Nuremberg Revisited

Imagine the following scenario: Suffering a severe head injury, a victim of a car accident has just been rushed to a hospital. His doctor knows about a new, experimental treatment that just might save the patient’s life and, not incidentally, provide valuable research data. But the man is unconscious; the doctor can’t ask his permission to try the unproven treatment. What should the good doctor do? Thanks to a recent decision by the Food and Drug Administration (FDA), the doctor is now free to behave like a modern-day Dr. Frankenstein: He can experiment on his patient even without the patient’s permission. Until a few weeks ago, doctors were forbidden to perform experimental treatments unless they had patients willing to serve as guinea pigs. This law was inspired by a code of ethics called the Nuremberg Code, drawn up in 1946 following the Nazi war-crimes trials in Nuremberg, Germany. Nazi doctors had been convicted of conducting horrifying and unnecessary medical experiments on Jewish prisoners. The doctors’ defense of their barbarous behavior was that, under German law, Jewish prisoners were considered nonpersons. To prevent similar atrocities from occurring here, American judges drafted the Nuremberg Code, which states that all patients are persons and have the right to decide their own medical treatment, including those who are imprisoned, mentally disabled, or politically unpopular. If they cannot decide for themselves, the code requires that any experimental treatments be approved by relatives or legal guardians. But today some scientists seem less worried about the rights of patients than about the progress of their own research. Dr. Norman Fost of the Center of Clinical Ethics complains that “research [is] not moving forward” because patients’ relatives can’t be reached fast enough to obtain their approval for experimental treatments. Other researchers told the FDA that there simply aren’t enough voluntary patients to make clinical trials possible. Last November the FDA caved in to these complaints. The agency declared that doctors would now be allowed to try out experimental treatments on unconscious, critically ill patients without obtaining consent from either the patient or the patient’s family. In other words, it is now legal to treat certain patients as “nonpersons” for the sake of medical research. This is a dangerous precedent. In essence, the FDA has accepted a new criterion of personhood: conscious awareness. American doctors of course aren’t Nazis. But there are uncomfortable parallels between the FDA ruling and the abuses that led to the Nuremberg Code. Both are departures from the biblical teaching that personhood and human dignity are rooted in our status as living beings created in the imago Dei—the image of God. And as the Phoenix Gazette editorialized, “the assumption that Americans are somehow too... moral to commit crimes against [humanity] simply won’t stand up to the evidence.” Just recall the experiments performed for several decades on black victims of syphilis in the Deep South. The abortion debate has sensitized us as to how dangerous it is to tamper with the biblical definition of human dignity. You and I ought to tell our Congressmen what we think about the FDA’s new ruling. Without a Christian respect for human dignity, every one of us is now—thanks to the FDA—just a car accident away from being treated like the Jews in Nazi Germany.

01/9/97