Defense Department and CIA interrogation policies after 9/11 forced medical professionals to abandon their ethical obligations to "do no harm" to those in their care and some prohibited practices, including force-feeding of hunger strikers, continue today, a report issued Monday alleges.
The report, Ethics Abandoned: Medical Professionalism and Detainee Abuse in the War on Terror, was carried out by a 19-member task force of Columbia University's Institute on Medicine as a Profession and the Open Society Foundations. The researchers spent two years examining public records of medical professionals' involvement in military and intelligence interrogations and treatment of detainees.
It accuses the counter-terrorism operations of having "improperly demanded that U.S. military and intelligence agency health professionals collaborate in intelligence gathering and security practices in a way that inflicted severe harm on detainees in U.S. custody."
The involvement of medical professionals in abuse and interrogation occurred at the Guantanamo Bay detention center for terrorism suspects as well as at Bagram air base near Kabul, Afghanistan, and at other CIA "black sites," the report claimed.
Doctors, nurses, psychologists and medics, in violation of their ethical commitments, were said to have been compelled to take part in "enhanced interrogation" methods, including the simulated drowning procedure called waterboarding that has been defined as torture and prohibited from practice by any U.S. agents.
The report cited three areas in which medical professionals were ordered to ignore ethical standards:
- involvement in abusive interrogation, including monitoring of vital signs under stress-inducing procedures
- using patients' medical information for interrogation purposes
- force-feeding of hunger strikers, in violation of World Medical Assn. and American Medical Assn. prohibitions
Force-feeding continues, the report said, referring to a massive hunger strike this year at Guantanamo, where more than 100 detainees were refusing food.
"It's clear that in the name of national security, the military trumped (the Hippocratic Oath), and physicians were transformed into agents of the military and performed acts that were contrary to medical ethics and practice," said Gerald Thomson, a retired Columbia professor of medicine and coauthor of the study.
Spokesmen for both the Pentagon and the CIA disputed certain findings of the task force.
"The allegations made in the report are not new. They have been subject to numerous investigations over the years, and those investigations -- which had access to more information than the authors of this report -- have never substantiated these claims," said Lt. Col. J. Todd Breasseale, a Defense Department spokesman.
It is the Pentagon's policy to protect the life and health of detainees, Breasseale said, adding it "will not knowingly allow a detainee to commit suicide -- not by means of a weapon, medication, nor self- or peer-imposed starvation."
Fourteen of Guantanamo's remaining 164 prisoners continue to regularly refuse food and are thus approved for "enteral feeding," Breasseale said.
CIA spokesman Dean Boyd said the report contains "serious inaccuracies and erroneous conclusions." He also noted that the CIA no longer has detainees in its custody and that its "rendition, detention and interrogation program" ended with President Obama's executive order in 2009.
The report, which calls for further investigation and respect for internationally accepted medical professional standards, observed that the worst alleged abuses occurred before 2006, and that some, but not all, controversial practices have been discontinued.
“Abuse of detainees, and health professional participation in this practice, is not behind us as a country,” said Leonard Rubenstein, a legal scholar at the Center for Human Rights and Public Health at Johns Hopkins Bloomberg School of Public Health and the Berman Institute of Bioethics. "Force-feeding by physicians in violation of ethical standards is illustrative of a much broader legacy in which medical professionalism has been undermined.”
The report calls on the Defense Department and CIA to follow international medical standards on the treatment of detainees and cease pressuring their medical personnel to compromise their avowed principles.
"Putting on a uniform does not and should not abrogate the fundamental principles of medical professionalism,” said David Rothman, the Columbia institute president. “‘Do no harm’ and ‘put patient interest first’ must apply to all physicians regardless of where they practice."