Editing Nuremberg Code (section)

==Background==
The origin of the Code began in pre–[[World War II]] German politics, particularly during the 1930s and 1940s. Starting in the mid-1920s, German physicians, usually proponents of [[racial hygiene]], were accused by the public and the medical society of [[Unethical human experimentation|unethical]] medical practices. The use of racial hygiene was supported by the German government in order to promote an [[Aryan race]]. Racial hygiene extremists merged with [[Nazism|National Socialism]] to promote the use of biology to accomplish their goals of racial purity, a core concept in the Nationalist ideology. Physicians were attracted to the scientific ideology and aided in the establishment of the National Socialist Physicians' League in 1929 to "purify the German medical community of '[[Jewish Bolshevism]]'." Criticism was becoming prevalent; Alfons Stauder, member of the Reich Health Office, claimed that the "dubious experiments have no therapeutic purpose", and Fredrich von Muller, physician and the president of the [[Deutsche Akademie]], joined the criticism.<ref name=grodin92>Grodin MA.  "Historical origins of the Nuremberg Code".  In: ''The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation''. Annas, GJ and Grodin, MA (eds.). Oxford University Press, Oxford, 1992.</ref>
[[File:Karl Brandt SS-Arzt.jpg|thumb|[[Karl Brandt]], the chief defendant in the U.S. military tribunal that resulted in the Nuremberg Code]]
In response to the criticism of unethical human experimentation, the [[Weimar Republic]] (Germany's government from 1919 to 1933) issued "Guidelines for New Therapy and Human Experimentation". The guidelines were based on [[Beneficence (ethics)|beneficence]] and [[non-maleficence]], but also stressed the legal doctrine of [[informed consent]]. The guidelines clearly distinguished the difference between therapeutic and non-therapeutic research. For therapeutic purposes, the guidelines allowed administration without consent only in dire situations, but for non-therapeutic purposes any administration without consent was strictly forbidden. However, the guidelines from Weimar were negated by [[Adolf Hitler]]. By 1942, the Nazi party included more than 38,000 German physicians, who helped carry out medical programs such as [[Nazi eugenics|the Sterilization Law]].<ref name="vollman96">{{cite journal |doi=10.1136/bmj.313.7070.1445|title=Informed consent in human experimentation before the Nuremberg code|year=1996|last1=Vollmann|first1=J.|last2=Winau|first2=R.|journal=BMJ|volume=313|issue=7070|pages=1445–1447|pmid=8973233|pmc=2352998}}</ref>

After World War II, a series of trials were held to hold members of the Nazi party responsible for a multitude of [[war crime]]s. The trials were approved by President [[Harry Truman]] on 2 May 1945, and were led by the United States, Great Britain, and the Soviet Union. They began on 20 November 1945, in [[Nuremberg]], Germany, in what became known as the [[Nuremberg trials]]. In the trial of ''USA v. Brandt,'' which became known as the "[[Doctors' trial|Doctors' Trial]]", German physicians responsible for conducting unethical medical procedures on humans during the war were tried. They focused on physicians who conducted inhumane and unethical human experiments in [[concentration camps]], in addition to those who were involved in over 3.5 million [[Sterilization (medicine)|sterilization]]s of German citizens.<ref name="Credo Refernece">{{cite web |url=http://www.credoreference.com/entry.do?ta=abcgeamrle&uh=eugenics_euthanasia |title=Eugenics/Euthanasia |publisher=ABC-CLIO |access-date=16 September 2013}}</ref><ref>{{Cite web |url=http://www.stanford.edu/group/psylawseminar/The%20Nuremburg%20Code.htm |title=The Nuremburg Code |access-date=5 October 2013 |archive-date=8 October 2013 |archive-url=https://web.archive.org/web/20131008125500/http://www.stanford.edu/group/psylawseminar/The%20Nuremburg%20Code.htm |url-status=dead }}</ref>

