“ETHICALLY IMPOSSIBLE” STD Research in Guatemala from 1946-1948 
death being the premeditated outcome in a number of these experiments.” 686 
In fact, however, those who were later convicted in the Nazi doctors’ trial 
were found guilty of participation in mass slaughter, not for violations of 
medical ethics. 
Writing in The Netu York Times in April 1947 about syphilis research, jour- 
nalist Waldemar Kaempffert, reported that any plan to “shoot living syphilis 
germs into human bodies” to advance science would be “ethically impos- 
sible.” Yet human testing of the very kind described in the note as “ethically 
impossible” was about to begin in Guatemala. Upon reading the New 
York Times article, Dr. Cutler called it to the attention of his superior Dr. 
Mahoney, VDRL Director. In his letter to Dr. Mahoney, Dr. Cutler expressed 
his concern that, in light of the unqualified ethical statement made in 
Kaempffert’s article, a recent public notice regarding the Guatemala research 
would draw undesirable criticism. Dr. Cutler also emphasized the need to 
increase secrecy and limit information about the program to those “who can 
be trusted not to talk.” 687 
Kaempffert’s New York Times article and the concern it engendered on Dr. 
Cutler’s part illustrate the tensions that were created as a result of evolving 
research ethics standards in the period immediately following World War II. 
The rules subsequently issued by the Nuremberg court in its judgment on 
the Nazi doctors’ case in August 1947, now famously called “The Nuremberg 
Code,” largely echo Drs. Ivy and Alexander’s original formulation. 688 First, 
the court found that “the voluntary consent of the human subject is absolutely 
essential.” 689 The court emphasized the need for careful attention to risks and 
rigorous commitment to individual participant welfare. Experiments should 
be conducted “so as to avoid all unnecessary physical and mental suffering and 
injury,” the court ruled, and be “not random and unnecessary in nature.” 690 
Furthermore, “[n]o experiments should be conducted where there is an a priori 
reason to believe that death or disabling injury will occur, except, perhaps, in 
those experiments where the experimental physicians also serve as subjects.” 
Like Dr. Ivy and the American Medical Association, the tribunal asserted 
that its rules were already understood and followed by all ethical medical 
researchers everywhere in the world. 691 However, more recent scholarship has 
disclosed that these assertions were at the very least highly exaggerated. 692 It 
would be more accurate to state that these rules were available in the culture 
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