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March 5, 1997

The Nuremberg Code, Informed Consent, and Involuntary Treatment

Author Affiliations

Longboat Key, Fla

JAMA. 1997;277(9):712-713. doi:10.1001/jama.1997.03540330034026

To the Editor.  —As Dr Grodin and Mr Annas1 mention, another area wherein the Nuremberg Code is not merely World War II history is the especially difficult situation in which the informed consent mandate is waived by government agencies for active-duty soldiers because of presumed battlefield exigencies—as was the case when Gulf War troops were ordered to take pyridostigmine for an experimental purpose. This waiver and the process by which it was accomplished compel serious examination.The Food and Drug Administration (FDA) informed consent waiver was based on production of safety and efficacy data for pyridostigmine as a protective agent against nerve gas attack. Several animal studies have documented the dangers of pyridostigmine and its futility to protect against nerve gas exposure.2 In addition, FDA's Investigational New Drug (IND) approval required coadministration of atropine, the actual protectant against nerve gas lethality. In fact, however, atropine was not administered. The US Department