is hardly surprising. We
should consider, however, whether her research failed
to meet the standards required of an ethical researcher.
First, it is apparent that she manipulated her
research study in order to provide ‘‘evidence’’ to justify
her preexisting belief that the Gypsy and part-Gypsy
children were ‘‘inferior’’ and should not be allowed to
reproduce. She encouraged the Gypsy children to ‘‘run
wild in the woodlands,’’ for example, ‘‘as if they were
primitives.’’
75
This was in direct contrast to the behav-
iors that were taught by the nuns, and enabled Justin to
document behavior that supported her hypothesis that
the Gypsy children were unable to be assimilated and
should be sterilized.
76
Although by today’s standards any scholarly
research designed in such a way would be immediately
ruled as inadmissible, it is not surprising that it went
unchallenged because anthropological-ethnographic
research at that time remained methodologically
unsophisticated, with the conduct of fieldwork left to
the discretion of the researcher. As Eriksen and
Nielsen
77
describe in their history of anthropology,
apart from the role of Malinowski in the adoption of
the method of participant observation, the development
of a scientific methodology was largely done by non-
German scholars. Furthermore, the distinctive German
study of race (Rassenkunde)
78
was largely untouched by
the wholesale renovation of the discipline effected during
the late 1920s and 1930s by its founders.
79
Many of these
had Jewish family histories and their writings were
ignored in Germany; in addition, the universities had
been starved of funds after the First World War, with
a consequent shortage of high level ethnological and
264 Journal of Medical Biography 26(4)

anthropological scholars. During the 1930s, many of these
scholars fled Germany, the policy of Gleichschaltung
(alignment, co-ordination)
80
having shackled the dis-
cipline to the Nazi agenda. Even Justin’s objectifica-
tion of the children, and her manifestly negative
behavior toward them, was likely a common feature
of anthropological field research which sought to docu-
ment the inferiority of certain ‘‘undesirable’’ groups.
With hindsight, we see in the colonial attitudes of
many European and American fieldworkers, for exam-
ple, obvious paternalism, disingenuousness, and exploit-
ation, even by those who are regarded as leading figures.
Indeed, treating research subjects not as ‘‘participants’’
but as ‘‘objects to be studied’’ was widely regarded as
necessary for ‘‘scientific’’ research and, bearing in mind
the acculturation noted above, again it would be difficult
to condemn Justin on such grounds.
An aspect of Justin’s research that appears unethical
in today’s context was her failure to obtain any kind of
informed consent and her use of coercion during the
study. However, we must consider this within the con-
text of the day and site. Most of the parents of the
children of St. Josef’s Home were either dead, missing,
or incarcerated. Locating them would have been impos-
sible. Just because one’s parents are not available to
consent for a minor does not eliminate today the need
to obtain consent from a legal guardian. During the
Nazi era, individual rights were not respected and the
government mandated that this particular children’s
home ‘‘support the scientist and to give her any infor-
mation desired.’’
81
It is quite possible that the study was
viewed by orphanage staff as entailing minimal harm
and that resisting the order would have been dangerous
for all concerned. The possibility that Justin had been
involved in engineering this mandate also arises, in
which case there was certainly a breach of the
Guidelines (Richtlinien) which formed part of the 1931
Code. Second, the Guidelines state that ‘‘motiveless and
unplanned experimentation involving human subjects
shall obviously be prohibited’’
82
and it is difficult to con-
sider Justin’s potato-harvesting competition to be any-
thing other than trivial and unscientific.
A more significant ethical breach is mentioned by
Nichols who stated that Ritter and his assistants, includ-
ing Eva Justin, would sometimes pose as missionaries to
obtain information from the Gypsies.
83
‘‘Interviewees
who were reluctant to cooperate were threatened with
arrest and incarceration in a concentration camp,’’
84
and
local police and officials were ordered to ‘‘render all pos-
sible assistance.’’
85
Thus, it is apparent that in at least
some instances Ritter’s and Justin’s research included
coercion, but it is not clear to what extent such threats
attended the research with the children at St. Josef’s.
There are accounts of other nurses involved in
research during the Nazi era including nurses who
helped with the sterilization experiments at Auschwitz;
however, these were prisoner-nurses who did not have
the ability to decline without facing a certain death.
