Ethics of the Nuremberg Code

From 1946 to 1947, the Nuremberg War Crime Trials took place, withfifteen of twenty-three German physicians and research scientist-physicians found guilty of criminal human experimentation projects. The trial court attempted to establish a set of principles of human experimentation that could serve as a code of research ethics. The result was the Nuremberg Code, which attempted to provide a natural law-based set of universal ethical principles. Looking beyond the Nuremberg Code and applying it to modern medical research ethics, there are many challenges that it poses. Many have argued that the Code tries to provide for all unforeseen events, which restricts the researcher by requiring him to anticipate every situation, demanding the impossible. The most important contribution of the Code is the first principle, which says that voluntary consent of the human subject is absolutely essential. The subject involved should have legal capacity to give consent, should have free power of choice, as well as sufficient knowledge and comprehension of the experiment. This restricts that populations upon which some experiment may be conducted, since many do not have “legal capacity”. For instance, studies of mental illness and children’s diseases have been curtailed because neither of these populations has the legal capacity to give consent. Another group of people, prisoners, are never really able to give voluntary consent since they might be enticed by financial rewards, special treatment, and the hope of early release in exchange for participating in the human experimentation projects. British biostatitcian Sir Austin Bradford Hill also questioned whether it was important to inform a research subject who was receiving a placebo since it does...

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...n such that it was a physician’s duty or role to act in the best interest of their patient and safeguard the health of the people. It was a set of professional guidelines written by physicians for physicians as opposed to the Code, which was written by jurists for use in a legal trial. The Declaration of Helsinki was also a much longer document than the Nuremberg Code and thus laid out more principles and with less room for uncertainty.

The two sets of principles are just ethical principles and nothing more. Neither of them has any legally binding authority or means of enforcement. The adequate protection of human research subjects is not guaranteed under these codes, we just have to trust that they are being treated properly. The Code should be rewritten so that there is some enforcement of the principles instead of just hoping that doctors will behave ethically.