Making Modern Medical Ethics

How African Americans, Anti-Nazis, Bureaucrats, Feminists, Veterans, and Whistleblowing Moralists Created Bioethics

The little-known stories of the people responsible for what we know today as modern medical ethics.

In Making Modern Medical Ethics, Robert Baker tells the counter history of the birth of bioethics, bringing to the fore the stories of the dissenters and whistleblowers who challenged the establishment. Drawing on his earlier work on moral revolutions and the history of medical ethics, Robert Baker traces the history of modern medical ethics and its bioethical turn to the moral insurrections incited by the many unsung dissenters and whistleblowers: African American civil rights leaders, Jewish Americans harboring Holocaust memories, feminists, women, and Anglo-American physicians and healthcare professionals who were veterans of the World Wars, the Cold War, and the Vietnam War.

The standard narrative for bioethics typically emphasizes the morally disruptive medical technologies of the latter part of the twentieth century, such as the dialysis machine, the electroencephalograph, and the ventilator, as they created the need to reconsider traditional notions of medical ethics. Baker, however, tells a fresh narrative, one that has historically been neglected (e.g., the story of the medical veterans who founded an international medical organization to rescue medicine and biomedical research from the scandal of Nazi medicine), and also reveals the penalties that moral change agents paid (e.g., the stubborn bureaucrat who was demoted for her insistence on requiring and enforcing research subjects’ informed consent). Analyzing major statements of modern medical ethics from the 1946–1947 Nuremberg Doctors Trials and Nuremberg Code to A Patient’s Bill of Rights, Making Modern Medical Ethics is a winning history of just how respect and autonomy for patients and research subjects came to be codified.
Robert Baker is William D. Williams Professor of Philosophy Emeritus at Union College in Schenectady, New York, and Professor of Bioethics and Founding Director (Emeritus) of the Bioethics Program at Clarkson University–Icahn School of Medicine at Mount Sinai in New York City. He is the author of The Structure of Moral Revolutions (MIT Press) and Before Bioethics.
Contents

Preface ix
Acknowledgments xv
Chronology of Events Referenced xvii
Acronyms, Jargon, and Non-English Words xxv
Who’s Who: People Referenced xxix

1 Moralists and True Scandals: Medical Ethics during the Pre- and Interwar Periods 1
2 Nazi Medical Ethics 11
3 The Nuremberg Doctors Trial and the Nuremberg Code 23
4 The Declaration of Geneva: Old Things Become New 37
5 The Declaration of Helsinki: Negotiating Practical Principles for Research on Human Subjects 53
6 Kelsey, Pappworth, and Beecher: Moral Awakenings 63
7 Protesting the USPHS’s Syphilis Study: Gibson, Schatz, Buxtun, and Jenkins 103
8 Scientistic Medical Paternalism and Its Discontents 125
9 Reforming Modern Medical Ethics 145
10 The Bioethical Turn in Modern Medical Ethics 163
11 Making the Unseen Visible: A Metahistorical Analysis of Why the Role of Anti-Nazism and the Names of Significant Blacks, Bureaucrats, Feminists, Veterans, and Most Whistleblowing Moralists Are Absent from, or Minimally Noted in, Standard Histories of Bioethics 191

Epilogue 207
Appendix 217
Notes 229
Bibliography 277
Index 301

About

The little-known stories of the people responsible for what we know today as modern medical ethics.

In Making Modern Medical Ethics, Robert Baker tells the counter history of the birth of bioethics, bringing to the fore the stories of the dissenters and whistleblowers who challenged the establishment. Drawing on his earlier work on moral revolutions and the history of medical ethics, Robert Baker traces the history of modern medical ethics and its bioethical turn to the moral insurrections incited by the many unsung dissenters and whistleblowers: African American civil rights leaders, Jewish Americans harboring Holocaust memories, feminists, women, and Anglo-American physicians and healthcare professionals who were veterans of the World Wars, the Cold War, and the Vietnam War.

The standard narrative for bioethics typically emphasizes the morally disruptive medical technologies of the latter part of the twentieth century, such as the dialysis machine, the electroencephalograph, and the ventilator, as they created the need to reconsider traditional notions of medical ethics. Baker, however, tells a fresh narrative, one that has historically been neglected (e.g., the story of the medical veterans who founded an international medical organization to rescue medicine and biomedical research from the scandal of Nazi medicine), and also reveals the penalties that moral change agents paid (e.g., the stubborn bureaucrat who was demoted for her insistence on requiring and enforcing research subjects’ informed consent). Analyzing major statements of modern medical ethics from the 1946–1947 Nuremberg Doctors Trials and Nuremberg Code to A Patient’s Bill of Rights, Making Modern Medical Ethics is a winning history of just how respect and autonomy for patients and research subjects came to be codified.

Author

Robert Baker is William D. Williams Professor of Philosophy Emeritus at Union College in Schenectady, New York, and Professor of Bioethics and Founding Director (Emeritus) of the Bioethics Program at Clarkson University–Icahn School of Medicine at Mount Sinai in New York City. He is the author of The Structure of Moral Revolutions (MIT Press) and Before Bioethics.

Table of Contents

Contents

Preface ix
Acknowledgments xv
Chronology of Events Referenced xvii
Acronyms, Jargon, and Non-English Words xxv
Who’s Who: People Referenced xxix

1 Moralists and True Scandals: Medical Ethics during the Pre- and Interwar Periods 1
2 Nazi Medical Ethics 11
3 The Nuremberg Doctors Trial and the Nuremberg Code 23
4 The Declaration of Geneva: Old Things Become New 37
5 The Declaration of Helsinki: Negotiating Practical Principles for Research on Human Subjects 53
6 Kelsey, Pappworth, and Beecher: Moral Awakenings 63
7 Protesting the USPHS’s Syphilis Study: Gibson, Schatz, Buxtun, and Jenkins 103
8 Scientistic Medical Paternalism and Its Discontents 125
9 Reforming Modern Medical Ethics 145
10 The Bioethical Turn in Modern Medical Ethics 163
11 Making the Unseen Visible: A Metahistorical Analysis of Why the Role of Anti-Nazism and the Names of Significant Blacks, Bureaucrats, Feminists, Veterans, and Most Whistleblowing Moralists Are Absent from, or Minimally Noted in, Standard Histories of Bioethics 191

Epilogue 207
Appendix 217
Notes 229
Bibliography 277
Index 301