86,87
Similarly, nurses who were employed by the SS at
Ravensbru
¨ck concentration camp participated in the
medical experiments conducted there.
88
Even though
not prisoners, had they refused their assignment, there
would have likely been dire consequences. A key factor
distinguishing Justin’s research from those studies in
which the Auschwitz and Ravensbru
¨ck nurses partici-
pated is that Justin was the Principal Investigator of
her study and received the highest academic degree for
doing so. The full consequences of her research design
and ethics are borne by her as Principal Investigator.
Conclusion
Eva Justin was one of the first nurses in Europe to attain
a Doctor of Philosophy degree, albeit not in the discip-
line of nursing, but her scholarship was highly question-
able, biased, and aimed at furthering the Reich’s goals of
sterilizing or exterminating the Gypsies because of their
‘‘racial inferiority.’’ In the Nazi environment, racial the-
ories readily became the basis for Justin’s study, but she
broke the first rule of scholarship and instead of sup-
porting or not supporting a hypothesis by rigorous test-
ing, she set her study so that the results supported the
preconceived (and egregiously wrong) theories promul-
gated by the National Socialist regime. Bias completely
overwhelmed any objectivity.
There is no doubt that Justin exploited the Sinti chil-
dren to further her own ambitions, and that the design
and conduct of her research was unscholarly, but per-
haps the most relevant question is ‘‘Could Eva Justin
have prevented the children from being shipped to
Auschwitz?’’ Perhaps she could have, had she devised
more scenarios for observation, and therefore delayed
their transportation, but to do this also would have
delayed receiving her PhD. A second question raised
is whether or not Justin knew what would happen to
the children if they were sent to Auschwitz. Justin vis-
ited Gypsies in concentration camps so she had an
awareness of the conditions, and her subsequent role
in assessing the racial status of inmates at Moringen
and Uckermark would surely have removed any
doubts as to the children’s fate.
Today there are many nurses with PhDs who serve
as Principal Investigators of their own studies. Indeed,
to obtain a PhD, one must do so. In addition, there are
many ‘‘research nurses’’ who are coinvestigators or who
manage the studies of other Principal Investigators. It is
often these nurses who explain participation in the stu-
dies, recruit subjects, obtain informed consent, and who
monitor data collection.The capriciousness of Justin’s
design and deceitfulness of her data collection methods
Benedict et al. 265

would be disallowed and even severely penalized in
today’s research world.
Acknowledgements
We thank Ms Kay Newman, Tropical Health Research Unit,
Townsville Hospital and Health Service, for help with editing
this paper.
Declaration of conflicting interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
References and notes
1. In the present day, the word ‘‘Gypsy’’ is not the preferred
term for Roma and Sinti people; however, it is included in
this paper because it was the language of Nazi Germany
and is generally used in relevant publications.
2. McKenna H and Cutcliffe J. Nursing doctoral education
in the United Kingdom and Ireland. Online Journal of
Issues in Nursing 6: 2, www.nursingworld.org//
MainMenuCategories/ANAMarketplace/ANAPeriodi
cals/OJIN/TableofContents/Volume62001/No2May01/
ArticlePreviousTopic/
UKandIrelandDoctoralEducation.aspx (2001, accessed
27 May 2015).
3. Benedict S and Rozmus C. Nurses and human subjects
research during the Third Reich and now. In: Rubenfeld
S and Benedict S (eds) Human subjects research after the
Holocaust. New York: Springer International Publishing,
2014, pp.87–98.
4. Benedict S and Shields L (eds) Nurses and midwives in
Nazi Germany: the ‘‘euthanasia’’ programs. New York:
Routledge History, 2014.
5. Personalakten Eva Justin, Stadt Frankfurt am Main,
92.546, no date.
6. Idem.
7. Idem.
8. Kater M. Hitler youth. Cambridge, MA: Harvard
University Press, 2004, p.159.
9. Op cit ref 5.
10. Brustein W. Roots of hate: Anti-Semitism in Europe before
the Holocaust. New York: Cambridge University Press,
2003, p.134.
11. Galton F. Hereditary genius. London: Macmillan, 1869,
p.357.
12. Friedlander H. The origins of Nazi genocide. Chapel Hill:
University of North Carolina Press, 1995, pp.11–12.
13. Heberer P. Children during the Holocaust. Washington,
DC: United States Holocaust Memorial Museum in asso-
ciation with AltaMira Press, 2011.
