Borderline Human Experimentation

September 1, 2009 5:06 AM

PHR (Physicians for Human Rights) have released a new report (pdf) that details the extent to which doctors were involved in monitoring and recording data on detainees subjected to waterboarding and other techniques [via]

From the article:

A team of PHR doctors authored the white paper, which details how the CIA relied on medical expertise to rationalize and carry out abusive and unlawful interrogations. It also refers to aggregate collection of data on detainees’ reaction to interrogation methods. Physicians for Human Rights is concerned that this data collection and analysis may amount to human experimentation and calls for more investigation on this point. If confirmed, the development of a research protocol to assess and refine the use of the waterboard or other techniques would likely constitute a new, previously unknown category of ethical violations committed by CIA physicians and psychologists.

posted by scrutiny (23 comments total)

It bothers me that there could be a group of doctors opposed to Human Rights... but I suppose that means I'm either falling for the Pro-Life style framing of the group, or I take thinks like sworn oaths to Apollo and Asclepius a bit too seriously.

Or, more briefly: people suck, including doctors. Which sucks.
posted by rokusan at 5:28 AM on September 1, 2009

interesting read
Doctors Under Hitler
In this history of medicine and the medical profession in the Third Reich, Michael Kater examines the career patterns, educational training, professional organization, and political socialization of German physicians under Hitler. His discussion ranges widely, from doctors who participated in Nazi atrocities, to those who actively resisted the regime's perversion of healing, to the vast majority whose ideology and behavior fell somewhere between the two extremes. He also takes a chilling look at the post-Hitler medical establishment's problematic relationship to the Nazi past.
http://www.amazon.com/Doctors-Under-Hitler-Michael-Kater/dp/0807848581/ref=sr_1_1?ie=UTF8&s=books&qid=1251808529&sr=8-1
posted by robbyrobs at 5:37 AM on September 1, 2009

The report also confirms the theory of a "slippery slope" in interrogation settings, namely that torture by its very nature escalates in the severity and frequency of its use beyond the approved techniques.

emphasis mine

It kind of sucks that they picked a name for an observable and repeated phenomenon that happens to be the same as the name of a fallacy.
posted by idiopath at 5:58 AM on September 1, 2009

It kind of sucks that they picked a name for an observable and repeated phenomenon that happens to be the same as the name of a fallacy.

Yeah, that's true. In med school they teach you to memorize a whole bunch of stuff to diagnose diseases, but not necessarily how to think about anything else. Logical fallacies just aren't part of the curriculum. I think this is also part of the reason why MDs aren't as good scientists as they could be. They were trained for something else entirely.
posted by scrutiny at 6:07 AM on September 1, 2009 [1 favorite]

The fallacy is false identification of a slope as being slippery, not that slopes can't be slippery or that slopes that are slippery aren't dangerous. Pointing it out as a problem in this report is like damning agriculture as a useful human endeavor because they use "strawmen" to defend the corn against crows.
posted by DU at 6:12 AM on September 1, 2009 [13 favorites]

You know, either my fellow countrypersons recognize the immorality of torture or they do not.

Apparently, many of them do not. That's a disgusting portent.
posted by fourcheesemac at 6:24 AM on September 1, 2009 [2 favorites]

DU, that's the best antimetaphor I've read in a long time.
posted by rokusan at 6:25 AM on September 1, 2009

In med school they teach you to memorize a whole bunch of stuff to diagnose diseases, but not necessarily how to think about anything else.

I know a few US-trained doctors, a few Canadian-trained doctors, and a few UK-trained doctors. I find their differences fascinating. So with a broad brush and a small sample size at the ready, let me summarize crudely:

They have the same skills and knowledge, roughly, but there's a huge difference in attitude. I never know whether to attribute this to the schools, the pay scales, or the overall societies.

The US doctors seem to think they're know-everything geniuses who can expertly analyze everything from automotive problems to the federal deficit... and they're so, so horribly wrong so often. They see "doctoring" as a high calling that makes them a superior class of citizen. The UK ones generally believe that they're trained technicians in a narrow field and seem to know better than to leap out of it, and seem to see "doctoring" as something akin to a public service. The Canadian ones, characteristically, are somewhere in between.

