3rd Degree TORTURE by Doctors

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Editor: NAGARAJA.M.R… VOL.7 issue.43…… .23/10/2013

TORTURE  BY  DOCTORS -  Terrorists in White robe  

Doctors  involvement  in  TORTURE

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We respect doctors  who respect other human beings & save their lives . Hereby , we  want to bring to book  those doctors who defy basic human ethics  in their greed for money , career. These inhuman doctors conduct  illegal , inhuman clinical trials  on poor people , promote fake drugs , aid  police in the 3rd degree torture of  innocents , etc.  In India , these  TERRORISTS  in  WHITE  are more , that is the reason  more & more lock-up deaths , encounter deaths are taking place , illegal clinical trials are being conducted , fake drugs are sold & even exported to nigeria & other african countries.  Still these White Terrorists are not legally prosecuted.

Medical torture describes the involvement and sometimes active participation of medical professionals in acts of torture, either to judge what victims can endure, to apply treatments which will enhance torture, or as torturers in their own right. Medical torture may be called medical interrogation if it involves the use of their expert medical knowledge to facilitate interrogation or corporal punishment, in the conduct of torturous human experimentation or in providing professional medical sanction and approval for the torture of prisoners. Medical torture also covers torturous scientific (or pseudo-scientific) experimentation upon unwilling human subjects.

Doctors from both non-democratic and democratic countries are involved in torture. The majority of doctors involved in torture are doctors at risk. Doctors at risk might compromise their ethical duty towards patients for the following possible reasons: individual factors (such as career, economic or ideological reasons), threats, orders from a higher ranking officer, political initiatives, working in atrocity-producing situations or dual loyalty. In dual loyalty conflicts, factors that might compromise doctors' ethical obligations towards detainees/patients are: ideological totalitarianism, moral disengagement, victim blame, patriotism, individual factors or threats. Another important reason why doctors are involved in torture is that not all doctors are trained in addressing human rights issues of detainees. Torture survivors report that they have experienced doctors' involvement in torture and doctors themselves report that they have been involved in torture. Testimonies from both torture survivors and doctors demonstrate that the most common way doctors are involved is in the diagnosis/medical examination of torture survivors/prisoners. And it is common before, during and after torture. Both torture survivors and doctors state that doctors are involved during torture by treatment and direct participation. Doctors also falsify journals, certificates and reports. When doctors are involved in torture it has devastating consequences for both torture survivors and doctors. The consequences for the survivors can be mistrust of doctors, avoidance of seeking doctors' help and nightmares involving doctors. Mistrust and avoidance of doctors could be especially fatal to the survivor, as it could mean a survivor who is ill may not seek medical attention. When the unambiguous role of the doctor as the protector and helper of people is questioned, it affects the medical profession all over the world.

Doctors Who Aid Torture

Disturbing new questions have been raised about the role of doctors and other medical professionals in helping the Central Intelligence Agency subject terrorism suspects to harsh treatment, abuse and torture.

The Red Cross previously documented, from interviews with “high-value” prisoners, that medical personnel helped facilitate abuses in the C.I.A.’s “enhanced interrogation program” during the Bush administration. Now Physicians for Human Rights has suggested that the medical professionals may also have violated national and international laws setting limits on what research can be performed on humans.

The physicians’ group, which is based in Cambridge, Mass., analyzed a wide range of previously released government documents and reports, many of them heavily censored. It found that the Bush administration used medical personnel — including doctors, psychologists and physician assistants — to help justify acts that had long been classified by law and treaty as illegal or unethical and to redefine them as safe, legal and effective when used on terrorism suspects.

The group’s report focused particularly on a few issues where medical personnel played an important role — determining how far a harsh interrogation could go, providing legal cover against prosecution and designing future interrogation procedures. The actual monitoring data are not publicly available, but the group was able to deduce from the guidelines governing the program what role the health professionals played, assuming they followed the rules.

In the case of waterboarding, a technique in which prisoners are brought to the edge of drowning, health professionals were required to monitor the practice and keep detailed medical records. Their findings led to several changes, including a switch to saline solution as the near-drowning agent instead of water, ostensibly to protect the health of detainees who ingest large volumes of liquid but also, the group says, to allow repeated use of waterboarding on the same subject.

