Friday, December 26, 2014

Torture vs Medical Ethics: Should Doctors that Assisted in CIA interrogations be Held Accountable?

by Nomad

Dick Cheney recently claimed that controversial procedures applied to detainees were a medically necessity. Experts dispute this and call for a full investigation of possible ethics violation and crimes committed by contracted physicians. 

Cheney's Attempt at Damage Control
Recently, ex-vice president Dick Cheney appeared on MSNBC's "Meet the Press." Following the release of the Senate report on CIA detention and interrogation program. Cheney was in full damage control mode.
In spite of his attempt, it was pretty clear that the master manipulator's tricks had worn tissue thin. 

During the interview, Cheney repeatedly tried in vain to use 911 as an excuse for what went on behind prison walls. Nobody has ever argued that the detainees were nice people but without a trial, they were still innocent. Nobody has ever argued that the things done on September 11 2001 should be forgotten or that we must do everything- within the law- to stop attacks.
Nevertheless, Cheney's argument was that the ends justified the means, even when those means included torture (as defined by various international treaties that the US is a party to.)

All in all, even Cheney's supporters were embarrassed by what amounted to what can charitably called "misrepresentations." When asked about one of the more inexcusable techniques used by the CIA, namely "rectal feeding  and "rectal hydration"

Cheney claimed these procedures were done only as a medical necessity.  Michael Hayden, former CIA director recently used the same rebuttal to torture allegations.

The Experts Respond
Of course, the defense was ridiculous but it also opened the door for yet another problem for the CIA and its contracted physicians. 

According to an article in the UK Guardian, the group has called for a federal commission to investigate the full extent of health professionals’ participation in CIA torture. Cheney's defense has absolutely no validity, says one group, Physicians for Human Rights (PHR). 
[R]ectal hydration is almost never practiced in medicine because there are more effective methods, and it is never considered as a first option for rehydration or nutritional support. PHR notes that the report indicates that rectal hydration was used to “control and/or punish the detainees ... Insertion of any object into the rectum of an individual without his consent constitutes a form of sexual assault.”
PHR is a nonprofit human rights organization made up of medical specialists. Founded in 1986, this organization has worked in more than 60 countries and territories, including countries like Afghanistan, Bahrain, Burma, Democratic Republic of the Congo, El Salvador, Iran,  Israel,   Libya,  Palestine, Sudan, Syria, Turkey, and- yes- even the United States. 

According to its website, PHR uses medicine and science to document and call attention to mass atrocities and severe human rights violations. 

This month, PHR published its analysis of information provided by the Senate CIA Torture report. For those medical professionals who participated in any capacity in the CIA program, it must have quicken their pulse and caused palpitations.

Brutal and Systematic
The group also notes that although the doctors were supposed to be ensuring that CIA agents were following policy, they appear to have been assisting the interrogators to find ways to increase the pain.

Two contracted psychologists James Mitchell and Bruce Jessen played a central role, the PHR analysis points out, in devising strategies for "the direct infliction" of both "physical and psychological harm on detainees." 

Sources tell us that prior to being brought onboard, Mitchell had never conducted an interrogation nor did he have any training to be one. He did not speak Arabic- certainly a hindrance in an interrogation- and had no special knowledge al-Qaeda or radical Islam in general.

Despite a conspicuous absence of qualifications, Mitchell was not only allowed to design and implement an interrogation plan, but actually oversaw and conducted water-boarding on at least one detainee. (A cameo appearance by a special guest star.)
Perhaps his only real qualification was his obedience to following orders and an ability to rationalize cruelty. 

(In spring of 2009, the CIA, after having paid $81 million, canceled the contracts of Mitchell and Jessen. Furthermore, the CIA agreed as part of the contract to provide legal costs for Mitchell and Jessen of at least $5 million if necessary.)

Other medical professionals served different functions as well. CIA-recruited physicians also helped US department of justice lawyers to create a fiction of “safe, legal and effective” interrogation practices. (This in turn provided a cover for higher level officials.) 

According to PHR analysis, health professionals played "not only a central, but an essential role in the CIA torture program – to an extent not previously understood." 
Dr. Vincent Iacopino, PHR’s senior medical advisor and an author of the analysis.
"Doctors and psychologists working for the U.S. government engaged in the brutal and systematic torture of detainees. Health professionals who participated in these crimes betrayed the most fundamental duty of the healing professions – to do no harm. They must be held accountable in order to restore trust in our professions and ensure this never happens again."
Code of Ethics Ignored
Similar things were declared after the war when German physicians were brought to Nuremberg court, charged with crimes against humanity. In 1999, the American Medical Association adopted a code of ethics for all, which, while not laws, outline standards of conduct for "honorable" physicians.  
That code makes specific reference to torture.  Torture is broadly defined but it is narrow enough to apply in the CIA case.  
Torture refers to the deliberate, systematic, or wanton administration of cruel, inhumane, and degrading treatments or punishments during imprisonment or detainment.
The AMA code of ethics goes on:
Physicians must oppose and must not participate in torture for any reason. Participation in torture includes, but is not limited to, providing or withholding any services, substances, or knowledge to facilitate the practice of torture. Physicians must not be present when torture is used or threatened.
Throughout the CIA interrogations, the violations to the code of ethics were crystal clear. Breaching of those ethics was in no way accidental.
Physicians may treat prisoners or detainees if doing so is in their best interest, but physicians should not treat individuals to verify their health so that torture can begin or continue. Physicians who treat torture victims should not be persecuted. Physicians should help provide support for victims of torture and, whenever possible, strive to change situations in which torture is practiced or the potential for torture is great.  
The last question is now whether America can actually muster the moral will to take the step that history demands and justice dictates.

The PHR analysis is provided in a downloadable pdf file below.