Nuremberg Code

BMJ_No_7070_Volume_313_The_Nuremberg_Code

https://media.tghn.org/medialibrary/2011/04/BMJ_No_7070_Volume_313_The_Nuremberg_Code.pdf

The Nuremberg Code (1947)

Permissible Medical Experiments

The great weight of the evidence before us to effect that certain types of medical

experiments on human beings, when kept within reasonably well-defined bounds,

conform to the ethics of the medical profession generally. The protagonists of the

practice of human experimentation justify their views on the basis that such

experiments yield results for the good of society that are unprocurable by other

methods or means of study. All agree, however, that certain basic principles must

be observed in order to satisfy moral, ethical and legal concepts:

1. The voluntary consent of the human subject is absolutely essential. This

means that the person involved should have legal capacity to give consent;

should be so situated as to be able to exercise free power of choice, without

the intervention of any element of force, fraud, deceit, duress, overreaching,

or other ulterior form of constraint or coercion; and should have sufficient

knowledge and comprehension of the elements of the subject matter involved

as to enable him to make an understanding and enlightened decision. This

latter element requires that before the acceptance of an affirmative decision

by the experimental subject there should be made known to him the nature,

duration, and purpose of the experiment; the method and means by which it is

to be conducted; all inconveniences and hazards reasonably to be expected;

and the effects upon his health or person which may possibly come from his

participation in the experiment.

The duty and responsibility for ascertaining the quality of the consent rests

upon each individual who initiates, directs, or engages in the experiment. It isa personal duty and responsibility which may not be delegated to another with

impunity.

2. The experiment should be such as to yield fruitful results for the good of

society, unprocurable by other methods or means of study, and not random

and unnecessary in nature.

3. The experiment should be so designed and based on the results of animal

experimentation and a knowledge of the natural history of the disease or other

problem under study that the anticipated results justify the performance of the

experiment.

4. The experiment should be so conducted as to avoid all unnecessary physical

and mental suffering and injury.

5. No experiment should be conducted where there is an a priori reason to

believe that death or disabling injury will occur; except, perhaps, in those

experiments where the experimental physicians also serve as subjects.

6. The degree of risk to be taken should never exceed that determined by the

humanitarian importance of the problem to be solved by the experiment.

7. Proper preparations should be made and adequate facilities provided to

protect the experimental subject against even remote possibilities of injury,

disability or death.

8. The experiment should be conducted only by scientifically qualified persons.

The highest degree of skill and care should be required through all stages of

the experiment of those who conduct or engage in the experiment.

9. During the course of the experiment the human subject should be at liberty to

bring the experiment to an end if he has reached the physical or mental state

where continuation of the experiment seems to him to be impossible.

10. During the course of the experiment the scientist in charge must be prepared

to terminate the experiment at any stage, if he has probable cause to believe,

in the exercise of the good faith, superior skill and careful judgment required

of him, that a continuation of the experiment is likely to result in injury,

disability, or death to the experimental subject.

For more information see Nuremberg Doctor's Trial, BMJ 1996;313(7070):1445-75.