Another government memorandum concluded from medical observations on 25 detainees that combining several techniques — say a face slap with water dousing or a stress kneeling position — caused no more pain than when the techniques were used individually. That was used to justify the application of multiple techniques at the same time.

The group concludes that health professionals who facilitated these practices were in essence conducting research and experimentation on human subjects. The main purposes of such research, the group says, were to determine how to use various techniques, to calibrate the levels of pain and to create a legal basis for defending interrogators from potential prosecution under antitorture laws. The interrogators could claim that they had acted in good faith in accord with medical judgments of safety and had not intended to inflict extreme suffering.

The report from the physicians’ group does not prove its case beyond doubt — how could it when so much is still hidden? — but it rightly calls on the White House and Congress to investigate the potentially illegal human experimentation and whether those who authorized or conducted it should be punished. Those are just two of the many unresolved issues from the Bush administration that President Obama and Congressional leaders have swept under the carpet.

Legal  prosecution  of  cruel  &  inhuman  STF  police  personnel
-       An  appeal  to H.E. HONOURABLE  GOVERNOR  OF  KARNATAKA

During “catch forest brigand veerappan operation” , Special Task Force
police personnel  , illegally arrested , detained , tortured &  murdered innocent tribal people of both tamil nadu & Karnataka states. NHRC  has clearly noted the crimes of STF personnel & ordered both  Karnataka & tamil nadu governments to pay compensation to victims of  police atrocities. However still some of these victims are not yet  paid compensation by these governments , why ? also , the government  instead of legally prosecuting guilty police officers on murder  charges , has given  awards & promotion to guilty inhuman police  officers. Is the government sending a message that 3rd degree torture  & murders in lock-up / fake encounters is acceptable & legal ? is it
equitable justice ? is there one set of law for police & another for common people ?

Hereby , we do once again request your kindself , to dismiss guilty  police officials from police service , to withhold their pension benefits ,  to legally prosecute them on charges of murders of  innocent tribal people & on charges of attempt to murder innocent  tribal people by 3rd degree torture methods. Hereby , we also request  you to make public  JUSTICE A.J. SADA SHIVA COMMISSION’s findings  about atrocities by STF personnel.

To order the prison authorities to subject the four convicts, accomplices of Veerappan to Narco analysis & Bran mapping tests in a fair manner with unbiased questionnaire.

So that truth will come out about Ex-Minister Nagappa's Murder  case, Amount of Ransoms paid during all kidnap episodes including Movie star Raj Kumar's kidnap episode. Truth will come out about the Minister M.L.As. M.Ps. Police & Forest Officials who have stacked away riches by helping him. Truth will come about Granite quarry  owners who helped him. Truth will come out about traders, merchants who traded in goods , sandal wood , Ivory supplied by forest brigand Veerappan.

To order the Govt of Karnataka , to make public the Justice A J  Sadashiva's commission's final report & complete proceedings . Then the truth will come out, how the STF personnel, police tortured tribal people at a place called WORK SHOP IN M M HILLS how they gang raped tribal women repeatedly for days together, how they burnt their breasts, how they pushed sticks smeared with chilli sambar powder into their anus. How the police tied men folk upside down from the ceiling . How many died, unable to bear the shame & torture ? Are not these brutal inhuman STF police personnel fit to be hanged till death, along with four accomplices of Veerappan ?

To order the National Human Rights Commission to make public the findings of its independent enquiry conducted about the police torture on tribal people. Violations of human rights of tribal people in the forest brigand veerappan's Territory i.e. M M Hills.

Jai Hind. Vande Mataram.

Your’s Sincerely,

Nagaraja.M.R.

Editorial : FAKE ENCOUNTERS , LOCK-UP DEATHS & 3RD DEGREE TORTURE BY POLICE IN  INDIA

Recently, it has been reported in the media , how in gujarath state  high ranking police officials took SUPARI to murder & committed the  murders by giving it the name of encounter. Nowadays , it has become  common place that police take law into their own hands , settle  scores , conducts their own courts of justice like compromise panchayaths at police stations. All these acts of police are illegal , the police must be first thought the lessons of law before enforcing  it. The murderers , criminals in police uniform must be punished at  the earliest.

