nuremberg, & history

There’s a lot been said recently about the Nuremberg code. So what is it, and why is it popping up now?

As described in this excellent NEJM article, the Code was developed over 80 years ago in August 1947, by judges involved in the “Doctors Trial” at Nuremberg. There were a total of 13 court trials at Nuremberg: the Doctors Trial was the second of these, coming after the main trial of the major German war criminals. It “involved 23 defendants, all but 3 of whom were physicians accused of murder and torture in the conduct of medical experiments on concentration-camp inmates.” Of the 23, 16 were found guilty and 7 executed. After the trial,

The judges at Nuremberg, although they realized the importance of Hippocratic ethics and the maxim primum non nocere, recognized that more was necessary to protect human research subjects. Accordingly, the judges articulated a sophisticated set of 10 research principles centered not on the physician but on the research subject. These principles, which we know as the Nuremberg Code, included a new, comprehensive, and absolute requirement of informed consent (principle 1), and a new right of the subject to withdraw from participation in an experiment (principle 9).

More recently, informed consent also forms the basis of the International Ethical Guidelines for Biomedical Research Involving Human Subjects and is a foundation of the Helsinki Declaration of 1964, with its focus on the obligations of physicians and researchers to those participating in their research. And both the Code & the Declaration require peer review of proposed research protocols by a committee that includes a community representative, before any research project can begin.

The key word here is research. This means that the Code, & the Helsinki Declaration, are relevant to the randomised controlled trials that were designed to assess the various covid-19 vaccine candidates. The RCT protocol for the Pfizer vaccine is freely available and the same is true for other candidate vaccines. Phases I, II & III of the trials involved human volunteers, who gave informed consent, could withdraw from the study at any point, and were participants in the research experiments. As Orac has said,

From a scientific definition, these vaccines had been found to be safe and effective in large randomized clinical trials involving tens of thousands of people before the EUA had been issued.

He goes on to explain that

Because the vaccines at the time had been approved by the FDA for use under an “emergency use authorization” (EUA), by law they had to be listed as “investigational.”

They stopped being experimental when the FDA granted full approval.

So, claims that the vaccine rollout is in breach of the Nuremberg Code are poorly informed and incorrect. (See also this article in The Conversation.)


Coda: Yes, I get it; those making the claim are also trying to imply the people in charge of the rollout are N-zis. So let’s look at that one too.

Thus those who claim that health workers, politicians, public servants, & all the others working to stem the flow of Delta around the motu should be subjected to “Nuremberg 2”, could benefit from a history lesson. Because people making those claims also oppose vaccination, are increasingly describing themselves as “purebloods¹,” and describe some of our duly-elected leaders as N-zis, they could also take a good look in the mirror and consider the company they keep. Why? Because the 3rd Reich’s leaders promoted “racial purity” and “blood purity” (see also here), and – rather than promoting vaccinations, relaxed existing requirements in that area and forbade the use of vaccines for those deemed undesirable. Public health measures are the polar opposite of the atrocities carried out by that regime.

¹ oh, and if they’re channeling Harry Potter, they’re on the wrong side there too. Voldemort’s “death eater” adherents were very definitely not the good guys.

EDIT: this is discussed in much more detail by David Gorski over on Science-Based Medicine.

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