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The Nuremberg Code and medical research.

On December 4th and 5th, 1989, the Law, Medicine and Ethics Program of Boston University School of Medicine and Public Health sponsored a symposium entitled "The Nazi Doctors and the Nuremberg Code: Relevance for Modern Medical Research." The goal of the conference was to explore the nature, scope, and historical underpinnings of Nazi medical "experiments," to examine the origins of the Nuremberg Code, and to understand the role of the Code and its principles in modem medical research.

In the opening session historical perspective was provided by West German physician and medical historian Christian Pross and author Robert Proctor. Both highlighted the extent of physician involvement in Nazi experimentation, and Proctor, author of Racial Hygiene, argued that far from being passive pawns, physicians were instrumental in formulating and took the lead in carrying out the Nazi racial hygiene program. Herman Wigodsky, professor of pathology and former director of U.S. Air Force research, discussed the role of the U.S. government in collaborating with Nazi scientists after the war, and the role of physician-scientists working for the government.

In a session on the Nuremberg Code, conference co-director Michael Grodin focused on the doctors' trial and traced the origins of the Code to the prosecution's chief medical witnesses, Dr. Andrew Ivy and Dr. Leo Alexander. Based in the Hippocratic tradition, the Code draws on several previous codes of research ethics, including pre-war German regulations that were as strict and comprehensive as the post-war Nuremberg Code. Arthur Caplan, director of the Center for Biomedical Ethics at the University of Minnesota, addressed the

relevance of codes of medical ethics in modem medical practice and the extent to which informed consent has come to protect researchers rather than subjects. And Elie Wiesel, Boston University professor, Nobel Laureate, Holocaust survivor, and Nuremberg witness, cited the emphasis on abstraction, and dehumanization as central to understanding how educated physicians from prestigious universities could have participated in the Holocaust.

In sessions on the legal dimensions of the Code, Yale professor Jay Katz focused on the centrality of the doctrine of informed consent to the Code, and its relationship to the Declaration of Helsinki and present Health and Human Services Regulations, while Robert Drinan, S.J. (former U.S. Congressman and currently professor of law at Georgetown University), put human experimentation in the context of broader international human rights violations and called for a permanent international court or tribunal to deal with crimes against humanity, such as torture and atrocities, on an ongoing basis.

George J. Annas, co-director of the conference, reviewed the use to which the Nuremberg Code has been put in U.S. courts since 1947, noting that it has rarely been cited and has never been used to award money damages to anyone injured in a human experiment in the U.S., or to provide the basis of criminal liability. Professor Leonard Glantz reviewed state statutes and federal regulations on human experimentation, noting especially the various conflicting definitions of "human experimentation and research" that are used, and the fact that in the U.S. fetuses are the most protected subject population, and children the least protected.

The final session focused on modern medical research ethics. Ruth Macklin, professor of bioethics at Albert Einstein College of Medicine in New York, addressed the question of whether ethics is relative to time, culture, and place, rejecting cultural relativism and making strong claims for a set of universal principles. Marcia Angell, executive editor of the New England Journal of Medicine, addressed the responsibility of journals and editorial reviewers, and argued that medical journals should not publish research data obtained in an unethical manner.

In concluding remarks and discussions participants concurred on the need for more scholarly research on the history and present day implications of the Nazi medical research and the Nuremberg Code. There was a call for gathering all written documents, briefs, transcripts, and exhibits from the Nuremberg trials in a central repository (they are now scattered throughout Europe and the U.S.). The ultimate legacy of this conference, however, may be the call by some participants for the development and promulgation of an International Covenant on Human Rights in Human Experimentation.Michael A. Grodin, Law Medicine and Ethics Program, Boston University.
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Title Annotation:symposium on Nazi medical atrocities and medical research
Author:Grodin, Michael A.
Publication:The Hastings Center Report
Date:May 1, 1990
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