At the outset , HRW salutes the few honest police personnel who are  silently doing their duties inspite of pressures , harassment by  political bosses & corrupt superiors , inspite of frequent transfers ,  promotion holdups , etc. overcoming the lure of bribe ,those few are  silently doing their duties without any publicity or fanfare. we  salute them & pay our respects to them and hereby appeal to those few  honest to catch their corrupt colleagues.

The police are trained , to crack open the cases of crimes by just  holding onto a thread of clue. Based on that clue they investigate  like "Sherlock holmes" and apprehend the real criminals. nowadays ,  when police are under various pressures , stresses – they are  frequently using 3rd degree torture methods on innocents. Mainly there
are 3 reasons for this :

1) when the investigating officer (I.O) lacks the brains of Sherlock  holmes , to cover-up his own inefficiency he uses 3rd degree  torture on innocents.

2) When the I.O is biased towards rich , powerful crooks , to frame  innocents & to extract false confessions from them , 3rd degree  torture is used on innocents.

3) When the I.O is properly doing the investigations , but the higher- ups need very quick results – under work stress I.O uses 3rd degree  torture on innocents.

Nowhere in statuette books , police are legally authorized to punish let  alone torture the detainees / arrested / accussed / suspects. Only  the judiciary has the right to punish the guilty not the police. Even  the judiciary doesn't have the right to punish the accussed /
suspects , then how come police are using 3rd degree torture unabetted. Even during encounters , police only have the legal right , authority to immobilize the opponents so as to arrest them but not to  kill them.

There is a reasoning among some sections of society & police that use  of 3RD DEGREE TORTURE by police is a detterent of crimes. It is false  & biased. Take for instance there are numerous scams involving 100's  of crores of public money – like stock scam , fodder scam , etc  involving rich businessmen , VVIP crooks. Why don't police use 3rd  degree torture against such rich crooks and recover crores of public
money where as the police use 3rd degree torture against a pick-  pocketer to recover hundred rupees stolen ? double standards by  police.

In media we have seen numerous cases of corrupt police officials in  league with criminals. For the sake of bribe , such police officials  bury cases , destroy evidences , go slow , frame innocents , murder  innocents in the name of encounter , etc. why don't police use 3rd  degree torture against their corrupt colleagues who are aiding  criminals , anti nationals ? double standards by police.  All the bravery of police is shown before poor , innocents , tribals , dalits , before them police give the pose of heroes. Whereas ,
before rich , VVIP crooks , they are zeroes. They are simply like  scarecrows before rich crooks.

Torture in any form by anybody is inhuman & illegal. For the purpose of investigations police have scientific investigative tools like  polygraph, brain mapping , lie detector , etc. these scientific tools must be used against rich crooks & petty criminals without bias.

Hereby we urge the GOI & all state governments :

1) to book cases of murder against police personnel who use 3rd degree torture on detainees and kill detainees in the name of encounter  killings.

2) To dismiss such inhuman , cruel personnel from police service and  to forfeit all monetary benefits due to them like gratuity , pension ,  etc.

3) To pay such forfeited amount together with matching government  contribution as compensation to family of the victim's of 3rd degree  torture & encounter killings.

4) To review , all cases where false confessions were extracted from  innocents by 3rd degree torture.

5) To make liable the executive magistrate of the area , in whose  jurisdiction torture is perpetrated by police on innocents.

6) To make it incumbent on all judicial magistrates ,to provide a  torture free climate to all parties , witnesses in cases before his  court.

7) To make public the amount & source of ransom money paid to forest  brigand veerappan to secure the release of matinee idol mr. raj kumar.

8) To make public justice A.J.Sadashiva's report on "torture of tribals , human rights violations by Karnataka police in M.M.HILLS , KARNATAKA".

9) To make it mandatory for police to use scientific tools of investigations like brain mapping , polygraph , etc without bias  against suspects rich or poor.

10) To include human rights education in preliminary & refresher  training of police personnel.

11) To recruit persons on merit to police force who have aptitude &  knack for investigations.  

