Doctors were asked to torture
detainees for intelligence gathering, and unethical practices continue,
review concludes
Doctors and
psychologists working for the US military violated the ethical codes of
their profession under instruction from the defence department and the CIA to become involved in
the torture and degrading treatment of suspected terrorists, an
investigation has concluded.
The report of the Taskforce on Preserving Medical Professionalism in
National Security Detention Centres concludes that after 9/11, health
professionals working with the military and intelligence services
"designed and participated in cruel, inhumane and degrading treatment
and torture of detainees".
Medical professionals were in effect told that their ethical mantra
"first do no harm" did not apply, because they were not treating people
who were ill.
The report lays blame primarily on the defence department (DoD) and
the CIA, which required their healthcare staff to put aside any
scruples in the interests of intelligence gathering and security
practices that caused severe harm to detainees, from waterboarding to
sleep deprivation and force-feeding.
The two-year review by the 19-member taskforce, Ethics Abandoned: Medical
Professionalism and Detainee Abuse in the War on Terror, supported by
the Institute
on Medicine as a Profession (IMAP) and the Open Society
Foundations, says that the DoD termed those involved in interrogation
"safety officers" rather than doctors. Doctors and nurses were required
to participate in the force-feeding of prisoners on hunger strike,
against the rules of the World Medical Association and the American
Medical Association. Doctors and psychologists working for the DoD were
required to breach patient confidentiality and share what they knew of
the prisoner's physical and psychological condition with interrogators
and were used as interrogators themselves. They also failed to comply
with recommendations from the army surgeon general on reporting abuse
of detainees.
The CIA's office of medical services played a critical role in
advising the justice department that "enhanced interrogation" methods,
such as extended sleep deprivation and waterboarding, which are
recognised as forms of torture, were medically acceptable. CIA medical
personnel were present when waterboarding was taking place, the
taskforce says.
Although the DoD has taken steps to address concerns over practices
at Guantánamo Bay in recent years, and the CIA has said it no longer
has suspects in detention, the taskforce says that these "changed roles
for health professionals and anaemic ethical standards" remain.
"The American public has a right to know that the covenant with its
physicians to follow professional ethical expectations is firm
regardless of where they serve," said Dr Gerald Thomson, professor of
medicine emeritus at Columbia University and member of the taskforce.
He added: "It's clear that in the name of national security the
military trumped that covenant, and physicians were transformed into
agents of the military and performed acts that were contrary to medical
ethics and practice. We have a responsibility to make sure this never
happens again."The taskforce says that unethical practices by medical
personnel, required by the military, continue today. The DoD "continues
to follow policies that undermine standards of professional conduct"
for interrogation, hunger strikes, and reporting abuse. Protocols have
been issued requiring doctors and nurses to participate in the
force-feeding of detainees, including forced extensive bodily
restraints for up to two hours twice a day.
Doctors are still required to give interrogators access to medical
and psychological information about detainees which they can use to
exert pressure on them. Detainees are not permitted to receive
treatment for the distress caused by their torture.
"Putting on a uniform does not and should not abrogate the
fundamental principles of medical professionalism," said IMAP president
David Rothman. "'Do no harm' and 'put patient interest first' must
apply to all physicians regardless of where they practise."The
taskforce wants a full investigation into the involvement of the
medical profession in detention centres. It is also calling for
publication of the Senate intelligence committee's inquiry into CIA
practices and wants rules to ensure doctors and psychiatrists working
for the military are allowed to abide by the ethical obligations of
their profession; they should be prohibited from taking part in
interrogation, sharing information from detainees' medical records with
interrogators, or participating in force-feeding, and they should be
required to report abuse of detainees.
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