Week 2 Assignment

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Week 2: Questions on reading & video assignment on World War II & the Nuremberg Code 1) During the Nuremburg Doctors trial, the attorneys for the Nazi defendants argued that their treatment of prisoners in the Nazi concentration camps were no worse than the American malaria experiments conducted on prisoners in the Statesville, Illinois Penitentiary. Who was Andrew Ivy & How did he respond to this claim in his testimony during the trial? Answer- Andrew C. Ivy was one of the three doctors who prosecuted 23 nazi doctors with murder and torture of Nazi concentration camp prisoners because of unethical and inhumane medical trials carried out on them. Born in Missouri in 1893, he was a committed scientist and the vice president of the University of Illinois. He played a key role in the Nuremberg Doctors’ Trial focused on the medical experiments conducted by Nazi physicians on concentration camp inmates, which often resulted in severe suffering and death ( Historian Examines U.S. Ethics in Nuremberg Medical Trial Tactics | Cornell Chronicle , 1996). During the trial, the attorneys for the Nazi defendants argued that the medical experiments carried out on the Nazi concentration camp prisoners were no different from the American malaria experiments conducted on the prisoners of Statesville, Illinois Penitentiary. Andrew Ivy was called for the rebuttal of this claim. He rejected the idea that these two situations were comparable and cited the following differences between the two: - Consent: Ivy said that the American experiments were carried out with explicit consent of the prisoners. On the other hand, the Nazi medical experiments were carried out without the consent of the prisoners, and this often resulted in death of the prisoners. - No scientific purpose: Ivy claimed that while the American malaria experiments were carried out with a definitive scientific purpose and knowledge, the Nazi experiments did not have any scientific purpose and were often just sadistic in nature. - Ethics- Ivy claimed that the Nazi doctors had violated biological ethics during these medical experiments on the concentration camp prisoners. Ivy claimed that while both the instances of experimentation were unethical, the Nazi experiments were sadistic and brutal on an inhuman level and violated the terms as mentioned above (Shuster, 2018).
2) Who was Albert Moll and what did he say about the role of a book published in 1920 entitled " Die Freigabe der Vernichtung Lebensunwerten Lebens " (translated: Permission to Destroy Life Unworthy of Life) . Answer- Albert Moll, who lived from 1862 to 1939, was a versatile figure renowned in the fields of neurology, psychology, sexology, and ethics. He is acknowledged as one of the early trailblazers in the development of medical psychology and sexology, sharing this distinction with figures like Iwan Bloch and Magnus Hirschfeld. However, despite his significant contributions, Moll's work often remained in the shadow of his contemporaries, particularly Hirschfeld and Sigmund Freud. This overshadowing was exacerbated by a strong sense of competition between these individuals. Moll criticized Freud for perceived biases in his work, while Freud countered that Moll was not receptive to constructive criticism after their initial encounter (Oosterhuis, 2019). Albert Moll took a strong stand against the concepts presented in the 1920 book "Die Freigabe der Vernichtung Lebensunwerten Lebens." He saw these ideas as highly unethical and morally problematic because they advocated for selectively ending the lives of individuals based on judgments about their value or worthiness (Sigusch, 2012). Moll's position highlighted his deep commitment to ethical standards in the fields of medicine and psychology. He emphasized the utmost importance of upholding human dignity and firmly rejected the notion of euthanizing individuals who were deemed socially undesirable or burdensome. 3) Who were the Axis Powers? What roles did they have in the establishment of the Nuremburg Code? Answer- The Axis powers, initially named Rome–Berlin Axis, were a military alliance that played a pivotal role in initiating World War II and opposing the Allied forces. This coalition primarily comprised Nazi Germany, the Kingdom of Italy, and the Empire of Japan. While the Axis powers shared right-wing ideologies and a common opposition to the Allies, they did not exhibit the same level of coordination and ideological unity. The formation of the Axis alliance resulted from independent diplomatic endeavors by Germany, Italy, and Japan during the mid-1930s, with each nation pursuing its own expansionist ambitions. The Axis powers, especially Nazi Germany, indirectly played a role in the formulation of the Nuremberg Code due to their involvement in unethical medical experiments during World War II. When the Nuremberg Trials unveiled the extent of these appalling actions, it prompted the establishment of Nuremberg Code as a framework of guidelines related to ethics for human research, aimed at averting similar abuses in the future (Malloryk, 2020).
