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The U.S. government has, since the onset of its "War on Terror", directed medical professionals working with detainees "to violate standard ethical principles and medical standards to avoid infliction of harm", according to a new report.
Practices common among medical personnel treating prisoners at Guantanamo and other facilities have led to years of detainee abuse and torture that blurred the distinction between care-givers and captors, according to the Task Force on Preserving Medical Professionalism in National Security Detention Centers, a team of experts from legal, medical, military and ethical backgrounds with funding from the Open Society Foundations and the Institute on Medicine as a Profession.
“We now know that medical personnel were coopted in ways that undermined their professionalism,” said Open Society Foundations president emeritus and task force member Aryeh Neier in a press release for the report. “By shining a light on misconduct, we hope to remind physicians of their ethical responsibilities.”
In the aftermath of the Bush administration’s decision to treat prisoners apprehended in its "Global War on Terror" as enemy combatants, U.S. detainee policy ignored traditional wartime rules governing prisoners of war as outlined in the Geneva Conventions. The administration argued that non-state actors attacking the United States were not subject to the treaty’s stipulations.
Task force member Dr. Gerald Thomson, a professor emeritus of medicine at Columbia University, said, “We have a responsibility to make sure this never happens again.”
“It’s clear that in the name of national security, the military trumped that covenant and physicians were transformed into agents of the military and performed acts that were contrary to medical ethics and practice,” he said in the press release.
The task force says the resulting atmosphere led to years of detainee abuse, including torture, and the establishment of an institutionalized system predicated on using medical expertise for unethical purposes.
The policies were overseen by the U.S. military and intelligence agencies, specifically the Central Intelligence Agency and the Department of Defense (DOD).
The United States began using the prison at Guantanamo Bay in 2002 to hold enemy combatants at the start of the war in Afghanistan. At its peak, the facility held almost 700 detainees, with Afghans and Saudis making up the majority. Though nearly half the detainees at Guantanamo Bay were cleared for release in 2009, most have not been repatriated because of legislation enacted by Congress that blocked the transfer of detainees to the United States and made it harder to send them abroad. The impasse is one reason some detainees have begun hunger strikes in recent years.
The task force said force-feeding detainees violates medical ethics and should be stopped immediately.
“The DOD should prohibit the use of force-feeding … and restore physicians to the proper role of having a true doctor-patient relationship with detainees engaged in hunger strikes. Taking that course not only is consistent with medical ethics and human rights but can prevent the confrontations that have characterized hunger strikes at Guantanamo,” it says.
The report also questioned other parts of U.S. policy at Guantanamo, including the unexplained use of the anti-malarial drug mefloquine on detainees, which is known to cause neuropsychiatric side effects.
Reached for comment, DOD spokesman Army Lt. Col. Todd Breasseale rejected the validity of the vast majority of the task force’s allegations, especially regarding U.S. detainee policy at Guantanamo Bay.
“It is the policy of the department to protect the life and health of detainees by humane and appropriate clinical means and in accordance with all applicable law and policy,” he said, adding that the medical staffers, who provide “exemplary” medical care to the detainees at Guantanamo, take their duty of caring for inmates “as seriously as they take their duty to provide medical treatment to U.S. service members or any other patient in their care.”
On the issue of force-feeding, he said “the policy on treatment of those not eating is focused solely on preserving the life and health of detainees in DOD custody and is in line with well-established U.S. law.”
“We remain committed to President Obama’s goal of closing the detention facility at Guantanamo Bay, Cuba. It is wildly expensive, it is inefficient, and it operates outside America’s best interests. However, until Congress changes the law, we will continue to humanely safeguard those held in our charge there,” he said.
While the Obama administration has rejected some of the Bush administration’s harsher methods — primarily, outlawing the use of torture under a 2009 presidential executive order — the task force argues that current detention policy remains inadequate and fails to uphold medical and ethical standards.
Some recommendations laid out by the report as essential steps:
– A more complete executive order to ban interrogation methods like “sleep deprivation, isolation and exploitation of fear,” which, it argues, are still legal.
– A comprehensive administration review delivered to Congress of all post-9/11 U.S. interrogation policies to account for the incidence of torture and the coopting of medical professionals.
– DOD and CIA implementation of new protocols to ensure that medical professionals under their command adhere to proper ethical standards regarding detainees.
– Updating DOD policy regarding detainee hunger strikes “in keeping with established professional ethical standards.”