Do no harm

July 11, 2005

UNDER A DOCTOR'S CARE apparently meant something different to the imprisoned patients of Guantanamo Bay, and later Abu Ghraib, than it does elsewhere in the free world.

Recently released memos and former and current military doctors and interrogators say doctors not only shared medical records with interrogators but devised interrogation plans based on a patient's health and mental problems - based on information so private that for any other patient or wartime prisoner its release would be considered unethical.

Such behavior goes against the solemn pledge taken by doctors, whether it be the modern Hippocratic oath or the alternate American Medical Association version - "That you will exercise your art solely for the cure of your patients, and will give no drug, perform no operation, for a criminal purpose, even if solicited, far less suggest it."

Yet at Guantanamo, psychiatrists and other doctors were assigned to interrogation teams and instructed by military memo that their purpose was "nontherapeutic," that they had a "limited doctor-patient relationship" with the prisoners. They advised questioners on prisoners' soft spots; they did not report the abuses that memos from fellow observers from the FBI have reported. They tacitly at least - and likely overtly- sanctioned the allegedly bad behavior of U.S. soldiers toward detainees.

The Army surgeon general's review announced last week found that prisoners, in the main, get good medical care, but it did not address the specific interactions between psychologists and interrogators. It did ask psychologists what they thought their role was; the answer: advising interrogators first, ensuring the well-being of detainees second. The Pentagon released new guidelines last month that say doctors must not engage in unethical conduct, though they still suggest that they may do so for "lawful interrogations," a term of art for what has been happening at prisons in Guantanamo Bay and Iraq.

The surgeon general also is working on prison-doctor guidelines - but in secret. That debate should be open: There already is too much secrecy over prisoner treatment; involving the greater medical community in the discussion also could result in stronger, clearer, more humane rules. Congress should call for a joint military-medical association investigation into the role of doctors at American prisons holding terrorist suspects.

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