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Towards a model of critical ethics to inform the research process in postgraduate research

 

Author - Aidan Kenny


 


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The significance of the Nuremberg Code

The Nuremberg Code, developed after the Second World War, dealt particularly with research on, or with, human subjects. A key tenet of that code is that the voluntary consent of the human subject in any research is absolutely essential. A relevant extract from the Nuremberg Code with regards to voluntary consent is as follows.

(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, 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.

(Nuremberg Code 1949)

During the Nuremberg War Crime Trials legal representatives acting on behalf of the Allied Forces sought to expose the full extent of the systematic acts of cruelty, brutality, torture, enslavement, starvation, and mass murder perpetrated by members and associates of the Nazi regime. Within the evidence that emerged during the trials and not withstanding the horror of the ‘Final Solution’,[1] the strategic plan was to efficiently and effectively annihilate what the Nazis viewed as lesser races or sub humans, specifically Jews, Gypsies and other minority groupings then living in Germany and the countries it controlled. Details surfaced which chronicled numerous research programmes developed by scientists, physicians and supported by politicians, industrialists and the military. This evidence led to a separate trial in 1947 with 23 leading scientists and physicians being charged with war crimes. The charges were stark and horrific the trial records[2] listed the experiments as ‘crimes committed in the guise of scientific research’, which included ‘high-altitude experiments; freezing experiments; malaria experiments; mustard gas experiments; Ravensbrueck experiments concerning sulfanilamide and other drugs, bone, muscle, and nerve regeneration and bone transplantation; seawater experiments; epidemic jaundice; sterilization experiments; typhus and related experiments; poison experiments; incendiary bomb experiments; and Jewish skeleton collection’, ‘crimes of mass extermination’, ‘murder of Polish nationals’ and ‘euthanasia’. It was suggested by some of the accused that the warrant for these experimentations and research was the pursuit of scientific knowledge, the advancement of medical practice, which would assist understanding and help in the development of procedures and cures, and would benefit humanity. As a result of the unearthing of this evidence which depicts the vile abuses perpetrated by the Nazi regime, the deplorable treatment of human subjects by scientists and physicians in their research experiments, prominent members of the Allied Forces proposed the Nuremberg Code (1949) in order to provide a mechanism that captured the learning from the trials which gave a clear international set of principles to inform future research and experimentation on human subjects.

The guiding principles of the Nuremberg Code – namely voluntary consent, informed consent, right to withdraw, avoidance of harm and suffering, duty and responsibility of the researcher to the participant, the expertise and qualifications of the researcher – are reflected in contemporary codes of professional practice and ethical guidelines. Other organisations that emerged after the Second World War which have had international influence and published substantial material on the appropriate treatment of humans are The United Nations Organisation Charter, which was formally signed by 50 nations in 1945; the Universal Declaration of Human Rights[3] approved by the UN Assembly in 1948; The Council of Europe, founded in 1949 under the London Treaty, with ten original members (including Ireland) which published the Convention for Human Rights and Fundamental Freedoms[4] in 1950.

These important international documents have served as the primary background texts utilised by various governments, policy-makers, funders and professional associations to inform their codes of practice and ethical guidelines in relation to research on human subjects. For example the World Medical Association (WMA) directly incorporated the 10 principles from the Nuremberg Code into their Helsinki Declaration[5] on Human Experimentation in 1964; the declaration has since been revised on five occasions, with the latest in 2000. The most recent area of ethical concern in the medical and bio-medical fields is genetics and research into cloning, stem cell, eugenics, pharmacogenetics, DNA data, and the unravelling of the human genome. International organisations, professional bodies, human rights organisations, religious organisations, industry and other interested parties are lobbying and exerting pressure on governments to pass laws in order to regulate the types of research that can occur in this emerging area.[6]


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