During the white-coat advocacy day on Tuesday, the medical student group conducted over 25 meetings with lawmakers and staff, met with the bill’s sponsors, and hand-delivered copies of the petition signed by hundreds of their peers and fellow New York State residents. They also conveyed the support of state and national professional organizations for this landmark legislation…(more)

The medical student action event was also mentioned on the Huffington Post and on PHR’s Health Rights Advocate blog. Since then, NYCAT has also released a letter of support for the Gottfried-Duane Bill signed by prominent leaders of medicine in New York state, including medical school deans, hospital CEOs, and Nobel Prize laureates.

Medical students and NYCAT members with Assemblyman Gottfried in Albany

Related reading:

• ACLU’s resources on torture
• The National Religious Campaign Against Torture (NRCAT)
• NRCAT, ACLU, and PHR: Working together against inhumane detention conditions at home?

UPDATE [06-08-2010]: PHR’s newest report, Experiments In Torture, raises concerns that the actions of CIA doctors who participated in waterboarding and other methods amounted to illegal human experimentation. Read coverage of the report in The New York Times and commentary at The Washington Post and The Atlantic.

Looking for ways to get involved closer to home? NRCAT has a list of events across the country for the month of June.

Related: China bans the use of torture in extracting confessions.

As I have written previously, medical professionals, students, and human rights groups in New York State are teaming up for action to pass the nation’s first law holding medical professionals accountable for assisting torture and abuse of prisoners.  AMSA is proud to join the list of organizations putting their support behind the proposed legislation:

• National Physicians Alliance
• Committee for Interns and Residents
• American College of Physicians-NY
• NY State Nurses Association
• NY Civil Liberties Union
• Center for Constitutional Rights
• Human Rights Watch
• Amnesty International
• Physicians for Human Rights
• I Have A Dream Foundation
• Metro NY Religious Campaign Against Torture
• (full list and statements at whenhealersharm.org/)

ANTI-TORTURE LOBBY DAY in Albany: Join AMSA and PHR with medical students from across the state in our first Anti-Torture Lobby Day in Albany on May 18th!  This is our chance to meet with our local lawmakers and tell them that ending torture is important to us as ethical medical professionals and Americans.  We will meet at 9AM for a white-coat press conference and advocacy training with experts from the Bellevue/NYU Program for Survivors of Torture, and follow up with advocacy meetings.  If you are a NY State resident and a medical or pre-medical student, don’t miss this chance for real-time local action for human rights!

Don’t forget to sign the petition: Stop Torture NY.org

Read AMSA’s statement of support after the cut:

From AMSA’s Letter of Support:

]]> http://www.globalpulsejournal.com/blog/index.php/2010/05/11/action-alert-amsa-anti-torture-ny-may-18th/feed/ 0 http://www.globalpulsejournal.com/blog/index.php/2010/02/15/ny-stand-against-torture/ http://www.globalpulsejournal.com/blog/index.php/2010/02/15/ny-stand-against-torture/#comments Mon, 15 Feb 2010 09:41:18 +0000 Hana Akselrod http://www.globalpulsejournal.com/blog/?p=672 Evidence about the role of American physicians, clinical psychologists, and other health professionals in abuse and coercive interrogation at military detention sites has been accumulating slowly but incontrovertibly in the wake of the War on Terror.  In August 2009, Physicians for Human Rights released its most recent report describing in detail how the CIA relied on medical expertise to rationalize, plan, and carry out unlawful interrogations at detention sites.  Licensed health professionals observed physically abusive interrogation sessions and advised on how to increase the prisoner’s suffering.  They kept records of waterboarding, and consulted medical literature on hypothermia to determine “precise gradations” of the procedure.  When not aiding “coercive interrogations” directly, health professionals were still involved in facilitating and monitoring them, and also observed clear medical evidence of abuse without intervening — practices that subverted and violated well-established medical ethical obligations, to say nothing of the Geneva Conventions, the U.S. Constitution, and U.S. military law (JAMA).

To date, the U.S. has barely begun to address the gravity of what has taken place.  In the absence of a meaningful national response, medical professional organizations and the legislatures of individual states are stepping up to the challenge.  With the introduction of the Gottfried-Duane Bill in the State Assembly and State Senate, New York is posed to become the first state  in the country to explicitly prohibit health professionals licensed in the state from assisting in torture, interrogations, and prisoner abuse, while providing them with strong legal protection to resist any future coercion to participate in such acts.

