Ethical questions arising from Otfrid Foerster's use of the Sherrington method to map human dermatomes

Otfrid Foerster (1873-1941) is well known for his maps of human dermatomes. We have examined the history of the development of his protocols for mapping dermatomes by analyzing his lectures and publications from 1908 to 1939, focusing on his Schorstein Memorial Lecture in 1932 and his use of the isolation (Sherrington) method, in which a single dorsal root is spared in a sequence of resections (dorsal rhizotomies). Because of the absence of medical records for Foerster's patients, we also review eyewitness accounts of his operating technique, his occasional comments on patients, and the issue of consent. There appears to be no medical justification-at that time or currently-for Foerster's use of the Sherrington method to map dermatomes L1, L5, S1, and S2, and in our view, these results were obtained unethically. Hence, clinicians and researchers who use his maps should acknowledge those whom Foerster exploited in order to produce them.