12) To insulate police from interference from politicians & superiors.

13) To make police force answerable to a neutral apex body instead of  political bosses. Such body must be empowered to deal with all service  matters of police.

14) The political bosses & the society must treat police in a humane  manner and must know that they too have practical limitations. Then on  a reciprocal basis , police will also treat others humanely.

15) The police must be relieved fully from the sentry duties of  biggies & must be put on detective , investigative works.

Violence and the ethical responsibility of the medical profession

Amar Jesani

Prof. Upendra Baxi, a well known expert on law and a former vice chancellor of Delhi and South Gujarat universities, in his comments on Women’s Studies in the ICSSR Newsletter seven years back, made some incisive and disturbing comments on the coverage of violence in social science discourses in India. “Mainstream social sciences in India have altogether ignored the fact that India is a very violent society. There do not exist even pre- theoretical discourses on violence in India. Compared with the practice of violence in India, there is a total denial of discourse on violence.”¹

Health care professionals have fared even worse than social scientists.

The concern for violence is conspicuous by its virtual absence in medical discourses. The special medical needs and rehabilitation of victims and survivors of violence are hardly ever discussed by doctors. Is this because health care workers do not come in contact with the victims and survivors of violence? The answer is a categoricalno. Violence invariably inflicts physical or psychological trauma and in any violence, the victims and survivors come in contact with health care workers, the last and extreme contact being established during autopsies on victims of violence. The apathy of medical personnel is all the more disturbing simply because of the many professions in our country, medicine has the greatest claim to nobility, compassion, humanity, rationality and scientific attitudes.

Unlike some extremely backward countries, we have nearly a million (9,27,624 in 1991) formally trained doctors, 42% of whom are trained in modern medicine - a ratio of one doctor for less than a thousand persons in the country as whole and one doctor for less than five hundred in the urban areas. An estimated 85% of all trained doctors work in the private sector³. Yet, the conscious response of the profession to one of the bigger epidemics of violence in recent times in our country has been grossly inadequate. We have either shown plain indifference or clumsy and ad hoc crisis management when faced with violence. This does not auger well for a profession claiming to have scientific basis for its practice. The implied failure in discharging social responsibility raises ethical questions for the profession at large in the country.

Violence and the medical profession
The science of medicine incorporates sociological and epidemiological understanding. Medicine, and for that matter any science, not geared to real social andepidemiological issues loses its humanitarian content. The violence described and documented by voluntary groups is not that by common criminals. The violence covered here includes the deprivation of human and democratic rights, is associated with social and political mobilisation, is often inflicted on helpless, oppressed, unarmed or innocent persons and has notable ideological underpinnings. There are strong, extreme and sometimes genuine differences within the social groups on the attitude society should take on the subject. One finds strong defenders (and opponents) of third degree methods, an euphesism for torture, almost routinely employed by the police. Similar divergence prevails in debates on caste, communal, gender and other forms of violence.

One’s social position and ideological orientation, rather than the fact of the violence and the plight of victims and survivors, seem to determine the stand taken on violence. Of course there is also a big segment that has either become emotionally numb due from excessive exposure to violence or is indifferent as at present it is not directly affected.

Such trends prevail in the medical profession as well. To what extent is the attitude of doctors to violence shaped by their social positions and ideological orientation? There has been very little research on doctors’ attitudes on violence and the extent to which individual biases get reflected in medical practice. Some indication on what is happening at the ground level within the profession is available from the recent reports of various local, national and international groups. These reports were prepared for specific purposes and their findings on the acts of commission and omission cannot and should not be generalised. Nevertheless, they do serve as pointers. The few examples given below on postmortems and torture and rape are purposefully selected by me in order to illustrate issues. I understand that there is always the other side to every story.

