"Do No Harm": Medical Professionals Urge New York to Ban Participation in Torture
On May 18, a group of 15 medical students, clinicians, psychologists, and instructors, met with lawmakers in Albany to advocate for the passing of a state-based anti-torture bill: New York State Assembly Bill A-6665-B (introduced by Assemblyman Richard Gottfried) and Senate Bill S-4495-A (introduced by Sen. Tom Duane). The first such law in the nation, the Gottfried-Duane Bill would permanently ban the involvement of state-licensed physicians and other health professionals in acts of torture and prisoner abuse. It would reinforce existing ethical obligations, outline disciplinary consequences for their violation, and protect physicians working in situations of dual loyalties from being pressured to assist in torture.
Medical students and members of the New York Coalition Against Torture meeting with Assemblyman Richard Gottfried (center), sponsor of New York’s anti-torture legislation, on May 18. (Photo: NY State Assembly)
During the white-coat advocacy day on Tuesday, the medical student group conducted over 25 meetings with lawmakers and staff, met with the bill’s sponsors, and hand-delivered copies of the petition signed by hundreds of their peers and fellow New York State residents. They also conveyed the support of state and national professional organizations for this landmark legislation.
The Gottfried-Duane proposal responds to revelations about the role medical professionals played in the egregious abuses committed by U.S. personnel at Abu Ghraib, Bagram Air Base, Guantánamo Bay, and other detention facilities. Painstakingly documented in a series of astonishing reports by Physicians for Human Rights, these violations were not the doing of “a few errant individuals, but a more systemic problem, facilitated by official policy.” Information declassified by the CIA and Department of Defense attests to exactly how minute the level of official control was, and how insidious the subversion of medical ethics became. Doctors and psychologists cleared suspects for torture; observed interrogations and advised on how to increase the prisoner’s pain; used medical literature to determine “precise gradations” of coercion; kept records of waterboarding; and may have committed illegal human experimentation. In addition, medical and psychological information obtained under doctor-patient confidentiality was inappropriately shared with interrogators to inform coercive interrogation. These actions were in clear violation of the Geneva Conventions, the U.N. Convention Against Torture, the U.S. Constitution and military law, to say nothing of professional guidelines. However, the perpetrators have largely escaped disciplinary or criminal penalties so far.
Doctors enjoy a privileged position of trust in society, largely because of the oath they swear to uphold the values of their profession and “do no harm.” The duty to do no harm applies to professional relationships with all patients, whoever they may be. In the eyes of medical ethics, a vulnerable patient such as a prisoner requires more protection by the doctor, not less. The American Medical Association (AMA) Code of Ethics Opinion 2.067 clearly defines torture in accordance with international standards and states:
Physicians must oppose and must not participate in torture for any reason. Participation in torture includes, but is not limited to, providing or withholding any services, substances, or knowledge to facilitate the practice of torture. Physicians must not be present when torture is used or threatened. Physicians may treat prisoners or detainees if doing so is in their best interest, but physicians should not treat individuals to verify their health so that torture can begin or continue.
The responsibilities of doctors towards victims of torture extend further. In the course of medical training, doctors and nurses learn how to identify the clinical signs that someone has been beaten, raped, or abused. Similarly, there are internationally validated guidelines on how to recognize and document clinical evidence of torture, codified in the Istanbul Protocol of 1999. Moreover, the medical profession possesses a great deal of knowledge about the devastating long-term effects of torture on physical and psychological health, through the experience of treating survivors from other countries who have come to the U.S. for asylum. Medical professionals thus have a moral duty to inform the public of the devastating consequences of torture policies on the lives of suspects, and to speak out against the practice. In a statement from the New York Coalition Against Torture (NYCAT), Dr. Allen Keller, Director of the Bellevue/NYU Program for Survivors of Torture, praised the effort of his students: “Preventing medical participation in torture is crucial to our profession’s moral integrity. It is appropriate that future health professionals are not only reminding us of this but leading the way.”
As students of medicine, we feel that it is not only appropriate for us to take action on this issue, but imperative and consistent with the pride we feel in our chosen profession. Today’s doctors are entrusted with knowledge distilled through dedicated effort by generations of predecessors; we receive it as part of an ancient trust, on the condition that we shall use it reverently and beneficently. This condition is what allows patients to trust us during the most vulnerable moments of their lives. To use that knowledge purposefully in order to inflict intolerable pain on a vulnerable human being, or to stand by and knowingly allow torture to proceed, is a perversion that shakes our profession to its core. It has no place in American medicine. Prohibitions against medical complicity in torture and mistreatment of prisoners must be incorporated into our education and our laws.
The Gottfried-Duane Bill has been favorably reported by the State Assembly’s Higher Education Committee in 2009 and is currently being reviewed by the Senate’s Health Committee. It is cosponsored by a number of legislators in both the Assembly and the Senate. A growing number of medical, legal, and civil-society organizations in New York have issued statements of support.
If you’re a New Yorker, please join us! Sign the online petition, and email or send a letter to your State Assembly member and senator, urging them to cosponsor and vote for Assembly Bill A-6665-B and Senate Bill S-4495-A.