The Torture Memos, Medical "Professionals", and the Hippocratic Oath

I just finished reading the torture memos that were released today. I cannot remember ever in my life being as ashamed of my country as I am at this moment. The contents of the memos are so insanely wrong that I'd like to believe that they're fiction, but they're clearly not. While I understand President Obama's desire to move forward, I am appalled by his decision to rule out prosecutions for anyone who relied on the excuse that these memos said that what they were doing was OK.

Of course, prosecutions aren't the only possible consequences, and there are some disciplinary options that the President does not actually have any control over. In particular, the President doesn't have the right obligation that professional societies have to enforce the professional and ethical standards of their professions.

Reading these memos, it's very clear that there are quite a few CIA employees who are allegedly medical professionals. Those people need to find new professions. I would strongly suggest that you take a few minutes - particularly if you're a doctor or a psychologist - to suggest to your colleagues at the American Medical Association and the American Psychological Association that it might be good to take some formal steps along those lines.

The first of the memos provides a good example of the role doctors played both in the torture and in the legal justification used to excuse the torture. That memo outlines the torture of one specific prisoner - Abu Zubaydah. The various torture techniques that the CIA was seeking permission to use were detailed in excruciating detail, as was the involvement of medical staff:

You have informed us that your research has revealed that, in rare instances, some individuals who are already predisposed to psychological problems may experience abnormal reactions to sleep deprivation. Even in those cases, however, reactions abate after the individual is permitted to sleep. Moreover, personnel with medical training are available to and will intervene in the unlikely event of an abnormal reaction. You have orally informed us that you would not deprive Zubaydah of sleep for more than eleven days at a time and that you have previously kept him awake for 72 hours, from which no mental or physical harm resulted. [emphasis added]

You would like to place Zubaydah in a cramped confinement box with an insect. You have informed us that he appears to have a fear of insects. In particular, you would like to tell Zubaydah that you intend to place a stinging insect into the box with him. You would, however, place a harmless insect in the box.

We also understand that a medical expert with SERE experience will be present throughout this phase and that the procedures will be stopped if deemed medically necessary to prevent severe mental or physical harm to Zubaydah. [emphasis added]

The author of the memo, Jay Baybee (now a Federal judge with lifetime tenure), made extensive use of the involvement of these doctors in his determination that doing things like stuffing someone afraid of insects into a confined box with a bug isn't actually torture:

To violate the statute, an individual must have the specific intent to inflict severe pain or suffering. Because specific intent is an element of the offense, the absence of specific intent negates the charge of torture. ... A defendent acts in good faith when he has an honest belief that his actions will not result in severe pain or suffering. Although an honest belief need not be reasonable, such a belief is easier to establish where there is a reasonable basis for it. Good faith may be established by, among other things, the reliance on the advice of experts.

Based on the information you have provided us, we believe that those carrying out these procedures would not have the specific intent to inflict severe physical pain or suffering. The objective on these techniques is not to cause severe physical pain. First, the constant presence of personnel with medical training who have the authority to stop the interrogation should it appear it is medically necessary indicates that it is not your intent to cause severe physical pain.

It's not torture, the Justice Department says, because there are going to be medical professionals present with the authority to stop the torture interrogation if it's "medically necessary" to do so.

In what twisted universe is monitoring torture extreme interrogation in order to ensure that the levels of pain involved remain "reasonable" consistent with having taken an oath that starts out "First, do no harm?"

I really think the AMA should really try to figure that one out - and take steps to ensure that the medical professionals who were involved in that process find new employment in a profession that does not have the same ethical demands as medicine. I think I'll give their press office a call in the morning and see what they think.

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Presumably, the argument can be made from an extremely pragmatic perspective that they are going to torture people anyways and that this will help minimize the harm from torture. If I'm going to be tortured I'd rather have a doctor present to make sure the torture stays non-fatal. I'd be inclined to argue that that's not a morally acceptable thing to do and the best solution is to actually stop the torture. Moreover, by being present one gives the torturers a clearly unacceptable veneer of moral legitimacy.

(Also can I just once again register my disgust that we've gotten to the point that these conversations need to even occur outside philosophy classes?)

You basic idea is sound. However, the American Medical Association is completely toothless. Even specialty societies are quite limited in what they can do. Plenty of doctors refuse to pay dues to these societies for philosophical or economic reasons. Not belonging is no big deal. The only meaningful sanction is at the state licensure level.

By Melissa Sedlis (not verified) on 16 Apr 2009 #permalink

What is the big deal about room 101? It obviously wasn't torture.

Nice post, Mike. I find this whole phenomenon very similar to the complicity of medical doctors in the death penalty. In both cases, this participation only lends these horrible practices legitimacy.

As someone who has known survivors of torture, many would rather be killed than sustain a longer torture including the mental and physical aftereffects.

By paul ferris (not verified) on 25 Apr 2009 #permalink