Cross posted from The Stars Hollow Gazette
Primum non nocere, Latin for “first do no harm,” is the fisrt principal precept of medical ethics that all medical students are taught in medical school and is a fundamental principle for emergency medical services around the world. It is part of the oath that physicians take on graduation. It appears that ethical standard was abandoned by military doctors after 9/11 and has continued with the inhumane treatment of detainees and Guantanamo and other black-ops sites around the world. In a report (pdf) from the Task Force on Preserving Medical Professionalism it was concluded that military doctors and psychologists worked with the CIA and the Pentagon to design, enable and participate in torture and cruel, inhumane and degrading treatment
An independent panel of military, ethics, medical, public health, and legal experts today charged that U.S. military and intelligence agencies directed doctors and psychologists working in U.S. military detention centers to violate standard ethical principles and medical standards to avoid infliction of harm. The Task Force on Preserving Medical Professionalism in National Security Detention Centers (see attached) concludes that since September 11, 2001, the Department of Defense (DoD) and CIA improperly demanded that U.S. military and intelligence agency health professionals collaborate in intelligence gathering and security practices in a way that inflicted severe harm on detainees in U.S. custody.
These practices included “designing, participating in, and enabling torture and cruel, inhumane and degrading treatment” of detainees, according to the report. Although the DoD has taken steps to address some of these practices in recent years, including instituting a committee to review medical ethics concerns at Guantanamo Bay Prison, the Task Force says the changed roles for health professionals and anemic ethical standards adopted within the military remain in place.
“The American public has a right to know that the covenant with its physicians to follow professional ethical expectations is firm regardless of where they serve,” said Task Force member Dr. Gerald Thomson, Professor of Medicine Emeritus at Columbia University. “It’s clear that in the name of national security the military trumped that covenant, and physicians were transformed into agents of the military and performed acts that were contrary to medical ethics and practice. We have a responsibility to make sure this never happens again.” [..]
“Abuse of detainees, and health professional participation in this practice, is not behind us as a country,” said Task Force member Leonard Rubenstein, a legal scholar at the Center for Human Rights and Public Health at The Johns Hopkins Bloomberg School of Public Health and the Berman Institute of Bioethics. “Force-feeding by physicians in violation of ethical standards is illustrative of a much broader legacy in which medical professionalism has been undermined.”
Joining Amy Goodman and Juan Gonzalez on Democracy Now! for a discussion of the report are retired brigadier general Dr. Stephen Xenakis, a military psychiatrist who advised the chair of the Joint Chiefs of Staff on military mental health issues, and Leonard Rubenstein, senior scholar at the Johns Hopkins Bloomberg School of Public Health and co-author of the report, “Ethics Abandoned: Medical Professionalism and Detainee Abuse in the ‘War on Terror.’”
The two-year study cites doctors for breaching patient confidentiality and advising interrogators on how to exploit prisoners’ fears and crush their will to resist. The task force is calling for a full investigation of the medical profession’s role in U.S. torture and an overhaul to ensure doctors involved in interrogations follow ethical standards. Both the CIA and the Pentagon have rejected the report’s findings.
Transcript can be read here
CIA made doctors torture suspected terrorists after 9/11, taskforce finds
by Sarah Boseley, The Guardian
Doctors were asked to torture detainees for intelligence gathering, and unethical practices continue, review concludes
Medical professionals were in effect told that their ethical mantra “first do no harm” did not apply, because they were not treating people who were ill.
The report lays blame primarily on the defence department (DoD) and the CIA, which required their healthcare staff to put aside any scruples in the interests of intelligence gathering and security practices that caused severe harm to detainees, from waterboarding to sleep deprivation and force-feeding.
The two-year review by the 19-member taskforce, Ethics Abandoned: Medical Professionalism and Detainee Abuse in the War on Terror, supported by the Institute on Medicine as a Profession (IMAP) and the Open Society Foundations, says that the DoD termed those involved in interrogation “safety officers” rather than doctors. Doctors and nurses were required to participate in the force-feeding of prisoners on hunger strike, against the rules of the World Medical Association and the American Medical Association. Doctors and psychologists working for the DoD were required to breach patient confidentiality and share what they knew of the prisoner’s physical and psychological condition with interrogators and were used as interrogators themselves. They also failed to comply with recommendations from the army surgeon general on reporting abuse of detainees.
The CIA’s office of medical services played a critical role in advising the justice department that “enhanced interrogation” methods, such as extended sleep deprivation and waterboarding, which are recognised as forms of torture, were medically acceptable. CIA medical personnel were present when waterboarding was taking place, the taskforce says.
US Medical Professionals Were Involved in the Design & Administration of Torture
by Kevin Gosztola, The Dissenter at FDL
At Guantanamo Bay, a policy was implemented to allow interrogators to use “medical and psychological information” on detainees in order to “exploit” weaknesses during interrogations. The International Committee of the Red Cross reported in 2004 that military interrogators were able to freely access detainee medical records. Detainee medical information can be used for “intelligence gathering,” and BSCTs are allowed to perform psychological assessments, which are passed on to interrogators, so long as that information is not used to treat a prisoner inhumanely. The Task Force urges this practice be brought to an end.
