Development and Human Testing of Chemical Warfare Agents and Means of Treatment of Lesions in Germany in 1933–1945

Despite serious attention to the issues of war crimes and crimes against humanity, committed on an unprecedented scale in concentration camps in Nazi Germany, the problem of medical experiments on prisoners appears to be one of the least-studied in modern Russian historiography. Moreover, no special attention was paid to testing chemical weapons on humans. The aim of this work is to review the history of the development and testing of chemical warfare agents (CWA) in Germany in 1933–1945. During the First World War, Germany was one of the leading countries in the sphere of military chemistry in the world. After the Versailles treaty this potential was largely lost as a result of the restrictions. After the National Socialist German Workers' Party (NSDAP) came to power, Germany not only restored, but also increased its military power and achieved a qualitative superiority over its opponents in the field of chemical weapons. The tests of CWA, as well as the study of the effectiveness of the means and protocols for the treatment of the lesions caused by CWA, were carried out both by the military structures of the Wehrmacht and the SS, and by civilian research and academic institutions. Experiments on prisoners were carried out in the concentration camps of Dachau, Ravensbrück, Auschwitz-Birkenau, Buchenwald, Sachsenhausen, Natzweiler-Struthof, Neuengamme, etc. Basically, the damaging effects of sulfur mustard and phosgene was investigated. In Auschwitz-Birkenau «a study of the action of various chemical preparations was carried out on the orders of German firms». After the war several SS doctors, who performed involuntary experiments on humans, were convicted by military tribunals for war crimes and crimes against humanity. Seven doctors were sentenced to death and executed on June 2, 1948, at the prison for war criminals in Landsberg, Bavaria. As a result of the Nuremberg trials, the Nuremberg Code was drawn up. It was the first international document that introduced ethical standards for scientists engaged in experiments on humans. It consisted of 10 principles, including the necessity of voluntary informed consent of the patient for the participation in medical experiments after providing him with full information about the nature, duration and purpose of the experiment; on the methods of its implementation; about all the perceived inconveniences and dangers associated with the experiment, and, finally, the possible consequences for the physical or mental health of the subject, which may arise as a result of his participation in the experiment.

Improving the quality assessment of goods movement objects in the context of modern challenges to economic security

A look at the Nuremberg Code in which the so called “Doctors’ Trial” carried out in 1946—1947 by the American occupation authorities laid down the moral principles of experimental research on humans needs to be updated, since over the past almost seventy five years a layer of factual errors and fictitious assessments has formed around it. This paper offers a critical review of this phenomenon based on more than sixty Russian- and English-language scientific publications, as well as other sources including official court materials content analysis. A historical approach is taken, thanks to which the text of the Nuremberg Code appears as the result of a process that took place under the influence of many factors in the period before and during the trial. The thesis is put forward that the subsequent formation of a contradictory and kaleidoscopic image of the Code leads to its transformation into a historical legend.

Consent. Modern interpretation: "Voluntary Informed Consent"

The article is devoted to voluntary informed consent. It considers the historical issues of the formation of this concept in modern health care and medical science. The article highlights a historical role of the Nuremberg Code which was taken as the basis for the Universal Declaration of Human Rights, the World Medical Association (WMA) Code of Ethics, the Declaration on Bioethics and Human Rights, i.e. documents that defined the world order after the end of World War II.

Psilocybin: From Serendipity to Credibility?

Psilocybin has a long history of non-medical use and some seem to infer from this that it has therapeutic utility. Early phase clinical trials with psilocybin are encouraging, but suggest only that larger, multicentre trials are required. These are ongoing but will take many years to complete. Meanwhile, retreat centers offering paid experiences with psilocybin truffles have opened in some countries, often using early phase clinical trial data as a basis for bold, public facing claims. This seems unwise. Early phase trials are not designed for their results to be generalized outside the setting they were undertaken in. To do so risks being misleading. Providing what may be seen as an unregulated drug intervention as a paid service is difficult to reconcile with long-held ethical principles underpinning human research and treatment development that were laid down by the 1947 Nuremberg Code and the 1962 Kefauver Harris Amendments. By using psilocybin before it has been properly tested, retreat centers may be undermining their own credibility and the credibility of the wider field.

Covid-19, the WHO, and the apparent collapse of traditional medical research ethics

On January 14, 2021, a WHO Ad Hoc expert group published an article in the highly influential The New England Journal of Medicine, titled: “Placebo-Controlled Trials of Covid-19 Vaccines – Why We Still Need Them” justifying the use of placebo in further trials of Covid-19 vaccines, even after purported efficacious vaccines have become available. Medical research involving human beings ought to conform strictly to principles, rules and procedures established since the Nuremberg Code (1947), especially as elaborated in the Declaration of Helsinki (2013) and the WHO/CIOMS Guidelines (2016). The NEJM article forms part of an observable trend of moral backsliding that needs to be recorded. In this paper, considering traditional medical research ethics under the impact of the Covid-19 pandemic and its ramifications and effects, and with a particular focus on the highly vulnerable populations and countries of sub-Saharan Africa, I make some relevant remarks. My arguments here are anchored in my observations as a moral philosopher though limited by my lack of expertise in any of the branches of medical science.

