Scholars working on the history of human experimentation have long puzzled over the neglect of medical research ethics in the first two decades after World War II, a period that saw a vast increase in human experimentation in medicine but that seems to have been characterized by a lack of moral leadership among physicians. This essay reexamines this notion by drawing on ethical debates about human experimentation in the Dutch medical profession between 1945 and 1971. In the international literature, Dutch (...) physicians are often singled out as having been exceptionally quick to note the need for better research ethics after World War II. This essay, however, shows that it is a mistake to identify these Dutch concerns as one of those exceptions that ultimately proves the rule. Instead, the Dutch ethics discourse developed in this period sought to carve out a legitimate space for “good medical research,” where “good” stood simultaneously for “methodologically valid” and “ethically just” and where research ethics committees were imagined to function as epistemic filters that would increase both the quality and the quantity of human experimentation in medicine. This connection between ethics and episteme has hitherto received little attention in the history of research ethics governance but remains a core element of medical research ethics today. (shrink)

Ethics boards have become obligatory passage points in today's medical science, and we forget how novel they really are. The use of humans in experiments is an age-old practice that records show goes back to at least the third century BC and, since the early modern period, as a practice it has become increasingly popular. Yet, in most countries around the world, hardly any formal checks and balances existed to govern the communal oversight of experiments involving human subjects until at (...) least the 1960s. Ethics by Committee traces the rise of ethics boards for human experimentation in the second half of the twentieth century. Using the Netherlands as a case-study, Noortje Jacobs shows how the authority of physicians to make decisions about clinical research gave way in most developed nations to formal mechanisms of communal decision-making that served to regiment the behavior of individual researchers. This historically unprecedented change in scientific governance came out of a growing international wariness of medical research in the decades after World War II. Research ethics committees were originally intended not only to make human experimentation more ethical but also to raise its epistemic quality. By examining complex negotiations over the appropriate governance of human subjects research, Ethics by Committee advances our understanding not only of the history of research ethics and the randomized controlled trial but also, more broadly, of how liberal democracies in the late twentieth century have sought to resolve public concerns over charged issues in medicine and science. (shrink)