The nature of the medical treatment of prisoners in the Gulag has emer
ged from accounts published by survivors. Over a period of 70 years so
me doctors entrusted with the medical care of prisoners failed to disc
harge their ethical duties, contributing to the prisoners' neglect and
suffering. The medical profession must carefully examine what occurre
d and properly assign responsibility for ethical as well as unethical
medical acts. Understanding the history of these ominous events will a
lert doctors worldwide to the importance of medical autonomy in the su
pport of imprisoned patients.