Which principles, doctor? The early crystallization of clinical research ethics in the Netherlands, 1947-1955.

Abstract

Historians have argued that the Guidelines for Tests upon Human Beings, issued by the Dutch Health Council in 1955, were the first local implementation of the international 1947 Nuremberg Code. This thesis shows however that the Guidelines were no elaboration or implementation of the Nuremberg Code, but rather a response to a specific Dutch challenge. As the 1947 Code was perceived to be 'a good code for barbarians' by the Dutch medical profession, it was in fact not received in the Netherlands at all. Instead, the 1955 Guidelines represented the specific Dutch response to criticsm voiced by the Dutch antivivisectionist movement which faulted the modern biomedical sciences for neglecting the role of the psyche and failing to respect the bodily integrity of the patient. With that, the Health Council aimed to pacify anxieties concerning the role of medicine in the modern Dutch society. Overall, this thesis is a study of 'ethics-in-the-making' and the embeddedness of medico-ethical documents in the historical context in which they have first been formulated.