Thread by @EmpireinWinter

Bodily Integrity and Informed Choice in Times of War and Terror

'Medicine has historically been based on paternalism. The Hippocratic physician was obligated to act in the best interests of the patient-as the physician judged those interests'

americanbar.org/groups/crsj/pu…

'American law, on the other hand, is based on...the doctrine of informed consent--better termed informed choice--under which individuals make the ultimate decision about what, if anything, will be done to their bodies.'

'All of the articles in this issue make that central point from a remarkable variety of perspectives.'

It's more than seat belts...
'The question of when the law assumed the dominant role in defining ethical medical practice can be debated, but my nomination is at the "Doctors' Trial" at Nuremberg.'

'the court articulated what has come to be called the Nuremberg Code....The most significant provision is the first of ten: "The voluntary consent of the human subject is absolutely essential...'

'...the person involved should have the legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion"

'and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision...'

'The 1948 Universal Declaration of Human Rights (UDHR) declares bodily integrity central to both human rights and human dignity'

'the International Covenant on Civil & Political Rights, made the link unmistakable by adding an additional sentence to the UDHR's Article 5 in its Article 7: "No one shall be subjected to torture or to...degrading treatment or punishment.'

'In particular, no one shall be subjected without his free consent to medical or scientific experimentation. This is, of course, now a fundamental precept of international human rights law.'

'Moreover, under the treaty, Article 7 is nonderogable, even "in time of public emergency which threatens the life of the nation."'

'In the United States, our courts later adopted and applied the doctrine of informed consent to the therapeutic as well as the research setting, reversing the Hippocratic ethic by placing choice in the hands of patients rather than physicians.'

'Looking at informed consent directly, Stephen F. Hanlon and Robyn S. Shapiro argue persuasively that there is more at stake in human experimentation than physical injury: such experimentation without consent is also an affront to human dignity...'

'and courts should recognize a dignitary harm even in the absence of physical harm when informed consent is not obtained. The Nazis showed us the extreme physicians could go to in the service of the state.'

'Although soldiers may relinquish their right to refuse medical treatment upon enlisting, they retain, as all humans do, their right to refuse to be subjects of human experiments--'

'and so retain their right to refuse experimental or investigational drugs and vaccines, even in wartime. The Nuremberg Code is, after all, a wartime document and made no exceptions for informed consent for either war or the soldiers assigned to fight it.'

'It should go without saying (but, of course, it doesn't) that civilians retain all of their rights to bodily integrity, even during war & times of domestic emergencies, & that under no circumstances should civilians be subjected to forced vaccination'

'or other bodily invasions-even those deemed "necessary" by military, medical, or public health officials. Human rights lawyers should resist current proposals to grant public health officials the power over the bodies of civilians...'

'during a bioterrorist attack or other public emergency. Such proposals are not only destructive of basic human rights, they are counterproductive in that they replace a medical & public health system based on truthful communication & trust'

'with one based on fear and arbitrary power.'

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