Siddhartha Yadav: Doctors’ involvement in torture

My attention was drawn to a story in yesterday’s Guardian newspaper about alleged abuse of eleven Iraqis by British soldiers, coming less than a month after the BMJ covered a press conference organised by Physicians for Human Rights, which I attended.

PHR was launching its report on alleged torture of detainees at US prisons in Iraq, Afghanistan and Guantanamo Bay, reported with an accompanying video on At that press conference, we were told that doctors were involved in torture in these prisons.

This came as quite a surprise to me and since then I am not quite sure what I might hear or read about doctors. Yesterday’s Guardian story did not mention any medical involvement.

Both stories made me try and imagine what it is like to be arrested by soldiers some day. What would it feel like to be taken to an army prison and stripped naked, shackled and made to lie down in an overcrowded cell made of barbed wire.

The only time you can stretch your body is when you walk to a makeshift toilet where soldiers with guns look directly at you. You are tortured – beaten, sodomised, given electric shock, forced to drink urine, jabbed with a screwdriver through your cheek- so much so that you even try committing suicide.

Finally, years later, you are released. But no, you are not going home. You are put into a refugee camp in a different country, far from your friends and family. You know no one there and no one speaks your language. And worst of all, you are still wondering why you were arrested in the first place. Neither those who arrested you have officially charged you with anything.

This is a difficult scenario to imagine. But it is the picture that the PHR report paints for some of the tortured detainees in Guantanamo Bay, Abu Ghraib (Iraq), and Baghram (Afghanistan).

If what the report says is true, then I am interested in knowing about the doctors involved in this torture. Who are they? Why did they do it? Are they sadists who derive pleasure from the pain and suffering of the prisoners? Or doctors who think of it as revenge on the death of their fellow soldiers? Or doctors who think they are just performing their duties?

The report and the experts interviewed afterwards suggest that everyone, including doctors, simply became a part of the system which used torture as a method of interrogation.

They say that doctors were made to put interrogation as their priority rather than patient care: they provided conditional care i.e. if prisoners agreed to cooperate with interrogation; they gave drugs to aid in interrogation; they performed procedures without consent; and they did not report incidents of torture.

This was another surprise for me. I had thought that five years of everyday reminders in a medical school that patient welfare is above everything would be sufficient to make you understand this priority. But it seems that you forget all of it when you work in an environment that encourages you to see ill detainees as suspected terrorists rather than patients.

Does this mean that we are only the products of our environments? And then, what about our duty to the medical profession and the Hippocratic oath when we work in such an environment? Will medical ethics, our duty to our profession, and even our conscience be meaningless to us if we work in a place that does not totally uphold these values?

As I said earlier, the Guardian’s story has no mention of doctors. But it is likely that doctors could have come in contact with some of those who were severely injured or suffered the psychological consequences of such tortures.

This, many would argue, forms the basis for our (medical professionals’) wider involvement in human rights issues beyond the traditional ‘health’ domain and the need to expose gross violations, if any, occurring in such settings.

But as a prerequisite, it is perhaps necessary that we reiterate our own commitments to respect medical ethics, professional integrity, and human rights.