INTRODUCTION

Experiments on humans have been conducted since antiquity. The practices enjoyed a resurgence in the seventeenth century, becoming even more prevalent from the mid-eighteenth century onward (Howard-Jones 1982; Lederer 1995; Rothman 1995; see Chapter 49). The reasons for this renaissance were manifold, cultural, and medical. To stay within medicine: The discovery of the circulation of blood in the first half of the seventeenth century prompted physiological studies, including the intravenous application of traditional drugs. Effects of new drugs began to be tested in various ways in the eighteenth century (Maehle 1999a) and, about the same time, new surgical procedures were comparatively evaluated (Tröhler 2000a; Chalmers et al. 2003). Perhaps the most prominent of these early modern trials were those involving inoculation for smallpox, a series of experiments in preventive medicine implemented throughout Europe (Rusnock 2002). During this period no distinction was made between nontherapeutic studies aimed at understanding bodily functions in health and disease, and therapeutic studies testing (new) diagnostic, preventive, or therapeutic interventions relative to professional care. This chapter examines the history of the perception of the ethical dimensions of human experimentation and the origins of its regulation through international ethics codes.

“FOR THE PUBLIC GOOD”: LITTLE REGULATION OF HUMAN EXPERIMENTATION PRIOR TO WORLD WAR II

Under the ancien régime, doctors had little difficulty finding patient–subjects with whom to work. Hierarchical societies with impoverished lower social orders were filled with people who could be commanded or paid to undergo experimental procedures, even if they did not understand them.