Torture and health care professionals

As we have again been reminded by the latest bombings in Bali, Islamist terrorism isn't suddenly going to evaporate, and consequently the war against it - in Iraq and globally - has to be sustained. But neither the war on terror nor anything else can justify this:

Recent guidelines from the US Department of Defense (DoD) contravene international principles of medical ethics by permitting physicians to facilitate and monitor abusive interrogation practices, according to a commentary published in the Journal of the American Medical Association for September 28.

"When the DoD guidelines came out, they looked similar to the United Nations guidelines," lead author Leonard Rubenstein told Reuters Health. "So we took a closer look and the differences were strikingly significant and very disturbing, not just because they seem to undermine traditional and well established ethical principles."

"It seemed clear that the ethical guidelines were designed to accommodate the kinds of roles the military wanted health care professionals to play in interrogation rather than starting with what the right ethical stance was," he added.

Rubenstein, from Physicians for Human Rights in Cambridge, Massachusetts, and his colleagues note that the UN principles state that physicians may not participate, either actively or passively, in torture or other cruel, inhuman or degrading treatment or punishment.
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The new DoD guidelines state that only health care personnel actively engaged in clinical treatment of detainees are prohibited from participating in the interrogation process. Otherwise, physicians are permitted to assist in interrogations as long as their activity is in accordance with "applicable law."

"We think this substitution of international standards with the phrase 'applicable law' accommodates a very expansive role of physicians in interrogations," Rubenstein said. "The impact of that is to allow health care professionals to participate in highly coercive interrogation practices that were banned in the past."

Such practices have included lengthy sleep deprivation, long-term isolation, severe humiliation, imposition of fear and exploitation of phobias, the authors note in their report, methods recognized as torture and ill treatment by the US Department of State.

For reasons which I won't insult the reader by spelling out, the use of doctors or other health care people in the abuse of human beings is a particular obscenity, over and above the more general one of the abuse itself. It disfigures the project and aims being fought for in the war against terror, and for democracy in Iraq. Andrew Sullivan today focuses on the story of Captain Ian Fishback. Along with worse, see this:

Even now, while the administration insists that it doesn't condone torture, its definition of what is permitted short of "torture" is murky. In written answers to a senator's inquiry, leaked last week to The Washington Post, a key official in the White House counsel's office who helped craft the new policy, Timothy Flanigan, gave nonanswers to clear questions.

He was asked if "water-boarding" was inhumane. "Water-boarding" entails tying a prisoner to a wooden plank and immersing his head in water to the moment of drowning, saving him at the last second, and then repeating this terrifying process again and again. Flanigan replied that "whether a particular interrogation technique is lawful depends on the facts and circumstances". Without knowing these, "it would be inappropriate for me to speculate about the legality of the techniques you describe".

Andrew goes on to pose the question of accountability which has been there since the original revelations about Abu Ghraib back in May 2004.