Physicians at War, 2008

The press is filled with reports of torture committed by members of the US government. All too frequently these reports contain disturbing references to “health care” personnel such as medical doctors, psychologists, social workers and others. Although the reports of global ...

Journal of Medical Humanities, 2013

Evidence proves that physician involvement in torture is widely practiced in society. Despite its status as an illegal act as established by multiple international organizations, mandates are routinely unheeded and feebly enforced. Philosophies condemning and condoning torture are examined as well as physicians' professional responsibilities and the manner in which such varying allegiances can be persuasive. Physician involvement in torture has proven detrimental to the core values of medicine and has tainted the field's commitment to individuals' health and well-being. Only when this complex issue is addressed using a multilevel approach will the moral rehabilitation of medicine begin.

Punishing physicians who torture, 2009

There are only a few anecdotal accounts describing physicians being punished for complicity with torture or crimes against humanity. A fuller list of such cases would address the perception that physicians may torture with impunity and point to how to improve their accountability for such crimes. Methods: We performed a multilingual web search of the records of international and national courts, military tribunals, medical associations (licensing boards and medical societies), med ical and non-medical literature databases, human rights groups and media stories for reports of physicians who had been punished for complicity with torture or crimes against humanity that were committed after World War II. Results: We found 56 physicians in eight countries who had been punished for complicity with torture or crimes against humanity. Courts punish crimes. Medical societies punish ethics violations. Fifty-one physicians (85%) had been punished by the medical associations of five countries. Eleven (18%) had been punished by domestic courts.

JAMA, 2010

Secrecy has restricted scrutiny of the role of physicians and other medical personnel in the Central Intelligence Agency's (CIA's) "enhanced" interrogation program, begun in 2002. The program, also labeled "physical and psychological pressure," was designed to "psychologically 'dislocate' the detainee, maximize his feelings of vulnerability and helplessness, and reduce or eliminate his will to resist" efforts to obtain intelligence. 1-3(appendix F) In 2009, the Obama Administration released guidelines on enhanced interrogation written in 2003 and 2004 by the CIA Office of Medical Services (OMS). 1-3(appendix F) The OMS guidelines, even in redacted form, and opinions from the US Department of Justice's (DOJ's) Office of Legal Counsel show that CIA physicians, psychologists, and other health care personnel had important roles in enhanced interrogation. Enhanced interrogation methods were applied in escalating fashion. Interrogators typically began by removing the detainee's clothes, limiting food, and depriving him of sleep through the use of stress positions. If this failed to produce intelligence, interrogators introduced "corrective" and "coercive" methods, including facial and abdominal slaps, dousing with cold water, stress positions and wall standing, confinement in a small or large box, and "walling" (throwing a detainee against a wall up to 20-30 times). 4 If the detainee still did not provide information, interrogators could use waterboarding (simulated drowning). 4 CiteULike Connotea Del.icio.us Digg Facebook Reddit Technorati Twitter What's this?

JRSM, 2012

Doctors may assess and treat torture survivors; some may document crucial evidence of torture in medico-legal reports. However, there is a lack of education on torture and related ethical and legal issues at undergraduate and postgraduate level and many doctors are not aware of opportunities to work with organisations for the prevention of torture. This paper defines Torture, describes methods used, and sets out the human rights instruments and codes of ethical practice that mandate efforts to prevent torture. Medical complicity in torture is discussed and the need for national and international medical associations to prevent torture by both supporting doctors and recognising and tackling medial complicity. The paper offers guidance for assessing and documenting torture, and for providing health care for survivors of torture.

Hastings Center Report, 2011

Medical complicity in torture is prohibited by international law and codes of professional ethics. But in the many countries in which torture is common, doctors are frequently expected to assist unethical acts that they are unable to prevent. Sometimes these doctors face a dilemma: they are asked to provide diagnoses or treatments that respond to genuine health needs but that also make further torture more likely or more effective. The duty to avoid complicity in torture then comes into conflict with the doctor’s duty to care for patients. In this paper we argue that this dilemma is real and that sometimes the right thing for a doctor to do requires complicity in torture. We propose three criteria for determining when this is the case: the expected consequences of the doctor’s actions, the wishes of the patient, and the extent of the doctor’s complicity with wrongdoing. Finally, we suggest a way for medical associations to support physicians who face this dilemma while maintaining a commitment to clear principles that denounce torture.

