[T]here was no system of normative ethics on human experimentation during the 1930s that compelled medical researchers to temper their scientific curiosity with respect for the patient’s rights.
The American Medical Association’s code of ethics did not address research on humans until 1946. The Nuremberg Code, often considered the foundational document of research ethics, dates from the 1947 verdict in the Doctors Trial – the military tribunal for German physicians on their participation in war crimes.
Thus, there were no explicit, written codes of ethics for nontherapeutic human research for American civilian researchers prior to World War II (this was not the case for American military researchers). But the lack of a written code or guidelines for civilian researchers does not mean that ethical standards for nontherapuetic research did not exist.
In fact there were norms regarding what could be done in the context of research on humans. Throughout the 19th century, researchers voiced their reaction to experiments that they deemed outrageous or unethical in oral addresses and in articles and commentaries in medical journals. Together, these sources created a de facto professional consensus on the ethical standards for research.
Human Research Ethics In The 19th Century – Risk And Consent
According to these unwritten but nevertheless real ethical standards, experimentation on humans ought be preceded by experimentation on animals. It was also acceptable (and even laudable) for a researcher to experiment on himself or his family before turning to other research subjects. Self-experimentation could help justify nontherapeutic experimentation on others, but it was not the only factor in making a nontherapeutic experiment ethically permissible. There were two other factors to be considered: the avoidance of research-related injury and consent from the subject.
The first item in the Nuremberg Code says that the voluntary consent of the subject is essential. Yet, in the United States prior to World War II, norms concerning when consent should be sought were tied to the possibility of research-related harm.
In most cases, individual consent was expected for nontherapeutic research, but certain types of non-harmful, non-invasive research could be conducted without it. For example, getting consent from hospitalized patients before using them as subjects to test new medical equipment wasn’t considered necessary, so long the testing was non-invasive and not seen as potentially harmful.