Vollmann J, Winau R
Institute of the History of Medicine, Free University of Berlin.
BMJ. 1996 Dec 7;313(7070):1445-9. doi: 10.1136/bmj.313.7070.1445.
The issue of ethics with respect to medical experimentation in Germany during the 1930s and 1940s was crucial at the Nuremberg trials and related trials of doctors and public health officials. Those involved in horrible crimes attempted to excuse themselves by arguing that there were no explicit rules governing medical research on human beings in Germany during the period and that research practices in Germany were not different from those in allied countries. In this context the Nuremberg code of 1947 is generally regarded as the first document to set out ethical regulations in human experimentation based on informed consent. New research, however, indicates that ethical issues of informed consent in guidelines for human experimentation were recognised as early as the nineteenth century. These guidelines shed light on the still contentious issue of when the concepts of autonomy, informed consent, and therapeutic and non-therapeutic research first emerged. This issue assumes renewed importance in the context of current attempts to assess liability and responsibility for the abuse of people in various experiments conducted since the second world war in the United States, Canada, Russia, and other nations.
20世纪30年代和40年代德国医学实验中的伦理问题在纽伦堡审判以及对医生和公共卫生官员的相关审判中至关重要。那些参与可怕罪行的人试图为自己开脱,辩称当时德国没有关于人体医学研究的明确规则,而且德国的研究做法与同盟国并无不同。在这种背景下,1947年的《纽伦堡法典》通常被视为第一份基于知情同意制定人体实验伦理规范的文件。然而,新的研究表明,人体实验指南中知情同意的伦理问题早在19世纪就已得到认可。这些指南揭示了自主性、知情同意以及治疗性和非治疗性研究概念最早何时出现这一仍有争议的问题。在当前试图评估自第二次世界大战以来美国、加拿大、俄罗斯和其他国家进行的各种实验中虐待人员的责任归属的背景下,这个问题再次变得重要起来。