Nuremberg Code: 75th Anniversary

Nuremberg Code: Following the end of World War II, international court proceedings were initiated in the city of Nuremberg, in Bavaria, Germany on the 20th November 1945 against German Nazi officials charged with committing crimes against humanity. Prime amongst these crimes was the genocidal attack on European Jews, also known as the holocaust.

Seventy five years ago on August 19th 1947 a Nuremberg tribunal passed judgement against leading Nazi medical officers. This was at the conclusion of a series of trials against doctors charged with the crimes of murder, medical experimentation on humans and falsifying death certificates as instructed by their employer, the German government. The judgement included the Nuremberg Code as part of the verdict that found the doctors guilty as charged. This Code articulated specific ethical guidelines for the protection of future generations from systemic abuses by doctors, health care practitioners, and medical systems.

Nuremberg code

Nazi medical professionals facing trial in Nuremberg: 1947

In her commemorative speech in Nuremberg last month Vera Sharav, holocaust survivor and human rights advocate, warned that “the holocaust was preceded by nine years of incremental restrictions of personal freedom and the suspension of legal rights, civil rights and essential human rights. The stage was set by fear mongering and hate mongering propaganda” and that “medicine was perverted from its healing mission and was weaponised”.

Although it was the atrocities committed by the Nazi regime during WWII that provided the stimulus for the Nuremberg trials and Code, we should be aware that abuses relating to medical experimentation on humans without consent or information, using coercion and deceit, were not uncommon before then. Medical abuse by governments has also occurred in Cambodia in the late 1970s and Stalin’s Russia.

In his commemorative edition booklet Ken McCarthy says “The Code was drafted in response to the horror of an entire country’s medical system being politicized and science being perverted to justify mass crimes against humanity in which physicians played a key role”.

The Code sets out ten principles to promote a just and safe system, for people and medical professionals alike, when it comes to experimental treatments on humans. Such experimentation occurs during clinical trials as part of the approval of medical products, as well as under emergency use authorisations of medical products in times of crisis.

The first Code starts with the words “The voluntary consent of the human subject is absolutely essential”, immediately followed by the provisos that the persons involved should have “legal capacity to consent” and the “free power of choice without the intervention of force, fraud, deceit, duress, overreach or other ulterior form of constraint or coercion” and that before acceptance “there should be made known to them.…the effects upon their health or person which may possibly come from their participation in the experiment”.

Nuremberg Code

Protests against mandatory injections: 2021-2022

Code two, three and four speak of the medical experiment being necessary, justifiable and of avoiding suffering and injury.

Code five states that “No experiment should be conducted where there is a priori reason to believe that death or disabling injury will occur”. Code seven stipulates that all cautionary measures should be taken to avoid such death, disability or injury.

Code six emphasises that the degree of risk taken should not exceed that of the health problem to be averted.

Code eight deals with the competence and expertise of the medical and scientific persons involved in the conduct of the experiment.

Code nine and ten stipulate the right of people to withdraw from the medical experiment and the obligation of the medical professionals to stop the use of the medical products in question if there is probable cause to believe that a continuation is likely to result in the injury, disability or death of people.

The Code has become the prototype for all medical ethical practice globally, and not just experimental. It is recognised as a universal legal standard like the norms prohibiting slavery and piracy. It is the basis for the gold standard of ‘informed consent’.

The Nuremberg Code is incorporated in the International Criminal Code. It is enforceable even if countries, institutions or individuals deny its validity. It holds doctors and other medical staff personally liable. The Code is also legally applicable in peacetime. We honour the victims of the holocaust by learning the lessons it teaches us.

This article was published in the Senior Times of the Times of Malta on the 23rd September 2022