4) What is the Nuremburg Code ( how many parts are there and what are they ), who issued it and when? Answer- The Nuremberg Code, born out of the Nuremberg Trials, particularly the "Doctors' Trial" focused on the horrific Nazi experiments on humans, stands as a pivotal document laying down crucial ethical standards for conducting research with human subjects. These principles were officially introduced in August 1947 as a component of the judges' decision. At first, the Nuremberg Code wasn't widely acknowledged for its significance beyond its response to the horrifying Nazi human experiments. However, its importance gradually became apparent as it went on to influence the development of ethical standards for researchers. Essential principles from the Nuremberg Code found their way into various documents such as the Declaration of Helsinki, the Belmont Report, and the United States' Common Rule. - The ten points of the Nuremberg Code (UNC Research, 2022): 1. In research involving human subjects, obtaining their voluntary and informed consent is crucial. This means individuals should have the capacity to consent, make decisions freely without any pressure or manipulation, and fully understand the experiment's details, risks, and potential effects on their health. Anyone conducting the experiment is personally responsible for ensuring the quality of consent and cannot delegate this duty. 2. The experiment should have a clear purpose - to produce valuable results that benefit society, results that can't be obtained through other, unnecessary, or arbitrary study methods. 3. The experiment designs should be informed by forgoing animal research and a comprehensive understanding of the study of disease or problem. The expected outcomes should reasonably justify conducting the experiment. 4. The experiment should be carried out in a way that minimizes both physical and mental harm, avoiding any unnecessary suffering or injury. 5. Experiments should not be conducted if there is a reasonable expectation of death or severe injury, except in cases where the physicians conducting the experiment are also participating as subjects, and even then, such risks should be carefully considered. 6. The risk taken in an experiment should always align with the importance of addressing a humanitarian problem.
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7. Proper preparations and facilities must be given to protect participants from any potential harm, no matter how unlikely. 8. Only scientifically qualified individuals should conduct the experiment, and they should exercise the highest level of skill and care throughout the entire process. 9. Throughout the experiment, the human participant should have the freedom to stop it if they reach a physical or mental condition where they believe continuing is no longer possible. 10. While conducting the experiment, the overseeing scientist must be ready to halt it at any point if they have genuine reasons to believe, based on their expertise and good judgment, that continuing the experiment could lead to harm, disability, or death for the participant. Overall, the Nuremberg Code marked a significant value in acknowledging and upholding the basic rights of individuals in terms of research ( Nuremberg Code - New World Encyclopedia , n.d.). 5) Why did the WMA consider the Declaration of Geneva to be insufficient & issue a second code of ethics in 1964 entitled the Declaration of Helsinki ? Answer- The World Medical Association (WMA) deemed the Geneva Declaration unsatisfactory for a variety of reasons, prompting the publication of a second code of ethics, the Helsinki Declaration, in 1964 ( WMA - the World Medical Association-WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects , n.d.). Some of the key reasons why the WMA considered the Declaration of Geneva to be insufficient: - Ethics in research: Ethical issues like taking consent, risk-benefit assessment and other ethical issues rose into prominence and the Declaration of Geneva did not provide any guidance on how to approach these issues in research. - Improvement in medical ethics: Over time, there was significant improvement in medical ethics with new ethical guidelines and procedures. The Declaration of Helsinki combined these expanded ethics into a single document. - Increase in clinical trials: With the advent of time, medical research became more advanced with more clinical trials involving testing on humans. The former Declaration of Geneva did not provide any details about ethical issues regarding the protection of clinical trial participants. - Human Rights: The Declaration of Helsinki served to elaborate the importance of consent of human clinical trial participants and make sure that the research is carried out ethically (Peters, 2020).
