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Biko to Guantanamo: 30 years of medical involvement in torture

September 13, 2007

As I noted in my post yesterday marking the 30th anniversary of Stephen Bantu Biko’s death, his martyrdom reminds us that we need to be vigilant against the abuses of state police power, and take up the cause of political prisoners and the tortured. This week, a group of 266 physicians and ethicists from around the world used the anniversary of Biko’s death to speak out again against the role of physicians at Guantanamo Bay and the War on Terror.

In the Biko case the two physicians responsible for his care were found to have provided grossly inadequate treatment and to have falsified records. One of the physicians had his licensed removed, and the other was reprimanded. In a letter published in the British medical journal The Lancet (free registration required), the group argued that:

There are strong parallels between the Biko case and the ongoing role of US military doctors in Guantanamo Bay and the War on Terror. Last year, we suggested that the physicians in Guantanamo force-feeding hunger strikers should be referred to their professional bodies for breaching internationally accepted ethical guidelines. One of us (DJN) lodged formal complaints with the medical boards for Georgia and California as well as pointing out to the American Medical Association (AMA) that the former hospital commander at Guantanamo, John Edmondson, was a member. After 18 months, there had been no reply from the AMA, the Californian authorities stated that they “do not have the jurisdiction to investigate incidents that occurred on a federal facility/military base”, and the authorities in Georgia stated that the “complaint was thoroughly investigated” but “the Board concluded that there was not sufficient evidence to support prosecution”. Yet an analysis of the same affidavit by the Royal College of Physicians concluded that “in England, this would be a criminal act”.

The UK government has refused a request from the British Medical Association for a group of independent doctors to assess the detainees4 and, to date, there has been no formal report on the three alleged suicides in Guantanamo that took place in June, 2006.

The resolution of the Biko case was instrumental in the rehabilitation of the South African Medical and Dental Council and the Medical Association of South Africa, which had been subject to boycotts during the apartheid years. The failure of the US regulatory authorities to act is damaging the reputation of US military medicine. No health-care worker in the War on Terror has been charged or convicted of any significant offence despite numerous instances documented including fraudulent record keeping on detainees who have died as a result of failed interrogations. We suspect that the doctors in Guantanamo and elsewhere have made the same mistake as Tucker who, in 1991, in expressing remorse and seeking reinstatement, said “I had gradually lost the fearless independence…and become too closely identified with the organs of the State, especially the Police force…I have come to realise that a medical practitioner’s first responsibility is the wellbeing of his patient, and that a medical practitioner cannot subordinate his patient’s interest to extraneous considerations.”

The attitude of the US medical establishment appears to be one of “See no evil, hear no evil, speak no evil”.

The Lancet 2007; 370:823

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