September 28, 2005

Coercive US Interrogation PoliciesA Challenge to Medical Ethics

Author Affiliations

Author Affiliations: Physicians for Human Rights, Cambridge, Mass (Mr Rubenstein and Dr Iacopino); Center for the Treatment of Torture Victims, Berlin, Germany (Dr Pross); Hamburg Foundation for the Advancement of Research and Culture, Hamburg, Germany (Dr Pross); editor emeritus of Annals of Internal Medicine, Philadelphia, Pa (Dr Davidoff); and Department of Medicine, University of Minnesota, Minneapolis (Dr Iacopino).

JAMA. 2005;294(12):1544-1549. doi:10.1001/jama.294.12.1544

As world attention has focused on allegations of torture and ill treatment (cruel, inhuman, and degrading treatment or punishment)1 by US forces, there have been questions about the role of physicians and other health professionals in abusive interrogations.26 Considerable light has been shed on these allegations by documents released in 2004 and 2005 under the Freedom of Information Act and official US Department of Defense (DoD) investigations initiated since the Abu Ghraib investigations in 2004, including an internal review of medical practices regarding detainees by the US Army surgeon general.7 Following the release of these documents and reports, in June 2005, the assistant secretary of defense for health affairs released new ethical guidelines8 for all health care personnel, including physicians, nurses, and medics. The new guidelines are troubling, however, because they do not come to terms with the participation of physicians and other health care professionals in officially authorized interrogation practices that are absolutely prohibited by international human rights law,1,9 the Third Geneva Convention,10 and US military11 and domestic law that criminalizes torture, including psychological torture.12 While the new DoD ethical guidelines apply to all health care personnel, we focus on how the guidelines enable physicians to facilitate and monitor abusive interrogation practices and subvert well-established ethical duties to support health and human dignity.

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