Following World War ii, many medical investigators continued their ambitious experimental interventions as rationalized, rather than justified, trials. In Canada, there were hardly any legally proscriptive or prescriptive instruments to regulate clinical experimentation until the 1960s. What was ethical could rightly be established only in the course of devising clinical research protocols and undertaking the procedures thereof. This paper examines an historical trajectory shaping human-subject research and its regulation in Canada. I argue that public disclosures of human experimentation, court litigation resulting from clinical research, international standardization of regulations on biomedical investigation, and the proliferation of clinical trials induced the evolution of human research ethics and the elaboration of guidelines to regulate it. In this process, Canadian physician-investigators adopted British and American guidelines on the conduct of ethically acceptable clinical research and modified them according to local circumstances. The first research ethics committees emerged at the Canadian university-affiliated teaching hospitals, where the investigative practices revealed and clarified the changing meanings of human research ethics.
This article analyzes the formation of research ethics and particularly of ethics committees in Switzerland by tracing their early history along distinct phases: (1) the first guidelines on human experimentation issued by the Swiss Academy of Medical Sciences in 1970; (2) conceptual struggles in establishing these norms; (3) the emergence of a central medical-ethical committee in 1979; and (4) the first local ethics committee established in the rural canton of Thurgau in 1987. It analyzes the interplay between local practices, industrial standards, and a neoliberal, low-key, soft regulation by negotiation among peers. Key actors are the Swiss Academy of Medical Sciences, the pharmaceutical industry, and the canton of Thurgau. In this context, ‘research’ and ‘experiments’ for a long time remained disputed, unclear and risky notions. rec s were encouraged mainly as a way of distributing responsibility, of managing a wide array of risks and, crucially, as part of a wider strategy to avoid juridical and political regulation. The article asks, on a more general level, how and why ‘ethics’ entered this field and what becomes visible or obscured when issues are transposed into an ethical language.
Prescriptions of Local Botanicals for Emergency Use (K. Hyang’yak Kugŭppang 鄕藥救急方) is the oldest medical text extant on the Korean Peninsula and known to have been compiled during the latter half of the Koryŏ 高麗 dynasty (918–1392 ce). The key value of this work lies in the dissemination and praxis of medical knowledge. First, the author used annotations in order to record Koryŏ people’s pronunciations of the names of medicinal ingredients and symptoms introduced in the main body of the text. In addition, he made use of actual empirical cases to enhance the persuasiveness of treatment methods and integrated medicine newly introduced from Song 宋 China (960–1279) into medicine familiarly used from before. Finally, he edited this text with a focus on important and simple yet efficacious treatment methods. The book continued to be used steadily following publication. It was additionally printed no fewer than twice by the government of the Chosŏn 朝鮮 dynasty (1392–1910), which ousted Koryŏ, with its clinical usefulness heightened through the supplementation of explanations on medicinal ingredients use in these processes. In particular, the quotation of sentences from Prescriptions for Emergency Use in medical texts published by the Chosŏn government implies that the utility of the medical knowledge in this work was amply acknowledged. The intended readership of the medical information in Prescriptions for Emergency Use was the not the general populace who lived in the Korean Peninsula in the thirteenth-fourteenth centuries. They not only lacked the financial means to pay physicians but also were illiterate, so that they could not even read medical texts. In order for this work to be effective, it was necessary for it to address those who could read medical texts and put their contents into practice. In the end, the author of this book assumed scholar-gentry equipped with academic knowledge as its readers and sought to provide medical information tailored to their level and to realize medical service through them. Through this work, it is possible to see in a very concrete and vivid manner how medical knowledge was disseminated and, furthermore, how medical knowledge thus disseminated was put to use in an era when medical resources were insufficient.