THE NUREMBERG CODE
Given the rabid politicization of public health in recent years—particularly in respect of experimental preventive measures and treatments for novel diseases—readers (including public health officials and health care providers) would do well to review the Nuremberg Code that emerged from the prosecution of persons responsible for war crimes committed during World War II (1939–1945).
The ten points of the Code (as written in the source document1) are reproduced here. Notwithstanding the criticality of every point articulated, points 1 and 9 have been highlighted to emphasize the neccessarily absolute autonomy that the human subject must have in terms or either particpating in or withdrawing from any health care experiment.
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, over-reaching, 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.
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 probably [sic] cause to believe, in the exercise of the good faith, superior skill and careful judgement required by him that a continuation of the experiment is likely to result in injury, disability, or death to the experimental subject.
Concerning more recent events—not to mention what is looming on the horizon—accountability is coming. You can take that to the bank.
— FINIS —
Extracted from section titled, PERMISSIBLE MEDICAL EXPERIMENTS, in Trials of War Criminals Before the Nuernberg Military Tribunals Under Control Council Law No. 10. Nuernberg October 1946–April 1949 (Washington: U.S. Government Printing Office, 1949–1953), Volume II, pp. 181–182. See Google Books—Trials of War Criminals Before the Nuernberg Military Tribunals Under Control Council Law No. 10. Nuernberg October 1946–April 1949 (Volume II).↩️