Doctors implicated in abuse
of Iraqi prisoners
NewScientist.com news service
00:01 20 August 04
The medical community is calling for an investigation into the
role of US medical staff in the prisoner abuse that took place in
Iraq's Abu Ghraib prison, according to two new journal articles
and appeals from physicians' groups.
The abuse of Iraqi prisoners in the US-run prison sparked
controversy in spring 2004 when photographs surfaced showing US
soldiers grinning as they posed beside naked and injured
prisoners.
Now, a damning picture is emerging about what role medical
staff played in the abuse.
The US military medical system "failed to protect detainees'
human rights, sometimes collaborated with interrogators or
abusive guards, and failed to properly report injuries or deaths
caused by beatings," writes Steven Miles, a physician at the
University of Minnesota in Minneapolis, US, in The Lancet.
Miles, along with the journal's editors, is calling for a full
investigation of the role of medical staff after he scoured news
reports and available government documents on the abuse.
Whistle blowing
Miles describes one interrogation in which medical staff left
after reviving a prisoner who collapsed after a beating, allowing
the abuse to continue. In another case, a medic inserted a
catheter into the corpse of a detainee who died from torture to
create evidence the prisoner was alive at the hospital.
And in another incident in November 2003, a surgeon listed
"natural causes" as the cause of death of a man who actually died
when interrogators put his head in a sleeping bag and sat on his
chest. Six months later, the Pentagon ruled the death a homicide
by asphyxia.
But crucially, doctors are concerned about what military
medical staff did not do in an environment of physical abuse.
"Where was their protest, where was their whistle blowing?" asks
physician Michael Grodin, director of the law, medicine, and
ethics program at Boston University, US.
He says doctors, despite their oath of care, have a long
history of subverting their duties to patients in favour of other
interests in "closed systems where there's no transparency", such
as prisons. The most egregious offenders, he says, were Nazi
doctors who murdered people in death camps.
"The medical community and the world at large want doctors to
behave like doctors," he told New Scientist.
Survive and evolve
Robert Jay Lifton, a psychiatrist at Harvard Medical School in
Cambridge, US, discusses the dual loyalties military doctors face
in a 29 July article in the New England Journal of Medicine (vol
351, p 415).
Lifton, who has written a book on the Nazi doctors, says they
were able to commit murder and go about their normal lives by
essentially forming a second self in a type of dissociation he
calls "doubling."
He says this trait has ironically helped humans survive and
evolve, but that it can lead to adapting to violent norms in
certain "atrocity-producing" situations.
He writes that Abu Ghraib is one such situation, in which
"doctors and other medical personnel were part of a command
structure that permitted, encouraged, and sometimes orchestrated
torture to a degree that it became the norm - with which they
were expected to comply."
Various codes - from the Hippocratic Oath, to the 1975 World
Medical Association Declaration of Tokyo, to the Geneva
Convention - prohibit doctors from colluding in any way in
torture.
"But I don't think under current practice physicians feel they
have any such obligation," says Leonard Rubenstein, executive
director of the advocacy group Physicians for Human Rights in
Boston, US.
As well as calling for a full investigation of policies that
led to detainee abuses, the group has drawn up a list of
guidelines for medical professionals in organisations - including
the military or prison service - that call for doctors to report
any abuse they see and to refuse to participate in
interrogations, torture, or the misuse of patients' confidential
medical records.
Journal references: The Lancet (vol 364, p 725 and 637)
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