The Nuremberg Code

Earlier rules existed. Public controversy over Albert Neisser's non-consensual syphilis research contributed to a Prussian directive in 1900, reconstructed by Jochen Vollmann and Rolf Winau. In 1931 the German Reich Ministry of the Interior issued more detailed Richtlinien, or guidelines, for new therapy and human experimentation. They distinguished therapeutic innovation from non-therapeutic experiment, addressed consent and prior animal work, and assigned professional responsibility. Hans-Martin Sass's translation and historical analysis shows that these regulations remained formally binding during the Nazi period.

Rules did not protect people when institutions embraced persecution. The existence of the 1931 guidelines disproves a simple “no ethics before Nuremberg” story; it does not show that German research was humane. Nazi racial ideology, wartime agencies, universities, the SS, armed-services medical organizations, and concentration camps supplied authority, personnel, facilities, and captive people. The judgment itself rejected the idea that the crimes were isolated acts by a few uncontrolled doctors, describing coordinated governmental, military, and party planning.

Victims challenged the experiments before and during the trial. Historian Paul Weindling documents protest, evasion, sabotage, survivor reports, and declarations by prisoner doctors after liberation. At Ravensbrück, Polish prisoners subjected to wound and sulfonamide experiments called themselves króliki (“rabbits”) and resisted further operations. Their agency matters: ethical condemnation did not begin only when Allied physicians or American judges supplied words for it.

1945–August 1946: investigation before prosecution. Liberated prisoners and prisoner physicians reported experiments at Auschwitz, Bergen-Belsen, Buchenwald, Dachau, Ravensbrück, and other camps. Allied scientific-intelligence officers had to connect medical records, material evidence, institutions, and individual perpetrators. At a Paris meeting on medical war crimes on 31 July–1 August 1946, U.S. physiologist Andrew C. Ivy outlined consent, prior evidence, social usefulness, avoidance of suffering, qualified investigators, and a bar on predictably fatal or disabling research. This draft helped make an ethics standard part of the proposed case.

9 December 1946: the Medical Case opened. Twenty-three defendants—twenty physicians and three non-physician administrators—were prosecuted before an American, not a four-power international, tribunal. Charges included war crimes and crimes against humanity arising from high-altitude, freezing, infection, wound, poison, sterilisation, and other experiments, as well as participation in killing programmes. The categories were those of a criminal indictment; they neither encompass every Nazi medical crime nor recover every victim.

20 December 1946: injuries and resistance entered the courtroom record. Polish survivor Jadwiga Dzido testified that Ravensbrück prisoners were not asked to volunteer, that women resisted renewed operations, and that she still required treatment and special footwear she could not afford. She displayed her injured leg while prosecution medical expert Leo Alexander interpreted scars, muscle loss, impaired movement, and radiographs. The court transcript is indispensable testimony, but it is also a translated record structured by prosecutors' questions and Alexander's retrospective examination. His medical inferences should not be confused with everything Dzido herself knew or said.

December 1946–April 1947: proposed rules were revised. Ivy, appointed after nomination by the American Medical Association, and Alexander, a U.S. Army physician advising the prosecution, each developed formulations. Alexander completed an early memorandum in December and submitted a six-point version to the prosecution on 17 April. Defendants and expert witnesses argued about voluntariness, state authority, professional custom, and precedents in other countries. Scholarship has sometimes credited either Ivy or Alexander as sole author. The documentary reconstruction instead supports cumulative authorship: Ivy supplied an early framework, Alexander expanded it, courtroom evidence tested it, and the three judges issued and were responsible for the final ten points.

19–20 August 1947: principles, findings, and sentences. On 19 August Judge Harold L. Sebring read the “Permissible Medical Experiments” section. The tribunal then compared the proven experiments with the ten principles and found pervasive absence of consent and withdrawal, unnecessary suffering, inadequate safeguards, and disabling or lethal harm. Individual judgments were completed the next day: sixteen defendants were convicted and seven acquitted; seven received death sentences. The code was part of the court's reasoning, but guilt still required proof connecting each defendant to crimes under the tribunal's governing law.