Henry Knowles Beecher, Jay Katz, and the Transformation of Research with Human Beings

The modern history of experimentation with human beings is notable for its ethical lacunae, when even the clearest directives fail to prevent violations of subjects' rights and welfare. One such lacuna occurred during the 25 years between 1947, when the Nuremberg Code was articulated in the judgment passed on the men who had performed medical experiments in the Nazi concentration camps, and 1972, when the revelation of the 40-year-long Tuskegee Syphilis Study shocked the public and pushed Congress to adopt legislation that eventually transformed the governance of human subjects research. The work that Henry Beecher and Jay Katz did on the ethics of human experimentation beginning in 1964-which was mutually supportive but also divergent in its premises and prescriptions-played a prominent role in the policy-making processes. Beecher, whose detailed disclosure of the ethical lapses of leading researchers in his renowned 1966 New England Journal of Medicine article initiated the policy reform process, proved less influential in shaping those reforms than Katz. Ultimately, Beecher was one of the last and best exemplars of "medical ethics," while Katz-in his service on the Tuskegee Syphilis Study Ad Hoc Advisory Panel and in his testimony before, and work with, the Senate Health subcommittee-was an early practitioner of bioethics, a field in which the rules are not all written and applied by the medical profession but arise through a messier process involving outsiders and formal regulatory decisions.