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Report: Military doctors have abused detainees, breached ethics

Nov. 5, 2013 - 07:33PM   |  
Guantanamo Bay Facility Continues To Serve As Dete
A watchtower is seen in the currently closed Camp X-Ray, which was the first detention facility to hold 'enemy combatants' at the U.S. Naval Station in Guantanamo Bay, Cuba. A three-year review of physicians' participation in force-feedings and detainee interrogations has concluded that military doctors engaged in abusive practices in Iraq, Afghanistan and Cuba and continue adhering to Defense Department policies that breach medical ethics. (Joe Raedle / Getty Images)
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A new report claims that military physicians participated in abusive practices in Iraq, Afghanistan and Cuba and continue following Defense Department policies that breach professional medical ethics.

The report released Nov. 4 by an Institute of Medicine As a Profession task force found that military doctors and health professionals on interrogation teams, also called behavioral science consultation teams or BSCTs, and those supporting force-feedings at the Guantanamo Bay prison routinely violate the primary principle of medical ethics: First, do no harm.

According to the report, DoD and the CIA “required physicians, psychologists and other health professionals to act contrary to their professional obligations” by “enabling torture and cruel, inhumane and degrading treatment of detainees.”

“The agencies inappropriately held health professionals to ethical standards contrary to professional ethical principles,” the authors wrote in “Ethics Abandoned: Medical Professionalism and Detainee Abuse in the War on Terror.”

While DoD has shifted policies to protect physicians serving on BSCTs, established an ethics board at Guantanamo and received court confirmation of the legality of its hunger strike policies, more must be done to ensure U.S. military doctors adhere to medical ethics, according to the 20-member panel of academicians, legal experts, medical ethicists and retired military personnel.

Retired Brig. Gen. Stephen Xenakis, a former Army psychiatrist who has testified before the Senate recommending the closure of Guantanamo and a longtime member of Physicians for Human Rights and Human Rights First, said the report is a wake-up call to military doctors to stand up for their independence in military commands.

“Clinicians need to affirm their values and remember what got them into this profession,” Xenakis said. “Our principles are basic to human rights and we have a unique role as physicians to help people have quality of life.”

But a DoD spokesman said the report findings are not new and added that both the feedings as well as medical support of detainees during interrogation “have been subject to numerous investigations over the years and those investigations have never substantiated these claims.”

“It is [DoD] policy ... to protect the life and health of detainees by humane and appropriate clinical means, and in accordance with all applicable law and policy,” DoD spokesman Army Lt. Col. J. Todd Breasseale said.

To create their report, task force members reviewed public documents as well as unclassified information and media articles. Members found that military physicians:

■ Were complicit in interrogations by recommending practices such as sleep and sensory deprivation, stress and extreme noise and temperature changes to facilitate interrogations.

■ Sought vulnerabilities in detainees’ psychological evaluations and possibly health records to exploit in interrogations.

■ Did not appropriately provide mental health treatment for detainees with psychological conditions caused by interrogations.

■ Are inappropriately acting as agents for Guantanamo Bay Detention Center by participating in force-feeding.

“The American public has a right to know that the covenant with its physicians to follow professional ethical expectations is firm regardless of where they serve,” said Dr. Gerald Thomson of Columbia University, a task force member. “It’s clear that in the name of national security, the military trumped that covenant.”

However, the report stopped short of blaming physicians themselves for the activities. Instead, the recommendations focus on policy changes by DoD and the White House, as well as the associations that govern medical ethics and states, which license health professionals, to adopt policies and practices that protect human rights and censure those who breach professional standards.

“These young doctors, the captains, majors and lieutenant colonels, need to be fully supported. The burden rests with the senior leaders,” Xenakis said.

Fourteen detainees at Guantanamo are eligible for enteral feedings or “e-feedings,” as they are known, but not all require tube feedings, said Navy Cmdr. John Filostrat.

“The enteral feeding procedure is medically sound, and is based on procedures performed not only in U.S. prisons, but in hospitals and nursing homes worldwide,” Filostrat said.

DoD has taken a number of steps to shield its medical professionals, including setting policies that protect detainees’ medical records, establish certain health providers as security officers rather than practicing clinicians and establishing an abuse reporting system.

Defense Secretary Chuck Hagel in October appointed former Marine and attorney Paul Lewis to serve as special envoy for the closure of the Guantanamo prison.

Breasseale said Nov. 1 that DoD “remains committed to President Obama’s goal” of closing the detention facility.

He said the facility is “wildly expensive, it is inefficient and it operates outside Americans’ best interests. However, until Congress changes the law, we will continue to humanely safeguard those held in our charge there.”

About 160 detainees are now held at the facility.

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