- Internationally relevant: As international collaborations in medical research increased, it was necessary to have a single document that different countries could refer to regarding medical research. In other words, the Declaration of Helsinki was adopted by the WMA and then revised multiple times to include more ethical concerns over the years. However, it still remains a pivotal document as a reference for human research for researchers, organizers, and other medical companies (Goodyear et al., 2007). 6) In the article Dubious Premises ..., the Nazi defendants used these few arguments to justify their actions: 1) as physicians they were morally neutral bystanders; 2) the state and the law superseded ethics; 3) they were acting for the good of the whole nation and society; 4) their acts were really compassionate; 5) ethics is relative to persons and times. Choose 3 of these rationales and explain, in the context of biological research involving human subjects, how Kant would challenge them. Answer- If Kant were to challenge these arguments, they would be as follows: As physicians they were morally neutral bystanders: Kant would probably argue that just because a person is a physician, they are not excused from the sense of moral responsibility and understanding what is ethically correct and what is not. Everyone must abide by their own sense of morality, responsibility and ethics, no matter how imposing the situation is, or if the cause is for the greater good. Kant would likely not agree that it is possible for physicians to be morally neutral bystanders while watching innocents being harmed in an inhuman way and the physicians should have upheld their ethical principles in the face of these experiments, no matter what is demanded from them professionally. They were acting for the good of the whole nation and society: Kant would rightfully argue that “greater good” does not come at the cost of violating the rights and autonomy of individuals. Each person has their own dignity and autonomy, and no matter how beneficial the act might be for the society, it is unethical and unacceptable because Kant believed that individuals must always be treated with dignity, even if the end of the experiments is for the greater good. Their acts were really compassionate: Kant would likely ask what defines “compassionate”. This is because “compassionate” cannot mean harming, forcing or violating an individual’s autonomy and dignity for the sake of socially important experiments. Only the intention behind
the action cannot determine compassion, the actual action cannot violate someone’s ethical rights. Kant would argue that true compassion would uphold the rights of the prisoners in the face of these experiments.
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References Goodyear, M. D., Krleža-Jerić, K., & Lemmens, T. (2007). The Declaration of Helsinki. BMJ , 335 (7621), 624–625. https://doi.org/10.1136/bmj.39339.610000.be Historian examines U.S. ethics in Nuremberg Medical Trial tactics | Cornell Chronicle . (1996, December 5). Cornell Chronicle. https://news.cornell.edu/stories/1996/12/historian-examines-us-ethics-nuremberg-medical -trial-tactics Malloryk. (2020). The Nuremberg Trial and its Legacy. The National WWII Museum | New Orleans . https://www.nationalww2museum.org/war/articles/the-nuremberg-trial-and-its-legacy Nuremberg Code - New World Encyclopedia . (n.d.). https://www.newworldencyclopedia.org/entry/Nurember g_Code Oosterhuis, H. (2019). Albert Moll’s Ambivalence about Homosexuality and His Marginalization as a Sexual Pioneer. Journal of the History of Sexuality , 28 (1), 1–43. https://doi.org/10.7560/jhs28101 Peters, B., MD. (2020). What is the Declaration of Helsinki? Verywell Health . https://www.verywellhealth.com/declaration-of-helsinki-4846525 Shuster, E. (2018). American doctors at the Nuremberg Medical Trial. American Journal of Public Health , 108 (1), 47–52. https://doi.org/10.2105/ajph.2017.304104 Sigusch, V. (2012). The Sexologist Albert Moll – between Sigmund Freud and Magnus Hirschfeld. Medical History , 56 (2), 184–200. https://doi.org/10.1017/mdh.2011.32 UNC Research. (2022, October 28). Nuremberg Code - UNC Research . https://research.unc.edu/human-research-ethics/resources/ccm3_019064/
WMA - The World Medical Association-WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects . (n.d.). WMA - the World Medical Association-WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for -me dical-research-involving-human-subjects/