From the Nuremberg “Doctors Trial” to the “Nuremberg Code”

At the close of the Nuremberg Medical Trial (NMT) on 19 August 1947, the judges pronounced guidelines on permissible clinical experiments. From around 1963 these guidelines were called the “Nuremberg Code”, thereby investing them with status as a fundamental document on research procedure. Their status as part of a judgement at an international court set a precedent in judging landmark cases of murderous and maiming conduct arising from coercive research. The aim of this paper is to correct some misconceptions concerning the origins and implications of these guidelines. The first misconception is that the Guidelines/Code arose solely from courtroom proceedings. This overlooks an agenda which had existed since the liberation of concentration camps to secure a set of regulations to protect research subjects. In short, the victim had agency by protesting against, resisting and sabotaging the coerced experiments, and when it came to being witnesses at the NMT, a reflective voice. Victims of research and liberated prisoner doctors made a profound impression on Allied scientific intelligence officers, who then laid the knowledge-base for the NMT. Secondly, although the judges stressed the autonomy of the research subject and the obligation to inform about potential risks, the key term “informed consent” did not appear in the guidelines of 1947. Thirdly, it is a misapprehension that the principles promulgated by the judges received neither publicity nor recognition. The case against the Vienna internist Wilhelm Beiglböck illustrates salient aspects

The dangers of white supremacy: Nazi sterilization and its mixed-race adolescent victims

Mixed-race African German and Vietnamese German children were born around 1921, when troops drawn from the French colonial empire occupied the Rhineland. These children were forcibly sterilized in1937. Racial anthropologists had denounced them as “Rhineland Bastards,” collected details on them, and persuaded the Nazi public health authorities to sterilize 385 of them. One of the adolescents later gave public interviews about his experiences. Apart from Hans Hauck, very few are known by name, and little is known about how their sterilization affected their lives. None of the 385 received compensation from the German state, either as victims of coerced sterilization or as victims of Nazi medical research.The concerned human geneticists went unprosecuted

Conceptualising eugenics and racial hygiene as public health theory and practice

Eugenics arose at a crucial juncture in terms of demography (with the declining birth rate) and morbidity (with the shift to chronic diseases) in the later nineteenth century. These, in turn, shaped public measures in the early twentieth century. This chapter will examine eugenic concepts of population health, and how these entered public health concepts and practices. It will review the theoretical writings of Galton in Britain, and Schallmayer and Ploetz in Germany. Their theoretical writings provided fundamental concepts of how population health could be sustained in the emergent welfare state. Eugenics became a norm embedded in public health concepts, structures and interventions. The chapter will consider eugenic ideals and how these were to be sustained by such measures as health examinations prior to marriage, family welfare support and restriction of immigration. Eugenicists demanded comprehensive measures to promote the fit and healthy, and segregate the degenerate. I will consider the historiography of eugenics and its limitations as regards public health, as well as the implementation of actual health measures regarding a range of ‘racial poisons’ such as alcohol, tuberculosis and sexually transmitted diseases. Wider issues raised are those of the dissemination of eugenic ideas as well as the role of eugenically minded experts as guardians of national health

'All emigrants are up to the physical, mental, and moral standards required': A tale of two child rescue schemes

The current paper critically assesses and reflects on the ideals and realities of two major (British) child migration schemes, namely the British Home Child scheme (1869–1930) and the Kindertransport scheme (1938–1940), to add to current understandings of their place within wider international histories of child migration, moral reforms, eugenics, settlement, and identity. Specifically, we focus on constructions of “mentally and physically deficient” children/young people, informed by eugenic viewpoints and biological determinism, and how this guided inclusion and exclusion decisions in both schemes. Both schemes made judgements regarding which children should be included/excluded in the schemes or returned to their country of origin (as was the case with children in the Canadian child migration scheme) fueled by a type of eugenics oriented to transplanting strong physical and psychologically resilient specimens. By viewing the realities of the child migration schemes, including the varied experiences and narratives in relation to child migrants, in light of eugenicist narratives of difference, pathology, victimhood, and contamination, we shed a light on uneven practices, formations of power, and expectations of the times

