Professional ethics in a time of war

An article in the New England Journal of Medicine alleges that doctors were active participants in prisoner abuse at Guantanamo and Abu Ghraib.

Published January 7, 2005 2:35PM (EST)

Doctors at Guantánamo Bay and Abu Ghraib used their medical knowledge to help devise coercive interrogation methods for detainees, including sleep deprivation, stress positions and other abuse, it was reported Thursday. An article in the New England Journal of Medicine provides the most authoritative account so far that doctors were active participants in the abuse of prisoners in America's "war on terror."

"Clearly, the medical personnel who helped to develop and execute aggressive counterresistance plans thereby breached the laws of war," says the article, which is based on interviews with more than two dozen military personnel and recently released official documents. It adds: "The conclusion that doctors participated in torture is premature, but there is probable cause for suspecting it."

The issue that the administration had encouraged the use of coercive interrogation techniques was raised Thursday in the Senate confirmation hearings of Alberto Gonzales, President Bush's nominee for attorney general. Gonzales was attacked for a memo that said only the most severe types of torture were not permissible under U.S. law.

The NEJM article accuses doctors of violating professional ethics by passing detainee health records to military intelligence and by watching interrogation sessions. It also describes collaboration with interrogators in which doctors and medics helped set the parameters for abuse, determining 72-hour "sleep management" schedules for detainees, approving bread and water regimens for those subjected to "dietary manipulation," and sanctioning long periods of isolation.

At Guantánamo and at Abu Ghraib in Iraq, doctors had the final say on the interrogation plan for each detainee. "The medic would screen him and ensure he was fit for interrogation ... After that the medic would watch over the interrogation from behind the glass," the article quotes a military police commander as saying.

Last August an article in British medical journal the Lancet accused medics at Abu Ghraib of failing to report the beating of detainees and of forging death certificates. But the practices described Thursday suggest for the first time that medical practitioners played an active role in abuse. "This is physicians and psychiatrists being involved in the design and implementation of interrogation plans," said Jonathan Marks, a British lawyer and fellow at the Georgetown University Law Center who coauthored the report.

There was no comment from the U.S. military Thursday, but the article includes comments from the deputy assistant secretary of defense for health, David Tornberg, that suggest the Pentagon believes professional ethics do not apply in a time of war. That view has raised concern in the medical community. "You have to protect physicians from being ... used to serve military purposes," said Leonard Rubinstein, director of Physicians for Human Rights.

By Suzanne Goldenberg

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