The Nuremberg Code: The Tuskegee Experiment

The Nuremberg code refers to a set of guiding research ethic principles specific to human experimentation. This code arose from the Nuremberg trials at the end of World War II which involved 23 German physicians and adminstrators who were arraigned for their participation in crimes against humanity. These people had allegedly carried out medical experiments leading to debilitating and fatal results in the war concentration camps on numerous people without voluntary consent. For this reason, the origin of the Nuremberg code can be attributed to the Nazi atrocities carried out in the second World War because it raised awareness about the non-existence of international standards for conducting research with human participants. Ultimately, the
establishment of the Nuremberg code in 1948 required voluntary consent of human participants as absolutely essential and stated that the benefits of the proposed human research must outweigh the potential risks. The Belmont Report has its origin in the Tuskegee Syphilis Study because of the controversy the study generated.
In 1932, the United States Public Health Service conducted a study of Syphilis in African Americans to investigate the progression of the disease in the absence of antibiotic treatment which led to a number of participants dying due to comlications arising from the disease or the disease itself. The Tuskegee study was named after an African American college in Alabama and African Americans were recruited through the duration of the study which lasted for forty years. The main controversy about this study stemmed from the fact that despite the availability of treatments for the disease while the study was being carried out, the researchers chose to deny participants the treatments in order to achieve their desired results. The nature of this research eventually became public in the 1960s leading to public outcry against the unjust treatment of participants as well as a loss of trust in the medical community by African Americans who felt all other related programs were being unjustly manipulated by the researchers. Therefore, the Belmont report which was a response to the public outcry regarding the Tuskegee study outlined three basic ethical principles which was designed to be the basis for all future research conducted on human
subjects. Research in certain aspects of science and humanities depends on the use of human volunteers therefore the involvement of humans is quite essential to research discoveries. However, there has to be limitations regarding the extent to which human subjects can be used for experiments to prevent the events that led to the establishment of the Nuremberg Code and the Belmont report. Since the aforementioned are the guiding principles for conducting human research, the need thus arises to discuss ethic within human research. The Belmont report categorizes ethics within human research into three categories; boundaries between practice and research, basic ethical principles and applications. The report starts by creating a distinction between standard accepted practice and research as a means of cartegorizing activities that require ethical conduct of human research. The report refers to practice as interventions designed specifically for the enhancement of the wellbeing of an individual with an expectation of success. The report then refers to research as an activity which utilizes protocol and is carried out in order to test a hypothesis that would lead to a conclusion which can then be developed into general knowledge. Therefore the Belmonr report states that any proposed research should be reviewed in order to protect human participants and maintain ethics.
In regards to basic ethical principles, the Belmont report specifically outlines the following principles as absolute requirements for human research; respect for persons, beneficence and justice. Respect for persons involves the recognition of autonomy and dignity of individuals while also making special provision for those with diminished autonomy. This is interpreted to mean that the human participants must be viewed as an individual capable of making personal decisions as well as acting on those decisions. Furthermore, in the absence of the ability to make such decisions, the individual must be protected from persuasion from others that may lead to activities that would be potentially harmful to the participants. These consdierations must be made while comparing the risk of harm and the potential benefits of the research so the human participants who participates in research does so voluntarily and with accurate information about the research goals. The second principle which is beneficence requires that the human participants should be protected by maximizing potential benefits and minimizing risks associated with the research. This is an obligation expected of the researcher to the participant to ensure that deliberate injury to one does not occur even if it serves to benefit others. The final principle is justice and it requires that both risks and benefits of the research be equally distributed amongst human participants with regards to fair selection among the society for research purposes. Justice ensures that participants are not being unduly selected from a specific societal group for ulterior purposes rather participants are chosen fairly.
In order for these principles to be fairly applied, the following need to occur; informed consent of participants wherein sufficient, comprehensible information is given to participants after which they can voluntarily decide to participate or not in the research study.
Also, the risks and benefits of the study have to be carefully reviewed by the researcher, a review committee as well as the human participants to ensure justice in the research. Finally, in terms of subject selection, participants should not be selected in order to favor one group or put another at a disadvantage. Therefore the research has to be reviewed to eliminate selection bias by the researchers in order for the research to be carried out in a justifiable manner. This responsibility also falls on the Institutional review boards to ensure that unjust social patterns do not occur within the groups being
studied.
The Nuremberg code is very similar to the Belmont report in all its entirety. The code also includes the requirements that all research on human subjects be conducted by scientifically qualified persons, that the human subject should be able to end the research at his own free will and that the scientist must be willing to end the experiment at any stage if he believes that further experimentation will have harmful consequences on the participant. Personally, I believe the question of human research is a gray area with no specific right or wrong anaswer in regards to its ethicality. Human research does have its benefits as can be seen multiple cases where certain hospital patients (usually in terminal conditions) had been placed on certain trials yielding results which were then utilized for the common good of the society. I believe human research conducted with the guiding principles outlined by the established ethical rules is ethical and beneficial to humans. I am of this school of thought because humans and animals as well as other alternatives have various physiological and psychological systems so the results based on a human alternative may not directly have the same impact on a human. Of course scientific advances have come a long way by applying research information obtained from animal research to humans but ultimately, the best and most accurate results would occur when studies are conducted and applied in the same contexts. I believe the Belmont report and the Nuremberg code provides enough specific guidelines which when utilized would lead to ethical human research which is acceptable.