The Nuremberg Code

I’m seeing a lot of references to the Nuremberg Code cropping up in anti-vax circles, up to and including self-proclaimed Queen of Canada Romana Diuldo (no, inexplicably, that’s not her porn name) claiming a Malaysian doctor had been put to death after administering a COVID vaccine in violation of it. 

Romana Didulo up early today spewing untrue statements about doctor executions for COVID vaccines pic.twitter.com/EjSXgipSy8

— Dr. Christine Sarteschi, LCSW (@DrSarteschi) November 14, 2022

Having covered it a bit in various health and research ethics classes, I wanted to give the average person some context on the Nuremberg Code so they don’t just blindly believe the nutters.

What is it?

Following WWII, it came to light that Nazi doctors had been performing “medical experiments” on prisoners in concentration camps that basically amounted to torture in a lot of cases. One of the war crime trials at Nuremburg (US v. Brandt) resulted in a set of ethics that must be followed in any study involving human subjects, including:

1. Informed, voluntary consent
2. Yielding useful results for the good of society, unattainable by other means
3. Designed based on prior animal experimentation such that the results can be somewhat predicted
4. Constructed so as to avoid all unnecessary physical suffering/injury
5. Constructed such that there is no reason to expect serious injury or death of the subjects
6. The degree of risk must never outweigh the potential gain to society
7. Proper experimental safety must be planned to safeguard all subjects against serious injury or death
8. Conducted only by scientifically qualified people
9. The subject must be able to quit at any time
10. The scientist in charge must be willing to pull the plug at any time should continuing start to pose a risk of serious injury or death

Why is it necessary?

This used to be commonly accepted as fact: Nazis are bad. Just terrible people. Not all of them are idiots though, and there’s the potential for one to make it to the level where they’re designing scientific experiments with human subjects. That’s where the Research Ethics Board (REB) comes in. Any study that is going to be funded and performed at a professional research institute such as a university has to pass an REB review before it can proceed, and the Nuremburg Code is a tool that helps the REB identify studies that shouldn’t. Even studies that involve animal models (mice, pigs, dogs, monkeys, etc.) have to pass REB scrutiny. Most people have heard of “Clinical Trials” without giving much thought to what that means, but basically clinical trials are divided into levels where a medical treatment can be evaluated for safety and efficacy. Safety is the very first thing that is checked, on a small number of subjects, followed by effectiveness, comparison to existing treatments, and finally approval and observation of long-term effects. 

What does this have to do with COVID vaccines?

Not a lot at this point. Of course, every new vaccine that comes out has to go through these phases, but unless you sign up for a clinical trial the shot you get is both safe and effective by the time it gets to you. The die-hard anti-vaxxers will say they don’t consent to being in an experiment, and technically phase IV is still part of the experiment, but there’s a simple solution: don’t get the shot. It’s that simple, nobody’s forcing you to. You have the absolute freedom to decline. However, other people have the right to protect themselves and ask that you not be around them if you’re not vaccinated. That’s their freedom. In closing, please don’t reference this code of experimental ethics as a way you have been wronged, because it has been satisfied once you choose to opt out.

Andrew Harris Honors BSc || Medical Physics || Former PhD Candidate – Medical Biophysics

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