The Pentagon on Tuesday unveiled its most comprehensive guidance to date for medical professionals in dealing with detainees, but rights activists denounced it for allowing broad use of prisoners' health data to guide interrogations.
The directive allows a detainee's medical information to be disclosed for several reasons other than medical treatment, including "lawful law enforcement, intelligence or national security-related activity", which includes interrogations.
The following is a press release from Physicians for Human Rights.
Physicians for Human Rights (PHR) mobilizes the health professions to advance the health and dignity of all people by protecting human rights. As a founding member of the International Campaign to Ban Landmines, PHR shared the 1997 Nobel Peace Prize.
Physicians for Human Rights Denounces New Pentagon Instructions on Medical Support for Interrogation
June 6, 2006
Contact: Nathaniel Raymond
nraymond@phrusa.org
Senior Communications Strategist
Cell: (617) 413-6407
Phone: (617) 301-4232
Physicians for Human Rights (PHR), a health professional organization that has served as a leading voice against torture and abuse of detainees in US custody, today denounced new Defense Department guidelines on the role of health personnel in interrogations, calling them “an assault on medical ethics, the professional integrity of military health personnel, the Geneva Conventions, and on US military tradition and discipline.”
"The DoD directive released today by Assistant Secretary of Health Affairs, William Winkenwerder, Jr., puts doctors and other health professionals in the untenable position of assisting in the infliction of harm,” said Leonard Rubenstein, Executive Director of Physicians for Human Rights. “This policy takes the United States further away from the most basic medical ethical and legal standards”
These new guidelines directly involve certain military health personnel, particularly mental health professionals, in the interrogation of detainees, making them active parts of the Behavioral Science Consulting Teams (known as “BSCTs”). “Military medical leadership ought to protect the ethical commitments and honor of our dedicated military health personnel,” said Brigadier General Stephen N. Xenakis, MD (USA—RET), an Advisor to Physicians for Human Rights. “Instead, they are subverting the essence of the Hippocratic Oath and compromising the integrity of the health professions as a whole.”
"The Pentagon policy also explicitly allows clinical information from medical records to be used in interrogation, in violation of core ethical principles protecting the confidentiality of information provided by patients to their health care providers,” said Rubenstein.
Rubenstein noted that the guidelines conflict directly with new policies issued last month by the American Psychiatric Association (APA) and World Medical Association (WMA), which prohibit psychiatrists and physicians, respectively, from directly supporting individual interrogations in any way. The WMA amended part of the Declaration of Tokyo, setting forth medical ethics regarding prisoners and detainees, to provide that “physicians should be particularly careful to ensure the confidentiality of all personal medical information” and that “[t]he physician shall not use nor allow to be used, as far as he or she can, medical knowledge or skills, or health information specific to individuals, to facilitate or otherwise aid any interrogation, legal or illegal, of those individuals.” The American Medical Association is a member organization of the WMA.
"The WMA and APA position recognizes that even lawful interrogation is an inherently adversarial and coercive process,” Rubenstein said, “and that there can be no ethical role for a health professional in the inevitable, ensuing infliction of stress and harm to a subject’s health and dignity. The only way to protect the health professional’s essential function as healer is to protect them from the interrogation process altogether, as the WMA and APA have done.”
The threat to health professional ethics extends even further, Rubenstein explained. The Pentagon guidelines do not follow universally recognized standards of medical ethics to guide the conduct of the BSCTs or any other health personnel, nor do they require the BSCTs to comply with international humanitarian and human rights law endorsed or ratified by the United States, such as the Geneva Conventions or the Convention Against Torture. Instead, BSCT health professionals are authorized to engage in any interrogation-related activity that complies with “applicable” US law.
"The problem with that standard,” Rubenstein warns, “is that the Bush Administration has interpreted US law on psychological torture in a way that violates the Convention Against Torture, as was recently reported by the UN Committee Against Torture. The Administration has further denied the applicability of the Geneva Conventions to many detainees and, according to news reports, has sought to delete the most basic tenets of the Conventions from the sections of the revised Army Field Manual that govern interrogations. What’s more, the Administration has sought to undermine the enforcement of the ‘McCain Amendment,’ passed by Congress last year to reaffirm the absolute ban on cruel, inhuman and degrading treatment by all US personnel. The net result is that health personnel participation in psychological forms of torture are not prohibited by these guidelines because they do not violate the Administration’s interpretations of US law.”
The Pentagon directive also instructs health professionals to violate ethical standards regarding hunger strikes, Rubenstein added, by instructing them to force-feed detainees who protest against their conditions of confinement by denying nutrition. Earlier this year, PHR and 250 leading doctors from around the world condemned the brutal force feeding methods used by military personnel in a campaign to break the will of hunger strikers at Guantanamo Bay.
The American Medical Association has also clarified that medical ethics generally prohibit force feeding hunger strikers. In a March 10, 2006 statement, the AMA said that the Association “has shared with U.S. military officials its position on hunger strikes or feeding individuals against their will. Specifically, the AMA endorses the World Medical Association's Declaration of Tokyo, which states:
‘Where a prisoner refuses nourishment and is considered by the physician as capable of forming an unimpaired and rational judgment concerning the consequences of such a voluntary refusal of nourishment, he or she shall not be fed artificially. The decision as to the capacity of the prisoner to form such a judgment should be confirmed by at least one other independent physician.'"
"The new Pentagon directive flies in the face of these established ethical guidelines, Rubenstein said, “and open the door to painful and abusive force-feeding methods intended to discourage detainees from calling attention to inhumane conditions of confinement through this form of protest. It is beyond ironic for the Pentagon to justify its unethical force-feeding policy by claiming concern about the health and well-being of detainees.”
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