The Nuremberg Code is a set of ten principles for medical research on human subjects, formulated by the judges who tried twenty-three Nazi doctors at the so-called Doctors’ Trial in Nuremberg in 1946-47. The Code is the foundational document of modern medical research ethics, and its principles are now embedded, directly or in derivative form, in every research ethics framework operating today.
The trial that produced it
The Doctors’ Trial, formally United States of America v. Karl Brandt et al., ran from December 1946 to August 1947. Twenty of the twenty-three defendants were medical doctors. They were charged with conducting medical experiments on concentration camp prisoners that involved deliberate infliction of injury, infection with disease, exposure to extreme cold and pressure, and direct killing. Sixteen of the twenty-three were convicted. Seven were sentenced to death and hanged. The Code was set out in the judges’ verdict as a statement of the principles the defendants had violated and the standards that any future medical research should observe.
The ten principles
The first and most fundamental principle is that the voluntary consent of the human subject is absolutely essential. The subject must have the legal capacity to consent, must understand the nature of the experiment, and must be free to withdraw at any time. The remaining principles require that the experiment should be designed to produce results for the good of society, that it should be based on the results of animal experimentation and prior knowledge of the disease under study, that it should avoid all unnecessary physical and mental suffering, that it should not be conducted where there is reason to believe death or disabling injury will occur, that the degree of risk should never exceed that determined by the humanitarian importance of the problem, that proper preparations should be made and adequate facilities provided to protect the subject, that the experiment should be conducted only by scientifically qualified persons, that the subject is free to bring the experiment to an end at any time, and that the scientist must be prepared to terminate the experiment if continuation seems likely to result in injury, disability, or death.
The continuing relevance
The Nuremberg Code was extended and refined in the Declaration of Helsinki, adopted by the World Medical Association in 1964 and revised many times since. It is the basis of the informed consent requirements that govern every clinical trial, every research project involving human subjects, and every institutional review board across the world. The Code is the most consequential single document to emerge from the Nuremberg trials, and arguably the most consequential to emerge from the Holocaust as a whole, in terms of subsequent practical effect.
See also
Sources
- Saul Friedländer, Nazi Germany and the Jews, 2 vols, HarperCollins, 1997 and 2007
- Christopher Browning, The Origins of the Final Solution, University of Nebraska Press and Yad Vashem, 2004
- Peter Longerich, Holocaust: The Nazi Persecution and Murder of the Jews, Oxford University Press, 2010
- Ian Kershaw, Hitler 1936 to 1945: Nemesis, Allen Lane, 2000
- Trial transcripts and judgment, Trials of War Criminals before the Nuernberg Military Tribunals under Control Council Law No. 10, U.S. Government Printing Office, 1949 onwards