Independent Panel: U.S. Doctors Violated Medical, Ethical Standards in Detention Facilities

By Clara Ritger

November 4, 2013

U.S. military and intelligence agencies improperly required doctors and health professionals to participate in "cruel, inhumane, and degrading treatment and torture of detainees," an independent panel has found.

The Task Force on Preserving Medical Professionalism in National Security Detention Centers concludes that at the request of the Defense Department and the Central Intelligence Agency, physicians performed acts that defied their medical ethics and practice, including participating in the abusive interrogation of detainees and force-feeding hunger strikers, following the terrorist attacks of Sept. 11, 2001.

A DoD spokesman confirmed that detainees who refused to eat were fed through nasogastric intubation, the insertion of a tube through the nose.

"We have a very specific mandate to keep the detainees alive," said Lt. Col. Todd Breasseale. "The medical professionals that are employed at Guantanamo provide humane treatment and necessary care to the detainees. Not one of [the Task Force] has any access to the detainees. It's high comedy that one can opine about someone's condition without having seen them."

The Task Force is made up of 19 military, ethics, medical, and legal experts and is sponsored by the Institute on Medicine as a Profession, a nonprofit health care policy think tank, and the Open Society Foundations, an institute that promotes democratic governance and human rights.

The panel convened between December 2009 and January 2012, examining Defense Department and CIA documents, congressional reports, and journalistic investigations to determine whether violations of medical practice and ethics occurred at various U.S. detention facilities, including Guantanamo Bay.

The group was unable to speak with any of the detainees, said Task Force member Dr. Gerald Thomson, and unable to identify some of those being held. But what they found in public documents confirmed that violations took place, Thomson said, and they want the Obama administration to launch an investigation to get the classified documents the independent panel was unable to obtain.

"Society and the public expects its physicians to act in accordance with medical ethics and professionalism standards in all situations," said Thomson, professor of medicine emeritus at Columbia University. "When they do otherwise—even under the pressure of national security—the public should be concerned about that. It's time to make corrections."

The World Medical Association's Declaration of Malta, as well as the American Medical Association, maintain the position that physicians should respect an individual's right to refuse to eat. The Task Force report calls on the Defense Department to change its policies so they align with medical ethical principles.

But the DoD said it has no intention of doing so, because it doesn't believe it acted improperly.

"We don't agree with their premise that our doctors are acting in any way that is unethical and unprofessional," Breasseale said. "I think there's some very reasonable allegations that have been positioned against other agencies other than the DOD and we acknowledge that."

CIA spokesperson Todd Ebitz said the agency's medical staff acted in accordance with the standards of their profession.

"It's important to underscore that the CIA does not have any detainees in its custody and President Obama terminated the Rendition, Detention and Interrogation Program by executive order in 2009," Ebitz said. "The task force report contains serious inaccuracies and erroneous conclusions."

The Task Force says CIA's Office of Medical Services approved enhanced interrogation methods, including waterboarding and sleep deprivation, which violate medical practice and ethics. While some have argued that the use of torture is a necessary intelligence-gathering operation to strengthen national security, Thomson said the use of torture is never justified.

"Most people would say no," he said. "We never thought the U.S. would engage in such practices."

President Obama issued an executive order at the start of his first term in 2009 banning torture as a method of interrogation. The panel wants the president to take it one step further and ban sleep deprivation, isolation, and exploitation of fear which "amount to torture," the report says.

Other recommendations include altering the status of doctors in the military, implementing educational and training programs, and strengthening the Defense Department's review board.

While the report focuses primarily on the Obama administration and national security agencies, Thomson said they are supportive of the Senate Intelligence Committee's investigation into the CIA's treatment of detainees, and they hope the committee's report will also influence U.S. policy on the matter. That report, however, is currently not available to the public.

(Image via Andy Dean Photography/Shutterstock.com)


By Clara Ritger

November 4, 2013

http://www.govexec.com/defense/2013/11/independent-panel-us-doctors-violated-medical-ethical-standards-detention-facilities/73138/