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August 12, 1988

The Patient as Partner: A Theory of Human-Experimentation Ethics

JAMA. 1988;260(6):860. doi:10.1001/jama.1988.03410060136048

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As the decade of the 1940s began, private and governmental support of medical research was meager. By the middle of the 1950s it had grown dramatically to about $240 million. Today it is a flourishing, multibillion-dollar enterprise, with a glowing future of potential accomplishment.

The technological component of this research growth has been matched by increased understanding of its significant ethical dimensions, particularly regarding the use of human subjects. From the nadir of the Nazi experiments in World War II, social and medical advances have occurred whose milestones are mainly codes and government regulations: 1946, the Nuremberg Code; 1953, the British Medical Research Council's Memorandum on Clinical Investigations; 1964, the Declaration of Helsinki; 1966, the US Public Health Service's requiring institutional review of experimental protocols involving humans; and 1974, passage of the National Research Act in the United States, establishing a National Commission for the Protection of Human Subjects of