Physicians and other medical personnel were involved in the abusive interrogation of terrorists suspects held overseas by the CIA, according to a secret report by the International Committee of the Red Cross (ICRC). The report was obtained by journalist Mark Danner, who has written extensively about torture. The conclusions of the report point to a serious breach of medical ethics.

The report also confirms that torture was carried out in Guantanamo Bay, Cuba, where medical professionals working for the CIA were in charge of monitoring prisoners who underwent water boarding and other torture methods. Amnesty International and Physicians for Human Rights have stated that the conditions in Guantanamo amounted to the cruel, inhuman or degrading treatment of prisoners and, as such, are prohibited by international conventions to which the United States is a party.

The ICRC report states that prisoners have been subjected to cruel and inhuman treatment, including forced feedings to hunger strikers through tubes painfully inserted in their nose. According to the International Committee of the Red Cross and Physicians for Human Rights, force feeding of hunger strikers is in direct violation of international codes of medical ethics.

Physicians’ participation in torture is an ongoing phenomenon, especially in countries under military rule. Many prisons in those countries have medical and paramedical personnel on their staffs.

Doctors’ role in torture can take several forms, ranging from assessing a prisoner’s health status before torture is initiated to determining how much longer torture may be continued without immediate danger to the prisoner’s life. Complicity also includes reviving torture victims who have fainted from pain, and active participation in the interrogation process. One detainee alleged that a health professional threatened to withhold medical treatment unless there was cooperation with the interrogators.

Dr. Robert Jay Lifton, who has written extensively on issues of medical ethics, stated that “there is increasing evidence that doctors, nurses and medics have been compliant in torture and other illegal procedures in Iraq, Afghanistan and Guantanamo Bay.”

In that regard, the Declaration of Tokyo, agreed in 1975 by the World Medical Association, clearly establishes that, “The doctor shall not countenance, condone or participate in the practice of torture or cruel, inhuman or degrading procedures, whatever the offense of which the victim of such procedures is suspected, accused or guilty, and whatever the victim’s beliefs or motives, and in all situations, including armed conflict and civil strife.”

For the U.S., a serious ethical challenge is how to continue its war on terrorism and at the same time reaffirm its adherence to international human rights principles. CIA interrogation techniques were declared legal by the Justice Department under George W. Bush’s presidency. President Barack Obama has prohibited all government interrogators from using techniques not included in the Army Field Manual. And the CIA is decommissioning the secret overseas prisons where prisoners were subjected to cruel interrogation methods.

These positive actions should be accompanied by the creation of a bipartisan truth commission in charge of investigating the Bush administration’s detainee policies, an idea forcefully promoted by Sen. Patrick Leahy, a Democrat from Vermont.

Although so far the Obama administration has shown little interest in this idea, it is consistent with Obama’s avowed decision that this kind of action should never happen again. Showing that nobody is above the law and that these unlawful actions should be rigorously investigated and punished is the best way to secure that policy.

No country, no matter how technically advanced, is free from the dangers of using and/or exporting brutal repression. Unless strict limits are followed and legal constraints are respected, barbarism will extend its cruel practices over any country’s powerless citizens.

Cesar Chelala, a medical doctor and an international public health consultant, is a cowinner of an Overseas Press Club of America award for an article on human rights.

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