THE NUREMBERG CODE

The idea of, "state before individual" was typical of the Nazi era and physicians began to lose sight of their moral obligations as they were swept into the dehumanizing Nazi political culture. The slew of exotic diseases and afflictions, a condition of the war environment, were seen as a, "national threat," and it was to these "threats" that German doctors began to assume the responsibility of acting on behalf of the state in order to imporve the health of the nation. On the basis of national thought and utilitarianism doctors no longer acted as caretakers but as puppets of a government obsessed with racial and genetic purity. Medical experiments committed under the disguise of scientific research fell into three basic categories: (1) Medico-Military Research; (2) Miscellaneous, Ad Hoc Experiments; and (3) Racially Motivated Experiments. (1)

Dr. Josepf Mengele, more familiarly known as the 'Angel of death,' is probably the most famous of the Nazi doctors who used the prisoners in Nazi concentration camps for medical experimentation. Mengele sought to unlock the genetic basis for a superior race and conducted goulish experiments with precision going even beyond the limits of scientific inquiry. He was fanatical about twin studies, obsessing over the differences between twins, and would make them sit together in the nude for hours while he personally examined them leaving no bady part untouched. Furthermore, drawing blood from identical twins was routine, which often left them bleeding to death. Mengele was also involved in other studies that sought to design better equipment for the Nazi soldiers, and for this purpose naked prisoners were placed in ice cold vats to determine the lowest possible temperature in which a human could survive. However, Mengele wasn't alone in his medical exploits, many German doctors made trips to Nazi concentration camps where they could use the large potential subject pool without concern for the harm of the subjects.

The Aftermath

Following World War II, leading Nazi doctors were brought to justice before the International Military Tribunal at Nuremberg. 20 doctors (unfortunately Dr. Josepf Mengele was not among these twenty. He fled Auschwitz in 1945, before the liberation of the camps by the Americans.), were charged with War Crimes and Crimes Against Humanity. The Nuremberg trial of doctors, which began in 1946, revelaed evidence of sadistic human experiments conducted at the Dachau, Auschwitz, Buchenwald and Sachsenhausen concentration camps.

The Nuremberg Code is the most important document in the history of the ethics of medical research and the first of its kind to ensure the rights of subjects. Formulated 50 years ago, in August 1947, by the American judges heading the trial of Nazi doctors accused of conducting macabre human experiments in the concentration camps. During the course of the trial the judges at Nuremberg correctly recognized that more than the Hipporatic ethics and the maxim primum non nocere, were necessary to ensure and protect the rights of human research subjects. Thus the judges defined a set of 10 research principles that were centered on the research subject rather than the physician. The judges were emphatic about the necessity and quality of the subject's consent, explicitly adding the subject' s right to withdraw from the experiment. The Nuremberg Code insists that the medical investigators alone cannot set the rules for the ethical conduct of research, even when guided by beneficience and the Hippocraric ethics. In the traditional doctor-patient relationship, the silent and dutiful patient trusted the physician to act in their best interests or atleast do no harm. However, more often than not scientific research lies outside the beneficient context of the physician-patient relationship whereby the physician's primary goal is now motivated by a scientific hypothesis and not to treat the patient. This breach of trust led the judges heading the Nuremberg trials to merge Hippocratic ethics and the protection of human rights into a single code.
                                                                                                                                                                                                   courtesy of USHMM Photo Archives

REFERENCES

(1) http://www.jlaw.com/Articles/NaziMedEx.html
(2) Shuster, E : Fifty Years Later: The Significance of the Nuremberg Code. NEJM 337
(3) "Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law No. 10", vol. 2, pp 181-182. Washington, D.C. : U.S.
    Government Printing Office, 1949.