I think the UK attitude is best: they are technicians with a narrow, specialized training, and we all (including me) would be better served to stop thinking of them as supermen, despite the social (?) reflex.

(And I sometimes wonder what quality of physician might be achieved in the US if all pay was reduced by half.)
posted by rokusan at 6:32 AM on September 1, 2009 [2 favorites]

I'm trying to think of what a group of Republican physicians would call themselves. Doctors Against Human Rights?
posted by Avenger at 6:38 AM on September 1, 2009

Doctor Barons? Doctors _{for profits} Without Borders?
posted by DU at 6:43 AM on September 1, 2009

I've actually never met any UK or Canadian trained MDs, but the differences there are interesting. That reminds me a study I heard about on NPR or somewhere else (a year ago now?) where some Australian doctors had found a bacteria that was linked to ulcers in the gut. US doctors would never have even looked for one because it was "well-known" that ulcers were caused by stress.

I guess it's just interesting what gets taken as fact and what gets taken as a subject of valid scientific inquiry. There are more cultural nuances to facts than I would expect.
posted by scrutiny at 6:45 AM on September 1, 2009

That reminds me a study I heard about on NPR or somewhere else (a year ago now?) where some Australian doctors had found a bacteria that was linked to ulcers in the gut.

Barry Marshall and Robin Warren, who won the Nobel Prize in Physiology or Medicine "for their discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease."
posted by grouse at 7:14 AM on September 1, 2009 [1 favorite]

I wonder how they square this with the guidelines of the World Medical Association, of which the AMA is a member.

I will not use my medical knowledge to violate human rights and civil liberties, even under threat

Seems like a clear-cut case for striking-off to me.
posted by Jakey at 7:45 AM on September 1, 2009

Seems like a clear-cut case for striking-off to me.

The American Medical Association is a voluntary professional association, not a regulatory body. Expulsion from the AMA (if allowed by their rules) would have no impact on a physician's legal ability to practice medicine.
posted by grouse at 7:48 AM on September 1, 2009 [1 favorite]

So is the regulation in the US at state level? Do the state regulatory bodies have any ethical guidelines on the conduct of the medics, or can these jokers walk straight out of Guantanamo into a high street medical practice?
posted by Jakey at 8:34 AM on September 1, 2009

Yes, yes, and yes. (Your latter sentence indicates a false dilemma—it is possible to have ethical rules that do not prevent this behavior, although they probably should.)
posted by grouse at 8:44 AM on September 1, 2009

Doctors against humans rights? Really?? Maybe, just maybe, the CIA found a few physicians who thought that it might be more humanitarian (stretch your brain here) to help these interrogators some understanding as to the kind of damage they are doing to the bodies and minds of their prisoners. It may be a naive assumption on my part, certainly on the physicians' (if they had it), but I'm reminded of the first docs that stepped up to be in the execution chambers during lethal injections after California passed its law requiring their presence. Clearly a violation of the ethical code. But dammit, and IANAD, the state has condemned the men to death, and I can understand a physician wanting to make sure that the man dies without pain. There could be there some parallels to that kind of motivation there, and this group's report wouldn't exactly highlight them.
posted by njbradburn at 10:18 AM on September 1, 2009 [1 favorite]

I've actually never met any UK or Canadian trained MDs, but the differences there are interesting. That reminds me a study I heard about on NPR or somewhere else (a year ago now?) where some Australian doctors had found a bacteria that was linked to ulcers in the gut. US doctors would never have even looked for one because it was "well-known" that ulcers were caused by stress.

While this was truly an amazing upsetting of medical dogma and one which deserved the Nobel prize, the stress=ulcers paradigm was well-established worldwide. Warren and Marshall intially encountered resistance to their findings within Australia itself; their initial presentations of their findings met with substantial criticism and were rejected for presentation at least one domestic conference. As near as I can tell from my minimal research, the United States was more or less at pace with the rest of the world in accepting H. pylori as the causative agent, so I don't think that this case really demonstrates that U.S. doctors have more closed or narrow minds than those trained in other countries.

