The Nuremberg Code

In the years after the Second World War, various efforts were made to rebuild war-torn countries; to repair the damage done; and to bring to justice those responsible for the various atrocities committed in Nazi Germany. One of the most notorious criminals of the concentration camps was Dr Josef Mengele, known more familiarly as the 'Angel of Death' to those who fell foul of his sadistic experimentation. Along with other Nazi doctors, he used his knowledge of medicine to perform various research, while completely ignoring human rights and basic medical ethics.

Some of these doctors were eventually brought to justice at the International Military Tribunal at Nuremberg in 1946. However, the judges at the trial realised that the Hippocratic Oath alone was not enough to properly protect human research subjects, and in August 1947 they drew up a code of ten points to protect the safety and rights of those involved in such experimentation. Thus the Nuremberg Code was formed, and is part of international legislation due to a UN resolution in December 1946 which made the Nuremberg trials official law.

The Ten Points

The ten points of the Nuremberg Code may seem obvious as they are rights which are taken quite for granted nowadays. However, up until 1947 there were no foundations or codes of this sort whatsoever, and after the Holocaust the nations realised how dangerous a lack of such rules was. Below is a summary of and commentary on each of the ten points - the exact details can be found at the above link.

1 - Voluntary Informed Consent

This is one of the most important points of the code - the subject must know what they are letting themselves in for, and must take part of their own accord. The victims of Dr Mengele had no choice whatsoever as to whether they took part in his experiments, and obviously would not have consented if given the chance.

2 - Fruitful Results for the Good of Society

Experimentation must yield useful results which aid society instead of just benefiting individuals. Many of the Nazi doctors' 'experiments' were simply based on their desire to learn, no matter what the human cost.

3 - Prior Experimentation on Animals and Prior Knowledge of the Problem

The experiments should not be performed on humans without tests to determine their safety on animals¹, and the researchers should determine from prior knowledge the likely effects of the experiment.

4 - Avoidance of Unnecessary Physical or Mental Injury

The experiments should be designed to protect the human subject as much as possible, and there should be no degree of apathy towards the subject. It is unacceptable to run an experiment where the subject will come to pointless harm..

5 - Banning of Known Lethal or Disabling Procedures

Experiments should not be performed if there is an a priori² reason to believe that death or disabling injury will occur. The exception to this rule is if the physicians performing the experiment also serve as subjects.

6 - Degree of Risk Should Not Exceed Benefits

The risks taken by the human subject should not exceed the humanitarian importance of the problem being solved. This rule quantifies the other rules on risks and benefits by defining acceptable and unacceptable risks.

7 - Proper Preparation and Proper Facilities to Prevent Injury or Death

This rule is here to ensure that seemingly safe experiments are performed safely, without any degree of apathy or complacency, by enforcing strict measures.

8 - Performance of Experiments Only By Scientifically Qualified Persons

This rule prevents dangerous experimentation by those who are not able to perform the procedures properly. The Nazi doctors were capable physicians to a certain extent, but were either not skilled or apathetic enough³ to allow patients to come to harm. In fact it was a mixture of both factors.

9 - Participants May Freely End the Experimentation

The volunteers⁴ may freely leave the experiment at any time if they feel physically or mentally unable to continue. Combined with rule 1, this allows the subjects to choose what happens to them, and allows them to protect their rights.

10 - The Experiment Must Stop If It Proves Too Dangerous

If, despite every care, the experiment starts to show an unacceptable level of risks, ie it starts to result in injuries, disabilities or deaths, then the physician should end the study immediately.

In Reality...

Although its creation was an important victory for human rights, the rules of the Nuremberg Code often require the use of judgement and moral values if they are to be effective. One person's idea of acceptable levels of risk differs from another's, and there are always the extreme cases such as Dr Mengele who believe that their research is more important than anything - even a human life.

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¹ Although some experiments are obviously so dangerous that they should not be performed at all.
² Known or deducible from known facts.
³ See rule seven above.
⁴ All participants should be volunteers according to rule one.