DIRECTIVES FOR HUMAN EXPERIMENTATION
The Nuremberg Military Tribunal's decision in the case of
the United States v Karl Brandt et al. includes what is now called the
Nuremberg Code, a ten point statement delimiting permissible medical
experimentation on human subjects. According to this statement, humane
experimentation is justified only if its results benefit society and it is
carried out in accord with basic principles that "satisfy moral, ethical,
and legal concepts." To some extent the Nuremberg Code has been superseded by the Declaration of
Helsinki as a guide for human experimentation.
--"Permissible Medical
Experiments." Trials of War Criminals before the Nuremberg Military Tribunals under Control
Council Law No. 10.
Nuremberg October 1946 - April 1949, Washington. U.S. Government Printing Office (n.d.),
vol. 2., pp. 181-182.
- 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 situated as to be
able to exercise free power of choice, without the intervention of any
element of force, fraud, deceit, duress, over-reaching, 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 is a 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 will
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 by him that a continuation of the experiment is likely
to result in injury, disability, or death to the experimental subject.
