A report entitled “Ethics Abandoned: Medical Professionalism and Detainee Abuse on the War on Terror,” by the Task Force on Preserving Medical Professionalism in National Security Detention Centers states 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.” This new report confirms the findings of the report of the Task Force on Detainee Treatment, written by the members of the Constitution Project, a non partisan research and advocacy group in Washington, D.C.
Using almost the same words the report of the Constitution Project had stated, “U.S. forces, in many instances, used interrogation techniques on detainees that constitute torture. American personnel conducted an even larger number of interrogations that involved ‘cruel, inhuman, or degrading’ treatment. Both categories of actions violate U.S. laws and international treaties. Such conduct was directly counter to values of the Constitution and our nation.”
The new report on abuse of detainees, supported by the Institute on Medicine as a Profession (IMAP) and the Open Society Foundations states that the US Department of Defense (DoD) called those involved in interrogation of detainees “safety officers” rather than doctors, which constitutes a linguistic abuse on top of the ethical abuse.
One of the main arguments for denying constitutional protection to the Guantánamo prisoners rests on the allegation that Guantánamo is in Cuba, off American soil. Yet, respect for basic human dignity fostered by the Bill of Rights is not limited by nationality and territory. And if the US Constitution were not enough, international human rights law (customary and treaty-based), extends such protection.
Doctors and nurses were directed to participate in the force-feeding of prisoners who were on hunger strike, thus violating not only the Hippocratic Oath but also the rules established by the World Medical Association and the American Medical Association, among many such professional societies. Also, in a fundamental breach of their privacy responsibility doctors and psychologists working for the DoD were required to alter the confidential nature of their relationship with the prisoners and inform the authorities what they knew of the prisoners’ physical and psychological status.
What explains doctors’ participation in torture? That professionals who are trained to do everything in their power to alleviate suffering would instead contribute to carrying out torture is one of the most tragic perversions of the medical mandate. It is a fundamental problem in medical ethics. In the case of physicians, their participation in torture is one of most blatant violations of basic tenets established some 2,500 years ago by Hippocrates.
Richard Goldstein and Patrick Breslin offered one explanation: “Most physicians involved in torture seem to be caught up in vast government machines and descend gradually into the torture chamber, propelled by a combination of fear, weakness and self-delusion that is all too depressingly human.”
Norberto Liwsky, an Argentine physician who had been abducted by the Argentine military and who was tortured with the complicity of a medical colleague named Héctor Jorge Vidal, told me, “No one participates in torture without first going through a process of justifying unethical values, even before he enters the torture chamber.” As stated by David Rothman, IMAP’s president, “‘Do no harm’ and ‘put patient interest first’ must apply to all physicians, regardless of where they practice.”
The inhumane treatment of prisoners at Guantánamo has been repeatedly condemned by international human rights organizations. The moral and legal challenge confronting the United States is to continue its war on terrorism while adhering to international human rights standards. Guantánamo has been an indelible stain in the US reputation throughout the world. The time to close it and stop the inhumane treatment of prisoners is long overdue.
Dr. Cesar Chelala is an international public health consultant and a co-winner of an Overseas Press Club of America award.