by Derek Gilna

The Task Force on Preserving Medical Professionalism in National Security Detention Centres issued a report slamming health care professionals voluntarily working with the military and intelligence communities who “[p]articipated in cruel, inhumane and degrading treatment and torture of detainees.” Although the American government claims that these practices no longer take place, the evidence seems to say otherwise.

The report issued by the group after a two-year investigation, titled “Ethics Abandoned: Medical Professionalism and Detainee Abuse in the War on Terror,” prepared with the assistance of the Institute on Medicine as a Profession (IMAP) and the Open Society Foundations, found that physicians and nurses employed by the Department of Defense (DOD) and Central Intelligence Agency (CIA) engaged in professionally-suspect practices. Included in the activities, in apparent breach of commonly-accepted professional ethics, were participating in force-feeding of prisoners on hunger strikes, breaching of doctor-patient confidentiality by sharing information on prisoners’ physical and mental conditions with their interrogators, and advising and participating in “enhanced interrogation” methods, including extended sleep deprivation and waterboarding.

The report highlighted how both the DOD and CIA “undermin(ed) health professionals’ allegiance to establish principles of professional ethics and conduct through reinterpretation of those principles.” It also noted that despite extraordinary efforts by the DOD and CIA to justify and then conceal those practices, eventually it all came to light, forcing both agencies to change many, but not all, of their questionable interrogation procedures.

Justifying their actions as necessary after 9/11, DOD and CIA formed what they termed Behavioral Science Consultation Teams (BSCTs), which generally consisted of a psychologist, a psychiatrist, and a mental health technician. Most of these teams were first used at the military prison at Guantanamo Bay, starting in 2002.

According to the report, these techniques used by these teams originated in Afghanistan in 2002, and “a theory of interrogation soon emerged that was based on inducing fear, anxiety, depression, cognitive dislocation, and personality disintegration in detainees to break their resistance against yielding information, “ to produce “debility, dependency and dread,” to “psychologically dislocate the detainee, maximize feelings of vulnerability, and reduce or eliminate the will to resist” interrogation. Aside from the issue of interrogation techniques, the report was also critical of the overall level of medical care given terror detainees, noting that only recently had the quality of care reached acceptable levels.

The report further said that “the activities of medical personnel at the CIA and in the military were largely a result of policies designed, contrary to professional ethical requirements, to employ those personnel in advancing interrogation.” This practice came in for withering criticism from civilian medical experts. “Putting on a uniform does not and should not abrogate the fundamental principles of medical professionalism,” said IMAP president David Roth, who added, “‘Do no harm’ and ‘put patient interest first’ must apply to all physicians regardless of where they practice.”

Dr. Gerald Thomson, professor of medicine emeritus at Columbia University, and member of the investigatory task force, was also critical: “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. 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 that this never happens again.”

Unfortunately, according to the report, some of these same practices continue even after they were made public: “Although the CIA no longer detains terrorist suspects, many of DOD policies and rules governing health professionals in detention centers remain in place and must be changed.” This includes the force-feeding of prisoners intranasally, contrary to accepted international medical standards, in response to the six-month hunger strike that continues among many detainees at Guantanamo Bay. One can only express disgust at the questionable ethics of “medical professionals” who voluntarily abandon the tenets of their profession to advance such questionable practices.

See: http://imapny.org, “Ethics Abandoned,” 2013.

See also: www.theguardian.com, “CIA made doctors torture suspected terrorists,” November 4, 2013.

See also: http://thinkprogress.org, November 4, 2013.

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