Medicine, truly revealing its fertile wings over humanity relatively recently - in the nineteenth and twentieth centuries, has made it possible to significantly improve people's lives. Such terrible diseases as plague, typhoid, and cholera have disappeared or sharply decreased. Significantly increased life expectancy.
However, man is true to himself. The development of medicine quickly began to be used for the most cruel experiments, to look for ways of massacres. This was especially marked by the Nazi regime during the Second World War.
And then certain actions began to be taken to limit the use of medicine for hostile purposes and to punish initiators, as well as performers. This was especially evident in the mid-twentieth century, after the defeat of Nazi Germany and militaristic Japan. The atrocities were so great that led to the advent of the Nuremberg Code.
Trial
The Nuremberg medical trial took place shortly after the war, from December 9, 1946 to August 20, 1947, and was the first in a list of a dozen others. Officially, it was referred to as the “USA against Karl Brandt” and was held in the eastern building of the Nuremberg Palace of Justice.
In total, twenty doctors of concentration camps of fascist Germany, as well as one lawyer and two representatives of the state apparatus, were put on trial in these legal cases. All of them were charged with medical crimes committed with particular cruelty.
The main charges were forced medical experiments, the destruction of prisoners for the private collection of A. Hirt or forced euthanasia, forced sterilization.
Of the 23 people brought to trial, 7 were sentenced to immediate death, 5 were sentenced to life imprisonment, 4 were sentenced to separate prison terms (from 10 to 20 years), and 7 were acquitted.
In the course of this, the content of the Nuremberg Code was crystallized. The process in this regard was a method of honing the basic principles of a document.
Accusations
All those brought to trial received four indictments:
- commission of war crimes and aggressive crimes against humanity ;
- taking part in militaristic crimes;
- participation in activities deemed a crime against humanity;
- participation in officially recognized criminal organizations.
On the proposal of the official defense, the court decided to disassemble the first item from the list of charges only in the context of the rest. On November 5, 1946, each of the convicts received the content of the prosecution. However, prior to the trial, none of the accused pleaded guilty.
The content of the charges later went into the provisions of the Nuremberg Code. Bioethics was formed in many respects in this direction thanks to the aforementioned theses.
Sentence
The verdict was announced (no longer subject to any appeal) on August 20, 1947. Specifically, the prisoners received the following charges: conducting dangerous experiments on people without their consent, actions that were initially harmful to their health, including death:
- medical experiments on twins;
- experiments forbidden even in those years with cooling the human body and freezing;
- experiments with massive and single infection of healthy people with malaria;
- inhuman experiments with mustard gas;
- medical illegal experiments with sulfanilamide;
- painful experiments with sea water;
- illegal experiments to sterilize people;
- deadly experiments with different poisons in order to study the threshold of pain and determine the effective portion for the death of different people.
The focus and level showed the role of the Nuremberg Codex in the further development of medicine.
Nuremberg Medical Code
In Nuremberg in the postwar years, not only was the conviction of those responsible for the maliciously negative use of medicine. After the end of the Nuremberg trial of fascist doctors in August 1947, the Nuremberg Tribunal adopted and published an important document regulating ethical codes in medicine. The Nuremberg Code is the first and basic international document regulating the principles of organizing medical experiments on humans, clarifying the ethical rules for scientists conducting medical experiments. This document is still one of the leading ones. The main principles highlighted by the Nuremberg Tribunal in the content of the Nuremberg Code were that medicine can work only for a person, and if experiments conducted on humans did harm him, they were carried out only with the voluntary consent of a patient who was aware of the dangers of the move and the results of experience on him, the consequences for his personal health and the health of others. Such experiments are carried out only for the sake of improving the situation of all mankind.
Codex human rights
10 principles of the Nuremberg Code emphasized the provisions on voluntariness, democracy and harm to human health at every stage of the medical experiment. An absolutely necessary condition for carrying out this medical process on a person is the voluntary consent of the latter.
This notes that a person who takes part in an experiment as a test subject must:
- have the formal right to give such consent;
- have the right to make their own choice and not feel psychological or physical pressure, any methods of violence, deception, fraud, cunning or other hidden forms of coercion;
- possess the information that is enough to understand the essence of the experiment and decide what to do.
The last paragraph means that the patient, before giving consent to his participation in a particular experiment, should be acquainted with information on the content, type and duration of this process; about methods and ways of its implementation; about all the possible problems and risks associated with the course of the experiment, and, finally, the possible outcomes for the physical or psychological health of the patient, which may arise as a result of his participation in the experiment.
Guilt
The provisions on liability in experiments firmly laid down the content of the Nuremberg Code. Bioethics also notes that during the medical process there must be a person who is responsible for the safety of the patient, who is a direct participant in the experiment. As a rule, this is an employee who initiates, leads or occupies a leading position among physicians - authors, scientists or researchers conducting this experiment. It is also an individual duty and responsibility of any official who cannot be transferred to another person under any pretext.
Mandatory conditions
There are a number of provisions, including 10 principles of the Nuremberg Code, which physicians must observe at least for ethical reasons:
- no medical experience can be realized when there is an absolute possibility of death or development of a disease, pathology, trauma causing a patient’s disability; outside the scope of the ban, perhaps there may be experiments in which the research physicians themselves will be tested in dangerous experiments;
- the level of risk associated with the implementation of the experiment should in no way be more important than the humanitarian significance of the issue that this particular experiment is aimed at solving;
- the experience should be preceded by proper training, and its implementation should be carried out using special equipment necessary to protect the patient from even a slight possibility of disability or even death;
- an experiment must be carried out only by specialists with the appropriate qualifications; at all levels of the experiment, the responsible persons employed in it need great attention and high professionalism;
- during the experiment, the patient should have the potential to stop the process when, in his opinion, the physical or nervous state of the body is dangerous to continue the experiment.
