納粹時代的精神醫學及精神藥物的濫用和紐倫堡大審：人體試驗的倫理議題

The Abuse of Psychiatry and (Psycho) Pharmacology in Nazi Regime and the Nuremberg Trials: Ethical Issues in Human Research

第二以世界大戰後，國際軍事法庭判定20 位納粹醫師及3 名共犯，有違犯人道的罪 行。這些審判過程，就是70 年前的紐倫堡大審 (Nurmberg Trial)。在納粹政權下，這些受刑 者是以公共衛生及人體試驗之名，以醫療行為迫害無辜的人民。這些受刑人不顧醫療論理， 用優生學 (eugenicist theories) 及種族衛生 (racial hygiene) 的名義，做為政府有系統的迫害人民 的工具。在納粹統治之前，德國的精神醫學有相當的國際名聲，但在納粹時代，德國的精神 科醫師配合政府政策，迫害弱勢族群的精神科病人。在這篇綜說中，有關以安樂死之名， 用研究工具處死病人，作者們做了一些歷史回顧。由於這些紐倫堡法庭的罪行調查，因此紐 倫堡法規 (Nurmberg Code) 就誕出了，這件文獻是第一次、有關人體試驗的國際性的倫理規 範。由1947 年的紐倫堡法規，到 1996 年的馬德里宣言 (Declaration of Madrid)，70 年來，精 神學醫學及精神藥物學使用的倫理規範已經進步不少。

After World War II, an international military court sentenced 20 Nazi doctors and 3 collaborators with crimes against the humanity at the Nuremberg Trials. For the past 70 years after Nuremberg Trials, the restoration to pre-Nazi’s ethical standard has been progressed. The eugenicist theories and the policies of racial hygiene were the fundamental axes of the Nazi euthanasia programs without paying attention to the basic ethics of the medicine. German psychiatry that it enjoyed an extraordinary international reputation, played a capital role in these programs and the mental patients supposed the main group of risk for these practices during the Nazi era. In this overview, we deal with, the historical perspective of the euthanasia programs of the mental patients, and the procedures for its execution, and the use of the mental patients as investigation tools. Direct consequence of the mentioned penal process gave birth to the Nuremberg Code, which has been considered as the fi rst international code of ethics for the medical experiments with human subjects. During the last 70 years, it has advanced substantially in the restoration of ethical codes and norms to protect patients in particular in the fi eld of psychiatry and psychopharmacology, and its culmination of advancement has been in the 1996 Declaration of Madrid.