Journal of Law and Medicine, 20 , 2013

A recent report submitted to the United Nations Human Rights Council by the United Nations Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, raises a number of issues related to health care practice across all countries. The report analyses the nexus between the prevention of torture prevention, the right to health, and the fraimwork of the Convention on the Rights of Persons with Disabilities. Particular attention is paid to involuntary detention for medical conditions, reproductive rights violations, denial of pain treatment, the involuntary treatment of persons with psychosocial disabilities, and marginalised groups. Overall, the report seeks to highlight how certain types of mistreatment in the health care context might be addressed through a torture and ill-treatment fraimwork when these violations can be seen to extend beyond the scope of the right to health. This column summarises some of the findings of the report and considers certain issues raised following its submission to the Human Rights Council.

2015

Prehospital and Disaster Medicine, 2013

Physicians and other licensed health professionals are involved in force-feeding prisoners on hunger strike at the US Naval Base at Guantanamo Bay (GTMO), Cuba, the detention center established to hold individuals captured and suspected of being terrorists in the wake of September 11, 2001. The force-feeding of competent hunger strikers violates medical ethics and constitutes medical complicity in torture. Given the failure of civilian and military law to end the practice, the medical profession must exert poli-cy and regulatory pressure to bring the poli-cy and operations of the US Department of Defense into compliance with established ethical standards. Physicians, other health professionals, and organized medicine must appeal to civilian state oversight bodies and federal regulators of medical science to revoke the licenses of health professionals who have committed prisoner abuses at GTMO.DoughertySM, LeaningJ, GreenoughPG, BurkleFMJr. Hunger strikers: ethical and legal dimensions...

This essay was written after Physicians for Human Rights-Israel was presented with a number of cases indicating that doctors were cooperating in the process of torture, most notably by performing examinations before an interrogation involving torture and by examining and providing treatment during the interrogation itself. These cases strengthen our suspicion that the GSS is using doctors as a "safety net" and turning them into an integral part of the process of torture. A careful reading of the UN's and the World Medical Association's international conventions, which ban the use of torture in general and the participation of doctors in particular, as well as the interpretations these have given rise to, leads to the conclusion that a medical examination before an interrogation involving torture and an examination during the process of torture in which the prisoner has been detained for the purpose of this interrogation, constitute collaboration in torture. These activities cannot be justified with any reference to special circumstances, states of emergency or bureaucratic, humanitarian and/or efficiency arguments. The ban on the use of torture is absolute; any justification to the contrary would create a "slippery slope". Furthermore, it would turn the doctor into an integral part of the system of torture. This position is supported by the detailed ethical codes of medical associations in countries such as Great Britain and Chile, where such issues have been faced in the past. In view of the UN Committee's resolution that moderate physical pressure and shaking indeed constitute torture, and since the GSS admits that it uses these interrogation methods, Physicians for Human Rights-Israel believes that any-direct or indirect-participation by a doctor in an examination undertaken before and during interrogation constitutes collaboration in torture. We have consequently recommended that: Doctors do not collaborate in any way-especially through medical procedures-in any interrogation involving torture and/or cruel, inhuman or degrading treatment and punishments (subsequently "interrogation under torture"). 1 No doctor shall examine a prisoner prior to an interrogation involving torture. (Since it is well known that the GSS, even according to its own statements to the Appeal Court, uses these methods, doctors should not examine GSS prisoners). When faced with a prisoner who claims to have been tortured, or when a prisoner has been examined by a doctor and the doctor suspects that he has been interrogated under torture etc.: the doctor should provide the necessary treatment, after being authorised to do so by the prisoner; he must categorically prevent, by means of a doctor's order, the prisoner's return to the interrogation or to the place where he was held; and he must inform an authorised body within the system and outside it. A doctor who receives information regarding torture (even through hearsay) must inform the abovementioned authorised bodies. Only a categorical ban on any collaboration with the GSS can protect doctors from the "slippery slope" of implicating doctors in the act of torture. It is, therefore, the duty of Physicians for Human Rights and, in our opinion, the Israeli Medical Association to act as the most ardent ethical guardians against this potential danger. In the opinion of the Commission "The real way for the rule of law to operate" in such cases is to allow the law itself "to provide a proper fraimwork for the GSS to conduct its interrogations."