That medical professionals were involved in the CIA “enhanced interrogation” represents a breach of medical ethics that sickens me, as a physician. This breach of medical ethics harkens back to Nazi Germany and Joseph Mengele. There is no excuse for this breach, the United States and those individuals have no violated basic human rights – and while some will state the end justifies the means, or that our enemies do worse- we, as physicians, must not stand for nor approve of such methods.
If you are not a physician, I ask you- would you go to a doctor who participated in the systematic abuse and torture of another human being? Would that make you feel comfortable that such a doctor had empathy, or beneficence, or that such a doctor had a sense of justice?
The news media is caught up with “first do no harm” – which is not a part of modern medical ethics – but for a full discussion of that see Modern Medical Ethics.
But to reproduce a part of that here:
A key tenet for physicians is nonmaleficence – to not use our skill and knowledge to harm a patient. Deliberate harm would be to put a patient at risk for a treatment we know doesn’t work. Risk associated with procedure does not count as “doing harm” unless the procedure has no hope of benefit.
When non-physicians offer treatment that they state “has no harm” they would be violating medical ethics. Many non-medical treatments have not been tested, so we do not know how they would compare to traditional treatments. When “Traditional Chinese medicine” offers a tea that ultimately causes kidney failure, they have violated ethics that a modern physician would lose their license over: the treatment was not tested, and when it was found to cause harm, they didn’t ask for it to be removed.
We know conventional chemotherapy has the potential to cause illness, and even death – I know this personally because my brother died four years ago after his first dose of chemotherapy put his frail body into septic shock, from which he did not recover. Some suggested that because my brother had metastatic lung cancer that the chemotherapy robbed him of the few months he had- and therefore the physician went against nonmaleficence by administering a therapy that would not do benefit. But that chemotherapy was not to prolong Jimmy’s life- certainly there were no illusions that it would cure him – but he was suffering horribly, and it was hoped a reduction of the tumor burden would give him some relief.
In order to obtain information from prisoners, they were experimented upon – and when you experiment upon prisoners there is an entire series of medical ethics that have been in place since the Nuremberg Code.
The CIA’s office of medical services advised the Department of Justice that the methods used for “enhanced interrogation” were medically acceptable. But lets go through the ethics as we know them today:
Force feeding of prisoners on hunger strike is against the rules outlined by the American Medical Association as well as the World Medical Association.
Patient confidentiality was clearly breeched- even though a physician, nurse, or psychologist is clearly given the right of confidentiality by their medical personnel.
There is no change in the medical ethics when a physician puts on a uniform. Physicians are still required, under army regulations, to report abuse of detainees to superiors.
One detainee, Abd al Rahim al-Nashiri (the alleged mastermind of the USS Cole bombing) was anally probed during his hunger strike and there was evidence of anal feeding (which does not work).
President Truman and Medical Ethics
The ethics for physicians is clear. The world made it clear with the help of President Truman in 1948 and the Nuremberg code- that at the basis of what a physician does is to do no harm. That we get “actionable intelligence” is not an exception to the rule- the exception to the rule is only for treatment of a person’s condition.
Those physicians and health care workers responsible are not exempt from the ethics of medicine, Geneva convention. We are better than those we captured- sadly, the sadists who received medical degrees and participated in this did not represent this.
Because those who oppose our government does not provide an exception to medical ethics. We must be the shining light that shows we are above this. Sadly, these physicians failed in their responsibility as care givers to these prisoners. They showed that there are some of us who are not ethical. Opening this for the world to see shows that we can find and punish those who are responsible – no matter the circumstances.
Those physicians involved need to come forward. Their license to practice medicine be revoked, and they must re-learn basic medical ethics should they ever wish to regain their license again.
Here is the official view of the American Medical Association.
Opinion 2.067 – Torture
Torture refers to the deliberate, systematic, or wanton administration of cruel, inhumane, and degrading treatments or punishments during imprisonment or detainment.
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.
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
Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and went to medical school. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit www.terrysimpson.com.