In 1961, the assistant dean of Harvard Medical School told an administrative board that the Nuremberg Code is not necessarily pertinent to or adequate for the conduct of medical research in the United States. p. 234. In fact, the view that American medicine deserved exception to the code was expressed during the trial before the close itself was drafted. Dr. Andrew C. Ivy, the "conscience of U.S. science" and the prosecution's key witness on medical ethics argued on the witness stand that prison research in America was "ideal" and "all subjects have been volunteers in the absence of coercion in any form." These pronouncements were endorsed later by the AMA and prominently printed in its respected journal for all physicians to digest. p. 234
Physicians reported that medical ethics were not taught in medical school and the Nuremberg Code never mentioned. Nazi medicine was a horrible but distant medical aberration that could never happen here... Prestigious medical journals published articles reporting and recommending the use of vulnerable, institutionalized children or prisoners as ideal test subjects. For physician researchers, there appeared to be few constraints. p. 235
Medical precedents, an insular AMA and a growing profit motive fueled by lucrative research contracts made reform impossible. p. 235
Kligman's research was acceptable to doctors in all fields. For those closest to him, the pursuit of career advancement, publications, lucrative contracts and fame, became the goals of their professional careers.. p. 237 No one in the prison questioned the studies, no one wanted to make waves.
Corrupting influence of money... p. 239
Many former test subjects and their families now regard the medical profession as torturers rather than healers. p. 242
All agencies looked the other way or encouraged the tests: FDA, EPA, the Army. No government agency knowing the inherent dangers to the prisoners in sloppy methods when drugs with unknowable effects are being tested, questioned that the prisoners could be exercising informed, uncoerced consent.
The doctors who entered Holmesburg Prison a few short years after Nuremberg were conditioned to see the mass of idle humanity before them as a fertile field of investigatory opportunity. p. 235
In time, no protocol was too risky, no relationship too troubling, no code immune to violating. p. 235
Of course there is little doubt that the Holmesburg human guinea pigs acquiesced in their own exploitation. Uneducated and isolated, desperately short of money, the inmates were an easy target for medical mercenaries looking for test subjects. A drowning person does ask penetrating questions about a life raft. Some may have decided to believe that the . . . tests were harmless, but many understood that they were gambling with their health and safety without knowing the risks and without giving genuine, uncoerced, informed consent. p. 241
There we are. No longer prisoners in institutions, but isolated due to Covid, the world is a prison. This explains it.