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Torture or Treatment?

August 7, 2010

Torture or Treatment:
Would You Participate?

 Writing in Psychiatric Times for July 30, 2010, H. Steven Moffic, MD, raises the question, would you ever participate in torture? It may seem that this subject has been argued to death, but he puts it in a rather interesting “real world” context.
            First of all, he notes that while the issue of the involvement of mental health professionals in interrogations at Guantanamo and elsewhere have received a great deal of attention, allegations of the use of electric shocks and other aversive techniques in the treatment of adults and children with disabilities living at a Massachusetts residential school (arguably also torture) have received far less attention.
            He also points out a number of ambiguities in the anti-torture statements of each of the major organizations of the “helping professions.”

“All of this leaves me a bit–or maybe more than a bit–uneasy. How can a simple position statement do justice to the complexity of these situations? Why all the attention to military torture, as very few of us work in such settings, while the more common residential facilities for adolescents are ignored? What about jails and prisons, where mental health professionals commonly work, and where reports of inmate abuse are common?”

Moffic has served in the military, and also works part time in a prison where, as he notes, “security is clearly the priority over healthcare.” However, he specializes in the treatment of refugees, many of whom suffer from PTSD. 

“It is easy to claim the presumed high ethical ground when one is not involved in the real life situation at hand. It is also easy to project and proclaim strong positions in order to cover our own inadequacies and anxiety. So I try to imagine a scenario where I am put in the position of being asked–or ordered–to help out at an interrogation and I think (however erroneously) that my knowledge might help prevent the harm or death of a loved one, colleagues, or many soldiers or citizens. Should I always follow the position statement of the American Psychiatric Association, or justify an exception? What would you do under such circumstances?”

If any of you want to offer your own answers to that question, please send us your comments.

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3 Comments leave one →
  1. H.E.Butler M.D., FACS permalink
    August 11, 2010 8:10 AM

    Which states are conducting a referendum on participation in torture and licensure? I ask because license-revocation is one way to address coercion in isolated units, including Bagram (AF), Abu Ghraib (Army), and the BSCT teams at Guantanamo (Army or Navy?), as follows:

    1. In 2004 Dr. Lifton alleged torture:
    http://www.mystart.com/search_g.php?q=torture+letter+nejm+winkenwerder&type=oovoo2_0mshp&pr=oovoo2_0&lz=us&provider=0&searchTypeId=0&ei=utf-8&fr=vmn&btnSH=Gsearch&hl=en&cx=partner-pub-1863604312000203%3Abw9y4hysb8t&cof=FORID%3A11&ie=UTF-8;

    2. The surgeons general during this period are known:

    AF: George P. Taylor M.D. 2002-2006
    Army: Kevin Kiley M.D., FACOG 2004-2007
    Navy: Donald C. Arthur M.D., J.D., Ph.D. 2004-2007.

    Did they address the issue raised by Dr. Lifton in 2004 and demonstrate to independent adjudication that they had done so; if not, have they profited from not doing so, as by taking profitable civilian positions which they would not hold if their participation/authorization of torture were known at the time they were hired?

    Where are they now: Did any of them authorize torture “from a distance” so as to maintain ‘deniability’ such as with the BSCT’s? Remember, physicians, psychologists, medics, corpsmen, nurses and others are all under the command of the surgeons general. It is not clear whether Southern Command places Guantanamo under the Army Surgeon General or leaves it under the Navy Surgeon General.

    3. In the course of serving over 20 years in the federal government, I met all three of these surgeons general, in the USA and in Germany:

    a. http://www.google.com/webhp?rls=ig#rls=ig&hl=en&source=hp&q=george+peach+taylor+m.d.+%2B+surgeon+general&btnG=Google+Search&aq=f&aqi=&aql=&oq=george+peach+taylor+m.d.+%2B+surgeon+general&gs_rfai=C7xsNFJJiTMWbJ4PSiAPpocWICQAAAKoEBU_Q2CfC&fp=8631cdd35a4d476d

    b. http://www.google.com/webhp?rls=ig#hl=en&client=hp&rls=ig&q=kevin+kiley+m.d.+%2B+surgeon+general&aq=f&aqi=&aql=&oq=&gs_rfai=&pbx=1&fp=8631cdd35a4d476d

    c. http://www.google.com/webhp?rls=ig#hl=en&client=serp&rls=ig&q=donald+c.+arthur+m.d.+%2B+surgeon+general&aq=f&aqi=&aql=&oq=&gs_rfai=&pbx=1&fp=8631cdd35a4d476d

    • August 11, 2010 10:54 AM

      Great and challenging questions, Dr. Butler — with probably not-so-great answers. I don’t know of any state that is taking action against physicians who have been complicit in torture, whether by referendum or any other means — but I’d be happy to find out I’m wrong. I’m not aware of any state medical or other licensing bodies taking a stand on this either.

      I was a little puzzled by the links you provided, which appear to lead to search pages, rather than individual articles. Was that your intent? If there are particular articles that you think would be most helpful, it would be great if you could point those out.

      Thanks for writing.

      • November 26, 2010 4:37 AM

        Yes, the links are to show how easily information can be acquired to exonerate, or not, those involved.

        Each state can declare its position on licensing torture-doctors: Approximately 25 states have the Initiative; this quesiton can be placed on the ballot by petition.

        Patients can ask their doctors about participation in torture. The doctors will listen.

        Most military doctors want no part of torture. Doctors trapped in isolated units may face political pressure to acquiesce, I have been told.

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