Medical Ethics Have Been Violated at Detention Sites, a New Report Says

http://www.nytimes.com/2013/11/05/health/medical-ethics-violated-at-detention-sites-group-says.html?nl=todaysheadlines&emc=edit_th_20131105&_r=0 November 4, 2013 Medical Ethics Have Been Violated at Detention Sites, a New Report Says By DENISE GRADY and BENEDICT CAREY A group of experts in medicine, law and ethics has issued a blistering report that accuses the United States government of directing doctors, nurses and psychologists, among others, to ignore their professional codes of ethics and participate in the abuse of detainees in Afghanistan, Iraq and Guantánamo Bay, Cuba. The report was published Monday by the Institute on Medicine as a Profession, an ethics group based at Columbia University’s College of Physicians and Surgeons, and the Open Society Foundations, a pro-democracy network founded by the billionaire George Soros. The authors were part of a 19-member task force that based its findings on a two-year review of public information. The sources included documents released by the government, news reports, and books and articles from professional journals. Among the abuses cited in the report are doctors’ force-feeding of hunger strikers by pushing feeding tubes into their noses and down their throats. The task force also suggested that medical personnel ignored their duty to report evidence of beatings or torture of detainees, and that the Defense Department “improperly designated licensed health professionals to use their professional skills to interrogate detainees as military combatants, a status incompatible with licensing.” The panel, the Task Force on Preserving Medical Professionalism in National Security Detention Centers, is not the first to protest what it said were violations of medical ethics at detention sites. Other groups that have described abuses include Physicians for Human Rights and the International Committee of the Red Cross. The Central Intelligence Agency and the Defense Department dismissed the new report as unsubstantiated and incorrect. Lt. Col. Todd Breasseale, a spokesman for the Defense Department, said in an email: “Task Force Guantánamo routinely provides comprehensive and humane medical care to the detainees held at Guantánamo. They are consummate professionals working under incredibly stressful conditions.” Colonel Breasseale defended the force-feeding of hunger strikers via nasal tubes, which he referred to as “enteral feeding,” as legal and necessary to prevent them from committing suicide by starvation. As of Monday, there were “14 detainees refusing to eat on a regular basis, and each is approved for enteral feeding,” he said. “While detainees may be on the enteral feed list, they do not always require the tube feeding — frequently they will drink the supplement or eat a meal out of sight of their peers.” Dean Boyd, a C.I.A. spokesman, said in an email: “It’s important to underscore that the C.I.A. does not have any detainees in its custody and President Obama terminated the Rendition, Detention and Interrogation Program by executive order in 2009. The task force report contains serious inaccuracies and erroneous conclusions. The agency is proud of its medical staff, who uphold the highest standards of their profession in the work they perform.” According to the new report, the C.I.A.’s Office of Medical Services drew up guidelines that called for medical personnel to be present during interrogations to ensure that no “serious or permanent harm” resulted. For instance, exposure to cold was to be stopped just before hypothermia was likely to set in, and loud noise was to be halted just before permanent hearing damage would occur. The report claims that C.I.A. medical personnel were present during waterboarding, and that “the guidelines advised keeping resuscitation equipment and supplies for an emergency tracheotomy on hand.” The military, it says, has adopted some of the interrogation techniques that the C.I.A. developed, including the use of doctors and psychologists to help with interrogations. The report is particularly critical of the American Psychological Association for allowing psychologists to participate in interrogations. The military has long employed psychologists in its “behavioral science consultation teams,” known as Biscuits, to assist with interrogations. Little is known about these teams, except that they study detainees, suggest lines of questioning and help decide when tactics are too harsh and when it is time to push harder. “What we’d like to see from the association is a prohibition saying that psychologists cannot participate in any individual interrogation of a detainee,” said Steven J. Reisner, the only psychologist on the task force that produced the report. Dr. Reisner, who practices in New York, is president of Psychologists for Social Responsibility, a nonprofit group that advocates the ethical application of behavioral science. He is running for president of the American Psychological Association. “We’d also like to see the association acknowledge what is already widely known about psychologists’ participation in interrogations, and use those as examples of what psychologists cannot and should not do,” he said. The association’s members have been debating its ethics guidelines regarding interrogation for years. In 2008, in documents alleging abuse, lawyers for a detainee at Guantánamo Bay singled out a psychologist as a critical player. At the time, the guidelines stated that it was “consistent with the A.P.A. ethics code for psychologists to serve in consultative roles to interrogation and information-gathering processes for national-security-related purposes” — as long as the interrogation did not involve any of 19 coercive procedures, including the use of hoods, waterboarding and physical assault. Later that year, the membership voted to prohibit any consultation in interrogations at Guantánamo or other so-called black sites run by the C.I.A. But the association has not gone as far as the new report urges: It has not prohibited psychologists from assisting in all interrogations. Psychologists are divided over the wisdom of such a blanket prohibition, with some arguing that it would only reduce the level of accountability during interrogations. Whether a blanket prohibition would alter military protocols is hard to say. Like most professional groups, the psychological association has little direct authority over its members. In a statement released on Monday, the association said it supported many of the recommendations in the report, including ethics training for psychologists working with the military and intelligence services. But, it added, the association has already issued repeated statements that “have forbidden psychologists from perpetrating or supporting torture; obligated psychologists to report torture and abuse; and prohibited specific enhanced interrogation techniques, such as waterboarding.” © 2012 The New York Times Company Donations can be sent to the Baltimore Nonviolence Center, 325 E. 25th St., Baltimore, MD 21218. Ph: 410-366-1637; Email: mobuszewski [at] verizon.net. Go to http://baltimorenonviolencecenter.blogspot.com/ "The master class has always declared the wars; the subject class has always fought the battles. The master class has had all to gain and nothing to lose, while the subject class has had nothing to gain and everything to lose--especially their lives." Eugene Victor Debs