Several of the accused argued that their experiments differed little from those used before the war, and that there was no law that differentiated between legal and illegal experiments. This worried [[Andrew Conway Ivy|Andrew Ivy]] and [[Leo Alexander]], who worked with the prosecution during the trial. In April 1947, Alexander submitted a memorandum to the United States Counsel for War Crimes outlining six points for legitimate medical research.<ref name=ushmm>{{cite web |title=Nuremberg Code |url=https://www.ushmm.org/information/exhibitions/online-exhibitions/special-focus/doctors-trial/nuremberg-code |website=The Doctor's Trial: The Medical Case of the Subsequent Nuremberg Proceedings |publisher=United States Holocaust Memorial Museum Online Exhibitions |access-date=13 February 2019}}</ref>

An early version of the Code known as the Memorandum, which stated explicit voluntary consent from patients is required for human experimentation, was drafted on 9 August 1947.<ref name="EmpMal">{{cite book |last1=Mukherjee |first1=Siddhartha |title=The Emperor of All Maladies |date=2010 |publisher=Scribner |page=33 |edition=First Scribner Hardcover |url=https://www.pbs.org/show/story-cancer-emperor-all-maladies/}}</ref> On 20 August 1947, the judges delivered their verdict against [[Karl Brandt (physician)|Karl Brandt]] and 22 others.<ref name="Annas, George J. 1992">Annas, George J., and Michael A. Grodin. ''The Nazi Doctors and the Nuremberg Code''. New York: Oxford University Press, 1992.</ref> The verdict reiterated the Memorandum's points and, in response to expert medical advisers for the prosecution, revised the original six points of the Memorandum to ten points. The ten points became known as the Code, which includes such principles as [[informed consent]] and absence of [[coercion]]; properly formulated [[scientific]] experimentation; and [[Beneficence (ethics)|beneficence]] towards experiment participants. It is thought to have been mainly based on the [[Hippocratic Oath]], which was interpreted as endorsing the experimental approach to medicine while protecting the patient.<ref name="weindling01">{{cite journal |doi=10.1353/bhm.2001.0049|title=The Origins of Informed Consent: The International Scientific Commission on Medical War Crimes, and the Nuremburg Code|year=2001|last1=Weindling|first1=Paul|journal=Bulletin of the History of Medicine|volume=75|issue=1|pages=37–71|pmid=11420451|s2cid=20239629}}</ref>
===Authorship 'controversy'===
The Code was initially ignored, but gained much greater significance about 20 years after it was written. As a result, there were substantial rival claims for the creation of the Code. Some claimed that [[Harold Sebring]], one of the three U.S. judges who presided over the [[Doctors' trial]], was the author. [[Leo Alexander]], MD and [[Andrew Ivy]], MD, the prosecution's chief medical expert witnesses, were also each identified as authors. In his letter to [[Maurice Henry Pappworth]], an English physician and the author of the 1967 book ''[[Human Guinea Pigs]]'', Andrew Ivy claimed sole authorship of the code. Leo Alexander, approximately 30 years after the trial, also claimed sole authorship.<ref name="gaw14">{{cite journal |doi=10.1177/0141076814523948|title=Reality and revisionism: New evidence for Andrew C Ivy's claim to authorship of the Nuremberg Code|year=2014|last1=Gaw|first1=Allan|journal=Journal of the Royal Society of Medicine|volume=107|issue=4|pages=138–143|pmid=24566934|pmc=4109334}}</ref> However, after careful reading of the transcript of the Doctors' trial, background documents, and the final judgements, it is more accepted that the authorship was shared and the code grew out of the trial itself.<ref name="shuster97">{{cite journal |doi=10.1056/NEJM199711133372006|title=Fifty Years Later: The Significance of the Nuremberg Code|year=1997|last1=Shuster|first1=Evelyne|journal=New England Journal of Medicine|volume=337|issue=20|pages=1436–1440|pmid=9358142|s2cid=9950045 |doi-access=free}}</ref>