Greetings,

Below is an article sent by George Povey to the International Health
Program that I thought may be of interest.

Mary Anne

* * * * * * * * * *

Concerning the message I sent earlier today. Apparently some of you failed
to receive the source. It
is the NEJM 351:415-416, JUL 29 2004. The link is
<http://content.nejm.org/cgi/content/full/351/5/415>http://content.nejm.org/cgi/\
content/full/351/5/415

These facts, though well known, have been studiously ignored by the media.
We are ourselves complicit
in letting them get away with this. We must bring this shameful situation
to the attention of every
print and electronic journalist that we know, as well as international
human rights lawyers.

These are crimes against humanity. These medical actors are in some cases
perpetrators, in others
accessories, and should be charged and prosecuted as such. This is truly a
conspiracy, with all that
that word legally implies, in which the media are complicit, just as they
were regarding the
Queda-Saddam link and the WMD.

gp.


---------- Forwarded message ----------

On Mon, 2 Aug 2004, George Povey wrote:

> There is increasing evidence that U.S. doctors, nurses, and medics have been
complicit in torture and
> other illegal procedures in Iraq, Afghanistan, and Guantanamo Bay. Such
medical complicity suggests
> still another disturbing dimension of this broadening scandal.
>
>
<http://content.nejm.org/cgi/content/full/351/5/415>http://content.nejm.org/cgi/\
content/full/351/5/415
>
> Doctors and Torture
>
> Robert Jay Lifton, M.D.
>
> There is increasing evidence that U.S. doctors, nurses, and medics have been
complicit in torture and
> other illegal procedures in Iraq, Afghanistan, and Guantanamo Bay. Such
medical complicity suggests
> still another disturbing dimension of this broadening scandal.
>
> We know that medical personnel have failed to report to higher authorities
wounds that were clearly
> caused by torture and that they have neglected to take steps to interrupt this
torture. In addition,
> they have turned over prisoners' medical records to interrogators who could
use them to exploit the
> prisoners' weaknesses or vulnerabilities. We have not yet learned the extent
of medical involvement in
> delaying and possibly falsifying the death certificates of prisoners who have
been killed by torturers.
>
> A May 22 article on Abu Ghraib in the New York Times states that "much of the
evidence of abuse at the
> prison came from medical documents" and that records and statements "showed
doctors and medics
> reporting to the area of the prison where the abuse occurred several times to
stitch wounds, tend to
> collapsed prisoners or see patients with bruised or reddened
> genitals."<http://content.nejm.org/cgi/content/full/351/5/415#R1>1 According
to the article, two
> doctors who gave a painkiller to a prisoner for a dislocated shoulder and sent
him to an outside
> hospital recognized that the injury was caused by his arms being handcuffed
and held over his head for
> "a long period," but they did not report any suspicions of abuse. A staff
sergeant–medic who had seen
> the prisoner in that position later told investigators that he had instru
>
> A June 10 article in the Washington Post tells of a long-standing policy at
the Guantanamo Bay facility
> whereby military interrogators were given access to the medical records of
individual
> prisoners.<http://content.nejm.org/cgi/content/full/351/5/415#R2>2 The policy
was maintained despite
> complaints by the Red Cross that such records "are being used by interrogators
to gain information in
> developing an interrogation plan." A civilian psychiatrist who was part of a
medical review team was
> "disturbed" about not having been told about the practice and said that it
would give interrogators
> "tremendous power" over prisoners.
>
> Other reports, though sketchier, suggest that the death certificates of
prisoners who might have been
> killed by various forms of mistreatment have not only been delayed but may
have camouflaged the fatal
> abuse by attributing deaths to conditions such as cardiovascular
> disease.<http://content.nejm.org/cgi/content/full/351/5/415#R3>3
>
> Various medical protocols — notably, the World Medical Association Declaration
of Tokyo in 1975 —
> prohibit all three of these forms of medical complicity in torture. Moreover,
the Hippocratic Oath
> declares, "I will use treatment to help the sick according to my ability and
judgment, but never with a
> view to injury and wrongdoing."
>
> To be a military physician is to be subject to potential moral conflict
between commitment to the
> healing of individual people, on the one hand, and responsibility to the
military hierarchy and the
> command structure, on the other. I experienced that conflict myself as an Air
Force psychiatrist
> assigned to Japan and Korea some decades ago: I was required to decide whether
to send psychologically
> disturbed men back to the United States, where they could best receive
treatment, or to return them to
> their units, where they could best serve combat needs. There were, of course,
other factors, such as a
> soldier's pride in not letting his buddies down, but for physicians this basic
conflict remained.
>
> American doctors at Abu Ghraib and elsewhere have undoubtedly been aware of
their medical
