To the Editor: Regarding the Perspective articles by Annas1and by Marks and Bloche2 (Sept. 11 issue) describing interrogationtraining of physicians by the military, participation in interrogationsviolates the duty of the physician to be a healer and underminesthe public's trust that the physician will act in the best interestof his or her patients. It is for these reasons that the AmericanPsychiatric Association and the American Medical Associationoppose the participation of physicians in interrogations. Beforeadopting those official positions, we consulted with the Departmentof Defense and arrived at an agreement that physicians wouldnot be called on by the military to take any role in interrogations.We are in the process of writing to Secretary of Defense RobertM. Gates to protest the involvement of physicians in any programthat would violate their professional ethics.
Nada L. Stotland, M.D., M.P.H. American Psychiatric Association Arlington, VA 22209 nadast{at}aol.com
References
Annas GJ. Military medical ethics -- physicians first, last, always. N Engl J Med 2008;359:1087-1090. [Free Full Text]
Marks JH, Bloche MG. The ethics of interrogation -- the U.S. military's ongoing use of psychiatrists. N Engl J Med 2008;359:1090-1092. [Free Full Text]
To the Editor: The practice of medicine is rooted in trust,even in times of war. The Code of Medical Ethics of the AmericanMedical Association (AMA) clearly states that as members ofthe medical profession, physicians must neither conduct nordirectly participate in interrogation.1 By authorizing militarypsychiatrists to directly participate in interrogation, theU.S. military undermines the physician's role as a healer andplaces at risk the public's trust in the individual physicianand the profession.
U.S. military policy on psychiatrists' participation in interrogationalso deviates from professional ethics when it differentiatesbetween treating and nontreating physicians, a distinction notrecognized in AMA policy. Physicians must never use their medicalskills to intentionally harm others. This ethical principleapplies even when a physician practices under the authorityof third persons. When physicians act primarily to serve theinterests of third parties, especially in activities that maybe physically and mentally coercive, they violate the fundamentalobligations of medicine.
The AMA calls on the U.S. military to revise its policy to conformto the ethical standards established by the medical profession.
Joseph M. Heyman, M.D. American Medical Association Chicago,IL 60654
References
Opinion E-2.068, physician participation in interrogation: code of medical ethics of the American Medical Association. Chicago: American Medical Association, 2007.
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