Nuremberg Code
The Nuremberg Code (German: Nürnberger Kodex) is a set of ethical research principles for human experimentation created by the court in U.S. v Brandt, one of the Subsequent Nuremberg trials that were held after the Second World War.
For the set of guidelines for determining what constitutes a war crime, see Nuremberg Principles. For the denaturalization of German Jews, see Nuremberg Laws.Though it was articulated as part of the court's verdict in the trial, the Code would later become significant beyond its original context; in a review written on the 50th anniversary of the Brandt verdict, Jay Katz writes that "a careful reading of the judgment suggests that [the authors] wrote the Code for the practice of human experimentation whenever it is being conducted."[1]
Importance[edit]
The Code has not been officially accepted as law by any nation or as official ethics guidelines by any association. In fact, the Code's reference to Hippocratic duty to the individual patient and the need to provide information was not initially favored by the American Medical Association.[14] Katz observes that the Western world initially dismissed the Nuremberg Code as a "code for barbarians, but unnecessary (or superfluous) for ordinary physicians."[1][15] Additionally, the final judgment did not specify whether the Code should be applied to cases such as political prisoners, convicted felons, and healthy volunteers. The lack of clarity, the brutality of the unethical medical experiments, and the uncompromising language of the Code created an image that it was designed for singularly egregious transgressions.[1]
However, the Code is considered by some to be the most important document in the history of clinical research ethics, because of its massive influence on global human rights. In the United States, the Code and the related Declaration of Helsinki influenced the drafting of regulations promulgated by the United States Department of Health and Human Services to ensure ethical treatment of human research subjects, known as the Common Rule, which is now codified in Part 46 of Title 45 of the Code of Federal Regulations.[16][17] These regulations are enforced by Institutional Review Boards (IRBs). In 1966, the International Covenant on Civil and Political Rights was adopted by the United Nations, and after enough nations had ratified the Covenant, it came into force on 23 March 1976. Article Seven prohibits experiments conducted without the "free consent to medical or scientific experimentation" of the subject.[14] As of September 2019, the Covenant has 173 states parties.
In his 2014 review, Gaw observes that the Code "not only entered the legal landscape, but also became the prototype for all future codes of ethical practice across the globe."[11] The idea of free or informed consent also served as the basis for International Ethical Guidelines for Biomedical Research Involving Human Subjects proposed by the World Health Organization.[11] Another notable symposium review was published by the Medical University of Vienna in 2017: "Medical Ethics in the 70 Years after the Nuremberg Code, 1947 to the Present". President and Rector Markus Muller writes in his introduction that the Code "constitutes one of the most important milestones in the history of medicine, providing for the first time a proper framework for research on human subjects. This milestone was not a voluntary, precautionary measure, but only came into existence in the aftermath of Nazi atrocities. The Nuremberg Code became a cornerstone of clinical research and bioethics."[18]
In 1995, Judge Sandra Beckwith ruled in the case In Re Cincinnati Radiation Litigation (874 F. Supp 1995) that the Nuremberg Code may be applied in criminal and civil litigation in the Federal Courts of the United States. [19]