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Medical Ethics Questioned in Manning Case

March 16, 2011

Physicians’ Group Questions Ethics of
Psychiatrists in Bradley Manning Case

Writing for the Guardian/UK, Ed Pilkington reports that the Human Rights group Physicians for Human Rights is raising concerns about the role of military psychiatrists in the treatment of Pfc. Bradley Manning – particularly in relation to his long-term solitary confinement. Pilkington writes that PHR “sees the psychiatrists as trapped in a classic case of ‘dual loyalty,’ where their obligations to the military chain of command may conflict with their medical duty to protect their patient.” He notes that Christy Fujio, Director of PHR’s Asylum Program, will soon be issuing a report on this issue: 

“Even if they do not officially approve it, by continuing to examine him and report back to the government on his condition, they are effectively taking part in security operations. Their failure to call it what it is – cruel and unusual punishment – constitutes a violation of their ethical duties as doctors.”
                                      —  Christy Fujio, JD, Physicians for Human Rights

I hadn’t planned to write about the Manning case – even though it makes me crazy – because it has been pretty well covered elsewhere. Then came the one-two punch of watching State Department spokesman Philip Crowley forced to resign for having the honesty to describe Manning’s treatment as “ridiculous, counterproductive and stupid,” followed by President Obama’s bland assurances that the soldier’s conditions of imprisonment are “appropriate and meeting our basic standards.” (He knows, because the Pentagon told him so.)
            Private Manning has been held in solitary confinement in a tiny cell for more than nine months, much of the time on suicide watch under a “Prevention of Injury” order. He is kept in his cell for 23 hours a day, and checked every five minutes, including during the night. He is forced to strip naked every night and submit to inspection every morning before being given back his clothes. Yet his lawyer cites observation records by prison psychiatrists stating that he is “respectful, courteous and well-spoken” and “does not have any suicidal feelings at this time.” Pilkington notes that 16 separate record entries made between August 27 and January 28 state that he was not a danger to himself.
            In a letter released by his lawyer, Manning has also reported that his prescription glasses have been taken away from him, and he has been forced “to sit in essential blindness.” This may not sound like a big deal to most folks, but as somebody who has lived with severe nearsightedness for most of my life, I can testify to what a disorienting and torturous experience that would be. The time when I lost my glasses while riding my bike on an otherwise deserted playground is still one of my recurrent nightmares. Of course, Manning doesn’t have to worry about getting lost, since he barely has room to turn around in his cell.
            All of that has been widely covered by at least some of the general media, but the issues raised by PHR have not, and they are highly relevant to the concerns of The Refuge Media Project, which is dedicated to confronting the issue of torture in all of its manifestations. Unnecessary solitary confinement has been recognized internationally as a form of torture. In a previous post, we quoted Bill Quigley, legal director of the Center for Constitutional Rights, writing in Counterpunch. Quigley writes: “Under international standards for human rights, extended isolation is considered a form of torture and is banned. The conditions and practices of isolation are in violation of the Universal Declaration of Human Rights, the U.N. Convention against Torture, and the U.N. Convention on the Elimination of All Forms of Racial Discrimination.
            Manning is accused of leaking a trove of government communications, including “state secrets,” to Wikileaks, though to date he has not been formally charged. Possible charges could include “aiding the enemy,” which carries the potential of a death sentence. Yet I have seen no claim by the government that he is an escape risk, and the physicians on the spot seem to agree that he is not a danger to himself. It’s therefore hard to come up with any reason for the way he is being treated other than punitive. It amounts, in effect, to pre-trial punishment – or an attempt to break him down psychologically. And that is to torture under almost anyone’s definition.
            A recent New York Times editorial commented: “The military has been treating him abusively, in a way that conjures creepy memories of how the Bush administration used to treat terror suspects. Inexplicably, it appears to have President Obama’s support to do so.” Forced nudity, the Times continued, “is a classic humiliation technique. During the early years of the Bush administration’s war on terror, CIA interrogators regularly stripped prisoners to break down barriers of resistance, increase compliance and extract information…It would be useful to revisit the presumption of innocence and the Constitutional protection against cruel and unusual punishment.”

Where Were the Docs?

