AMA: Prisoner Interrogation Unethical for Physicians, Declares AMA Panel

CHICAGO, June 12 ? It is unethical for physicians to participate in interrogation of prisoners by the military or law enforcement agencies, pronounced the AMA's Council on Ethical and Judicial Affairs (CEJA).

Priscilla Ray, M.D., of Houston, who chairs the council, said, declared that doctors "must neither conduct nor directly participate in an interrogation, because a role as physician-interrogator undermines the physician's role as a healer and thereby erodes trust in the individual physician interrogator and in the medical profession."

Opinions of the council are published in the Code of Medical Ethics, which is frequently referenced in court and legislative proceedings. The CEJA opinion came in a report, which was adopted unanimously by the AMA's policy-making House of Delegates. The AMA house cannot, however, amend the independent council's report.

News reports have suggested that psychiatrists and other physicians have been helping military officials interrogate detainees at Guantanamo Bay in Cuba, as well as detainees in Afghanistan and Iraq. Last month the American Psychiatric Association declared that psychiatrists should not participate in interrogations.

According to the CEJA report, physicians:

• "Must neither conduct nor directly participate in an interrogation;"
• "Must not monitor interrogations with the intention of intervening in the process, because this constitutes direct participation in an interrogation;"
• And when physicians "have reason to believe that interrogations are coercive, they must report their observations to appropriate authorities. If authorities are aware of coercive interrogations but have not intervened, physicians are ethically obligated to report the offenses to independent authorities that have the power to investigate or adjudicate such allegations."

CEJA said that physicians may "perform physical and mental assessments of detainees to determine the need for and to provide medical care," but when they do so the physicians must tell the prisoner that others will have access to that medical information "which may allow the prisoner to withhold information," said Dr. Ray.

CEJA also declared that physicians may ethically "participate in developing effective interrogation strategies for general training purposes," but they can not develop a specific strategy for use with a specific prisoner, Dr. Ray said.

The council released its report just a day after the military announced the suicides of three detainees held at Guantanamo and six months after Burlington, Vt., child psychiatrist David Fassler M.D. asked the AMA for an ethical ruling on involvement of physicians in prisoner interrogations.

Dr. Fassler called the report "thoughtful and responsive."

Air Force Surgeon General George Taylor Jr. M.D., a member of the AMA house, said, "This report provides valuable ethical guidance which is consistent with our commitment as military physicians to the practice of ethical medicine and to the defense of our great nation." Gen. Taylor said he and other uniformed services physicians supported the CEJA report.

But Stephen Xenakis, M.D., a psychiatrist and retired army brigadier general said the report, while well intentioned, was ambiguous.

Dr. Xenakis, who said he represented Physicians for Human Rights, said the language of the report was "too soft, when soft language isn't needed. And there are a number of loopholes." He said his 28 years of active military service taught him that "if there are loopholes, the military will find them."