Here I discuss how the first international code of human research ethics came into existence.
Nuremberg is a city in the German state of Bavaria. During World War II, it was an important site for military production, and the Flossenbürg concentration camp was also located here. During 1939-1945 Nazis conducted many medical war crimes like the mass murder of concentration camp prisoners. Medical experiments were also performed on thousands of concentration camp prisoners without their consent and included deadly studies such as injecting people with gasoline and live viruses. This was against ethics.
These war crimes were brought before an international tribunal in the Nuremberg Trials and Nuremberg was chosen as the site for the trials. In December 1946, the War Crimes Tribunal at Nuremberg indicted 20 physicians and 3 administrators for their willing participation in the systematic torture, mutilation, and killing of prisoners in experiments. The Nuremberg Military Tribunals found that the defendants had:
- Corrupted the ethics of the medical and scientific professions
- Repeatedly and deliberately violated the rights of the subjects
The actions of these defendants were condemned as crimes against humanity. Sixteen of the twenty-three physicians/administrators were found guilty and imprisoned, and seven were sentenced to death.
In the August 1947 verdict, the judges included a section called Permissible Medical Experiments. This section became known as the Nuremberg Code and was the first international code of research ethics.
The Code provides ten Directives for Human Experimentation:
- Voluntary consent of the human subject is essential
- The experiment must yield generalizable knowledge that could not be obtained in any other way and is not random and unnecessary
- Animal experimentation should precede human experimentation
- All unnecessary physical and mental suffering and injury should be avoided
- No experiment should be conducted if there is reason to believe that death or the disabling injury will occur
- The degree of risk to subjects should never exceed the humanitarian
- importance of the problem
- Risks to the subjects should be minimized through proper preparations
- Experiments should only be conducted by scientifically qualified investigators
- Subjects should always be at liberty to withdraw from experiments
- Investigators must be ready to end the experiment at any stage if there is cause to believe that continuing the experiment is likely to result in injury, disability or death to the subject
Nuremberg code established the basic principles that must be observed to satisfy moral, ethical, and legal concepts in the conduct of human subject research. The Code has been the model for many professional and governmental codes since the 1950s.