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# The Belmont Report (1979)

- International document

A US report that sums up research ethics in three principles: respect for persons, beneficence and justice.

Updated Nov 5, 2026

## Key points

- Three principles: respect for persons, beneficence and justice.
- Respect for persons → informed consent.
- Beneficence → assessment of risks and benefits.
- Justice → fair selection of participants.
- Consent = information + comprehension + voluntariness.
- It came from the National Research Act of 1974, after Tuskegee.

## What it is

The Belmont Report was written by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, created in the United States by the National Research Act of 1974, after the Tuskegee scandal. The commission finished the report in 1978 and it was published in 1979. It separates clinical practice (aimed at the good of a particular patient) from research (aimed at generalizable knowledge) and sums up research ethics in three principles, each with a practical application.

## Key points

- Respect for persons: treat each person as an autonomous agent and protect those with diminished autonomy.
- Beneficence: an obligation, not an act of charity; do no harm and maximize possible benefits while minimizing possible harms.
- Justice: ask who receives the benefits of research and who bears its burdens.
- Application 1, informed consent: enough information, real comprehension and a voluntary decision.
- Application 2, risks and benefits: a systematic analysis that justifies exposing people.
- Application 3, selection of participants: do not choose groups because they are easy to recruit, dependent or disadvantaged.

## Historical context

- The Tuskegee study became public in 1972 and led to the National Research Act of 1974.
- That law created the National Commission, which had to define the basic ethical principles of research with people.
- The name comes from the Belmont conference center, in Maryland, where the commission worked on the text.
- The report illustrates conflict between principles with prisoners: respecting their freedom to volunteer versus protecting them from coercion.

## Belmont Report principles and their application

| Principle | What it asks | Application |
| --- | --- | --- |
| Respect for persons | Autonomy and protection of those with diminished autonomy | Informed consent |
| Beneficence | Do no harm; maximize benefits and minimize harms | Assessment of risks and benefits |
| Justice | Share burdens and benefits fairly | Selection of participants |

## Today

- It is the basis of US federal regulation on the protection of participants and of institutional review boards.
- Its three principles are used as a framework to analyse any protocol: is information good?, do benefits outweigh risks?, is selection fair?
- Clinical principlism, with four principles, extended this scheme to medical care.
- The report does not rank the principles: when they clash, the case has to be weighed.

## Revisions and official text

- It is a historical document that has not been revised; its full text is published by the HHS Office for Human Research Protections.
- Official text consulted on 2026-11-05 at hhs.gov.

## Memory aid

«R-B-J → C-R-S»: Respect, Beneficence and Justice are applied as Consent, Risk-benefit and Selection.

## Test yourself

Think of the answer, then tap the question to see it.

## What are the three principles of the Belmont Report?

Respect for persons, beneficence and justice.

## Which practical application matches the principle of justice in the Belmont Report?

The selection of participants: share burdens and benefits fairly and do not choose groups only because they are vulnerable or easy to recruit.

## What are the three elements of informed consent according to Belmont?

Information, comprehension and voluntariness.

## Which event led to the law that created the commission that wrote the Belmont Report?

The public disclosure, in 1972, of the Tuskegee study of untreated syphilis, which led to the National Research Act of 1974.

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## Connections

## Related 5

- [The four principles of bioethics (principlism)](https://durgical.com/en/medical-ethics/the-four-principles-of-bioethics/)
- [Research abuses that changed the rules: Tuskegee, Willowbrook, Guatemala](https://durgical.com/en/medical-ethics/research-abuses-that-changed-the-rules-tuskegee-willowbrook-guatemala/)
- [Informed consent in research](https://durgical.com/en/medical-ethics/informed-consent-in-research/)
- [Justice: fair distribution and equal treatment](https://durgical.com/en/medical-ethics/justice-fair-distribution-and-equal-treatment/)
- [Respect for autonomy](https://durgical.com/en/medical-ethics/respect-for-autonomy/)

[← All of medical ethics](https://durgical.com/en/medical-ethics/)

Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal.

Sources: [The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research](https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-belmont-report/index.html) (U.S. Department of Health and Human Services, Office for Human Research Protections, 1979); [About The Untreated Syphilis Study at Tuskegee](https://www.cdc.gov/tuskegee/about/index.html) (Centers for Disease Control and Prevention, 2024).

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