I read with utter horror that psychologists and medical doctors were involved in the interrogation of captured terrorism suspect Abu Zubaida. Regardless of whether you consider the questioning of Zubaida to be torture or simply interrogation technique, there is no way it can be seen as anything but coercive. And medical people have no place in a coercive environment of that nature.
Doctors work in the coercive environment of prisons all the time, of course, but the doctor has no interaction with the restrictive requirements of prison (s/he doesn’t say whether the criminal should be incarcerated or not). The doctor’s only concern in a prison is his duty of care to the prisoners; to maintain their health. This is as it should be.
In the context of interrogation, all of that duty of care flies out of the window. Saying that the questioning of prisoners at Guantanamo was not torture because a doctor could have stopped it at any time, is merely using the medical profession to legitimize an ethically doubtful technique. This is something that no doctor should ever be attempting. Anyone who has sworn an oath to “first do no harm” should not be trying to decide what level of coercion can be considered “harmless”. Clearly, no level of coercion is ever truly harmless. But the ethics of the psychologists involved is far worse:
“The CIA psychologists had personal experience with SERE [Survival, Evasion, Resistance and Escape - the technique used by the US military to train soldiers to resist torture] and helped convince CIA officials that harsh tactics would coerce confessions from Abu Zubaida without inflicting permanent harm. Waterboarding was touted as particularly useful because it was “reported to be almost 100 percent effective in producing cooperation,” the memo said.”
So two psychologists (men trained in the alleviation of psychological harm) persuaded the CIA that waterboarding was not torture because it was not permanently harmful. Say what? Pulling out your fingernails without anaesthetic is not permanently harmful if done carefully – the nails grow back. Electrocution is not permanently harmful – the burns heal fully unless very deep. What crackpot decided that something wasn’t torture because it did not cause permanent harm? Joseph Mengele?
There are some who argue that patriotism should predominate over medical ethics:
“But Michael Gross, a professor at the University of Haifa in Israel and the author of “Bioethics and Armed Conflict: Moral Dilemmas of Medicine and Warfare,” said that if physicians think particular harsh interrogation techniques do not constitute torture, there is no reason they should not participate.
““Physicians are faced with a hard dilemma,” he said. “They have professional obligations to do no harm, but they also have a duty as a citizen to provide expertise to their government when the national security is at stake. In a national security crisis, I believe our duties as citizens take precedence.””
That is an extremely dangerous line to take. History is full of medical men who threw away their ethical stance in the name of loyalty to a country. These men did unspeakable things simply because they thought they were serving a cause rather than an ancient oath. But the hippocratic oath is there to protect our integrity and our relationship with our patients. Doctors who ignore a duty of care to patients, ignore the fundamental bedrock of medical practice. How can a patient trust his physician, when the physician may be serving the interests of the state rather than the patient? What if it is in the interests of the state to conduct dangerous medical experiments? Or kill someone in the name of “national security”?
Let me put it in a more common medical context. What if the state informs you that it cannot afford treatment for every single woman with breast cancer and asks you to choose which ones will have treatment? Will you advocate for your patient, or follow the state’s lead and deny them treatment? Note, I am not here talking about withholding futile treatment, but essential, life-saving treatment.
If we do not bring these doctors who participated in interrogations to account, how can our patients trust us to advocate for them? I am, therefore, in complete agreement with Dr Stephen Miles here:
“Steven H. Miles, a professor of medicine at the University of Minnesota and author of “Oath Betrayed: America’s Torture Doctors,” said the actions described in the memos were the “kind of stuff that doctors have been tried, convicted and imprisoned for in other countries — and that’s what should happen here.””
At the very least these doctors and psychologists should be immediately struck off and never allowed to practice medicine again. Otherwise we are in danger of letting medicine become a tool of the state, rather than a service to the people.