( M S I 31 )
Health Professionals Participation in Torture: An affront to humanitarian and medical ethics?
Deborah Vozzella Hall, Elizabeth Wiley, AMSA - USA
In December 2014, a United States Senate Select Committee released a report detailing how health professionals including physicians and psychologists participated in, led and even designed “enhanced interrogation techniques” as part of the U.S. Central Intelligence Agency’s Detention and Interrogation Program1. Although the report and accompanying documents are significantly redacted, the report details the use of torture including waterboarding, sleep deprivation, forced nudity, physical violence, denial of access to medical care, mock burials, prolonged stress positions and procedures without any medical indication such as rectal feeding and rehydration. Physicians and other health professionals facilitated and aided interrogations. Doctors reportedly recommended shackling techniques to enable prisoners to stand for more than fifty hours. For waterboarding, the use of saline rather than free water was advised to avoid water intoxication. During interrogations, health professionals reportedly monitored detainees’ vital signs and other clinical parameters to ensure interrogations could proceed. Instead of protecting and providing care for sick and injured detainees, medical professionals provided clearance for more torture.
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There is simply no defense of physicians’ and other health professionals’ participation in these “enhanced interrogation techniques,” or torture. Such behavior, whether passive or active, entails a blatant disregard for core principles of medical ethics including respect for human dignity and rights as well as medical professionalism2. Moreover, physician participation in torture is at odds with key humanitarian principles – it inflicts and perpetuates suffering rather than seeking to alleviate it and compromises physician impartiality.
Even more tragically, physician participation in torture is a global humanitarian challenge and is not limited to the U.S. CIA’s Detention and Interrogation Program3. Physician involvement in torture has been noted to be “widely practiced in society4.” The acts of torture described in the U.S. Senate Select Committee report are inconsistent with international humanitarian law and treaties including the Geneva Conventions. The United Nations Convention against Torture and Other Cruel, Inhuman and Degrading Treatment or Punishment, which has been ratified by the United States, prohibits the use of torture and stipulates that “[n]o exceptional circumstances whatsoever…may be invoked as justification of torture5.” Within the medical community, the World Medical Association (WMA) Declaration of Tokyo prohibits physicians from participating in or being present during the practice of torture or other cruel, inhuman or degrading procedures6. The WMA’s Declaration of Hamburg prohibits physicians from participating in “… torture or other forms of cruel, inhuman or degrading procedures for any reason7.” The WMA has further repeatedly affirmed a prohibition on physician participation in torture and commitment to physician impartiality8. Similarly, the American Medical Association (AMA) Code of Medical Ethics calls on physicians to oppose and not participate in torture for any reason9. In December, the WMA, AMA and the British Medical Association all issued statements reaffirming opposition to physician participation in torture as part of the U.S. CIA program10,11,12. Similarly, the American Medical Student Association’s (AMSA-USA) Principles Regarding Human Rights calls for physicians to be able to “fulfill their ethical obligations
medical students worldwide | MM 2015, Turkey