The Corpus Callosum

Ever since the inception of the Global and Perpetual War on Terror,
there has been concern about the role of professionals with training in
psychology and psychiatry in the design, conduct, and interpretation of
torture programs.

The American Psychiatric Association (APA) banned such participation in
May 2006.  The American Medical Association (AMA) followed a
few weeks later.

These associations do not have any regulatory authority.
 Nonetheless, their proclamations and highly influential.
 Oddly, the American Psychological Association [the other APA,
call it AP’A, (p-prime)] did not follow suit immediately.
 Instead, they issued a statement that some considered to be
equivocal, calling for less than absolute prohibition.

Now, as reported in the href="http://www.freep.com/apps/pbcs.dll/article?AID=/20080918/NEWS07/80918093/1009/NEWS07">Detroit
Free Press (“Freep”) and elsewhere ( href="http://www.nytimes.com/2008/09/18/us/18psych.html">NYT),
the AP’A has issued a much stronger statement.  


It is kind of interesting how this came about.  It started as
a survey posted on the Internet.  We’ve all seen a zillion of
these online polls.  For the most part, they are amusing but
inconsequential.  However, this particular one morphed into a
referendum, conducted by a mail-in vote.  The referendum
passed.  The organization’s bylaws require that the changes be
placed in the official policy during their next national meeting
(August 2009).  Their council could decide to take formal
action sooner than that.

Now, the New England Journal of Medicine (one of the oldest and most
influential medical journals) has published two open-access articles on
the subject of physician participation in torture.  (The NEJM
makes selected articles openly-accessible, when they are deemed to have
important public policy implications.)

  • href="http://content.nejm.org/cgi/content/full/359/11/1090">The
    Ethics of Interrogation — The U.S. Military’s Ongoing Use of
    Psychiatrists
  • href="http://content.nejm.org/cgi/content/full/359/11/1087">Military
    Medical Ethics — Physician First, Last, Always

It is good to see that the issue remains on the front burner.  

What they say in the first article is disturbing.  It is based
upon the authors’ findings from a series of FOIA requests.
 One document is a DoD memo, dated 20 October 2009 (after the
APA and AMA edicts) that ignored the APA resolution and watered down
the AMA resolution.  In fact, it partly contradicted
the AMA resolution.  Moreover:

Other documents obtained under FOIA indicate that
between July 2006 and October 2007, five Army psychiatrists were put
through the “behavioral science consultation” training course. The
policy memo raises critical questions about that course, among them,
Why are consultants receiving training in “learned helplessness”
— a term that invokes the work of psychologist Martin
Seligman, who used electric shocks to induce passive behavior in dogs
and destroy their will to escape? As Jane Mayer has revealed, Seligman
was invited by the CIA to give a lecture in learned helplessness at the
Navy’s Survival, Evasion, Resistance, and Escape school in 2002,
purportedly to help U.S. soldiers to resist torture rather than enable
them to inflict it. According to Mayer, at least one experienced
interrogator has claimed that learned helplessness was the paradigm for
some of the most aggressive interrogations in the war on terror. If
coercive interrogations are supposed to be off the table, why teach
this theory to behavioral science consultants?

I have to disagree with the wording in that passage.  The
military may have put five people through the training.  Those
people might have had previous training as psychiatrists.
 They may have been psychiatrists earlier in life.
 But they are not psychiatrists now.  I don’t know
what they are, but they are not members of any healing profession.
 They have betrayed the profession; for them, there is no
turning back.

Comments

  1. #1 Novalis
    September 23, 2008

    This is a crucial issue, but I don’t know much at all about the history or scope of this practice.

    I’m curious–why do they use psychiatrists, and not, say, non-clinical (perhaps forensic) psychologists? It’s hard for me to imagine how having gone to medical school would add that much to interrogation techniques.

  2. #2 Clark
    September 23, 2008

    Someone clarify to me how a soldier who happens to have a psychology or psychiatry training can refuse an order to work at such a facility.

  3. #3 stumpy
    September 23, 2008

    In reply to the comment or question posted by Clark: It seems to me that, ethically, a soldier has a duty, as well as a right, to refuse an order that is abhorrent. Also, the APA and AMA edicts do not seem to prohibit working in such a facility, but, rather, actively participating in torture. Any human being would have an ethical duty to refuse an order to participate in torture, and a physician would have an extra duty to refuse such an order (“First, do no harm.”) Of course, by refusing an order, a soldier would be subject to reprimand, but that reality does not change the ethical determination here. “There are bad laws [and orders], just as there are bad men.”

  4. #4 phisrow
    September 23, 2008

    @Novals: I don’t know; but I suspect it has something to do with the fact that psychiatrists can, and know how to, use drugs. I would imagine that there are some unseemly potential applications for psychopharmacology.

  5. #5 Hyperion
    September 23, 2008

    I think a major question would be whether the purpose here was to help soldiers understand potential torture methods that they might face so that they could at least have some chance of resisting, or whether they were actually training soldiers in how to torture. Even more abhorrent, of course, would be for physicians to actively participate in torture.

    8 years ago I might have been willing to believe the first possibility, but I think that it is hard to believe now. Physicians have an obligation not only to act to save life, but also to ease human suffering. There is no possible way to reconcile medical ethics with aiding in torture in any manner.

    To answer Clark’s question, this is a situation in which the physicians involved would have to decide whether they are soldiers or physicians. That being said, one could also make the argument that since torture violates the UCMJ and Geneva Conventions, their obligations as soldiers also should have prevented them from participating in this situation in any manner.

  6. #6 Novalis
    September 25, 2008

    Hmm, do they really try to use Amytal or Versed as “truth serum” I wonder?

  7. #7 Hyperion
    September 28, 2008

    If they are, they’re idiots. Versed would be a particularly bad choice: Leaving aside the fact that if you go too far you’ve got general anaesthesia and unconscious people rarely talk, benzodiazepines have a tendency to affect one’s memory. Generally, this results in amnesia of the time one is under its effect, but I’d imagine that it would probably also impair one’s ability to remember things while one is under its effects.

    On the other hand, I’d imagine that large doses of morphine might work, make the subject not care about revealing information.

  8. #8 Barbara
    September 30, 2008

    Perhaps I can shed some light on this subject. There are several crucial errors in this article.

    First, as far as torture techniques, they are not used by the DoD. I do not speak for the CIA, they work with completely different laws and they were the center of all of the water boarding heat last year. The rules set forth for the DoD can be found in FM 2-22.3 Chapter 8, which is unclassified, open source, and available on the internet.

    SERE, the school mentioned in this article, is used for all services for military members that work in jobs that are most likely to be captured. There are a number of interrogators that are put through the school, but only because other facets of their job makes them targets for kidnapping and imprisonment. SERE stands for Survival, Evasion, Resistance and Escape. This is a school that is largely based on Russian interrogation methods (or what we know of them). Although outdated, it does prepare military members to survive capture without betraying US interests.

    Interrogators have to have their work approved by a psychiatrist every time they talk to a detainee. If one asks “how’s the weather?” They must first consult with someone who knows more about the discipline than they in order to ensure that the weather is not a traumatizing topic for the detainee. I have never heard of a psychiatrist making suggestions about how to obtain information, and although it may happen, it is not their function.

    I think it is impossible to judge the ethical implications of the work these psychiatrists did without understanding the framework within which they were working. Perhaps this provides a VERY basic understanding of these two (of several) functions psychiatrist fill in the military services.

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