Knowledge, Attitude, and Practice of Family Medicine Trainees in Saudi Training Programs towards Medical Ethics, in Riyadh

BACKGROUND Medical ethics is a system of moral principles that govern the practice of medicine. Ethical challenges frequently arise within the field of family medicine and may lead to complications. We wanted to assess the existing knowledge, attitude, and practice of family medicine trainees currently engaged in Saudi programs in relation to medical ethics in Riyadh. METHODS A cross-sectional study was carried out which encompassed a population size of 256 trainees from a total of nine different training centres. A self-administrated questionnaire containing 28 items was used. The questionnaires were distributed manually during the month of December 2016. RESULTS 208 subjects returned the completed questionnaires with a response rate of 81.25 %. Eighty-eight percent of those surveyed agreed that a knowledge of medical ethics was important in medical practice. The most common source of knowledge of medical ethics and law of work amongst the trainees was found to be "during training" in both medical ethics (71.2 %) and law of work (60.6 %). Significantly, only thirty-eight percent participants had knowledge about content of a Saudi law of practicing healthcare professions. Meanwhile, 63.9 % were unaware of the content of the Hippocratic Code whilst 88.5 % were unaware of the content of the Nuremberg Code. Finally, 93.8 % were unaware of the Helsinki Declaration. In measuring the total scores of answers in relation to ethical problems for different values, the mean score for all respondents was 34.98 out of 50, and 51.92 of residents, got a score ≤ 35. CONCLUSIONS The knowledge, attitude, and practice of trainees toward medical ethics was found to be inadequate. It is, therefore, essential to incorporate teaching of medical ethics into future residency program for trainees as a structured course. KEY WORDS Ethics, Bioethics, Family Medicine, Training, Residency

Medicine Without Humanity – Chemical Warfare Agents Tests on Concentration Camps in Germany in 1933–1945

The publication presents documents related to the Nuremberg Doctors' Trial ("United States of America v. Karl Brandt et al."), Held in Nuremberg from December 9, 1946 to August 20, 1947. Documents are kept in the library of Harvard Law School (Harvard Law School , Cambridge, Massachusetts, USA). From the testimony of witnesses and the accused, it follows that in Germany, after the withdrawal from the Treaty of Versailles and the transition of military chemical research under the control of military structures and the SS, and especially during the Second World War, research on chemical warfare agents (CWA) went beyond scientific and industrial laboratories. , university and academic structures, and moved to concentration camps, where doctors from the SS performed experiments on prisoners. The goals and objectives of these tests are shown - the physiological and toxicological properties of CWA were studied. Plans for offensive chemical warfare in Germany were not systematically developed, considering their chemical weapons as a means of retaliatory use. However, the possibility of such a war was taken seriously. In addition, doctors were looking for the most effective means and treatment regimens for lesions caused by the use of BWA by a potential enemy, as well as dangerous, especially dangerous and widespread diseases. The documents show how important this research was. They were watched at the highest level, the test programs were coordinated with the SS Reichsfuehrer G. Himmler, A. Hitler was personally interested in them. At the same time, the documents show the barbaric methods of carrying out these tests, for which the doctors and leaders of medicine in Germany in the 1930-1940s. were convicted by tribunals for war crimes and crimes against humanity (“atrocities and hostile acts, including (but not limited to): murder, extermination, enslavement, expulsion, imprisonment, torture, rape or other inhuman acts committed against any civilian population, persecution on political, racial or religious grounds, regardless of whether these crimes were committed in violation of the laws of the country or not ”), and by the scientific community - for gross violations of medical and scientific ethics. Although at one time it was Germany (Prussia) at the end of the nineteenth century. was the first European country where, long before the Nuremberg Code of 1947, at the levels of the legislative, executive and judicial branches of government, they began to raise and decide the need to obtain informed consent of the patient for medical intervention, and also unconditionally prohibit experimental research with any purpose in humans without them consent. With this publication we open a series of materials and articles on chemical weapons in Germany in 1933-1945. Not Germany to accuse Russia of using chemical weapons.

To the 75th anniversary of the beginning of the Nuremberg trials and the creation of Nuremberg codex: global significance and the enduring lessons

The article reveals the significance of the Nuremberg trials for rethinking the moral foundations of medicine; the role of the Nuremberg Code in the development of voluntary informed consent in clinical practice and in clinical trials, as well as its impact on the international legal regulation of the health sector is considered. The authors focus on the importance of the lessons of Nuremberg for understanding the ethical challenges that have emerged in the 21st century as a result of the development of artificial intelligence technologies, editing of the human genome and the emergence of new forms of parenting, largely associated with the achievements of new reproductive technologies.