For Immediate Release
Today in Chicago, the American Medical Association's (AMA's) House of Delegates adopted ethical guidelines that make it unethical for physicians to participate in the interrogation of detainees, such as those held at Guantanamo Bay and other US facilities. The new ethical guidelines appear to conflict directly with the rules released last week by the Pentagon for guiding the involvement of military physicians and other health personnel in interrogations. The guidelines, drafted under the guidance of Assistant Secretary of Defense for Health Affairs, William Winkenwerder, find no ethical obstacle to physicians playing an active role in the interrogation process.
"The new AMA policy goes a long way toward protecting the ethical commitments and integrity of all military medical personnel," said Leonard Rubenstein, Executive Director of Physicians for Human Rights. "While the AMA rule leaves a bit more room for interpretation than do other medical association policies – something the AMA can and should quickly remedy – we believe this policy can only be read as an unambiguous rejection of the Pentagon's use of military physicians to support individual interrogations, as members of Behavioral Science Consultation Teams (BSCTs) or in any other capacity."
The AMA's action is the latest in a recent series of forceful statements from the medical community that repudiate the Pentagon's efforts to use medical knowledge and skill in the interrogation process, which, in even lawful interrogation, is inherently coercive and adversarial. In rejecting a role for physicians in individual interrogations, the AMA joined the American Psychiatric Association (APA) and the World Medical Association (WMA), both of which adopted explicit policies last month absolutely prohibiting physicians from participating in the interrogation process.
"The AMA acted today to defend the basic principles of medical ethics and to protect the men and women bravely serving our country as military health personnel," stated Brigadier General Stephen Xenakis, MD (USA-Ret), an advisor for Physicians for Human Rights. "Since 2001, the civilian leadership at the Pentagon has been engaged in a full frontal assault on the basic standards of medical and military ethics, from the Hippocratic Oath to the Geneva Conventions. All the major medical associations are now standing together to demand that this administration respect the core values of both the health professional and the soldier."
The new ethical policy adopted by the AMA prohibits physicians from directly participating in interrogations, from helping to plan and develop interrogation strategies for individual detainees, and from intervening in specific interrogations. This prohibition is needed, according to the new policy statement, to protect "the physician's role as healer" and to preserve trust in the medical profession.
Like the AMA, the new American Psychiatric Association policy prohibits psychiatrists from direct participation in interrogations, including "asking or suggesting questions, or advising authorities on the use of specific techniques of interrogation with particular detainees." The WMA rule, adopted with the support the AMA at last month's meetings, similarly provides that physicians may not "use, or 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 Pentagon's guidelines, however, require certain health personnel, particularly psychiatrists and psychologists on BSCTs, to participate directly and extensively in the interrogation of individual detainees, and they facilitate the unethical disclosure of confidential medical information.
"The Pentagon must immediately revise its guidelines and rescind all regulations permitting the use of physicians and psychologists in individual interrogations and as part of the BSCTs," Rubenstein said. He added that the AMA, APA and other medical associations can be expected to press for elimination of the BSCT role in view of their new policies banning direct physician involvement in interrogations.
Elaborating on the new limits imposed by the AMA on physicians in interrogations, Rubenstein emphasized that "no participation in individual interrogations is authorized by the new AMA rule. Physicians are only permitted under the rule to help develop interrogation strategies for 'general training purposes,' provided those strategies do not threaten or cause harm, are humane, and do not violate detainees' rights. We are deeply concerned even with this level of involvement," Rubenstein said, "because of the ambiguity of that qualifying language. It's simply not reasonable to require a physician to determine, in the abstract, whether a particular interrogation strategy will or will not be used in a way that inflicts harm, or whether it is clearly 'humane' or legal. Given the nature of interrogation, we believe it best, as the APA and WMA policies do, to insulate physicians entirely from the design of interrogation strategies, and we hope the AMA will fine-tune its policy accordingly."
Rubenstein also suggested that the AMA should continue to refine its policy on confidential medical information to provide greater protection against disclosure to interrogators. "In stark contrast to the Pentagon guidelines," he said, "the new AMA rule significantly restricts physicians from disclosing information they obtain from detainees when providing medical care. We urge the AMA to go one step further, as the WMA has done, in requiring physicians to do what they can to prevent interrogators themselves from gaining direct access to detainees' medical information."
In the wake of the three suicides of detainees over the weekend that were being held at the US detention facility in Guantanamo Bay, Cuba, PHR strongly called for the Pentagon to grant access to Guantanamo and other facilities to independent medical and human rights experts and to publicly commit to vigorously enforce the McCain Amendment's prohibition against cruel and inhumane treatment of detainees, including the use of psychological torture. The group also reiterated its standing call for the Pentagon to end the force feeding of hunger strikers at the facility, a practice that is against the Declaration of Tokyo, the World Medical Association's prohibition of force feeding voluntary hunger strikers.
Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.