The Task Force report addresses the role of medical personnel in force-feedings. It does not accept the Defense Department’s claim that force-feedings are undertaken to save lives. They have been “used commonly, not just in rare instances where a detainee’s life was threatened.” They have been explicitly used to break political protests. And, therefore, all force-feedings should be “prohibited.”
Finally, the report proposes that medical personnel be held accountable for their role in torture or inhumane treatment by further informing the public of the role of medical personnel in what has happened. There should be more “fact-finding and investigations” along with “stronger disciplinary action through state health professional licensing boards.”
It suggests that military and intelligence health professionals be subject to the same civilian disciplinary system as other health professionals because, no matter where they are working, all military and intelligence medical personnel are US physicians and psychologists. [..]
In conclusion, while it is not stated by the Task Force, this failure to hold medical professionals accountable should be understood in the context of the larger issue of impunity for those involved in authorizing and carrying out torture in the “war on terrorism” under President George W. Bush. It has been policy under President Barack Obama to decriminalize torture and not prosecute former Bush administration officials responsible for cruel and inhuman treatment. The administration is also presiding over military commissions at Guantanamo that will not permit evidence of torture to be mentioned in court by the very few defendants that have been granted some modicum of due process after actually being charged with committing crimes.
A 6,300-page report by the Senate intelligence committee details the CIA’s role in torture and likely contains critical details on medical personnel’s role in torture yet it remains secret. The CIA has effectively managed to resist or prevent the release thus far and the Obama administration has not taken the step of ordering that it be released in some form, which has enabled the CIA to continue to escape full responsibility for its role in the torture of prisoners.
Blue Ribbon Task Force Says Army Field Manual on Interrogation Allows Torture, Abuse
by Jeff Kaye, The Dissenter at FDL
A report by a multidisciplinary task force, made up largely of medical professionals, ethicists and legal experts, has called on President Obama to issue an executive order outlawing torture and other abusive techniques currently in use in the military’s Army Field Manual on interrogations. The Task Force, which wrote the report for The Institute on Medicine as a Profession (IMAP) and the Open Society Foundations (OSF), has also called on the Department of Defense to rewrite the Army Field Manual in accordance with such an executive order. [..]
Besides recommending that the Department of Defense (DoD) revise the AFM itself, the Task Force report calls for the United States to “accede to the Optional Protocol to the Convention Against Torture, which requires the creation of an independent domestic monitoring body for the purpose of preventing torture against individuals in custody.”
The recommendation to issue a new executive order on current forms of torture and abuse, and to rewrite the Army Field Manual is one of eight findings and numerous recommendations in the report. The first recommendation was for President Obama to “order a comprehensive investigation of U.S. practices in connection with the detention of suspected terrorists following 9/11 and report the results to Congress and the American people.”
The report continued, “The investigation should include inquiry into the circumstances, roles, and conduct of health professionals in designing, participating in, and enabling torture or cruel, inhuman, or degrading treatment of detainees in interrogation and confinement settings and why there were few if any known reports by health professionals.” In the body of the report, the Task Force indicated the investigation should include an examination of the “highly questionable” and “unexplained” use of the drug mefloquine on all the Guantanamo detainees, something I will examine in more depth in a future article.
Doctors: Force-Feedings at Guantanamo Have Been Used to Break Political Protests, Not Save Lives
by Kevin Gosztola, The Dissenter at FDL
This year at Guantanamo one of the biggest hunger strikes in the history of the facility took place. Lawyers for detainees reported more than 100 prisoners in the prison were at one point participating in the hunger strike, which aimed to call attention to the inhumanity and hopelessness of their indefinite detention. But the hunger strike, an act of protest, was eventually broken through force-feedings that involved medical personnel. [..]
A prisoner used to be able to control the rate that food was entering his body to limit discomfort. But, “in a major policy change from the past that adds to the coerciveness of force-feeding, the detainee is no longer permitted to control drip rates or order of ingredients during enteral feeding.” The new standard operating procedure states that giving prisoners this kind of control “has had the effect of prolonging the total time spent in the feeding chair and has given the detainee a measure of control over an involuntary process.” Therefore, the Task Force indicates “all elements
of detainee control over flow rate, content of feeding, or location of feeding is now prohibited.”
Furthermore, the Task Force maintains its conclusions are “consistent with decisions of courts reviewing similar practices. The European Court of Human Rights, while stating that force-feeding to save a life may not amount to a violation of laws against torture and cruel, inhuman, or degrading treatment, held that ‘repeated force-feeding, not prompted by valid medical reasons but rather with the aim of forcing the applicant to stop his protest, and performed in a manner which unnecessarily exposed him to great physical pain and humiliation, can only be considered as torture.'”
These medical professional should not just be barred from practicing medicine anywhere, they should be prosecuted for torture along with all those responsible for the implementation of these programs and policies from both the Bush and Obama administrations.