Accountability

Discussion of my earlier posting on the participation of physicians and other medical professionals in the torture of prisoners in Iraq, Afghanistan and Guantanamo Bay centered on whether the perpetrators can be held accountable by licensing boards.

Steve Hellig of the Cambridge Quarterly of Healthcare Ethics and colleagues Phillip Lee and Marcus Conant, in a letter to NEJM, call for precisely that:

Those who have served in the U.S. military know that there is a documented chain of command for every action. Health care personnel serving in the military all work under the authority of licensed military physicians, who are responsible for actions performed under their authority. We therefore call on the AMA and the American Psychological Association to request that relevant authorities act, at a minimum, as follows. First, the military must provide full disclosure of all medical personnel involved, directly or by chain of command, in the treatment of detainees in Iraq, Afghanistan, and Cuba - and elsewhere if relevant - since September 11, 2001. Second, the records and conduct of these personnel should be reviewed by the medical licensing boards, other responsible licensing authorities in each state where the military physicians are licensed, or both. Independent expertise in bioethical standards should be sought in conducting these reviews. Third, appropriate disciplinary action should be taken on the basis of the results of the reviews, and these actions should be made publicly available.

Of course, it is highly unlikely that the military will respond to such a request. The physician and psychologist perpetrators, if publicly identified, would no doubt offer in their own defense the names of the superior officers who ordered them to commit crimes. And as we know, the Department of Defense is not going to allow accountability for these atrocities to climb the chain of command. After all, where would it stop?