ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
3) One ought not to treat people as mere means to the ends of others. 
Subjects involved in experiments must not be treated as mere means to the 
ends of researchers or supervisors . 669 It follows that researchers must obtain 
the informed consent of individuals before experimenting on them as a neces- 
sary, but not sufficient, condition. Informed consent also rules out deception, 
unless individuals are informed and agree to be part of a practice that may 
entail deception. In that case they are not treated as mere means, as they have 
been informed and have agreed to be part of a practice that includes poten- 
tially justifiable deception. Without this condition another critical element of 
the Nuremberg Code cannot be satisfied, that the experimental subject must 
be free to withdraw from the study at any time. 
The individuals involved in the Guatemala experiments were used as mere 
means to further the ends of researchers and those responsible for their care- 
taking in a way that seems to ignore even the rudimentary consideration they 
should have been granted as human beings. Even a praiseworthy goal (in this 
case, finding effective prevention of STDs) does not justify the use of persons 
as mere means to that goal. Sophisticated expressions of moral philosophy 
and governmental or professional codes of research ethics are built upon the 
recognition of violations of human dignity, violations that characterize many 
of the practices involved in these experiments. The researchers and govern- 
ment officials who were involved in these experiments, both in the United 
States and in Guatemala, acted in ways that violated basic moral norms. 
Morally serious persons may disagree about the specific articulation of the 
elements of a list of principles such as those described above, and about their 
ultimate moral justification. As guides to conduct, they admit to exceptions 
and are subject to interpretation and application. Nonetheless, the Commission 
finds that, to a shocking degree, actions undertaken as part of the Guatemala 
experiments unjustifiably and often grossly violated the widely shared, basic 
sense of human decency encoded in such principled elements of the moral 
life . 670 Although much of the discussion that follows draws upon a fine-grained 
historical examination of formalized research practices and norms at that time, 
the Commission does not want to lose sight of a more basic point: many of the 
actions performed as part of the Guatemala project were unconscionable and 
those responsible for those actions were morally blameworthy. 
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