Doctors who assist in torture should be brought to justice
Near-silence surrounds the issue of doctors' complicity in the torture of terrorist suspects, writes William Hopkins.
The issue of Western complicity in the torture of terrorist suspects is not going away. In Britain, each day brings new demands for an inquiry into the security services' alleged involvement - not least in a severely critical report published this week by the Parliamentary Joint Committee on Human Rights. In the US, the imminent release of a CIA report from 2004 is expected to reveal a "Technicolor horror show" sanctioned by senior government lawyers.
But amid the furore about whether members of the intelligence services, or their political masters, should be held accountable, there has been no scrutiny of those who arguably played an equally critical role: the doctors, psychologists, psychiatrists and other medical personnel whose expert opinion was relied upon in arguing that "enhanced interrogation techniques" did not constitute torture.
In fact, near-silence surrounds the issue of doctors' complicity - despite the abundant evidence that documents the scale of medically assisted torture. Earlier this year, for example, classified memorandums released by President Obama revealed that medical personnel at American-run detention centres oversaw a litany of abuse, including multiple waterboardings (183 times, in one case), "insult slaps", "dietary manipulation", cramped confinement, "stress positions", sleep deprivation for up to 180 hours, and multiple "wallings" (slamming detainees into walls).
Doctors were also on hand for advice in the event that "an interrogator requires a more significant response to a question", and kept detainees alive to withstand more torture. One of the memos notes how "a qualified physician would immediately intervene" after an interrogation session to perform a tracheotomy if the detainee stopped breathing.
The US Department of Justice relied heavily on this system of medical and psychological monitoring, stating: "These safeguards were critically important to our conclusion about the use of techniques." In other words, the participation of medics was used to legitimise torture, in which they acted as arbiters, modulators and referees. Their participation was intimate, deeply complicit and ongoing.
Although President Obama has said that the memos demonstrate a loss of "moral bearings", he appears to have ruled out any investigation and prosecution of the CIA employees responsible. In Britain, too, ministers are rejecting the calls for an independent inquiry (even though there is no suggestion that British medical personnel and security officials were involved in the actual abuse).
This makes it all the more incumbent on the medical profession to respond robustly to the revelations about medically assisted torture. For example, the American Medical Association - the body of physicians in the US that sets standards for the medical profession - states that doctors "must not be present when torture is used or threatened" and rules that doctors can only treat detainees if doing so is in the patient's best interest.
Clearly, these ethical rules have been breached, as has the body of international law developed since Nuremberg which holds that "the doctor shall not countenance, condone or participate in the use of torture". When doctors betray these professional oaths and principles and criminal laws, they cease to be members of the healing profession. The need to undertake a full investigation into the role of clinical personnel, and for the guilty to be struck off, investigated and even imprisoned, is therefore overwhelming.
At stake is the principle of trust in the medical profession, and the reaffirmation and restoration of the Hippocratic Oath, which should underpin the work of the healing profession.
Dr William Hopkins is a consultant psychiatrist and psychotherapist with the Medical Foundation for the Care of Victims of Torture
