Comments(3)

Participation in coertion should void professional status

Myron Pulier   (18 October 2008)  UMDNJ-NJ Med School

The "ticking time bomb" theory justifying deviation from medical ethics withers upon exposure to reality. The argument assumes that greatest good for greatest number should override any individual's welfare; and it ignores the "greatest good" value of physicians making each patient's health their summum bonum.

Consideration of the utilities defuses the time bomb paradigm's power.

First, probability. Time bomb-like situations are rare enough to deserve no serious attention. In any case, the chances are almost nil that a psychiatrist or other therapist will actually prove indispensable for tipping a resistant captive into spilling the beans.

Second, benefit. Actually applying knowledge gained will rarely produce much tactical gain and may never make any discernible difference in the outcome of an entire war or campaign. In other words, the information won't really do any real good.

Third, disadvantage. The losses incurred through coercive interrogation are high: demoralization of all participants; costs of enduring, containing and repairing the psychological damages to torturers, their direct victims and of families and communities; degrading of the "moral status" of the perpetrator nation; encourages wider and more-casual exploitation of torture generally, and erosion of the essential trust that professionals by definition act solely for each client's welfare.

More generally, forensic psychiatry seeks release from medicine's "primum non nocere" stricture, claiming the person they examine is not the client. Dual agency--pressure to serve one master at the expense of the other--bedevils all professions. Putting one's professionalism at the service of any "higher" organization or aim (such as saving souls, national security, justice, or revolution) exploits and denigrates the profession. To preserve its integrity and reputation the profession should extrude members who violate its code of ethics.

Those trained to be psychiatrists and healers may opt to quit the profession and apply their skills in ways that flaunt the fundamental purposes of the American Psychiatric Association, but should do so with neither license to treat nor privileges to publish or teach in professional venues. They are not bad people, they just are not psychiatrists.

Competing interests

None declared

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New position statement by APA

Abraham Halpern   (19 October 2008)  Authors

Late last month (during the period 10 Sep. 2008, when our article was submitted, to 25 Sep., when the article was published by PEHM), the results of an American Psychological Association (APA) referendum were released, approving, by a significant margin, a position statement similar to the American Psychiatric Association’s (AΨA's) forbidding participation by APA members in interrogation of detainees. The new APA policy must be adopted by the APA Board of Directors at the annual meeting in August 2009. No doubt the APA will receive, as did the AΨA, much-deserved praise for their well-intentioned aims. Our conclusion, however, remains the same: the Position Statements of both organizations have not ended, will not end, and cannot end the participation of psychologists and psychiatrists in "enhanced" interrogation of prisoners.

AL Halpern, JH Halpern, SB Doherty

Competing interests

None declared

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The Dec. 11, 2008, Levin-McCain Report on the Treatment of Detainees in U.S. Custody

Abraham Halpern   (25 December 2008)  New York Medical College

I note that the unanimous report by the commission headed by Senators Carl Levin and John McCain validates the comments made in our article (by Halpern, Halpern & Doherty) concerning the aggressive interrogation techniques used in violation of U.S. and international law.

Competing interests

None declared

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