Nuremberg Code

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The Nuremberg Code is a set of research ethics principles for human experimentation created as one result of the subsequent Nuremberg trials at the end of World War II.

The origin of the Code began in pre–World War II German politics, particularly during the 1930s and 1940s. The pre-war German Medical Association was considered to be a progressive and democratic association with great concerns for public health, one example being the legislation of compulsory health insurance for German workers. The use of scientific racism was supported by the Nazi government in order to use biology to accomplish their goals of racial purity, a core concept in the national socialist ideology.

After World War II, a series of trials were held to hold members of the Nazi party responsible for a multitude of war crimes. In the trial of USA v Brandt, which became known as the "Doctors' Trial", German physicians responsible for conducting medical procedures on humans during the war were tried. They focused on physicians who conducted experiments in concentration camps, in addition to those who were involved in over 3,500,000 sterilizations of German citizens.[1][2]

An early version of the Code known as the Memorandum, which stated explicit voluntary consent from patients are required for human experimentation, was drafted on 9 August 1947.[3] On 20 August 1947, the judges delivered their verdict against Karl Brandt and 22 others.[4] The verdict reiterated the Memorandum's points and, in response to expert medical advisers for the prosecution, revised the original six points of the Memorandum to ten points. The ten points became known as the Code, which includes such principles as informed consent and absence of coercion; properly formulated scientific experimentation; and beneficence towards experiment participants. It is thought to have been mainly based on the Hippocratic Oath, which was interpreted as endorsing the experimental approach to medicine while protecting the patient.[5][6]

The ten points of the code were given in the section of the judges' verdict entitled "Permissible Medical Experiments":

  1. The voluntary consent of the human subject is absolutely essential. This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision. This latter element requires that before the acceptance of an affirmative decision by the experimental subject there should be made known to him the nature, duration, and purpose of the experiment; the method and means by which it is to be conducted; all inconveniences and hazards reasonably to be expected; and the effects upon his health or person which may possibly come from his participation in the experiment. The duty and responsibility for ascertaining the quality of the consent rests upon each individual who initiates, directs, or engages in the experiment. It is a personal duty and responsibility which may not be delegated to another with impunity.[7]
  2. The experiment should be such as to yield fruitful results for the good of society, unprocurable by other methods or means of study, and not random and unnecessary in nature.
  3. The experiment should be so designed and based on the results of animal experimentation and a knowledge of the natural history of the disease or other problem under study that the anticipated results will justify the performance of the experiment.
  4. The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.
  5. No experiment should be conducted where there is an a priori reason to believe that death or disabling injury will occur; except, perhaps, in those experiments where the experimental physicians also serve as subjects.
  6. The degree of risk to be taken should never exceed that determined by the humanitarian importance of the problem to be solved by the experiment.
  7. Proper preparations should be made and adequate facilities provided to protect the experimental subject against even remote possibilities of injury, disability, or death.
  8. The experiment should be conducted only by scientifically qualified persons. The highest degree of skill and care should be required through all stages of the experiment of those who conduct or engage in the experiment.
  9. During the course of the experiment the human subject should be at liberty to bring the experiment to an end if he has reached the physical or mental state where continuation of the experiment seems to him to be impossible.
  10. During the course of the experiment the scientist in charge must be prepared to terminate the experiment at any stage, if he has probable cause to believe, in the exercise of the good faith, superior skill and careful judgment required of him that a continuation of the experiment is likely to result in injury, disability, or death to the experimental subject.

See also

References

  1. Eugenics/Euthanasia. ABC-CLIO.
  2. Archived copy.
  3. (2010) The Emperor of All Maladies, First Scribner Hardcover, Scribner. 
  4. Annas, George J., and Michael A. Grodin. The Nazi Doctors and the Nuremberg Code. New York: Oxford University Press, 1992.
  5. Weindling, Paul (2001). "The Origins of Informed Consent: The International Scientific Commission on Medical War Crimes, and the Nuremburg Code". Bulletin of the History of Medicine 75 (1): 37–71. doi:10.1353/bhm.2001.0049. PMID 11420451. 
  6. Weindling, Paul. "The origins of informed consent: The international scientific commission on medical war crimes, and the Nuremberg code". Bulletin of the History of Medicine 75.1 (2001): 37–71.
  7. The Nuremberg Code (1949).