Health Professionals Involved in Guantanamo Interrogations

Doctors compromised medical ethics, article claims

THURSDAY, June 23, 2005 (HealthDayNews) -- Acting in contradiction to medical ethics, physicians, psychiatrists and psychologists have played an active role in the interrogations of foreign detainees in the U.S. prison at Guantanamo Bay, Cuba, new research claims.

The revelations, which will appear in the July 7 issue of the New England Journal of Medicine, were released online Wednesday night amid ongoing questions about the condition of terror suspects at the facility.

According to the report, prisoners do not have any medical confidentiality, which allows medical personnel to use what they have learned to aid in interrogations.

"Contrary to what the Bush administration has said, the rule is no confidentiality for the detainees at Guantanamo," said study co-author Dr. M. Gregg Bloche, a law professor at Georgetown University in Washington, D.C. "Assistant Secretary of Defense for Health Affairs William Winkenwerder said as recently as last week that confidentiality protections and exceptions were analogous to those enjoyed by American citizens."

However, there is a standing order that has not previously been reported, he said. Dated August 2002, Bloche said, the order requires health-care providers to report any information of potential interest to medical and non-medical personnel at Guantanamo.

"In addition, in a systematic fashion, medical information was employed by behavioral science consultants to support the interrogation process," Bloche said. "These behavioral scientists, typically a psychiatrist and psychologist, were assigned to a Behavioral Science Consultation Team."

These consultants had access to medical records and used them to develop profiles that could be used to help interrogators, Bloche said.

"The American people have not been leveled with," Bloche said. "We need to know a lot more, including the strategies for crafting interrogation tactics. Also, it's important that we separate the process of clinical caregiving from the process of interrogation."

To make medical information available for interrogation makes every health-care provider part of a network of surveillance, Bloche said. "That's going way too far. Clinical information should not be made available to those planning an interrogation," he added.

Bloche believes there is a narrow role for psychologists in developing lawful interrogation strategies. "But given what's been widely reported about the kind of tactics used at Guantanamo, it's plain that the tactics went too far. And we have learned that the Behavioral Science Consultation Teams were pervasively involved."

Not only is there probable cause to suspect that the members of the Behavioral Science Consultation Teams were complicit, Bloche said, "but the lack of confidentially makes clinical caregivers participants in this pervasive process."

"We need a fuller, thorough and independent inquiry for the abuses at Guantanamo," Bloche added. "As a part of that inquiry, there should be an inquest into the ways in which abuse of interrogation practices were devised."

"It's clear that the lack of protection of medical confidentiality violated Geneva [Convention] rules," he charged.

On Thursday, U.N. human rights experts said they had reliable accounts of terror suspects being tortured at Guantanamo, the Associated Press reported. The charge came on the heels of White House refusal Tuesday to create an independent commission to investigate such allegations at Guantanamo and elsewhere, according to a Washington Post report.

In addition, the Pentagon last week issued new guidelines for medical personnel that says their only involvement in treating detainees is to "evaluate, protect or improve their physical and mental health." According to an AP report, the guidelines, issued by Assistant Defense Secretary Winkenwerder, also said that doctors and experts -- such as the psychologists, profilers and forensic pathologists who advise interrogators -- are not to be involved in treating detainees, but must uphold the principles of humane treatment.

Speaking to reporters June 16, Winkenwerder could not say whether the guidelines mark any change from existing policy, AP reported. Their purpose is to prevent any abuse in the future, he said.

Reaction to the journal article was swift.

"It's great that somebody is talking about this," said Jumana Musa, advocacy director for domestic and international justice at Amnesty International. "It's been out there for a long time, but it gets lost in the mix because people don't realize the grievous nature of it."

Musa said it was unfair that prisoners are supposed to get medical care from doctors who can turn around and give the information to the military commission, where it can be used to convict them.

"Effectively, that means there is no medical care available to them," she added.

Having medical personnel in interrogations also raises questions, Musa said. "What's being done in interrogations if you need to have medical people standing by? What does that mean, ethically, to the medical profession?" Musa said.

And there are questions that go beyond whether prisoners have access to medical care, Musa said. "The lack of confidentially may prevent someone from seeking medical care if they know it's going to be used against them in interrogation," she added. "Your job as a doctor is to treat and to heal, not to facilitate interrogations."

More information

The American Medical Association has more on medical ethics.

SOURCES: M. Gregg Bloche, M.D., J.D., professor, law, Georgetown University, Washington, D.C. and adjunct professor, Bloomberg School of Public Health, Johns Hopkins University, Baltimore; Jumana Musa, advocacy director, domestic and international justice, Amnesty International, Washington, D.C.; July 7, 2005 The New England Journal of Medicine; June 22, 2005, Washington Post; Associated Press
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