Psyche, Science, and Society

Adbusters: Health Professional ethics in the War on Terror

Adbusters covers the involvement of health professionals in torture:

Ignored and Forgotten
Professional ethics in the War on Terror

By Blake Sifton

Though their actions invoke less dramatic imagery than the interrogators and prison guards who tortured and humiliated Muslim detainees at Guantanamo Bay and Abu Ghraib, equally guilty are the legions of professionals who facilitated the abuse.

Although the principal maxim of medical ethics is “First do no harm,” psychologists and doctors working for the military and CIA actively assisted in the torture of human beings. Psychologists helped fine-tune techniques such as sleep deprivation, stress positions and waterboarding, and doctors often monitored harsh interrogations, intervening when necessary to keep struggling prisoners alive and alert so the questioning could continue.

How could medical professionals demonstrate such little empathy in the presence of human suffering?

“People are capable of incredible cruelty. It’s increased in circumstances where there aren’t clear rules and boundaries,” says psychoanalyst Dr. Stephen Soldz. “We dehumanized the enemy after 9/11. We did it as a culture and the military did it spectacularly well. Like many others, military doctors felt a duty to serve their country.”
In 2007 Dr. Soldz urged the American Psychological Association to ban psychologists from participating in the interrogation of terror suspects.

“Professional ethics are always weak,” he says. “We have wonderful statements by professional associations about what the ethics are, but many people don’t internalize them.”

Justice Department memos revealed that doctors with the CIA’s Office of Medical Services declared that depriving prisoners of sleep for upwards of 180 hours was not classified as torture, nor was hosing down detainees with freezing cold water for up to two-thirds of the time it takes hypothermia to set in.

“They signed up to be part of the CIA’s covert operations, so presumably their commitment to medical ethics was long gone,” Dr. Soldz explains.

Another group whose human empathy lost out to zealous patriotism and cold, hard professionalism were the lawyers who crafted the framework for the authorization of torture. It was their technical expertise in legal jargon that allowed the United States to follow the path of every oppressive state before it and justify its disregard for human rights through a mantra of security.

“A few bad apples” did not cause the degradation and anguish of thousands of Muslims in Iraq, Afghanistan, Guantanamo Bay and an untold number of secret prisons around the world. Their pain was the product of system-wide moral failures by individuals whose conduct is supposed to be held to the highest professional standards.

The Justice Department recently determined that the lawyers who devised the technical justification for torture “exercised poor judgment” but were not guilty of professional misconduct. To this day there has been no investigation into the behavior of the medical personnel involved.

Kishore Mahbubani wrote, “In 1989, if anyone had dared to predict that within 15 years the foremost ‘beacon’ of human rights would become the first Western developed state to reintroduce torture, everyone would have shouted ‘impossible.’ Yet the impossible has happened!”

The speed with which the United States abandoned its principles and resorted to torture was startling. Centuries of progress were essentially abandoned overnight in a fit of fear and blind rage as the darkest potential of human nature was allowed to infect even the most venerable professions.

For there to be any chance of America reclaiming its moral legitimacy, President Obama’s government of hope and change must prosecute those responsible and refuse to allow the crimes of the recent past to be ignored, forgiven and forgotten.

June 29th, 2010

Police taser an 86 year old disabled woman out of fear for their safety?

Stories of police abuse with Tasers abound these days. Pregnant mothers, people who ask uncomfortable questions of politicians, and young children has all been subjected to excruciating disabling electric shots. Hundreds have died as a result.

Presumably the prevalence of these stories represent how often police abuse their authority in the most trivial of circumstances. In the old days it was with billy clubs and trumped-up arrests for “assault and battery on a police officer” or “resisting arrest,” both terms often used as codes for “police unjustifiably attacked person and is covering ass.” Either many police forces are full of the most fearful individuals ever to grow to be older than 10 or many police are systematically given the message that they can abuse anyone anytime they feel like it, and they feel like it quite often

In the latest unbelievable story, police in El Reno, Oklahoma are accused of Tasering an 86 disabled woman in her bed! Note that there were about 10 police, one disabled woman and her son, who had called for medical help, not police. Yet the commander claims to have been so terrified of a woman who couldn’t get out of her bed that he reportedly had to Taser her and step on her oxygen to partially suffocate her into submission.

If true, these police are obviously unqualified to serve. Either they are too scared to be allowed to have a wet noodle as a weapon, or they are so out of control that allowing them to have any authority is criminal.

The wave of Taserings of powerless individuals posing little or no serious threat suggests that something is seriously wrong in many police departments. It is a sad commentary on the brutalization of our culture that there is not more outrage fueling a demand for serious reform.

