Extract Military medicine is described as the ethical issue of dual loyalty, and how it relates to those health care personnel who are both officers in the military and are medical officers such as doctors and nurses. . . Notably, I wear two hats − one to my country as an officer and one to my patients as their doctor. This clinical role may bring conflict between professional duties to a patient and obligations − expressed or implied, real or perceived, to the interest of a third party such as an employer, an insurer or the state − that can violate patient’s rights. Dual loyalty, in this case, is simultaneous for obligations expressed or implied to a patient and a third party such as the military.
Because of the difficulties in researching torturers, little is known about how they are recruited, trained, and authorized, and how they morally justify their actions. This study examines oral history testimonies from 14 former torturers in Saddam Hussein’s Iraq. Torturers volunteered for jobs in the security services, and attributed their choice of career to psychologically traumatic childhoods. Torturers were trained to think of their victims as subhuman and dangerous, and to cultivate mercilessness as a type of strength. They carried out torture under direct orders, and two were tortured themselves when they failed to obey. They justified their actions morally by diffusing responsibility, blaming victims, and using just-cause thinking. Overall, the findings show that there is no single path to becoming a torturer, as there is great variation even among torturers from a single country. Much more research is needed to fully understand how torturers think and work.
Extract The Nazi doctors defended themselves primarily by arguing that they were engaged in necessary wartime medical research and were following the orders of their superiors. These defenses were rejected because they are at odds with the Nuremberg Principles, articulated a year earlier, at the conclusion of the multinational war crimes trial in 1946, that there are crimes against humanity (such as torture), that individuals can be held to be criminally responsible for committing them, and that obeying orders is no defense.
Extract Remember the many thousands who have served and are serving honorably, caring for American soldiers and Iraqis, and not the few who might have greatly disappointed us with their lack of proper ethical judgment.
Abstract Television images of torture chambers in Iraq and reports of the escalating use of torture in Zimbabwe remind us that this form of state-sponsored abuse continues unabated in many parts of the world. . . It is timely, therefore, to consider the reasons for the inadequate attention given to the topic by health professionals.
Extract Torture probably ended a long time ago in my country, but now we have more sophisticated ways of abusing human rights – in the way we deliver health care. The falsification of morbidity and mortality figures; not paying attention to the so-called ‘Capitalist’ diseases like drug abuse and even AIDS; not talking about the hazards of environmental pollution – all this has prevented us from taking ameliorating and protective measures.
Extract We reaffirm . . . our most categorical rejection of torture. Likewise, we reiterate our resolute support of the diverse initiatives aimed at investigating the participation of doctors in these unacceptable and condemnable practices, and the sanctioning of these activities within the medical profession and scientific organisations. . . There exists irrefutable proof that, during the 16 years of dictatorship, doctors and other members of the health care professions caused brutal suffering to their peers. Doctors involved in acts of torture are, for the most part, members of the armed forces. The conduct of these professionals is the result of the displacement of their medical vocation by the doctrine of ‘national security’, which conceives of the masses and their social and political organisations as the ‘internal enemy’.
(Notes that no doctors in private practice were known to have been involved in torture in Turkey. Those involved were working part-time or full-time for the government, or in the military.) Extract . . . Government pressure, on full or part-time employees, emerges in various forms. Doctors who refuse to participate in the act of torture can be accused of not obeying the orders of their immediate superiors and can be either dismissed from government service, or relocated to other posts with highly unfavourable working/living conditions. Material considerations, fear of being removed from family, and the obvious threat of coming under suspicion of ‘secretly collaborating with public enemies’, etc, exerts such emotional pressure that doctors are forced to participate, directly or indirectly, in the act of torture.
Extract The doctor-patient relationship is threatened. Once this association implied only one thing: the doctor above all must protect the patient. . . .
. . . it is not inconceivable that, as Canada moves towards socialized medicine and state control of all health facilities, we, too, may sacrifice the privacy of the doctor- patient relationship that we all once regarded as sacred.
. . . There is much concern regarding the involvement of medical personnel in the use of torture for political purposes. . .
. . . When the Dutch medical community refused to cooperate with the Nazi medical organization, 100 Dutch physicians were sent to concentration camps. Other Dutch physicians did not give in; they took care of the widows and orphans of their colleagues. They did not participate in any Nazi activity; they acted unanimously.
. . . Recently physicians in Portugal studied “the scientific effects” of torture; they examined persons before, during and after torture sessions and evaluated their ability to undergo further torture.
. . .We must therefore each ask what is our duty to our state and what to our profession and to our own sense of moral justice. To what extent might we unwittingly become agents of repression? . . . Physicians in Russia condone beatings; if the prisoner dies the physician complies with government policy and eliminates possible repression by signing the death certificate “cirrhosis of the liver.. or “coronary occlusion.”. . .