(a) Autopsy: The way autopsies are conducted, findings recorded and access to reports denied has been a bone of contention for long. There have been reports in the press about the pressure exerted on doctors by the police to give findings favorable to them. The death of Dayal Singh in police custody made the Resident Doctors’ Association of All India Institute of Medical Sciences (AIIMS) protest against such pressure. This is referred to in Amnesty International’s (AI) report titled Torture, Rape and Deaths in Police Custody⁴. The autopsy reports on two nuns murdered in a Bombay suburb and the role of doctors in unscientific inter F retation of its findings is also fresh in many minds⁵. On study of autopsy reports on victims dying in police custody and on so- called deaths during ‘encounters’ in the past few years, I found several disturbing issues which have grave implications on the unethical behavior of doctors conducting autopsies:

(1) Autopsies are generally conducted by police surgeons in police hospitals to which lay people and other doctors have no access. An independent medical audit of work being done there is unheard of. This situation is neither conducive to good science nor to ethics.

(2) A study of autopsy reports (no such study is available, hence the need for it) of victims of violence would probably show incomplete and unscientific documentation. The Supreme Court had to order, in 1989, that all postmortem examinations held at AIIMS be standardised. On making inquiries I learn that this Court order has remained inadequately implemented.

There is a crying need to adopt (with suitable modifications) the United Nations’ manual on the effective prevention and investigation of extralegal, arbitrary and summary executions.! Such routine, standardised and scientific investigation by the medical profession would go a long way in checking arbitrary killings and in upholding medical impartiality and neutrality’

(3) There is also need to make the whole process more accessible to other doctors and the public. The profession could allow a doctor appointed by the relatives of the deceased to remain present at autopsy. They should make the official report available to the family doctor and the patient’s relatives. This is an issue on which the profession can easily assert its authority.

(b) Torture and rape: There have been numerous official denials that the so- called third degree methods of interrogation or torture are practiced by our police and security personnel. The evidence accumulated so far does not support such a claim. Some of the retired police officers, reared in the old school of correct policing, have publicly criticised the ‘new methods of policing’ which condone the use of torture, illegal detention and tampering with records and in worst cases even condone execution of hard core criminals by police officers⁷.

AI’s report (1992) cites 13 cases of custody deaths due to torture in the period 1985- 89 in Maharashtra. A Bombay newspaper reported a study by the prestigious Karve Institute of Social Work, Pune giving the toll of custody deaths in Maharashtra in 1980- 89 as 155⁸. On inquiry I find that of these 155 deaths, 102 had taken place in the five year period 1985- 89 for which AI had reported only 13. On analysing the causes of the 155 custody deaths, I find that only 9.7% (15) were admitted as due to police action, 44.5% (69) were attributed to suicide or acts of the accused, 7% (11) to acts of the public, 22.6% (35) to disease and illness. 13.6% (21) were termed natural deaths and in 2.6% (4) the cause was not known or record not available. I was astonished to learn some of specific causes listed: alcohol consumption (9 cases), hanging (45), jumped in well (3), jumped under the train (2), jumped under the awtorickshaw (3), jumped under the bus (l), fell from the cot (l), skin disease (l), giddiness (l), unconsciousness (1) and so on. Given the norm that every death in custody ought to be investigated- and proper autopsy done, such causes are not only incomprehensible but also lead to suspicion about a larger proportion of deaths due to torture.

In an investigation of death in police custody in Bombay, I, along with two journalists and a lawyer, found that the young victim accused of petty theft was in the course of interrogation brought to the hospital in a serious condition with, as per hospital records, inflicted injuries on his wrists and thighs typical of torture, bloody vomiting, pain in the region around kidney etc. He was given some treatment and asked to go back to his cell by the doctor. It was also found that the doctor had taken case history and examined’his patient in the presence of the police officer who had accompanied the victim.

The doctor did not consider the presence of the police as violating the doctor- patient relationship. He insisted that he did not suspect torture as the victim never reported it to him. The victim died in his cell.

Similar findings were made by us in an investigation of a victim of gang rape wherein, inspite of the visible signs of injuries around the vagina, which could make any medical person suspect rape, the male doctor turned away the patient after treating her injuries simply because the woman could not tell him that she was raped’. The woman had reported rape to the nurse on duty but could not communicate this to the male doctor.