In reference to the posted report, yes, it is truly dismaying. Most doctors that I've encountered in my training are quite aware of and put a lot of thought into their ethical responsibilities, and while I can think of a likely rationalization that these doctors used in their participation in degradation and torture (that the subjects would be better served with medical oversight than without) this doesn't hold water, especially given their participation in the 'refinement' of the techniques used. Unfortunately, as Stanley Milgram showed, education and even a refined understanding of right and wrong is not a good shield against the sort of social and psychological pressures that come to bear in a situation like this; a more active mindfulness of one's actions is required to be able to do the right thing 'in the breach'. This is not to excuse these doctors, who appear to have clearly done wrong by the accepted ethical standards of their profession; they had a responsibility to cultivate and act on this sense, and did not. But, their individual failings should be considered alongside the greater structure that was intentionally assembled by the United States military and government: one does not excuse the other, but the first should perhaps been predicted from the second. The way that interrogation of detainees was carried out was an immoral exercise within itself, and it's not surprising that culpability carried over to each of the participants in the process.

One last point: people above have suggested that either overly narrow, technician-style reasoning or a malignant expansiveness present in the medical profession were contributory to this process. While I think both effects exist, I don't think that the outcome would be much different had the military assembled a team of non-clinician physiologists rather than doctors to comment on the interrogation process, for the reasons stated above. However, since doctors have direct responsibilities to their patients rather than the more general social responsibilities that scientists have, their individual failings in participating in this process are that much more dismaying.
posted by monocyte at 10:22 AM on September 1, 2009

I'm trying to think of what a group of Republican physicians would call themselves.

Free Doctors for Freedom-Loving Freedom for America.

Or, "NAMBLA".
posted by rokusan at 11:35 AM on September 1, 2009

Don't forget that psychologists were involved too...sickening.
posted by kathrineg at 11:39 AM on September 1, 2009

Rokusan: "US doctors seem to think they're know-everything geniuses who can expertly analyze everything from automotive problems to the federal deficit... and they're so, so horribly wrong so often. They see "doctoring" as a high calling that makes them a superior class of citizen. The UK ones generally believe that they're trained technicians in a narrow field and seem to know better than to leap out of it, and seem to see "doctoring" as something akin to a public service. The Canadian ones, characteristically, are somewhere in between.
(And I sometimes wonder what quality of physician might be achieved in the US if all pay was reduced by half.)"

I'm curious, are you American? I'm a US doctor and neither I nor any of my colleagues that I work with in the US fall into your narrow little category. I'm also young, so maybe this is a reflection of a much older generation of doctors, I can't say. But I was slightly put off by your generalization. It smacks of either jealousy or a generalized feeling of inferiority, which is your issue, and not US doctors'.
(I also wonder what quality of whatever work you do might be achieved if you're pay was reduced by half? What kind of question is that? Let's slash in half everyone's pay and see the quality of work it generates, hmm?)
As for these physicians, meh. They are the ones who probably hobknob with the hardcore Repub bigwigs, go to church with them, and think of themselves as doing god's work. I've long given up on trying to understand the right wing and their justification of evil things. Doctors, lawyers, ministers, careers that you would think require the highest ethics... it amazes me how differently ethics are viewed from those of different political perspectives.
posted by WilliamMD at 11:58 AM on September 1, 2009

...a new, previously unknown category of ethical violations committed by CIA physicians and psychologists.

If we don't stay ahead of the Terrorists, they win! Go-go rights violation rangers!
posted by yeloson at 1:12 PM on September 1, 2009

The fallacy is false identification of a slope as being slippery, not that slopes can't be slippery or that slopes that are slippery aren't dangerous. Pointing it out as a problem in this report is like damning agriculture as a useful human endeavor because they use "strawmen" to defend the corn against crows.

Eugene Volokh has a pretty good article about slippery slopes, which includes a taxonomy of the ways in which slippery slope arguments can be correct. (Actually I wish the article was a little better, but I think it's good that someone wrote on the subject.)
posted by grobstein at 8:19 PM on September 1, 2009