• Torture and Professional Ethics: There is no defense

    Torture at Abu Ghraib.

    Torture at Abu Ghraib.

    Senate Select Committee on Intelligence’s Study of the Central Intelligence Agency ‘s Detention and Interrogation Program documents that the United States tortured prisoners. The report provides great detail about the participation of physicians and psychologists in this torture. Atul Gawande has commented on this in a memorable series of tweets. Here I want to spell out the ethical accountability of physicians and psychologists who participated in torture and to clarify that according to the ethics of their professions, torture is indefensible.

    From the CIA’s records, the Senate report documents: a) that torture occurred, b) that physicians and psychologists not only participated in torture but also defined the procedures of torture, and c) that many of these professionals were aware at the time that their behavior was morally problematic. Do not take my word for this. You can review these details by searching the report for references to “OMS”, the CIA’s Office of Medical Services.

    Supreme Court Justice Scalia

    Supreme Court Justice Scalia

    Many people believe there is an ethical defense for torture. Here is Justice Antonin Scalia:

    Listen, I think it’s very facile for people to say, `Oh, torture is terrible.’ You posit the situation where a person that you know for sure knows the location of a nuclear bomb that has been planted in Los Angeles and will kill millions of people. You think it’s an easy question? You think it’s clear that you cannot use extreme measures to get that information out of that person?

    That is, torture was justified because of the possibility of a catastrophe, even though torture is otherwise morally impermissible.

    Let’s distinguish two questions. First, is an extenuating circumstance defense of torture ever morally valid? I think not and I refer you to (paywalled, unfortunately) articles by Henry Shue here and here.

    This post, however, focuses on a second and narrower question: is an extenuating circumstance defense open to physicians and psychologists?

    The answer to the latter question is clear. Physicians and psychologists cannot participate in torture. From the American College of Physicians Ethics Manual, 6th Edition:

    Physician participation in torture is legal in some countries but is never morally defensible… Under no circumstances is it ethical for a physician to be used as an instrument of government to weaken the physical or mental resistance of a human being, nor should a physician participate in or tolerate cruel or unusual punishment or disciplinary activities beyond those permitted by the United Nations’ Standard Minimum Rules for the Treatment of Prisoners.

    Note the word “never” and the phrase “Under no circumstances”.  Similarly, Opinion 2.067 in the AMA Code of Medical Ethics states that

    Torture refers to the deliberate, systematic, or wanton administration of cruel, inhumane, and degrading treatments or punishments during imprisonment or detainment.

    Physicians must oppose and must not participate in torture for any reason. Participation in torture includes, but is not limited to, providing or withholding any services, substances, or knowledge to facilitate the practice of torture. Physicians must not be present when torture is used or threatened.

    Again, note that physicians must not participate in torture “for any reason”.

    Finally, the American Psychological Association states that

    Torture in any form, at any time, in any place, and for any reason, is unethical for psychologists and wholly inconsistent with membership in the American Psychological Association.

    No exceptional circumstances whatsoever, whether a state of war or a threat of war, internal political instability or any other public emergency, legal compulsion or organizational demand, may be invoked as a justification for torture.

    There is no defense to torture under the Ethical Principles of Psychologists and Code of Conduct (2002).

    The APA Ethics Committee will not accept any defense to torture in its adjudication of ethics complaints.

    The professional ethics of physicians and psychologists have an absolute ban on participation in torture. The extenuating circumstances defense has been anticipated and is explicitly ruled out. You cannot be an ethical physician or psychologist and participate in torture.

    @Bill_Gardner

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