Raw Story has further details of the latest episode:

Officers taser 86-year-old disabled woman in her bed: lawsuit

Officer ‘s rationale: Bed-ridden grandmother ‘took more aggressive stance’ in her bed

When Lonnie Tinsley of El Reno, Oklahoma, called 911 to ask for medical assistance for his disabled, bed-ridden grandmother, he couldn’t have dreamed it would end with police tasering the 86-year-old woman twice, stepping on her oxygen hose until she couldn’t breathe, and sending her to a psychiatric hospital for six days.

Yet that’s what a lawsuit (PDF) filed in a federal court in Oklahoma this week alleges.

According to the lawsuit, in December, 2009, Tinsley came by his grandmother’s apartment to see if she was doing alright in the midst of a winter storm. When she wasn’t able to tell him if she had taken her medication, Tinsley called 911 and asked responders to send medical technicians over to evaluate her.

But instead of an ambulance, the lawsuit alleges, “as many as 10 El Reno police” arrived and “pushed their way through the door.”

At that point, 86-year-old Lona Varner told police to “get out of her apartment.” That’s when officer Thomas Duran, described in the lawsuit as the “leader” of the police unit, allegedly told another officer to “taser her.”

When Tinsley responded “Don’t tase my granny!” the officers threatened to taser him instead, the lawsuit states.

In his police report, officer Durgan asserted that Varner “took a more aggressive posture in her bed,” evidently causing him to fear for his and his officers’ lives.

Police then handcuffed Tinsley and took him to a waiting squad car. They released him without charge some time later. Meanwhile, the lawsuit alleges, officers “stepped on [Varner's] oxygen hose until she began to suffer oxygen deprivation.”

Officers then fired a taser at her, hitting her twice, causing her to pass out, the lawsuit states.

At the direction of El Reno police, Varner was sent to the psychiatric ward of St. Anthony’s Hospital in Oklahoma City, where she was held for six days.

The lawsuit, which names the city of El Reno and 13 police officers as defendants, alleges that Varner’s rights were violated under the Fourth and 14th Amendments to the US Constitution, and that “the defendants caused the plaintiffs to be wrongfully seized, assaulted, battered, physically harmed, humiliated [and] emotionally harmed.”

June 26th, 2010

Column in San Francisco Chronicle: Experiments in Torture and the APA

Steven Reisner and I have a column in the online San Francisco Chronicle on the recent report we are coauthors of, Experiments in Torture, and its relevance to the American Psychological Association:

June 26, is the United Nations’ International Day in Support of Victims of Torture

By Stephen Soldz and Steven Reisner

The CIA engaged health professionals to pursue unethical and illegal research and experimentation on detainees held by the agency in their secret “black site”prisons. Our report for Physicians for Human Rights documents that health professionals, including psychologists, used detainees as research guinea pigs, inflicting and then studying the effects of varying levels and combinations of harmful “enhanced interrogation” techniques, such as stress positions, slaps, sleep deprivation and waterboarding, to assess their effects. The resulting data was used by the CIA and Justice Department lawyers to permit the use of tactics that our government had always previously regarded as torture.

Legal prohibition against unethical research was weakened during the period that these egregious practices were implemented. The 2006 revisions to the War Crimes Act, made retroactive to 1997, reduced protections for research on military and CIA detainees.

But U.S. statutes were not the only prohibition against unethical experimentation that were changed during this period. In 2002, our professional association, the American Psychological Association, the world’s largest mental health organization, weakened its ethics code provisions requiring informed consent for psychological research. These revisions permit psychologists to dispense with informed consent when following laws or governmental or institutional regulations, no matter how dangerous the research may be to those studied. Even after government and news reports of widespread involvement of psychologists in the enhanced interrogation program were declassified, and the role of psychologists in designing and implementing the enhanced interrogation program was made public, the association ignored repeated calls to remove this loophole from its ethics code.

Ethical and legal protections for human subjects were a response to atrocities by Nazi doctors on unwitting prisoners. The 1947 Nuremberg Code begins “The voluntary consent of the human subject is absolutely essential.” This code went on to specify that researchers “avoid all unnecessary physical and mental suffering and injury.”For decades the association’s ethics code and professional policies reflected the lessons of Nuremberg and other abuses. But in 2002, all this began to change. The ethics code was amended not only to dispense with informed consent, but also weakened were protections against deception in research. Changes also permitted psychologists to follow law and military regulation, even if these conflicted with basic ethical principles.

In 2002, APA held a joint conference with the CIA where the two psychologists who designed the agency’s “enhanced interrogation” torture program were present. In 2005, the association appointed psychologists from military and CIA commands accused of these very abuses to formulate the APA’s ethics policy regarding participation in Bush administration interrogations at Guantánamo, the CIA’s secret prisons, and elsewhere.

