by Steven H Miles, MD
The Nazi Doctors at Nuremberg in 1945 brought enormous attention on medical war crimes. The unearthing of complicity of United States physicians and psychologists with interrogational torture during the war on terror of at the beginning of the 21st century reignited attention to participation of physicians in human rights crimes. In retrospect, two aspects of that renewed attention deserved more scrutiny. There was a lack of attention to international context for the United States experience and, against this background, the fact that no US physicians were held accountable for complicity with torture was as noteworthy as their collaboration with that practice. In both of these respects, the process of writing this book was profoundly disturbing.
The Torture Doctors examines physician complicity, accountability and impunity with regard to their practice of torture. In examining the professional identity of torture doctors, it concludes that most are simply careerists rather than motivated by sadism or fear. I compile their immensely varied tasks and from these define “torture doctor.” I consider the rise in the mid 1970s of efforts to hold such physicians accountable by courts and medical boards and professional associations and from these proposes reforms that medical licensing boards and associations can and have not taken.
The Torture Doctors is based on compiled information from human rights organizations’ reports, court rulings, newspapers, journals, and books. The investigation faced the problem that no organization compiles accounts of torture doctors, proceedings against them or even the outcomes of proceedings. The research was further complicated by being multilingual requiring confirmation of sources. In addition, there was selection bias: closed societies like China yield fewer secrets than open civil societies. Despite these difficulties, several conclusions can be drawn:
- An ‘atlas’ of torture doctors shows that physicians are entirely part of modern torture in at least one hundred countries, including democracies and autocracies, rich countries and poor ones, and fascist states as well as liberal polities.
- Torture doctors employ medical knowledge and skills to devise methods that do not leave scars or that keep people alive who are not supposed to die. And, they also employ their professional authority to falsify records and death certificates. Countless behavioral variants are compiled in an appendix.
- Although it is not surprising that governments protect their torture doctors from accountability, I was surprised at how mainstream medical organizations (including the World Medical Association) and licensing boards were integral to the infrastructure of impunity through a tradition that might be described as “condemn and abide,” in which they simply do not try to hold torture doctors accountable to the same anti-medical torture codes that they have endorsed and proclaim.
- The impetus to hold torture doctors accountable arises from humanists and human rights advocates who are largely at the periphery of organized medicine.
- Finally, it is not difficult to derive, from the few dozen instances where torture doctors have been held accountable, how national and international medical communities could advance accountability if they had the will to do so.
This book goes far beyond the limited scope of The Breaking of Bodies and Minds: Torture, Psychiatric Abuse, and the Health Professions (American Association for the Advancement of Science, 1985) or Medicine Betrayed: The Participation of Doctors in Human Rights Abuses (British Medical Association, 1992) or the vast literature on the war on terror medical torture program. When I started researching US war on terror physicians in 2004, (work that led to Oath Betrayed, in 2006), I expected to learn how the government suppressed the protests of physicians at the torture of prisoners. Instead, I found how physicians and psychologists were largely integrated, largely without protest, into the human rights crimes. In a similar trajectory, this latest book finds that the few heroic physicians challenging medical torture around the world do so in the face of the smothering indifference of mainstream medical associations and licensing boards. This book is the my discovery of a submerged wreck in the global house of medicine. After six years of research, the one thing that I am sure of is that I have only found a miniscule percent of the physicians and medical organizations that failed the interests of tortured human beings and thus have failed to engage the scourge or global torture itself.