In another case of custodial gang rape and torture of a tribal woman by police in Gujarat, the commission of inquiry constituted by the Supreme Court found that two doctors at the government hospital were guilty of shielding the policemen and issuing a false certificate¹⁰

These examples only represent the tip of the iceberg. Doctors who come in contact with survivors and victims of violence are not always conscious accomplices in ignoring or covering up the cases. I have been given the following reasons for non- reporting and conspicuous silence by medical doctors on torture and rape:

(1) A section of doctors involved are plainly ignorant about this aspect of medical work. If it is true that it never occurs to a doctor that a policeman should not be allowed to remain present during the doctor- patient interaction, or that certain signs and symptoms should make him/ her suspicious of possible torture, it shows crass ignorance in the profession and a grave lacuna in their training.

(2) Another section is indifferent to the plight of sufferer due to their own social biases against the victims and survivors. Such indifference is also produced by social pressure to conform to the dominant belief. In cases of torture inflicted on persons labeled as terrorists, I have found doctors faithfully treating the injuries of the victims but showing great reluctance in mentioning torture due to the fear of being seen as opposed to the state’s efforts at fighting terrorism and separatism.

(3) A third section simply believes that by being in the employment of the government, the police department or the prison, they are bound by the orders of their superiors and feel that the code of their service does not allow them to ‘blow the whistle’.

The profession has failed to take the unequivocal position that when a doctor has to choose between an administrative order and professional ethics, the latter must prevail. The profession has also failed to protest when doctors are transferred as punishment for cri ticising gimmicky and unscientific measures taken by the authorities during epidemics, or when security forces harass and raid hospitals, interfering with the treatment of patients as in Kashmir¹¹. Such lack of collective assertion of professional independence and neutrality on crucial issues has left individual doctors defenseless, cynical and by default subservient to the authorities.

(4) Another reason for doctors’ apathy to these issues is their unwillingness to ‘get involved’. Many remark, “We are doctors. We treat illness. We are not interested in torture or rape.” This is both inadequate science and poor ethics.

Treatment, rehabilitation and documentation
Recognition of the fact that the reported instances of torture represent only a tip of the iceberg emphasises the need to document the problem in a systematic manner. There is a need to put together experiences in treatment and rehabilitation of such victims, create a clearing house for such information to be disseminated among interested professionals, and thus systematise corrective medical intervention.

This would also provide precious information on the extent of problem encountered, the individuals and agencies (state, terrorists, armed groups, gangs) involved in torture, type of people affected, type of torture methods used and so on. This information in turn would sensitise the profession and make it easier for medical associations and groups to successfully campaign for rooting out conscious or unconscious complicity of doctors in torture or its cover up. Such information will also sensitise other professionals in the media, law, social work etc. to play active and meaningful roles in creating public awareness, in punishing the guilty and in rehabilitating survivors.

Code of medical ethics and torture
The code laid down by the Medical Council of India is a good but greatly neglected document. Despite debates about commercialisation and sensational revelations in the press on various allegedly unethical practices by doctors, very little has been done by the medical associations to popularise and enforce this code.

Although the principles enunciated in the code are universal and exhort doctors to refrain from participating or colluding in anything that harms the individual, there is a need to make them specific and directive, particularly in relation to the victims and survivors of violence. This could be easily done by incorporation of the international declaration on the subject in our code.

Syrian Whistleblower Says Detainees Were Tortured in Military Hospital

By ROBERT MACKEY

Britain’s Channel 4 News has obtained video said to have been recorded secretly in a military hospital in the Syrian city of Homs, showing patients shackled to their beds and bearing marks consistent with reports of torture at state-run medical facilities.

According to the French photographer who smuggled the video out of Syria, it was provided to him by an employee of the hospital who said he witnessed wounded civilians and rebel fighters being tortured there by medical staff and members of the security forces.

The Channel 4 News video report, which contains distressing images and accounts of gruesome incidents of torture at the hospital, includes an interview with the man who said he recorded the footage. The interview was conducted by a French photographer who uses the pseudonym Mani to report from Syria.

Restrictions on independent reporting inside Syria, imposed by the government, make it impossible to verify the authenticity of the footage, but the photographer who provided it, and conducted the interview with its source, shot remarkably vivid footage of the fighting inside Homs in February that was broadcast by Channel 4 News last month.