The APA has long resisted changing its policies or explaining its actions, leaving the psychological profession tarnished as report after report have documented the central role of psychologists in designing and implementing the CIA torture tactics. At this point, not only should the APA remove the informed consent exception from the ethics code, but an independent investigation of the APA’s connections with the military-intelligence establishment is needed to assure that psychologists prioritize essential ethical principles over political expediency.

The struggle within the APA is not simply an internal issue. Psychologists in particular and health professionals in general, can only function in an environment of trust. We are trusted not to betray confidence, to do good and not harm, to keep our patients’ best interests at heart. We are trusted to take care of all people, even those accused of crimes, even those accused of terrorism.

**********

Stephen Soldz is the president-elect of Psychologists for Social Responsibility and professor at the Boston Graduate School of Psychoanalysis. Steven Reisner is a clinical assistant professor at New York University Medical School and adviser on psychology and ethics to Physician for Human Rights. They are co-authors of a Physicians for Human Rights report detailing evidence that the Bush administration conducted experiments and research on detainees.

June 26th, 2010

Why do Republicans hate the unemployed?

Rachel Maddow on the Republican hatred of and disdain for the unemployed.

While Maddow brings up a lot of good material, she misses the most important point. This is part of an ideological strategy of blaming ills on the “parasites” below in order to deflect attention from the real parasites above, on Wall Street, in BP, and at Shaws Supermarkets here in New England, where the firm has launched a major union-busting campaign, threatening to fire and permanently replace 300 striking warehouse workers who won’t agree to pay more for their healthcare.

As long as the right can keep much of those suffering from the horrible situation created by our betters blaming those below them — whether it be the unemployed, immigrants, poor minorities, or the old welfare cheats — they can protect those who’ve been stealing us blind from just-deserved criticism.

Ronald Reagan’s greatest “accomplishment” was striving the stake into the long tradition of workers solidarity when he fired the striking Professional Air Traffic Controllers (PATCO) workers with little opposition from most others. The union movement, and the tradition of solidarity were dealt severe blows from which they have so far not recovered. In the current economic climate either a spirit of solidarity is recreated or the wealthy and powerful will destroy the fruits of over a hundred years of struggle.

June 26th, 2010

Boycott Shaws Supermarkets! Support striking workers

New England supermarket chain Shaws is engaging in some classic union-busting. The 300 workers at their Methuen, MA warehouse have been on strike since March 7, protesting healthcare cuts and other bad contract provisions. Shaws is now threatening to permanently fire the strikers.

The strikers have had roving pickets at Shaws varied stores. I have seen them in Dedham, MA, outside the Shaws on Rt. 1 there.

Shaws is a major supermarket chain, with stores throughout new England and a claimed 30,00 employees. Given the firms union-busting activities, it is important for other workers and consumers to support the strikers’ efforts. Their failure in this time of economic upheaval will be a setback for many more than those working for Shaws. A message must be sent that union-busting efforts are simply not acceptable and will not be tolerated.

An injury to one is an an injury to all!

June 26th, 2010

Honesty on the campaign trail: Clint Webb for Senate

Clint Webb for Senate. At last a candidate speaks honestly:

[H/t Crooks and Liars]

June 26th, 2010

Republicans to unemployed: “Get lost!”

What can one say. Over 1 million long-term unemployed abandoned…..

What now for them? Homeless shelters are full.

1 comment June 25th, 2010

Get New York health professionals out of torture

The New York Times has a new editorial on the need for states to act in order to get health professionals away from aiding torture and ill treatment of prisoners. Readers in New York state should immediately call and write their state Senators and members of the Assembly in support of the Gottfredson bill, as this initiative is known. The Assembly vote could come at any minute.

It also should be pointed out that, to their great credit, the New York State Psychological Association is fully supportive of this effort. In fact, a couple of weeks ago they awarded Steven Reisner an award for his work on the bill. Thank you NYSPA:

Do No Harm

New York Times Editorial

Health professionals who facilitate torture are violating the most fundamental medical ethics and ought to be punished. Unfortunately, neither Congress nor the Obama administration has shown any appetite for confronting the problem. The New York State Legislature is considering a state law that would bar such misbehavior and provide grounds for revoking the license of any health professional who participates.

The International Committee of the Red Cross and Physicians for Human Rights have presented persuasive evidence that the Bush administration used medical personnel to help shape and justify the Central Intelligence Agency’s “enhanced interrogation” techniques. There is no evidence, so far, that medical personnel conducted the torture. Doctors, psychologists and physicians’ assistants helped determine how far a harsh technique — waterboarding, prolonged sleep deprivation, shackling in stressful positions — could go without killing or inflicting extreme pain.