14. Schmuhl H. In the realm of opportunity: The Kaiser
Wilhelm Institute for Anthropology, Human Heredity and
Eugenics during World War II, 1938/42–1945: The Kaiser
Wilhelm Institute for Anthropology, Human Heredity and
Eugenics, 1927–1945. Boston Studies in the Philosophy of
Science (259). New York: Springer Publishing Company,
2008, p.357.
15. Op cit ref 13, 2011.
16. Meister J. Schicksale der ‘‘zigeunerkinder’’ aus der St.
Josefspflege in Mulfingen. Herausgeber: Historischer
Verein fu
¨rWu
¨rttembergisch Franken, 1984, p.204.
17. Ibid, p.202.
18. Idem.
19. Nichols L. Cruel world: the children of Europe in the Nazi
web. New York: Alfred A. Knopf, 2006.
20. The term ‘‘concentration camp’’ was first used in the late
1800s by the Spanish when suppressing rebellions in
Cuba. It was later used by the British who imprisoned
Boer families in South Africa during the Boer Wars.
91
At
the urging of Hitler, the order to establish concentration
camps in Germany was signed by Reich President
Hindenburg on 28 February 1933 in his decree on ‘‘The
Protection of the Nation and the State.’’ This allowed the
State to imprison citizens indefinitely, without appeal. It
was not necessary to violate a law to be imprisoned;
rather, the mere interpretation of a threat to the nation
or state was sufficient grounds for indefinite
imprisonment.
89
.
21. Lewy G. The Nazi persecution of the Gypsies. Oxford,
UK: Oxford University Press, 2000, p.52.
22. Op cit ref 16, p.204.
23. Ibid, p.205.
24. Ibid, p.207.
25. Op cit ref 13, p. 223.
26. Op cit ref 21, p. 166.
27. Op cit ref 13, p. 224.
28. Op cit ref 12, p.250.
29. Ibid.
30. Ibid, p. 251.
31. Justin’s thesis is available in German only: http://www.
sifaz.org/eva_justin_dissertation_artfremd_erzogene_
zigeunerkinder_1943.pdf (accessed Oct 3, 2015).
32. Justin E. Lebensschicksale artfremd erzogener
Zigeunerkinder und ihrer Nachkommen. Inaugural-
Dissertation der Friedrich-Wilhelms-Universita
¨t,5
November 1943.
33. Op cit ref 16, p. 206.
34. Op cit ref 16, p.207.
35. Ibid, p.208.
36. Op cit ref 32, p. 5.
37. Yeniche (jeniche) people are a group of travelers who live
mostly in southern Germany and Switzerland. Their
mobility is an important part of their culture, similar to
that of the Sinti and Roma.
90
38. Op cit ref 32, p.8.
39. Op cit ref 16, p. 210.
40. Idem.
41. Ibid, p.208.
42. Idem.
43. Ibid, p. 210–211.
44. Ibid, p. 209.
45. Stargardt N. Witnesses of war: children’s lives under the
Nazis. New York: Vintage Books, 2005, p.75.
266 Journal of Medical Biography 26(4)

46. Op cit ref 32, p. 121.
47. https://www.hu-berlin.de/de/ueberlick/geschichte/rekto-
ren/fischer (accessed 28 July 2015).
48. Op cit ref 14, p. 360.
49. Idem.
50. Op cit ref 19, p. 26.
51. Op cit ref 14, p. 360.
52. Op cit ref 12, p. 250.
53. Op cit ref 14, p. 360.
54. Op cit ref 32, p. 1.
55. Zu
¨lch T. Auschwitz vergast, bis heute verfolgt - zur
Situation der Sinti und Roma in Europa S. Hamburg:
Rowohlt, Reinbek bei Hamburg, 1979.
56. Op cit ref 16, p. 215.
57. Ibid, p. 213.
58. Idem.
59. Ibid, p. 215.
60. Idem.
61. Czech
66
noted that on 12 May, 39 Gypsy children from
St. Josefspflege children’s home in Mulfingen arrived.
Twenty boys were tattooed with the number Z-9873-Z-
9892 and 19 girls received the numbers Z-10629-Z10647.