In the interview, the Syrian man said: “I have seen detainees being tortured by electrocution, whipping, beating with batons, and by breaking their legs. They twist the feet until the leg breaks.”

He added: “I saw them slamming detainees’ heads against walls. They shackle the patients to beds. They deny them water. Others have their penises tied to stop them from urinating.”

The man also said that doctors in the hospital “perform operations without anesthetics” on detainees. Protesters injured during the crackdown on dissent in Homs were said to be taken to the military hospital for treatment.

One of Britain’s leading forensic pathologists, Derrick Pounder, examined the footage for Channel 4 News and concluded that the marks on one patient’s chest were likely to have been caused by blows from instruments like a whip and an electric cable shown near his bed in the hospital ward.

Jonathan Miller, a Channel 4 News correspondent who was in Syria in November, reported:

When the allegations that state-run hospitals had been turned into torture chambers first began to surface late last year, I was in Damascus. At the Tishreen Military Hospital, just north of the capital, I put the allegations to its director, Gen. Faysal Hassan, who insisted that wounded insurgents and injured civilian protestors are accorded the same level of care as any other patient. “If a terrorist comes injured, we give him every treatment,” the general said. “And armed civilians.”
“So what is your reaction to allegations that military doctors are refusing to treat injured protestors and are even doing worse – are involved in acts of torture?” I asked.
“This is untrue,” he said. After which, he denied that Syrian army tanks would ever fire into civilian neighborhoods.

Despite Syrian government claims to the contrary, recent satellite images posted on Facebook by the United States Embassy in Damascus on Monday offered more evidence that forces loyal to President Bashar al-Assad did launch a sustained military assault on the Homs neighborhood of Baba Amr last month. One of the declassified satellite images showed artillery pieces firing into the city on Feb. 25, and smoke and fire from the impact of the shells.

In an explanation of the composite image, Ambassador Robert Ford wrote that it “clearly shows the Syrian army’s equipment ringing the city of Homs. I want to be clear to those bloggers who said that this firing position is a normal military base with the artillery deployed normally. We know that these guns are aimed at Homs and that they are firing at Homs. Armed opposition groups do not have artillery.”

Other images, showing a school and a medical clinic on Feb. 5, at the start of the offensive, and again on Feb. 29, offered stark testimony to the damage caused to Baba Amr by three weeks of sustained bombardment.

Doctors and Torture

Robert Jay Lifton, M.D.

