"The Only Feasible Means": The Pentagon's Ambivalent Relationship with the Nuremberg Code

Article excerpt

In the early years of the 1950s, advisory committees in the United States Department of Defense (DOD) engaged in highly classified discussions about the permissible use of human subjects in military research. In spite of grave reservations expressed by many military officers and physician consultants, Pentagon officials not only adopted a formal set of rules to govern these activities, they settled upon the Nuremberg Code verbatim, making it even more rigorous with the addition of a requirement for written subject consent. Subsequently, however, the Pentagon policy was accorded limited influence not only in the defense establishment, but also among physician-investigators who were DOD contract researchers.

This strange and rich story has been largely unknown to medical historians and philosophers. A few commentators have alluded to the Pentagon policy in the bioethics literature,[1] but only recently has it become possible to place the document in historical context. Previous work on this subject has been limited by the classified status of many of the background documents and the complexity of the story in which they are embedded.

But on 15 January 1994 President Clinton created the Advisory Committee on Human Radiation Experiments. The committee was charged with uncovering the history of these experiments and of the intentional releases of radiation, identifying the ethical and scientific standards for judging them, and recommending ways to ensure that any wrongdoing could not be repeated. Along with the executive order that created the committee, the president also ordered a massive declassification process throughout the federal bureaucracy of any material that would shed light on this story.

As a member of the committee staff, I was charged with poring over thousands of once secret documents that might help tell the story of the evolution of federal standards in relation to the use of human subjects.[2] Especially critical was the tense decade following World War II, characterized by the early cold war, the Korean War, and McCarthyism. How did government advisors and policymakers weigh considerations of national security and human rights in this extraordinary time?

Motivations for Policy Creation

after World War II

Following the end of World War II there was a perceived need at the highest levels of the defense establishment for information from human experiments. This perception stemmed from two sources. First, it was believed that the Soviet Union was engaged in an intensive research and development program not only in conventional weapons but also in atomic, biological, and chemical warfare. Since Pentagon defense planners in the late 1940s and early 1950s assumed that the United States and the Soviet Union were on a collision course to armed conflict, this was a threat that had to be answered in kind. Second, many argued that the lessons that could be gleaned from animal research were inherently limited, a view often employed to explain the value of human experimentation. In the specific realm of radiation, by the late 1940s scientists had begun to learn from human "experiments of opportunity." These included several radiation accidents among Manhattan Project laboratory workers, the mass exposures at Hiroshima and Nagasaki, and the frustrating clean-up effort following the underwater detonation at Operation Crossroads in 1947. In particular, the Crossroads experience impressed war planners with the insidious nature of radiation hazards, hazards that are invisible and therefore hard for military commanders to manage. Panic reactions among both civilian populations and armed forces personnel were considered perhaps the greatest single threat posed by atomic warfare, and they could be studied only with human subjects. A desire began to emerge for more controlled experiments to explore such matters.[3]

Also in this period, radiation safety concerns shifted from laboratory workers to military personnel. …