> responsibility to document injuries and raise questions about their possible
source in abuse. But those
> doctors and other medical personnel were part of a command structure that
permitted, encouraged, and
> sometimes orchestrated torture to a degree that it became the norm — with
which they were expected to
> comply — in the immediate prison environment.
>
> The doctors thus brought a medical component to what I call an
"atrocity-producing situation" — one so
> structured, psychologically and militarily, that ordinary people can readily
engage in atrocities. Even
> without directly participating in the abuse, doctors may have become
socialized to an environment of
> torture and by virtue of their medical authority helped sustain it. In
studying various forms of
> medical abuse, I have found that the participation of doctors can confer an
aura of legitimacy and can
> even create an illusion of therapy and healing.
>
> The Nazis provided the most extreme example of doctors' becoming socialized to
> atrocity.<http://content.nejm.org/cgi/content/full/351/5/415#R4>4 In addition
to cruel medical
> experiments, many Nazi doctors, as part of military units, were directly
involved in killing. To reach
> that point, they underwent a sequence of socialization: first to the medical
profession, always a
> self-protective guild; then to the military, where they adapted to the
requirements of command; and
> finally to camps such as Auschwitz, where adaptation included assuming
leadership roles in the existing
> death factory. The great majority of these doctors were ordinary people who
had killed no one before
> joining murderous Nazi institutions. They were corruptible and certainly
responsible for what they did,
> but they became murderers mainly in atrocity-producing
> When I presented my work on Nazi doctors to U.S. medical groups, I received
many thoughtful responses,
> including expressions of concern about much less extreme situations in which
American doctors might be
> exposed to institutional pressures to violate their medical conscience.
Frequently mentioned examples
> were prison doctors who administered or guided others in giving lethal
injections to carry out the
> death penalty and military doctors in Vietnam who helped soldiers to become
strong enough to resume
> their assignments in atrocity-producing situations.
>
> Physicians are no more or less moral than other people. But as heirs to
shamans and witch doctors, we
> may be seen by others — and sometimes by ourselves — as possessing special
magic in connection with
> life and death. Various regimes have sought to harness that magic to their own
despotic ends.
> Physicians have served as actual torturers in Chile and elsewhere; have
surgically removed ears as
> punishment for desertion in Saddam Hussein's Iraq; have incarcerated political
dissenters in mental
> hospitals, notably in the Soviet Union; have, as whites in South Africa,
falsified medical reports on
> blacks who were tortured or killed; and have, as Americans associated with the
Central Intelligence
> Agency, conducted harmful, sometimes fatal, experiments involving drugs and
mind control.
>
> With the possible exception of the altering of death certificates, the recent
transgressions of U.S.
> military doctors have apparently not been of this order. But these examples
help us to recognize what
> doctors are capable of when placed in atrocity-producing situations. A recent
statement by the
> Physicians for Human Rights addresses this vulnerability in declaring that
"torture can also compromise
> the integrity of health
professionals."<http://content.nejm.org/cgi/content/full/351/5/415#R5>5
>
> To understand the full scope of American torture and abuse at Abu Ghraib and
other prisons, we need to
> look more closely at the behavior of doctors and other medical personnel, as
well as at the pressures
> created by the war in Iraq that produced this behavior. It is possible that
some doctors, nurses, or
> medics took steps, of which we are not yet aware, to oppose the torture. It is
certain that many more
> did not. But all those involved could nonetheless reveal, in valuable medical
detail, much of what
> actually took place. By speaking out, they would take an important step toward
reclaiming their role as
> healers.
>
>
> Source Information
>
> From the Department of Psychiatry, Harvard Medical School, Boston.
>
> References
>
> 1. Zernike K. Only a few spoke up on abuse as many soldiers stayed
silent. New York Times. May
> 22, 2004:A1.
> 2. Slevin P, Stephens J. Detainees' medical files shared: Guantanamo
interrogators' access
> criticized. Washington Post. June 10, 2004:A1.
> 3. Squitieri T, Moniz D. U.S. Army re-examines deaths of Iraqi
prisoners. USA Today. June 28,
> 2004.
> 4. Lifton RJ. The Nazi doctors: medical killing and the psychology of
genocide. New York: Basic
> Books, 1986.
> 5. Statement of Leonard Rubenstein, executive director, Physicians for
Human Rights, June 2, 2004.
> (Accessed July 9, 2004, at
>
<http://www.aclu.org/news/NewsPrint.cfm?ID=13965&c=36>http://www.aclu.org/news/N\
ewsPrint.cfm?ID=13965&c=36.)
> --
> George Povey
> Epidemiology, U.B.C.
> 5804 Fairview Avenue
> Vancouver V6T 1Z3 Canada
> Office phone: 604/822-3990
> Office fax: 604/822-4994
> Home phone: 604/267-9472
> george.povey@...
>
>