Article Text

Download PDFPDF
Suffering and the moral orientation of presence: lessons from Nazi medicine for the contemporary medical trainee
  1. Benjamin Wade Frush1,
  2. Jay R Malone2
  1. 1 Internal Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  2. 2 Department of Pediatrics and Critical Care Medicine, Washington University in St Louis, St Louis, Missouri, USA
  1. Correspondence to Dr Benjamin Wade Frush, Internal Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37204, USA; benjamin.w.frush{at}


Medical trainees should learn from the actions of Nazi physicians to inform a more just contemporary practice by examining the subtle assumptions, or moral orientations, that led to such heinous actions. One important moral orientation that still informs contemporary medical practice is the moral orientation of elimination in response to suffering patients. We propose that the moral orientation of presence, described by theologian Stanley Hauerwas, provides a more fitting response to suffering patients, in spite of the significant barriers to enacting such a moral orientation for contemporary trainees.

  • education for health care professionals

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors BWF performed the majority of research and provided content for early drafts of the paper. JRM performed further research and provided additional content in subsequent drafts. Both were heavily involved in the revision process. Both of their contributions are essential to the construction and revision of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.