Other
The Nuremberg Code noted that during the implementation of the experiment, all unnecessary physical and nervous torment, damage to the human body should be ignored as much as possible.
An experiment should give modern society positive results that cannot be achieved by other actions of science and practice; experience should not be allowed to drift, to give the character of a random, optional event.
Scientific experience should be based on data obtained in laboratory conditions on experimental animals, information gleaned from the history of the development of a particular disease or other scientific materials. Its process should be implemented in such a way that possible outcomes justify the very fact of the realization of experience on a person.
Contemporary issues
The problems of medical experiments raised in the Nuremberg Code are still relevant. A number of medical researchers, out of selfish motives or because of misunderstanding, continue to try, as before, to remove the differences between the physician (treating the patient) and the experimental scientist (working to confirm the hypothesis). It turns out that the difference between healing and experience, the patient and the subject of research for many physicians does not exist. However, these differences are fundamental from the standpoint of preserving human rights, since if scientists are engaged in dangerous experiences, and presented as a treatment for the patient, the rights of the latter are violated.
The Nuremberg Code, the current human rights law, and modern medical ethics are clearly connected. Doctors need to proclaim, observe and protect the general code of medical ethics, based on the preservation of human rights for the development of all mankind, since even doctors who have nothing to do with Nazism are not protected from political, economic and other organizations that can apply their activities to their selfish interests.
No wonder therefore, attempts have been made and are being made to expand the content of the Nuremberg Code. This document has become a kind of collection of ethical rules for the implementation of medical experiments with the voluntary participation of one or more people as experimental persons. Including research was envisaged with biological tissues or with information by which you can determine the specific person from whom they were obtained. The contents of the declaration are determined to be used as a single document, and any separate paragraph or thesis should not be used without taking into account the rest of the above provisions.
Although the document was addressed primarily to physicians, it was assumed that the rest of the members of medical organizations would be true to such principles. After all, the duty of a doctor is to help and protect the health of people.
Ethical implications
Recent events show the ethical significance of documents such as the Nuremberg Code and the Helsinki Declaration. Bioethics and the history of its violations have shown that physicians with authority and certain privileges may not remember their most important purpose and ethical rules, apply professional knowledge and skills specifically for killing, bullying and eliminating people under the pretext of developing medical science.
German doctors of the German era A. Hitler were not able to maintain prudence and were tempted to see the whole state as a patient and eliminate entire nations to “preserve the health of the nation”. The medicine of those years was characterized by antihuman activity in relation to certain socio-ethnic groups; various social and current political problems boiled down to medical aspects, doctors were taught to fulfill the necessary political tasks of the state, developing fear among an objectionable population, that is, forcing them to cooperate with the government; went bureaucratization and neglect of the problems of ethics and the rights of the population.
USA
Examples of the use of medicine in the interests of a particular state at the present stage, ignoring the content of the Nuremberg Code and the Helsinki Declaration are experiments to study the effect of radiation on people during the Cold War in the United States. In addition, studies were conducted on new medications for military personnel (without their knowledge) during the Gulf War, the involvement of doctors to carry out the death sentences for prisoners by injecting lethal doses of poisons, psychiatrists to suppress prisoners. In the USA, the knowledge of doctors was often used for militaristic non-medical purposes, the state authorized the use of euthanasia by doctors and so on.
Unfortunately, ethical rules do not firmly promise that the baggage of medical knowledge and skills will not be applied for inhumane purposes by states, militaristic institutions and corporations.
Modern furnishings
The historical significance of the Nuremberg Code has yet to be recognized, but even now its great importance is understood. Doctors need support so that they can work within the framework of the principles of medical ethics and official human rights, as well as punish those who violate these standards. We need a common international code and an international jurisdiction examining facts of violation of existing human rights, which was already an example of the Nuremberg trial. Doctors can also be involved in the design and implementation of such projects based on the Nuremberg Code and other laws. Nowadays, there are already organizations of doctors opposing human rights violations on a planetary scale, but in the most advanced form this should be done by an international organization of doctors and lawyers.
Through it, relevant specialists from all over the world could transmit to the press and society facts of human rights violations by doctors, expose violators to retaliation in the form of “professional isolation”, without giving them a license for professional activity or the right to improve their medical qualifications, work in professional organizations and publish their works. Lawyers will protect those doctors who do not want to use their own professional skills for other purposes, and forward their interests to various authorities. Lawyers will and will have to respect the laws that advocate for the professional independence of a physician in compliance with medical ethics and existing human rights.
Summary
Perhaps, always, when military operations, politics or a rigid ideology force one to look at a person only as an object, he loses his human essence. The significance of the Nuremberg Code is very, very great. The trial of doctors and the documents drawn up as a result of it gave the feeling that medical workers have a great responsibility to modern society in the field of protecting human rights.
The principles enshrined in the Nuremberg Code and the Helsinki Declaration (the process has become a precedent for international law) have repeatedly been the basis for many international and state legislative documents in the field of conducting medical experiments on humans.
The Constitution of the Russian Federation immediately in several articles refers to the conditions, nature and results of medical experiments. The main thread in this document is the idea of freedom of choice, non-violence and humanism.