Sunday, November 10, 2013

Should the War on Terror Trump Medical Ethics?

An independent report has highlighted ongoing violations of medical ethics at Guantánamo Bay and called on the Department of Defense (DoD) and the medical community to conform to ethical principles. The Task Force on Preserving Medical Professionalism in National Security Detention Centers claims that medical staff have been forced to act unethically.

"As a doctor who has been to Guantánamo and examined detainees, I am appalled that medical care there is controlled by command and security prerogatives," said Vincent Iacopino, of Physicians for Human Rights, a member of the task force. "It is time for the administration to end the inhuman and degrading practice of force-feeding and restore the ability of medical staff to act independently and according to their clinical and ethical obligations."

The 269-page report, Ethics Abandoned: Medical Professionalism and Detainee Abuse in the 'War on Terror', follows two years of review of public records by 19 medical, military, ethics, public health, and legal experts.

It discusses how medical personnel established and participated in torture. It also outlines how the DoD committed a number of ethical breaches, including improperly using health professionals during interrogations; implementing rules that permitted medical and psychological information obtained by health professionals to be used during interrogations; requiring medical staff to forgo independent medical judgment and force-feed competent detainees; and failing to adopt international standards for medical reporting of abuse against detainees.

The report also says that the CIA's Office of Medical Services played a critical role in torture, including waterboarding. It had advised the Department of Justice that "enhanced interrogation" methods, such as extended sleep deprivation and waterboarding, were medically acceptable. CIA medical personnel were present during waterboarding, the Task Force claims.

"Putting on a uniform does not and should not abrogate the fundamental principles of medical professionalism," said David Rothman, of the Institute for Medicine as a Profession, a sponsor of the report. "'Do no harm' and 'put patient interest first' must apply to all physicians regardless of where they practice."

Adding to the criticism, more than 35 prominent doctors and public health professionals - including a former US surgeon general, six Nobel laureates, and 18 deans of public health and medical schools - have asked President Obama to end force-feeding at Guantánamo Bay. "Force-feeding undermines appropriate medical care and ethical responsibilities because physicians act as agents of command - a fundamental violation of professionalism," they say in an open letter.

Source: BioEdge

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