Selected resources from The Hastings Center.

Bioethics Briefings:

Torture: The Bioethics Perspective

Torture is the intentional infliction of physical or psychological harm by a public official working in an official capacity. It is both illegal and widely practiced. Medical personnel have a long history of assisting with torture. While professional societies condemn the practice, participants in torture are rarely criminally or professionally published. Read our briefing to consider: What are the moral challenges to and bioethical concerns of torture?

From Hastings Bioethics Forum:

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  This Doctor Experimented on Slaves: It’s Time to Remove or Redo His Statue
  “There is a difference between remembrance of history and reverence of it,” Mayor Mitch Landrieu declared to explain the removal of four Confederate monuments in New Orleans in May. The statues were, he argued, part of the terrorism campaign that threatened African American citizens for more than 150 years. Other cities, colleges, and universities are…
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  U.S. Military Medical Ethics Guidelines in Limbo
  As President Barack Obama’s term comes to a conclusion, various initiatives started under his administration remain unfinished.  One of these, the adoption of the recommendations of the Defense Health Board (DHB), “Ethical Guidelines and Practices for U.S. Military Medical Professionals,”  is of utmost importance to health care professionals in our military. Health care providers in…
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  After Banning Torture, Psychology Association at a Crossroads
  The American Psychological Association (APA) voted at its 2015 meeting to ban psychologists from participating in national security interrogation programs, including torture. The policy change was in response to the public outcry over the release of unsettling Senate Intelligence Committee’s report on the Central Intelligence Agency’s detention and interrogation program and the Hoffman report. The latter was written by former…
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  Modern Day Mengeles
  “No power in the world will make us deny our duty, or forget even for a moment our historical task of maintaining the freedom of our people.” — Joseph Goebbels “These are patriots and whatever the report says, if it diminishes their contributions to our country, it’s way off base.” — Former President George W….
• Medicine as a Weapon in Syria and Beyond
  A recent editorial in The Lancet issued a dire warning to the international medical community: medicine is a weapon of war in Syria. It is just the latest in a series of reportsfrom across the Middle East on how medical care and medical professionals and facilities are being used to inflict politically-motivated violence. Theeditorial references a recent…
• Health Workers as Pawns of Warfare
  Last week, NPR reported a major humanitarian group’s decision to stop treating patients from detention centers in Misrata, Libya. According tothe report,“torture was so rampant that some detainees were brought for care only to make them fit for further interrogation.” While it must have been heart-wrenching to walk away from the detention centers, knowing some…

From Hastings Center Report:

Aesthetic Enhancement? Or Human Rights Violation?

First published: 08 November 2012

Abstract

The view that we must respect cultural traditions is a welcome change from the past, when colonial powers ridiculed native customs and often sought to eradicate them. Nevertheless, it is reasonable to ask whether there is a limit to tolerance of a ritual that has been designated a “harmful traditional practice” by the United Nations Office of the High Commissioner for Human Rights, the United Nations Population Fund, and the recently created agency, UN Women. The article “Seven Things To Know About Female Genital Surgeries in Africa,” by the Public Policy Advisory Network on Female Genital Surgeries in Africa, contends that a need exists for more balanced critical thinking and open debate about what the authors choose to call “female genital surgery.” No one can reasonably quarrel with the call for accurate information in descriptions of the methods and consequences of female genital cutting. The network’s own discussion of the facts is highly questionable, however.

Using Facts to Moderate the Message

First published: 08 November 2012

Abstract

The Public Policy Advisory Network on Female Genital Surgeries in Africa has written an article expressing concern about the media’s inaccurate depiction of this practice and suggesting a more fact-based approach to reporting on it. I applaud the network for soliciting input from various fields. I cannot agree more that some in the media have misconstrued, exaggerated, and used inflammatory language; words like “torture,” “barbaric,” and “horrific” will likely enrage readers while reinforcing discrimination against women who practice or have undergone genital cutting. The authors also assert that “any genuine public policy debate should be grounded in the best available evidence and begins with fact checking.” Again, I couldn’t agree more. My concern is that there is bias in the way some of the data are presented in this article.

The Tortured Patient

First published: May 2011

Abstract

Doctors sometimes find themselves presented with a grim choice: abandon a patient or be complicit in torture. Since complicity is a matter of degree and other moral factors may have great weight, sometimes being complicit is the right thing to do.

Laying the Groundwork for a Defense against Participation in Torture?

First published:

Abstract

According to the former chief of training at the Navy’s Survival, Evasion, Resistance and Escape (SERE) school, waterboarding is a “controlled drowning” that “occurs under the watch of a doctor, a psychologist, an interrogator and a trained strap-in/strap-out team.” When waterboarding is used as part of mock interrogations during SERE training, “A team doctor watches the quantity of water that is ingested and for the physiological signs which show when the drowning effect goes from painful psychological experience to horrific, suffocating punishment, to the final death spiral.” Since waterboarding entails introducing liquid into the airway and risks letting water get sucked into the lungs, if it is to be demonstrated at all it makes sense for it to be done under close medical supervision. After all, a mock interrogatee could potentially die during waterboarding, even if only by accident.

“The Only Feasible Means”: The Pentagon’s Ambivalent Relationship with the Nuremberg Code

First published: September 1996

Abstract

Convinced that armed conflict with the Soviet Union was all but inevitable, that such conflict would involve unconventional atomic, biological, and chemical warfare, and that research with human subjects was essential to respond to the threat, in the early 1950s the U.S. Department of Defense promulgated a policy governing human experimentation based on the Nuremberg Code. Yet the policymaking process focused on the abstract issue of whether human experiments should go forward at all, ignoring the reality of humans subjects research already under way and leaving unanswered ethical questions about how to conduct such research. Documents newly released to the Advisory Committee on Human Radiation Experiments tell the story of the Pentagon policy.

From Hastings Center Bioethics Timeline:

1946: AMA Adopts Principles for Permissible Human Experimentation

The Judicial Council of the American Medical Association (AMA), at the behest of researcher Andrew C. Ivy, approved three requirements for human subjects research: voluntary consent of the subject, prior animal experimentation to determine risk, and proper medical management of the experiment. These requirements were intended to buttress claims about conventions of experiments involving humans in light of the Nuremberg Doctors’ Trial.

1946: United States v. Karl Brandt et al. 

An American military tribunal presides at the trial of 23 high ranking Nazi doctors and administrators. These individuals were charged with war crimes, crimes against humanity, and medical experiments, without consent, on prisoners of war, civilians of occupied countries, and others, which included murder, brutality, torture, atrocities, and other inhuman acts.  

Annas, G. J., “Beyond Nazi War Crimes Experiments: The Voluntary Consent Requirement of the Nuremberg Code at 70,” American Journal of Public Health 108, no. 1 (2018): 42-46.

1947: Nuremberg Code

The judges in the Nuremberg Doctors Trial issue requirements for “Permissible Medical Experiments” with which to judge the Nazi doctors. The document outlines ten principles. The first and most widely cited principle states that “the voluntary consent of the human subject is absolutely essential.” The document, which has come to be called the Nuremberg Code, has been hailed as the most important document in the history of the ethics of medical research.

1976: United Nations Enacts International Covenant on Civil and Political Rights

Article 7 states: “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his free consent to medical or scientific experimentation.” This lays the foundation for later international guidelines on experimentation on human subjects and provides a basis for condemning health care professionals’ participation in torture.

https://www.ohchr.org/en/professionalinterest/pages/ccpr.aspx