Doctors Who Facilitate Torture Must Be Held to Account

Physicians hold a special position in U.S. society. They are given a place of honor in return for the expectation that they will use their knowledge and skills in the public interest and adhere to a clear set of ethical standards.

Under pressure from the government to misuse their expertise, though, some doctors have been willing to rationalize cooperation in unethical behavior. In recent years, nowhere has such ethical deviation been so starkly on display as in the case of the participation of medical professionals in the CIA torture program. The recent release of a CIA report, secured through an ACLU lawsuit, details how doctors willingly and even proudly became complicit in the CIA’s torture program.

The warped rationalizations the CIA doctors used to justify their participation reflect a blatantly unprofessional eagerness to violate medical ethics when encouraged by a government agenda. Once they began participating in interrogations — which is clearly prohibited by American Medical Association (AMA) guidelines — CIA medical professionals went to absurd lengths to deny the reality of the abuses and physical and psychological harms they were witnessing and effectively presiding over.

At one point, CIA doctors decided that waterboarding actually “provided periodic relief” to one prisoner “from his standing sleep deprivation.” The CIA doctors also claimed that when a different prisoner was forced into a coffin-sized box, this provided a “relatively benign sanctuary” from other torture methods. The descent into complicity with torture was so deep that they lost sight of the clear ethical breach in helping to modulate relative levels of pain infliction.

Torture isn’t the only recent example of unethical physician complicity in U.S. human rights violations. Throughout the last century, and into the current one, physicians have participated in all methods of executions, most recently through lethal injection, in violation of professional ethical guidelines. In a number of states that execute prisoners by lethal injection, physicians have continued to consult on lethal dosages, examine veins, start intravenous lines, witness executions, and pronounce death.  

Some doctors argue that a physician may be able to alleviate suffering during an execution. The presence of a physician, however, lends a veneer of humanity to a practice that is anything but humane. And all of these acts are in violation of ethical guidelines established by the AMA as well as the World Medical Association.

As Physicians for Human Rights laid out in its seminal report, “Breach of Trust,” written with the American College of Physicians and other groups, “doctors are trusted to act in the best interests of their patients, and participating in an execution fundamentally violates that trust.”

The twisted logic that states use to enlists doctors in executions — by claiming they are “easing the suffering” of those about to be killed — can also be seen in the CIA doctors’ misguided belief that they can lessen the pain of torture. These are merely excuses.

Execution and torture are not medical procedures, and they are not within the scope of medical practice. The trust society places in physicians to work for the benefit of their patients and the public is shattered when medical skills are used to facilitate state executions or government-sponsored torture. 

Justifications for such collusion are further eroded by the secrecy and anonymity that often accompanies this participation. A number of states have adopted laws that provide anonymity for doctors who participate in executions. Some also pay participating doctors in cash to eliminate a paper trail. Going to such lengths to keep identities hidden is an implicit acknowledgment that something that cannot survive professional or public scrutiny is taking place.

The medical profession cannot regulate and police itself properly if violators are protected from scrutiny and review. To prevent further stains on the medical profession through complicity in torture or executions, the names of those involved in both practices need to be made public. State medical boards, which are responsible for licensure and discipline, should define physician participation in torture and executions as unethical conduct and take appropriate action against physicians who violate ethical standards. In some cases, they should consider removing the medical licenses of those found to have participated in torture or executions. 

The CIA report claims that the torture techniques were “reassuringly free of enduring physical or psychological effects.” Those involved should be made to defend this assertion publicly, in light of what we now know. The detainees remaining in Guantanamo, and many of those released, still suffer from severe and disabling Post Traumatic Stress Disorder. In fact, one of the detainees referenced in the report was evaluated by a doctor appointed by the Defense Department who said he was one of the “most traumatized individuals I have seen” among hundreds of torture victims evaluated. The doctors who facilitated his torture should be held to public scrutiny.

The betrayal of ethical obligations by doctors in any circumstances should result in public stigma that will serve to deter future such actions. National professional associations should condemn those who collude in abuse and violations of core ethical obligations and remove them from membership if they are identified. Without consequences, we will all suffer a continuing threat posed to the moral standing of physicians.

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Anonymous

This is a salient point. Your standard jackboot with no knowledge of medicine or physiology should be the ones to administer executions and enhanced interrogation techniques.

Steven Miles MD

The physician should not only avoid the "enhanced interrogation techniques" (euphemism for torture) but they should have pointed out to the Defense Department and CIA that there are 60 years of research conducted by intelligence services showing that such techniques do not improve intelligence collection, produce bad intelligence, and destroy the possibility of recruiting human intelligence. Other historical studies show that they alienate sympathetic populations, promote retaliatory torture, produce unusable evidence, lead military planners and special operations forces off on poorly grounded policies and dangerous operations. One of the striking things about the DoD/CIA misadventures during the War on Terror was that the use of this large background of usable information on coercion during interrogation was ignored.
It must be pointed out however that in the modern world, at least 80 countries rely on physician complicity with torture to tell interrogators how to titrate it up for prisoners who are not supposed to die (yet), devising torture methods that do not leave scars and falsifying medical records and death certificates to conceal torture related injuries and deaths.
Steve Miles MD (MN ACLU Foundation Board [for identifying purposes only])

Anonymous

can you believe the hypocrisy of the radical left? Everybody needs to read this article written by the extreme radical left also known as the ACLU and see the hypocrisy. these same liberals that are complaining about inhumanity have no problem when it comes to taking a 9 month baby partially out of a mother's womb and sticking scissors in the back of its head and sucking its brains out.

Oooh, who's your dealer? Sounds like they have you on the good stuff if you're so out of your mind to think that condmening doctors who endorse torture is radical. Plus, you actually think that abortion is legal at nine months!!! Seriously, hook me up, because whatever you've got is some trippy stuff.

Anonymous

Where ever you are getting your information from, you are so completely off target. Abortions are NOT performed at the ninth month of pregnancy. NO one is sucking brains out of fetuses. I shudder to think what else you are stating is truth.

Anonymous

The ACLU should strongly support “Oath of Office Training” with an annual exam for all government servants from police officers to the FBI to the CIA. All government servants, including the CIA, take a supreme (and superseding) loyalty oath to the U.S. Constitution. The American loyalty oath is an indirect oath, it’s not to the country directly and not to the American people directly - it’s to a constitutional rule of law system of government.

Anonymous

I'm guessing, you don't put much credence in Trump's Non-disclosure Agreement for all his administration's hires? I wonder if General Kelly is under an NDA that would preclude him from testifying to Congress, the FBI, or in a court of law. I heard that several people like Priebus and Bannon, used the Trump NDA as a commitment not to disclose any information while testifying before Congress -- that their NDA extended to them executive privilege. Do you think the Trump NDA would be a substitute for a loyalty oath?

Anonymous

Do not forget the non- human animal “ research” which amounts to torture and moments of sexual depravity. This is all bad. What does it take for a physician, oathed to do no harm, to step away from any involvement with torture. Military have said it does not work, it is no help, it produces bad intelligence.

Chigurhs CattleGun

Pretty ballsy to assert that terrorist detainees are the ones suffering from victimization, as opposed to the victims that they've slaughtered.

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