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    Thursday, June 10, 2004

    Complicity: Prison doctors both home and abroad get scrutinized in today's New York Times. First, at home, there are the doctors who monitor executions. The overall tone is one of condemnation:

    Many of the states that encourage doctors to participate in executions have seemingly contradictory laws that allow doctors to be disciplined by state medical boards for violating codes of medical ethics. Those codes almost universally forbid participation in executions.

    The American Medical Association's ethics code, for instance, says that "a physician, as a member of a profession dedicated to preserving life when there is hope of doing so, should not be a participant in a legally authorized execution."

    The code forbids doctors to perform an array of acts at executions, including prescribing the drugs, supervising prison personnel, selecting intravenous sites, placing intravenous lines, administering the injections and pronouncing death.

    "They're not allowed to determine that the execution has been unsuccessful so that the execution can be repeated," said Dr. Stephen H. Miles, a professor of medicine at the University of Minnesota and author of "The Hippocratic Oath and the Ethics of Medicine."

    The AMA's ethics code isn't always so scrupulous about preserving life when there is hope of doing so.

    Actually, an argument can be made that a doctor who supervises an execution by lethal injection (supervises, not administers) is acting more ethically than one who performs elective abortions. The former is there to make sure the procedure is done humanely with a minimum of suffering. He doesn't administer the death blow. An abortionist, on the other hand, does.

    Complicity II: Then there are the prison doctors abroad. The military prison doctors of Abu Ghraib who "according to press reports," treated tortured Iraqi prisoners:

    According to press reports, military doctors and nurses who examined prisoners at Abu Ghraib treated swollen genitals, prescribed painkillers, stitched wounds, and recorded evidence of the abuses going on around them. Under international law — as well as the standards of common decency — these medical professionals had a duty to tell those in power what they saw.

    Instead, too often, they returned the victims of torture to the custody of their victimizers. Rather than putting a stop to torture, they tacitly abetted it, by patching up victims and staying silent.

    The duty of doctors in such circumstances is clear. They must provide needed treatment, then do all they can to keep perpetrators from committing further abuse. This includes keeping detailed records of injuries and their likely causes, performing clinical tests to gather forensic evidence and reporting abuses to those with the will and power to act.

    Unfortunately, that first sentence undermines the entire premise of the piece. Quite frankly, it's hard to decipher from press reports just how serious the crimes at Abu Ghraib were, since the press has an unfortunate tendency to exaggerate the bad and downplay the good when it comes to the war in Iraq. They also have an unfortunate tendency to have more faith in the assertions of our enemies than in those of our own government. But don't take my word for it. Here's an interview with an American doctor who served at Abu Ghraib:

    "They were firm but not abusive, if there was any abuse toward the prisoners I would have had to deal with it."

    He dealt with everything from broken bones to heart attacks. You can see one of his patients hooked to an EKG. He was later evacuated by helicopter to another hospital.

    'People ask me if it was terrible, and have to admit I feel like I did something good.'"

    Torture is wrong. And doctors should neither participate in it nor condone it. The question that remains, however, is this - was anyone actually tortured at the post-Saddam Abu Ghraib prison, or were they just posed for humiliating photographs? Neither is honorable conduct on the part of our soldiers, but there's a world of difference medically speaking.

    posted by Sydney on 6/10/2004 10:38:00 PM 0 comments


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