The bill is meant to stop physician-assisted torture ever becoming a reality again, as well as to help health professionals address abuse and medical neglect of prisoners in domestic jails and detention centers.  Co-sponsored by 30 members of the State Assembly from both parties, the bill was favorably reported by Assembly committees last year, and is currently being revised in preparation for the floor vote.  It is supported by the NY state chapter of the American College of Physicians; by nursing, psychology, and social work associations;  and by civil liberties and human rights advocacy groups.

More on the Gottfried-Duane Bill, and why you should care, after the jump.

Click here to sign PHR’s petition in support of the Gottffried-Duane bill.

(There is a link for out-of-staters to show solidarity, too.)

StopTortureNY.org

Legislation Details:

The Gottfried-Duane bill will prohibit direct and indirect actions which constitute participation, complicity, incitement, assistance, planning, design, attempt, or conspiracy to commit torture or improper treatment of a prisoner.  Partaking in such actions will result in the loss of the provider’s license.  Furthermore, a duty to report suspected cases of torture and prisoner abuse is established, as well as mitigation for compliance with an investigation of alleged torture.  This legislation applies to professionals licensed by the state of New York, regardless of where the conduct takes place.

Importantly, the bill establishes protections for potential abuse against healthcare providers. Improper treatment does not include adverse effects of standard treatments, providers must reasonably know that they are participating in torture to violate the law, and employees are protected if they report any violations of the law.

The full text of the Assembly and Senate versions is available:  A-6665/S-4495.

Ethics Background:

Regardless of one’s political allegiance or beliefs regarding the justifiability of torture, the ethics of the medical profession allow for but one stance on the issue of involvement or enabling it.  The AMA Code of Medical Ethics Opinion 2.067 clearly defines torture in accordance with international standards, and clearly states that:

Physicians must oppose and must not participate in torture for any reason. Participation in torture includes, but is not limited to, providing or withholding any services, substances, or knowledge to facilitate the practice of torture. Physicians must not be present when torture is used or threatened.

Physicians may treat prisoners or detainees if doing so is in their best interest, but physicians should not treat individuals to verify their health so that torture can begin or continue. Physicians who treat torture victims should not be persecuted. Physicians should help provide support for victims of torture and, whenever possible, strive to change situations in which torture is practiced or the potential for torture is great. (AMA)

For a more in-depth analysis of medical ethics, scroll down for a list of cases on the AMA’s Virtual Mentor website.

Politics and Accountability

Although Guantanamo Bay was closed by executive order in the early days of the administration, and illegal interrogation procedures discontinued, the procedural and legal loopholes that enabled torture remain.  The torture investigation commission championed by U.S. Senators Durbin (D-IL) and Whitehouse (D-RI) is currently waiting on a key report by the Department of Justice’s Office of Professional Responsibility, and the Obama Administration sporadically gets called out on stalling on the issue.   (See coverage of Sheldon Whitehouse’s speech on holding high-level officials accountable for torture at the PHR National Conference in Providence last year.)

In order to appreciate what the accountability investigation is all about, I highly recommend the website Torturingdemocracy.org — an astounding documentary project about how a brand-new system for unlawful interrogations came to be created:

Another revealing documentary, Doctors and Detainees, is anticipated in Spring 2010.

Relevance:

Why is it so important for doctors, medical students, and allied health professionals, to come out strongly in support of efforts such as the Gottfried-Duane Bill?  Because our profession’s complicity in acts of torture is not only illegal, but viscerally abhorrent.  Medical knowledge is gathered as the sum of society’s progress, distilled from the dedicated effort of generations of doctors and patients, and taught with reverence.  We receive it as part of an ancient trust, and on the condition that we shall use it for the good of others.  This obligation is codified in the terms of medical ethics, and upheld by medical professional organizations — but its true power is as old as witch-doctors, as old as society’s fundamental belief  in the beneficence of doctors.  It is what lets patients entrust themselves to our knowledge and our beneficence during the most vulnerable moments of their lives.  To use that knowledge purposefully in order to inflict intolerable pain on another human being, or to stand by and knowingly allow it to be used in that way, is a violation that shakes our profession to the roots.  No other compromise we make with our professional conscience — no other quandary of dual loyalty – can even come close.

