Situated bodies in medicine and research: Altruism versus compelled sacrifice

Introduction When considering the ethics of using the human body in medical research and education, historical and contemporary rules and tools for engagement, such as the Nuremberg Code, the Declaration of Helsinki, the Belmont Report, and the Code of Federal Regulations, immediately come to mind. These four guiding documents do not represent an exhaustive list of instruments that guide the use of the body in scientific and medical investigation and treatment. However, these ethical guidelines and the periods corresponding to their creation and endorsement often frame breeches of ethical behavior as products of a particular time, such that procedures performed before the codification of rules of conduct may be relegated to a status of diminished accountability or perhaps reframed as acceptable processes and outcomes in the quest for knowledge. In the chapter that follows, the reader is invited to set aside the timelines and social milieus anchoring the ethical guidelines introduced earlier. Instead, I invite you to consider a loftier subject – humanity – as the primary lens by which to evaluate past and present conduct involving scientific and medical research, training, and education. Inherent in the challenge is a reconsideration of the entrenched notion that ethical principles are uniquely rooted to or should be defined by particular periods in history. In other words, a by-product of anchoring bioethical principles to medicine's moral failings during particular periods further associates prevailing privileges and prejudices with a blip in time. Such a perspective considers medicine's moral failings as episodic rather than systemic. It will tend to focus on one set of “bad” medical actors – those who are caught – while ignoring others.