The traditional roles of the physician are to stave off death and to comfort the dying. The sick and the injured assume that a doctor will be able to prolong their lives by curing them of their disease. The dying, on the other hand, believes that a doctor will allow them to die peacefully and with dignity by relieving them of their suffering. In the process, the physician is transformed into a caretaker and protector of life. But what if physicians are required to use their medical skills to eliminate parties that are considered as threats to a society or a nation?
Doctors who are involved in capital punishment and or the torture of prisoners often claim that they follow a distinct set of obligations (Beauchamp and Childress 316). They are expected to place the interests of a community or a nation above both their own and the detainees’ benefit. As a result, they have to treat prisoners differently from their other patients. Physician participation in the death penalty is not a historical novelty. The inventor of the guillotine was a kindly doctor who wanted to make executions more humane (Gershman 23).
In Herman Melville’s novella Billy Budd (1924), a physician ensured that the hanging of the main character was “scientifically conducted” (Melville 293). Before Gary Gilmore was put to death, a doctor pinned a white circle over his heart as a target for the firing squad (Annas 69). The adoption of the lethal injection as a methodology of executing criminals further increased the involvement of physicians in capital punishment. Apart from supervising the execution, a doctor is likewise tasked with preparing the prisoner for execution, pronouncing death and determining which individuals should be excluded from the death penalty (Annas 69-70).
In 2002, the United States Supreme Court included the diagnosis of mental retardation as a ground for prohibiting execution. The physician, meanwhile, selects the detainees that would be spared from execution by subjecting them to a medical test that would establish “their (ability) to understand (capital punishment)” and why is it being imposed” (Annas 70). Advocates of physician involvement in the death penalty often argue that the goals of medicine can be reconciled with those of capital punishment.
The primary objective of the death penalty is to deter crime by executing those who have been proven guilty of heinous wrongdoings. The main purpose of medicine, on the other hand, is to alleviate suffering. In the context of medical participation in capital punishment, these goals are both met – society is rid of a criminal in a civilized and painless manner. In some cases, criminals that have been proven to be mentally ill are freed. But facts prove otherwise. Forensic psychology is an entirely different discipline from clinical psychology.
The latter is obligated by the Hippocratic tradition to give primacy to the needs of the patient (British Medical Association 105). The former, in sharp contrast, is bound to the objective truth – regardless of what a forensic psychologist may find on the prisoner whom he or she is studying. This difficult intersection between medicine and the law would definitely affect the processes of establishing guilt or innocence and resolving disputes (British Medical Association 106). The medical profession is also tainted with a long history of physician involvement in the torture of prisoners.
The Nuremberg trials revealed shocking atrocities committed by Nazi doctors and biomedical scientists during the Holocaust. Under their direct supervision, countless psychiatric patients and senile elderly persons were killed. Furthermore, they subjected unconsenting concentration camp inmates to cruel and sometimes lethal experiments (Caplan 78). It was first revealed in 2002 that doctors and other personnel were force-feeding and using truth serum on detainees in Guantanamo Bay, Cuba.
In 2003, medical personnel at Abu Ghraib treated torture victims and recorded the evidence, but failed to report these incidents. The International Committee of the Red Cross then reported in 2004 that the usage physical and psychological torture on prisoners were rampant in Guantanamo. Furthermore, a group of psychologists, known as the Behavioral Science Consultation Team (BSCT or “Biscuit”), advised the interrogators (Rejali 401). Why would doctors – people who are supposed to protect life – participate in torture?
It must be noted that the Guantanamo and Abu Ghraib doctors were working in prisons that held individuals that were believed to be terrorists. Thus, these physicians were expected to actively participate in the “War on Terror” by keeping tortured prisoners alive until American soldiers manage to extract valuable intelligence information from them. Simply put, the duty of the Guantanamo and Abu Ghraib doctors to the detainees under their care was to treat them not out of adherence to the Hippocratic Oath but that of the desire to help defeat the enemies of the US.
But it is never acceptable for military physicians to participate in torture. Article 1 of the Regulations in Time of Armed Conflict (likewise known as the Havana Declaration) maintains that there is no difference between medical ethics in times of armed conflict and medical ethics in times of peace. Article 2, meanwhile, makes clear that the primary task of the physician is to preserve health and save life, therefore prohibiting him or her from: a.
Giving advice or performing prophylactic, diagnostic or therapeutic procedures that are not justifiable in the patient’s interests; b. Weakening the physical or mental strength of a human being without therapeutic justification; and c. Employing scientific knowledge which would imperil health or destroy life (Singer and Viens 354). Because the primary task of doctors is to preserve health and save life, they are morally required to report incidents of torture or mistreatment of prisoners. According to Principle 5 of the Committee for the Prevention of Torture (CPT):
Doctors have a duty to monitor and speak out when services in which they are involved are unethical, abusive and inadequate or pose a potential threat to patients’ health. In such cases, they have an ethical duty to take prompt action as failure to take an immediate stand makes protest at a later stage more difficult. They should report the matter to appropriate authorities or international agencies who can investigate but without exposing patients, their families or themselves to foreseeable serious risk of harm. (354)
Reporting cases of torture and ill-treatment is part of the physician’s sworn duty to preserve health and save life. If he or she suspects or witness the abuse of detainees, he or she should immediately report his or her findings to the judiciary and any other investigative body (Action for Torture Survivors, CPT, Amnesty International, etc. ). A failure to do so is usually synonymous to “omission,” an offense which is actionable in criminal and civil law. But the doctor is not obliged to immediately report cases of torture if doing so would imperil his or her life.
In this case, it is necessary for him or her to wait until the threat to his or her security has passed and or there are already relevant third parties to whom she could disclose his or her findings (Singer and Viens 354). The end of medicine is not limited to the treatment of the sick and the injured. It should likewise concern itself with the health of the mind, spirit and the community as a whole. There are certain societal conditions that result in the physical, mental and spiritual degradation of a given populace.
The torture of prisoners is a good example of these societal problems – victims of torture are not only physically injured but are also stripped of their dignity as human beings. Being a doctor, therefore, means not only preserving health and saving life but likewise going against a status quo that would hinder him or her from fulfilling these duties. Human health, after all, is more than just the absence of disease. It also means living in a society that is conducive to physical, mental, social and spiritual wellbeing.
But how can people attain this objective if they live in a community that is hostile to it? Works Cited Annas, George J. American Bioethics: Crossing Human Rights and Health Law Boundaries. New York, New York: Oxford University Press US, 2005. Beauchamp, Tom L. , and James F. Childress. Principles of Biomedical Ethics. 5th ed. New York, New York: Oxford University Press US, 2001. British Medical Association. Medicine Betrayed: The Participation of Doctors in Human Rights Abuses. 2nd ed. London: Zed Books, Ltd. , 1992. Caplan, Arthur L.
When Medicine Went Mad: Bioethics and the Holocaust. New York, New York: Oxford University Press US, 1992. Gershman, Gary P. Death Penalty on Trial: A Handbook with Cases, Laws, and Documents. Santa Barbara, California: ABC-CLIO, 2005. Melville, Herman. Billy Budd and Other Stories. Ware, Hertfordshire: Wordsworth Editions Limited, 1998. Rejali, Darius M. Torture and Democracy. Princeton, New Jersey: Princeton University Press, 2007. Singer, Peter A. , and Adrian M. Viens. The Cambridge Textbook of Bioethics. Cambridge: Cambridge University Press, 2008.