Blog by Steven H. Miles, MD
The two-faced Roman god Janus is about transitions: from what came before to what now begins, from war to peace or from peace to war.
It is easy to imagine the image of Janus atop the arch of this moment in the history of the medical profession. Here, it could, if we choose, denote the transition between the past accommodation with physicians who take up the bludgeons of torturers and a future where the medical profession stands firmly with healing and human rights. Today, the medical profession seems to carry the Janus-topped arch in front of it so that it does not cross so that it remains in the age of the torture doctor instead of passing forward to abandon torture doctors in its past.
It is shocking but true. Far more doctors abet torture than rehabilitate its victims. They do so on behalf of democracies and fascist autocracies, rich nations and poor ones. They practice their craft in well over a hundred nations. Some directly oversee torture. Some devise and promote techniques that leave fewer evidentiary scars. Some conceal torture with false medical records and death certificates. Some titrate torture to keep alive those prisoners who are not yet supposed to die.
Although hundreds of countries rely on doctors to carry out or conceal torture, there are a mere four score of cases where torture doctors have been held accountable by courts or medical licensing boards. Impunity is the rule. It is tedious, but not difficult, to confirm the truth of this observation. One must simply diligently search through the reports of the United Nations Rapporteur on Torture, Amnesty International and other human rights groups and major newspapers as I did for The Torture Doctors: Human Rights Crimes and the Road to Justice.
The trial of twenty Nazi physicians at Nuremberg in 1946 is often touted as proof that the medical profession is committed to holding doctors who commit human rights crimes accountable. And yet, even as that trial was going forward, grounds were being laid to allow the vast majority of Nazi physicians to quietly slip back into practice in Germany. As the Nazi doctor’s trial was proceeding, Operations Overcast, Dustbin and Paperclip set about rescuing 1600 Nazi scientists, many of whom had conducted criminal experiments, to bring them to the United States to work on biological, chemical and aerospace warfare.
It is wrong to narrowly focus on the torture doctors in Western democracies. The United States imposed no accountability on the doctors and psychologists who tortured during the war on terror. The United Kingdom similarly gave a pass to those who abused prisoners in Northern Ireland and fifty-eight identified physicians who allegedly abused prisoners during the War on Terror. After reunification, Germany ignored the torture doctors who tortured for the Stasi in East Germany. Spain and Israel have substantial ongoing problems. All of these nations have relatively open civil societies where it is relatively easy to learn the truth and to speak of the atrocities. Medical torture in closed countries like Uzbekistan, Russia, and China and other unmonitored nations is surely more prevalent and severe. Even so, western democracies, though not worse in practice, must be called out for their failure to lead by example.
Passing through the arch of Janus requires leadership in developing accountability. There is no system for grading national compliance with anti-medical torture codes like the Declaration of Tokyo. No model protocols for conducting criminal or licensure hearings have been developed or endorsed. There is no international website of completed cases to show that accountability is possible. The medical profession cannot pass through this Janus-topped arch so long as maintains the position that it will condemn the practice and abide the practitioners.
Steven H. Miles is Professor of Medicine and Bioethics Emeritus of the University of Minnesota. He has extensively written on this topic including Oath Betrayed: America’s Torture Doctors and The Torture Doctors: Human Rights Crimes and the Road to Justice.