Over four decades, US nerve surgeon Professor Susan Mackinnon has pondered a terrible dilemma: Should she and other doctors continue to use an incredibly precise anatomical atlas, knowing the detailed illustrations come from Nazi atrocities?

In a BMJ feature, the professor of surgery at the Washington University School of Medicine in St Louis, US, outlines how she arrived at the conclusion that the so-called Pernkopf atlas can be a last-resort reference in difficult cases, but only with patients’ permission.

Professor Mackinnon first came across the Atlas of Topographical and Applied Human Anatomy during her hand fellowship in 1982, when it became her “dissection partner” during long hours in the anatomy lab.

However, some years later she learned the historic atlas by Eduard Pernkopf, then chair of anatomy and president of the University of Vienna, was derived from the Holocaust.