From scientific exploitation to individual memorialization: Evolving attitudes towards research on Nazi victims’ bodies

During the Third Reich, state-sponsored violence was linked to scientific research on many levels. Prisoners were used as involuntary subjects for medical experiments, and body parts from victims were used in anatomy and neuropathology on a massive scale. In many cases, such specimens remained in scientific collections and were used until long after the war. International bioethics, for a long time, had little to say on the issue. Since the late 1980s, with a renewed interest in the Holocaust and other Nazi crimes, a consensus has increasingly taken hold that research on human tissues and body parts from the Nazi era is inadmissible, and that such specimens should be removed from scientific collections and buried. The question of what to do with scientific data obtained from these sources has not received adequate attention, however, and remains unsolved. This paper traces the history of debates about the ethical implications of using human tissue or body parts from the Nazi period for scientific purposes, primarily in the fields of anatomy and neuropathology. It also examines how this issue, from after the war until today, influenced the establishment of legal and bioethical norms on the use of human remains from morally tainted sources, with a particular emphasis on Germany and Austria. It is argued that the use of such specimens and of data derived from them is unethical not only because of potential harms to posthumous rights of the victims, but also because such use constitutes a moral harm to society at large

The victims of unethical human experiments and coerced research under National Socialism

There has been no full evaluation of the numbers of victims of Nazi research, who the victims were, and of the frequency and types of experiments and research. This paper gives the first results of a comprehensive evidence-based evaluation of the different categories of victims. Human experiments were more extensive than often assumed with a minimum of 15,754 documented victims. Experiments rapidly increased from 1942, reaching a high point in 1943. The experiments remained at a high level of intensity despite imminent German defeat in 945. There were more victims who survived than were killed as part of or as a result of the experiments, and the survivors often had severe injuries

TIPIT: A randomised controlled trial of thyroxine in preterm infants under 28 weeks gestation: Magnetic Resonance Imaging and Magnetic Resonance Angiography protocol

<p>Abstract </p> <p>Background</p> <p>Infants born at extreme prematurity are at high risk of developmental disability. A major risk factor for disability is having a low level of thyroid hormone described as hypothyroxinaemia, which is recognised to be a frequent phenomenon in these infants. Derangements of critical thyroid function during the sensitive window in prematurity when early development occurs, may have a range of long term effects for brain development. Further research in preterm infants using neuroimaging techniques will increase our understanding of the specificity of the effects of hypothyroxinaemia on the developing foetal brain. This is an explanatory double blinded randomised controlled trial which is aimed to assess the effect of thyroid hormone supplementation on brain size, key brain structures, extent of myelination, white matter integrity and vessel morphology, somatic growth and the hypothalamic-pituitary-adrenal axis.</p> <p>Methods</p> <p>The study is a multi-centred double blinded randomised controlled trial of thyroid hormone supplementation in babies born below 28 weeks' gestation. All infants will receive either levothyroxine or placebo until 32 weeks corrected gestational age. The primary outcomes will be width of the sub-arachnoid space measured using cranial ultrasound and head circumference at 36 weeks corrected gestational age. The secondary outcomes will be thyroid hormone concentrations, the hypothalamic pituitary axis status and auxological data between birth and expected date of delivery; thyroid gland volume, brain size, volumes of key brain structures, extent of myelination and brain vessel morphology at expected date of delivery and markers of morbidity which include duration of mechanical ventilation and/or oxygen requirement and chronic lung disease.</p> <p><b>Trial registration</b></p> <p>Current Controlled Trials ISRCTN89493983</p

Christian Fleck, Etablierung in der Fremde. Vertriebene Wissenschaftler in den USA nach 1933. Reviewed by Paul J. Weindling, Oxford Brookes University.

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