75 years of Nuremberg

The Nuremberg Code was created in 1947 in Nuremberg, Germany as a result of the court trials of nazi doctors accused of conducting non-consensual, deadly and inhumane experiments on prisoners in concentration camps.  At the end of the trial, 16 people were found guilty and the findings evolved into a Code that protects human subjects in research, and which has shaped international human rights law and medical ethics ever since. The judge’s decision highlighted 10 principles that should govern medical research:

  1. The voluntary consent of the human subject is absolutely essential.
  2. The results of any experiments should be for the greater good of society.
  3. Human experiment should be based on previous results of animal experimentation.
  4. The experiment should be conducted so as to avoid all unnecessary physical and mental suffering and injury.
  5. No experiment should be conducted where it is believed to cause death, disability, or where injury will occur.
  6. The risk should never exceed the benefits of the experiment.
  7. Adequate facilities should be used to protect subjects against even remote possibilities of injury, disability, or death.
  8. The experiment should be conducted only by a scientifically qualified person.
  9. The human subject should be able to terminate the experiment at any time.
  10. The scientist in charge must be prepared to terminate the experiment at any stage, if continuing is likely to result in injury, disability, or death to the human subject.

The atrocities that the nazis committed against Jewish people are unthinkable, and the Code stands as a prohibition against non-consensual human medical experimentation. 

In North America, many people of colour are still distrusting of new medical experiments because of past government abuses. The United States which was one of the countries that supported the Nuremberg Trials, later strayed from the Code. In fact, the notion prevailed for a long time that certain races of people and the physically and mentally challenged, could be used for medical experiment.

The children in the Willowbrook Mental Hospital (1955-1970) were enrolled in a hepatitis experiment. Doctors felt that they met the terms of the Nuremberg Code because the parents consented on behalf of the children. The problem is that many parents were enticed through better treatment for their kids, and also that they were threatened that their child wouldn’t receive future treatment if they didn’t participate in the experiment. Many parents weren’t fully informed, and they were unaware that their children were being injected with hepatitis.

The Tuskegee experiment on African-American males lasted from 1930s to 1970s. Free clinics were set up for syphilis patients, with Whites being given treatment while African-Americans were unknowingly withheld treatment and given placebos. Patients were never told that they had the fatal disease of syphilis. In addition, if the patients left the clinic and found another doctor, the US public health told all other doctors not to treat these patients because they were an active control group to be studied. If a doctor treated them their license would be revoked by the US public health department. In addition, 40 wives contracted syphilis and 19 children were born of these men in the study. The families won a suit of approximately 10 million against the US government for this unethical experiment on the African-American community.

Right here in Canada First Nations were experimented on by the Department of Pensions and National Health (now Health Canada) between 1940 and 1950. The human experiments included 1,300 Indigenous people across Canada, approximately 1,000 of whom were children. Even when children were visibly seen as being malnourished and iron and other supplements were suggested, court documents show that the researchers went to great length to keep the children in a state of suffering to preserve the results of a control group.

The principles emanating from the Nuremberg trials prevail today. The human experiment on African-American men, the experiments on mentally challenged children,  and also the Canadian nutrition experiment on Indigenous people, all of which lasted for decades, remind us that even in modern times the tenets of informed consent and voluntary participation in scientific experiments, can be easily undermined by even our modern governments.

Starting with the horrors of Nazi Germany and recognizing human experiments conducted by the US and Canada, the lawsuits that emerged decades later are a stark reminder to governmental officials and scientists that there will always be a reckoning.

Lest we forget those who suffered under these unconscionable experiments by our failure to defend modern day abuses of any human experiment based on coercion: including attempts to entice participants, failure to give sufficient information to make an informed decision to participate, deliberately presenting false information on the treatment outcome to entice enrolment in the clinical trial, threatening punishment through ultimatums that will interfere with ones normal livelihood or mobility, or any other of the 10 principles outlined in the Nuremberg Code.

The wheels of justice may turn slowly, and may often even seem elusive; but they will always turn in the direction that eventually exposes truth. And, when that happens – there will certainly be a reckoning.

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