Table 13.2.

Ethical Issues of Medical Research Derived from the Nuremberg Trials, the Universal Declaration of Human Rights and Declaration of Helsinki

Nuremberg Doctors Trial, 1946–47	The voluntary consent of a human subject is absolutely essential, with the exercise of free power of choice without force, fraud, deceit, duress, or coercion
	Experiments should be such as to bear fruitful results, based on prior experimentation and the natural history of the problem under study. They should avoid unnecessary physical and mental suffering
	The degree of risk should not exceed the humanitarian importance of the experiment
	Persons conducting experiments are responsible for adequate preparations and resources for even the remote possibility of death or injury resulting from the experiment
	The human subject should be able to end his participation at any time
	The scientist in charge is responsible to terminate the experiment if continuation is likely to result in injury, disability, or death
Universal Declaration of Human Rights, 1948	Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing, and medical care and necessary social services
Declaration of Helsinki, 1964	Research must be in keeping with accepted scientific principles, and should be approved by specially appointed independent committees
	Biomedical research should be carried out by scientifically qualified persons, only on topics where potential benefits outweigh the risks, with careful assessment of risks, where the privacy and integrity of the individual is protected, and where the hazards are predictable. Publication must preserve the accuracy of research findings
	Each human subject in an experiment should be adequately informed of the aims, methods, anticipated benefits, and hazards of the study. Informed consent should be obtained, and a statement of compliance with this code
	Clinical research should allow the doctor to use new diagnostic or therapeutic measures if they offer benefit as compared to current methods
	In any study, the patient and the control group should be assured of the best available methods. Refusal to participate should never interfere with the doctor–patient relationship. The well-being of the subject takes precedence over the interests of science or society

Note: Summarized from the Nuremberg Trials (1948) and World Medical Association, Declaration of Helsinki.

Source: Adapted from Tulchinsky TH, Varavikova EA. The new public health, 3rd edition. San Diego, CA: Academic Press/Elsevier, 2014, chapter 15 page 812. United Nations. Universal Declaration of Human Rights. Available at: http://www.un.org/events/humanrights/2007/hrphotos/declaration%20_eng.pdf. World Medical Association. Available at: http://www.wma.net/ (accessed 3 May 2017).