Medical ethics have been corrupted because doctors
and medical bodies have taken direct and indirect part in abusing prisoners
detained as part of what U.S. and other officials call the "war on terror,"
a senior British Medical Association (BMA) official said Thursday.
"Governmental and medical bodies have begun adjusting and blurring their
ethical guidance, tilting themselves towards endorsement of gross ethical malpractice,
thereby ensuring the continuation of doctors' involvement," Michael Wilks,
the BMA's ethics committee chairman, said in the latest issue of the medical
journal The Lancet.
The issue received some media attention amid reports last year that prisoners
had been abused at U.S. detention centers at Abu Ghraib, Iraq, and Guantánamo
Bay, Cuba. But "the involvement of doctors in torture and the abuse of
prisoners' human rights has been well documented over the past few decades,"
He urged a series of steps to "reverse this corruption of ethics."
National medical associations need to tighten their ethics policies and bring
to book individual members found in violation. Likewise, international bodies
such as the World Medical Association, scheduled to meet in October, must hold
accountable their national chapters for failing to quell abuses, he said. Additionally,
he called on the United States, Britain, and their allies to reverse what he
termed their assault on the United Nations.
Wilks, citing media reports, a U.S. government report, and a leaked report
from the International Committee of the Red Cross, said that at Abu Ghraib and
Guantánamo Bay, "medical personnel failed to report evidence of torture, failed
to intervene to stop it being repeated, and made available to interrogators
information from confidential medical files, thereby allowing interrogators
to exploit weaknesses."
The incidents likely "represent isolated, rather than endemic, patterns of
behavior by U.S. military doctors," Wilks acknowledged.
Even so, he said, "the involvement of doctors in the direct or indirect abuse
of prisoners is not just a stain on medical ethics. By abandoning our principles,
we add fuel to the fires of distrust and despair."
In his view, U.S. medical bodies have failed to take adequate steps to resist
backsliding on ethics.
U.S. professional institutions failed to protest when the administration of
President George W. Bush declared in February 2002 that the Geneva conventions
would not apply to al-Qaeda terrorists, he said. They held their fire again
in August that year, when the administration issued a memo stating that "physical
pain amounting to torture must be equivalent in intensity to the pain accompanying
serious physical injury, such as organ failure, impairment of bodily function,
or even death."
According to Wilks, "this failure to oppose put prisoners, already incarcerated
without trial or access to legal representation, at the mercy of unprincipled
"This inertia is bad enough, but there is evidence of a more worrying trend--governments
and professional bodies rewriting existing ethical guidance in the service of
abuse," Wilks charged, citing research by groups including U.S.-based Physicians
for Human Rights.
Wilks urged ramped up ethics lessons in medical school and tighter codes of
conduct for healthcare professionals' associations.
"The problem is that published codes are strong in their application with
the one-to-one relationship with patients, but weak when applied to communities,
and therefore open to distortion and misrepresentation," Wilks said. U.S. defense
officials, for example, have said that "physicians assigned to military intelligence
have no doctor-patient relationship with detainees and, in the absence of life-threatening
emergency, have no obligation to offer medical aid."
These personnel are not answerable to the Department of Defense but to military
intelligence and work within Behavioral Science Consultation Teams commonly
known as "Biscuits."
In new guidance issued to the military, the Pentagon has subtly changed the
wording of a 1982 United Nations resolution on the ethical duties of health
professionals with respect to prisoners, he said by way of an example.
Similarly, he assailed the American Psychiatric Association's Statement on
Psychiatric Practices at Guantánamo Bay as "weak."
He singled out for special criticism a recent report of the American Psychological
Association's Presidential Task Force.
"This report rehearses conventional ethical principles about care of individual
patients, but then does an about-face when it comes to sanctioning input from
psychologists and advice on techniques to be used in interrogation," Wilks
said. "In effect, it becomes acceptable for a health professional to dispense
with any ethical responsibilities when their training and expertise is used
outside a strictly therapeutic context."
"The use of such knowledge in creating techniques intended to damage the minds
of people under interrogation, and to advise how these techniques can be refined,
is grossly unethical, and the fact that a professional body can support such
activity is a disgrace," he said.