They helped plan how various methods could be used in combination, calibrated the levels of pain and monitored the proceedings. Their involvement was apparently intended to provide legal cover for interrogators who, if they were ever prosecuted, could always argue that medical professionals monitored and judged their techniques as safe. The notion of doctors and other health professionals using their knowledge in any way to abuse prisoners is horrifying.

Bills to hold health professionals accountable have been introduced in both houses of the Legislature.

The Assembly’s bill, which has 45 co-sponsors and could be voted on as soon as Friday, would bar all health professionals licensed in New York from participating, directly or indirectly, in torture or other abuses no matter where they happen. They would have a duty to refuse to participate in torture and also to report abusive practices to appropriate authorities. Violators could be convicted of misdemeanors and subjected to professional misconduct proceedings that could lead to censure and suspension or revocation of a license.

We recognize that, if interrogation materials are kept classified, it could be difficult for state licensing boards to ascertain what role health professionals might have played — and for accused professionals to defend themselves. It would be far better to conduct investigations and mete out punishments at the national level.

There is no sign of that happening any time soon. The New York State Legislature should approve the bill. It could deter some unethical conduct, give health professionals added reasons to reject and report abusive interrogations, and exert pressure on the federal government to declassify more material. It would also serve as a model for other states to fill the void until Congress and the Obama administration step up to their responsibilities.

June 25th, 2010

Democrats serve their people, again…

Today was a good day for the Democrats in Congress. They served their people again, bringing home the loot.
Headlines in Huffington Post tonight tell all one needs to know:

DEMS SIDE WITH
WALL STREET… AGAIN
House Dems Trying To Gut Aggressive Derivatives Reform…
Sen. Harkin, Rep. Meeks Weakening Rules That Protect Seniors…
White House, Sen. Dodd Trying To Kill Measure That Boosts Shareholders

June 24th, 2010

USA: Worst healthcare for the highest cost

American know how: worst healthcare for the highest cost, says a new report from the Commonwealth Fund:

The United States ranked last when compared to six other countries — Britain, Canada, Germany, Netherlands, Australia and New Zealand, the Commonwealth Fund report found.

“As an American it just bothers me that with all of our know-how, all of our wealth, that we are not assuring that people who need healthcare can get it,” Commonwealth Fund president Karen Davis told reporters in a telephone briefing.

Previous reports by the nonprofit fund, which conducts research into healthcare performance and promotes changes in the U.S. system, have been heavily used by policymakers and politicians pressing for healthcare reform.

Davis said she hoped health reform legislation passed in March would lead to improvements.

The current report uses data from nationally representative patient and physician surveys in seven countries in 2007, 2008, and 2009. It is available here.

In 2007, health spending was $7,290 per person in the United States, more than double that of any other country in the survey.

Australians spent $3,357, Canadians $3,895, Germans $3,588, the Netherlands $3,837 and Britons spent $2,992 per capita on health in 2007. New Zealand spent the least at $2,454.

This is a big rise from the Fund’s last similar survey, in 2007, which found Americans spent $6,697 per capita on healthcare in 2005, or 16 percent of gross domestic product.

“We rank last on safety and do poorly on several dimensions of quality,” Schoen told reporters. “We do particularly poorly on going without care because of cost. And we also do surprisingly poorly on access to primary care and after-hours care.”

NETHERLANDS RANKED FIRST OVERALL

The report looks at five measures of healthcare — quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives.

Britain, whose nationalized healthcare system was widely derided by opponents of U.S. healthcare reform, ranks first in quality while the Netherlands ranked first overall on all scores, the Commonwealth team found.

U.S. patients with chronic conditions were the most likely to say they gotten the wrong drug or had to wait to learn of abnormal test results.

“The findings demonstrate the need to quickly implement provisions in the new health reform law,” the report reads.

Critics of reports that show Europeans or Australians are healthier than Americans point to the U.S. lifestyle as a bigger factor than healthcare. Americans have higher rates of obesity than other developed countries, for instance.

“On the other hand, the other countries have higher rates of smoking,” Davis countered. And Germany, for instance, has a much older population more prone to chronic disease.

Every other system covers all its citizens, the report noted and said the U.S. system, which leaves 46 million Americans or 15 percent of the population without health insurance, is the most unfair.

“The lower the performance score for equity, the lower the performance on other measures. This suggests that, when a country fails to meet the needs of the most vulnerable, it also fails to meet the needs of the average citizen,” the report reads.

June 23rd, 2010