There is increasing evidence that U.S. doctors, nurses, and medics have been complicit in torture and other illegal procedures in Iraq, Afghanistan, and Guantanamo Bay. Such medical complicity suggests still another disturbing dimension of this broadening scandal.
Abu Ghraib.
We know that medical personnel have failed to report to higher authorities wounds that were clearly caused by torture and that they have neglected to take steps to interrupt this torture. In addition, they have turned over prisoners' medical records to interrogators who could use them to exploit the prisoners' weaknesses or vulnerabilities. We have not yet learned the extent of medical involvement in delaying and possibly falsifying the death certificates of prisoners who have been killed by torturers.
A May 22 article on Abu Ghraib in the New York Times states that “much of the evidence of abuse at the prison came from medical documents” and that records and statements “showed doctors and medics reporting to the area of the prison where the abuse occurred several times to stitch wounds, tend to collapsed prisoners or see patients with bruised or reddened genitals.”1 According to the article, two doctors who gave a painkiller to a prisoner for a dislocated shoulder and sent him to an outside hospital recognized that the injury was caused by his arms being handcuffed and held over his head for “a long period,” but they did not report any suspicions of abuse. A staff sergeant–medic who had seen the prisoner in that position later told investigators that he had instructed a military policeman to free the man but that he did not do so. A nurse, when called to attend to a prisoner who was having a panic attack, saw naked Iraqis in a human pyramid with sandbags over their heads but did not report it until an investigation was held several months later.
A June 10 article in the Washington Post tells of a long-standing policy at the Guantanamo Bay facility whereby military interrogators were given access to the medical records of individual prisoners.2 The policy was maintained despite complaints by the Red Cross that such records “are being used by interrogators to gain information in developing an interrogation plan.” A civilian psychiatrist who was part of a medical review team was “disturbed” about not having been told about the practice and said that it would give interrogators “tremendous power” over prisoners.
Other reports, though sketchier, suggest that the death certificates of prisoners who might have been killed by various forms of mistreatment have not only been delayed but may have camouflaged the fatal abuse by attributing deaths to conditions such as cardiovascular disease.3
Various medical protocols — notably, the World Medical Association Declaration of Tokyo in 1975 — prohibit all three of these forms of medical complicity in torture. Moreover, the Hippocratic Oath declares, “I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrongdoing.”
To be a military physician is to be subject to potential moral conflict between commitment to the healing of individual people, on the one hand, and responsibility to the military hierarchy and the command structure, on the other. I experienced that conflict myself as an Air Force psychiatrist assigned to Japan and Korea some decades ago: I was required to decide whether to send psychologically disturbed men back to the United States, where they could best receive treatment, or to return them to their units, where they could best serve combat needs. There were, of course, other factors, such as a soldier's pride in not letting his buddies down, but for physicians this basic conflict remained.
American doctors at Abu Ghraib and elsewhere have undoubtedly been aware of their medical responsibility to document injuries and raise questions about their possible source in abuse. But those doctors and other medical personnel were part of a command structure that permitted, encouraged, and sometimes orchestrated torture to a degree that it became the norm — with which they were expected to comply — in the immediate prison environment.
The doctors thus brought a medical component to what I call an “atrocity-producing situation” — one so structured, psychologically and militarily, that ordinary people can readily engage in atrocities. Even without directly participating in the abuse, doctors may have become socialized to an environment of torture and by virtue of their medical authority helped sustain it. In studying various forms of medical abuse, I have found that the participation of doctors can confer an aura of legitimacy and can even create an illusion of therapy and healing.
The Nazis provided the most extreme example of doctors' becoming socialized to atrocity.4 In addition to cruel medical experiments, many Nazi doctors, as part of military units, were directly involved in killing. To reach that point, they underwent a sequence of socialization: first to the medical profession, always a self-protective guild; then to the military, where they adapted to the requirements of command; and finally to camps such as Auschwitz, where adaptation included assuming leadership roles in the existing death factory. The great majority of these doctors were ordinary people who had killed no one before joining murderous Nazi institutions. They were corruptible and certainly responsible for what they did, but they became murderers mainly in atrocity-producing settings.
When I presented my work on Nazi doctors to U.S. medical groups, I received many thoughtful responses, including expressions of concern about much less extreme situations in which American doctors might be exposed to institutional pressures to violate their medical conscience. Frequently mentioned examples were prison doctors who administered or guided others in giving lethal injections to carry out the death penalty and military doctors in Vietnam who helped soldiers to become strong enough to resume their assignments in atrocity-producing situations.
Physicians are no more or less moral than other people. But as heirs to shamans and witch doctors, we may be seen by others — and sometimes by ourselves — as possessing special magic in connection with life and death. Various regimes have sought to harness that magic to their own despotic ends. Physicians have served as actual torturers in Chile and elsewhere; have surgically removed ears as punishment for desertion in Saddam Hussein's Iraq; have incarcerated political dissenters in mental hospitals, notably in the Soviet Union; have, as whites in South Africa, falsified medical reports on blacks who were tortured or killed; and have, as Americans associated with the Central Intelligence Agency, conducted harmful, sometimes fatal, experiments involving drugs and mind control.
With the possible exception of the altering of death certificates, the recent transgressions of U.S. military doctors have apparently not been of this order. But these examples help us to recognize what doctors are capable of when placed in atrocity-producing situations. A recent statement by the Physicians for Human Rights addresses this vulnerability in declaring that “torture can also compromise the integrity of health professionals.”5
To understand the full scope of American torture and abuse at Abu Ghraib and other prisons, we need to look more closely at the behavior of doctors and other medical personnel, as well as at the pressures created by the war in Iraq that produced this behavior. It is possible that some doctors, nurses, or medics took steps, of which we are not yet aware, to oppose the torture. It is certain that many more did not. But all those involved could nonetheless reveal, in valuable medical detail, much of what actually took place. By speaking out, they would take an important step toward reclaiming their role as healers.

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