There were about 67,000 prisoners in Auschwitz-
Birkenau at that time, including approximately 6000
Gypsies. In 1937, Wolfgang Abel had contacted Ritter
to inform him of the supposed usefulness of fingerprints
as a mean of differentiating between ‘‘purebred’’ Gypsies
and ‘‘Gypsy mixed-breeds.’’ This is a possible explan-
ation for fingerprinting the children.
62. Strzelecka I and Setkiewicz P. The construction, explan-
sion and development of the camp and its branches. In:
Dlugoborski W and Piper F (eds) Auschwitz, vol. 1.
Oso
´wiecim: Auschwitz-Birkenau State Museum, 2000,
pp. 63–138.
63. Idem.
64. Op cit ref 21, p. 153.
65. ‘‘Noma’’ (Cancrum oris) is an infectious disease that
occurs in settings of poor hygiene and crowding.
Malnutrition and poor oral hygiene are contributing fac-
tors. Noma, also known as ‘‘water cancer’’ occurred with
an unusually high frequency in the Gypsy camp of
Birkenau and was of special interest to Dr Josef
Mengele. Today, it is most prevalent in sub-Saharan
Africa.
90
.
66. Czech D. Auschwitz chronicle 1939–1945. New York:
Henry Holt, 1989.
67. Op cit ref 21, p.209.
68. Ibid, p.210.
69. ‘‘Denazification’’ was a process implemented after
Second World War by the Allies in an attempt to
remove Nazism from German society. It consisted of
completion of a questionnaire, and classification into
various categories from which decisions (and subsequent
actions) about the person’s culpability in Nazi activities
were made. See http://www.yadvashem.org/odot_pdf/
Microsoft%20Word%20-%206265.pdf (accessed 1 May
2015).
70. Schmidt-Degenhard T. Robert Ritter (1901–1951). Zu
Leben und Werk des NS ‘‘Zigeunerforschers’’; Robert
Ritter (1901–1951). On life and work of the Nazi
‘‘Tsiganologist.’’ Doctoral Thesis, Universita
¨tTu
¨bingen,
Medizinische Fakulta
¨t. https://publikationen.uni-tuebingen.
de/xmlui/discover?scope¼%2F&query¼RobertþRitter&
submit¼OK (accessed 1 November 2015).
71. Op cit ref 21, pp.210–211.
72. Margalit G. Germany and its Gypsies: A post-Auschwitz
ordeal. Madison: University of Wisconsin Press, 2002,
p.173.
73. Annas GJ and Grodin MA. The Nazi doctors and the
Nuremberg Code: human rights in human experimentation.
New York: Oxford University Press, 1992, p.127.
74. Ibid, p.129.
75. Op cit ref 45, p.75.
76. Ibid, p. 76.
77. Eriksen TH and Nielsen FS. A history of anthropology.
London: Pluto Press, 2001.
78. Evans AD. Anthropology at war: World War I and the
science of race in Germany. Chicago: University of
Chicago Press, 2010.
79. Schaft, GE. From racism to genocide: anthropology in the
Third Reich. Chicago: University of Illinois Press, 2004.
80. For details of this word coined by the Nazis, see http://
www.history-ontheweb.co.uk/concepts/concept72_
gleichschaltung.htm (accessed 1 May 2015).
81. Op cit ref 16, p.208.
82. Op cit ref 73.
83. Op cit ref 19, p. 26.
84. Op cit ref 21, p. 45.
85. Idem.
86. Benedict S and Georges J. Nurses and the sterilization
experiments of Auschwitz: a Postmodernist Perspective.
Nursing Inquiry 2006; 13: 277–288.
87. Georges J and Benedict S. An ethics of testimony: pris-
oner nurses at Auschwitz. Advances in Nursing Science
2006; 29: 161–169.
88. Benedict S. The nadir of nursing: nurse perepetrators of
the Ravensbru
¨ck Concentration Camp. Nursing History
Review 2003; 11: 129–146.
89. Piper R. The origins of the camp. In Dlugoborski W and
Piper F (eds) Auschwitz. Vol. 1. Oo
´wiecim: Auschwitz-
Birkenau State Museum, 2000, pp. 39–62.
90. Enwonwu C, Falkler W and Idigbe E. Oro-facial gang-
rene (noma/cancrum oris): pathogenic mechanisms.
Critical Review Oral Biology and Medicine 2000: 11:
159–171.
Benedict et al. 267