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Rapid response to:

Editorials Christmas 2010: Editorial

Self experimentation and the Nuremberg Code

BMJ 2010; 341 doi: (Published 15 December 2010) Cite this as: BMJ 2010;341:c7103

Rapid Response:

Self experimentation and the Nuremberg Code. Long live self experiments.

Contrary to the impression given in your editorial, self
experimentation has remained popular during the past 100 years and has
been important in many medical advances. These advances include the
foundation of respiratory physiology by J.B.S.Haldane and colleagues in
the 1920s and of cardiac catheterisation by Werner Forssmann in the 1930s.
Throughout most of the latter half of the 20th century Alexander and Ann
Shulkin synthesised and self experimented with a wide variety of drugs
exploring their psychoactive effects in great detail. In the 1980s
Barry Marshall did a series of self experiments involving gastroscopy and
ingestion of Helicobacter pylori, which established the link between
H.pylori and gastric pathology, recognised by the award of the 2005 Nobel
Prize in medicine. Mike Stroud's careful investigations during his epic
unsupported crossing of Antarctica with Ranulph Fiennes in 1992 advanced
understanding of nutrition in extreme conditions. A glance at the
internet with the help of Google will reveal descriptions of these and
other remarkable advances associated with self experimentation.

On a more everyday scale, any medical intervention can be regarded as
an experiment. Self experimentation can highlight problems in pilot, or
pre-pilot studies, and in this way prove highly valuable, though rarely

Self experimentation has the advantage of convenience. The process
of getting approval from an ethical committee can be slow and daunting
1,2. The results of self experiments are likely to be more relevant to
other humans than the results of similar studies on other animals.

Ethics committees can be valuable in ensuring that participants in
research competent to give consent do so without coercion in full
knowledge of the risks and that sentient beings not competent to give
informed consent are protected from ill treatment.

(1) Rees,M., Wells,F. Falling research in the NHS. BMJ 2010;340:c2375.
(2) Sandhu,J.,Khan,N. Our first experience of an ethics committee.
British Journal of General Practice, January 2011:70

Competing interests: Have self experimented with a variety of wart treatments to the benefit, I hope, of former patients.

02 January 2011
Arthur P.K. John
Retired GP principal
133 Tickow lane, Shepshed, LEICS. LE12 9EY