As a future physician, I urge you to speak your mind on this issue, whether you agree, disagree, or are conflicted.   The worst thing we can do is pretend this chapter never happened.  If you are a resident of New York State, or are interested in similar efforts in your own state, please contact the New York Medical Student Coalition Against Torture, NYMSCAT@gmail.com. You may also find their Facebook group useful.

Further Reading:

For further reading on torture, medical complicity, and the need for public and professional responses:

• Len Rubenstein discusses the complicity and motives of health professionals in torture with AMSA’s Global Pulse Journal in our Fall 2009 issue
• Health and Human Rights Journal’s Open Forum Blog posts on torture
• PHR’s Anti-Torture Campaign and Health Rights Advocate Blog
• The Center for Constitutional Rights website: WhenHealersHarm.org
• Amnesty International’s Spotlight on Torture
• The AMA’s Virtual Mentor ethics journal’s discussions on physician duties in treating war detainees, the role of physicians in interrogations, the history of torture and human rights in medicine, and physicians’ obligations to speak out for prisoners’ health.

To read the reports in more detail:

• PHR’s reports: Break Them Down (2005), Leave No Marks (2007), and Broken Laws, Broken Lives (2008)
• The CIA Inspector General’s 2004 Report is available online from the New York Times.
• The U.S. Department of Defense’s website on detainee investigations.

Note: NYMSCAT leaders will be speaking at the PHR 2010 National Conference on Health and Human Rights Education in Boston next weekend. You may also contact me personally at editorinchief.gp@gmail.com to find out what AMSA is doing on this issue, and how to become involved. — HA

Consider Tom Malinowski. He’s the advocacy director for Human Rights Watch, an expert on genocide and torture. But when it came time for a top human rights job at the State Department, he was turned away.

Why? “Because he lobbied against torture,” says one incredulous administration official. “It’s crazy.”

But the rules are the rules: The ethics code requires that no lobbyist can be hired to work for an agency he may have lobbied.

So, just to clarify: Someone like Malinowski who lobbied against torture and is a widely acknowledged expert on international human rights law is, er, blackballed. More to the point, he was shown the door precisely because he tried to influence Congress on an issue that both he and the administration agree, and care deeply about. (Malinowski won’t comment.)

I think president Obama’s original intent was to avoid conflicts of interest, but can we agree this is a bit extreme? Advocating against torture is not the same as ripping off taxpayers on the behest of a giant insurance company.

Health professional supervision of torture is one of the gravest affronts to medical ethics and is illegal under both domestic and international anti-torture law. Danner’s disclosure of the ICRC report on detainee treatment in CIA custody is shocking but not suprising. For years evidence has been mounting through news articles, government investigations, and even the statements of Bush Administration officials that health professionals were centrally complicit in the breaking of bodies and minds at the black sites, Abu Ghraib, Guantanamo and elsewhere.

All of this was in the bad old days of WMDs, flag-waving, and Blackwater. . . right?  Not so fast, writes Sara Greenberg.

Something about this really gets under my skin.

As student doctors, we are given so much.  We are given amazing knowledge, the product of an entire history of human civilization and learning about the human body and mind; the time and experience of our mentors; and the unbounded kindness of our patients, who allow us to touch them and to learn from them, even at the risk of harming them by our inexperience or error.  We are given all these things in trust, to use in the remainder of our professional lives to heal and to help.  A medical professional who knowingly uses his or her knowledge to help violate another person’s body and autonomy has broken that trust, and broken it for all of us: past and present and future.

As evidence of medical participation in war crimes continues to accumulate, American medical professionals need to do some serious soul-searching.  I believe this applies to all of us — including those who have never seen the inside of a black site, voted for the Democrats every time, or are still in training — because somehow, our medical system obviously had produced a significant number of physicians who had no problem assisting in torture.  What kind of professional climate was it, that made that possible?  We need to make sure that the next generation of physicians, psychologists, and allied health professionals, are absolutely 100% positively sure, that it is not okay to do this.  We need to talk about it clearly and transparently, so that we may begin to rehabilitate some of that trust.

I leave all you fellow future physicians with this excerpt from a 2006 editorial from Time by Andrew Sullivan:

After a while, you get numb reading these stories. They read like accounts of a South American dictatorship, not an American presidency. But we learn one thing: once you allow the torture of prisoners for any reason, as this President did, the cancer spreads. In the end it spreads to healers as well, and turns them into accomplices to harm.