on defenseless political and war prisoners, that led to the Nuremburg trials and that made explicit for the first time in the Nuremburg Code the ethical principles for biomedical research on human beings. This code also formed the basis for the Declaration of Helsinki adopted by the World Medical Association in 1964 and the "Ethical Guidelines for Clinical Investigation" adopted by the American Medical Association in 1966.
In the 1960s and 1970s, a number of ethically questionable research designs came under public scrutiny, raising the issue of ethics for all types of research. The most infamous of these studies was probably the Tuskegee Syphilis Study conducted by the U.S. Health Service. This design involved withholding treatment from a group of black males infected with syphilis for 40 years. The purpose of the research was to identify a sample of men with syphilis and to observe the consequences of untreated syphilis over time. The researchers did not infect the men with syphilis, but once the research was under way the researchers actively altered the men's lives and chances without their awareness or consent. The researchers even worked to minimize the possibility of these men receiving treatment from other medical sources by giving them a free but ineffective treatment so they would not seek help elsewhere. There was no effective cure for syphilis when the study started, but later it was found that penicillin was effective. This new treatment was withheld from the subjects. The ethical lapses in this research design were numerous: lack of consent; deliberate lying about symptoms and treatment; deliberate withholding of treatment; periodic spinal taps that were painful and that involved medical complications; invasion of privacy for the subjects and their families (which continued after death with deception to obtain autopsy results); and so on. There was even a group of 200 men who were told they had syphilis whe...