“Medical personnel are always present in military prisons…Medical ethics and international codes of conduct oblige them to prevent and disclose torture. Why had they not blown the whistle?…
            “I found evidence that armed forces physicians, nurses and medics had been passive and active partners in the systematic neglect and abuse of prisoners.”
                                                        — Steven H. Miles, MD, in Oath Betrayed 

Given that the healthcare professionals dealing with Manning have reported that he is not suicidal, what more can we expect them to do. The answer is: to protect their patient, as their oaths demand – and that might include refusing to participate in any way in what is clearly abusive treatment.
            In the course of working on our film Refuge: Caring for Survivors of Torture, we had the privilege of interviewing Steven H. Miles, MD, author of Oath Betrayed: Torture, Medical Complicity, and the War on Terror. Miles is a practicing physician who also works with Minnesota’s Center for Victims of Torture. In our interview, he noted, “Torture is endemic in the prisons of the world. It’s practiced in around 100 different countries…Doctors in a real way are front line human rights workers because we’re responsible for the well-being of prisoners…We see the people who are kept away from human rights monitors and we know how to recognize abuse…When the pictures came out from Abu Ghraib, my question was, “Where were the docs?”

The argument that the psychologist is not involved in a treating relationship and therefore doesn’t have an obligation to the prisoner is Defense Department hogwash. There is no such exemption in any of the international laws.” 
                                                         — Steven H. Miles, MD, interviewed in 
                                                             Refuge: Caring for Survivors of Torture 

For some of the best commentary on the Bradley Manning case, google “Common Dreams, Bradley Manning

(If ordering books or DVDs discussed in this blog from Amazon, please consider doing so through our website, which will help to support the work of The Refuge Media Project. Click on the Book title above to be redirected to our site.) 

2 Comments leave one →
  1. Steve Miles, MD permalink
    March 17, 2011 10:59 AM

    Bradley Manning committed no act of terrorism.
    He belongs to no terrorist group.
    He has not been convicted of a crime indeed it is not even clear if he can be.

    Fundamentally, he is suspected of performing exactly the same kind of act (releasing documents embarrassing to his government) that we applauded when it led to regime change in Tunisia, an act which we applaud as citizens storm the secret police centers in Egypt to secure government files.

    Perhaps his actions were unwise or imprudent. So too was the government policy that indiscriminately classified these documents while making them available to tens of thousands of government insiders.

    Bradley Manning lit no bombs. He only disseminated truth.

    It has taken us less than a decade to go from US’ CIA and DoD tortures established after 9/11/01 in support of military operations to the domestic use of these same procedures against persons who use them in non-violent dissent.

    Who feels safer for these utterly unchecked military powers being used on US soil?

    Who feels better with this sense of military medical professionalism?

    Who can respect a medical profession that remains silent in support of its colleagues who are overseeing this abuse.


    A senior US state dept official who criticized this abuse was fired.

    The foreign press is on it.

    Physicians for Human Rights is on it.

    Amnesty International is on it.

    Human Rights First is on it.

    Meanwhile, the AMA, American Psychiatric Assn, ACP, IOM, ASBH and the Hastings Center for Bioethics and the Life Sciences doze away as the policy of military torture is brought on shore against our own servicemen, a US citizen on US soil.


    Steven Miles, MD


  2. March 17, 2011 10:59 PM

    Thanks for the comment, Steve. It also seems to me that there’s zero evidence that Manning had any intent to harm the United States. Rather, like Daniel Ellsberg in the Pentagon Papers case before him, he was trying to alert the American people to some of the questionable things our elected government is doing in our name. Ellsberg, too, was prosecuted — but ultimately acquitted, and today many of us regard him as something of a hero.

    Not surprisingly, Ellsberg has come to Manning’s defense. In a recent article, he wrote: “President Obama tells us that he’s asked the Pentagon whether the conditions of confinement of Bradley Manning, the soldier charged with leaking state secrets, “are appropriate and are meeting our basic standards. They assure me that they are.”
    “If Obama believes that, he’ll believe anything. I would hope he would know better than to ask the perpetrators whether they’ve been behaving appropriately. I can just hear President Nixon saying to a press conference the same thing: “I was assured by the the White House Plumbers that their burglary of the office of Daniel Ellsberg’s doctor in Los Angeles was appropriate and met basic standards.”

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