In the name of US national security, a number of morally questionable and illegal activities were carried out in the years following September 11, 2001. The use of torture and cruel and inhuman treatment in interrogations of detainees in US custody has been well-documented by Physicians for Human Rights and others. The role of health professionals in designing and participating in illegal interrogations has also been investigated and publicly revealed. This current report addresses another morally troubling yet unreported aspect of the role of health professionals in the “enhanced interrogation” program. Our research and analysis demonstrates that the program also involved doctors and other health professionals in conducting unethical research using detainees as human subjects.
The use of human beings as research subjects has a long and disturbing history filled with sometimes misguided and sometimes willfully unethical experimentation. In US history there are well-known cases: the horrors of the Tuskegee syphilis experiment from 1932 to 1972 in which African American men in Alabama were left untreated so they could be studied even after it was known the disease could be treated with penicillin; the Willowbrook case, involving mentally disabled children in New York intentionally infected with viral hepatitis from the 1950s to 1970s; and the extensive dermatological research on prisoners at Holmesburg State Prison in Pennsylvania from 1951 to 1974.
Perhaps the most well-known cases of human subject research, though, are the chilling experiments conducted by Nazi doctors on concentration camp prisoners during World War II. The trial of the doctors accused of this experimentation gave rise to a regime of protections for human subjects known as the Nuremberg code. That code and other guidelines which followed it set clear standards for informed consent of participants in research, an absence of coercion and a requirement for rigorous scientific procedures. Through their willing participation in monitoring and analyzing “enhanced interrogations,” US medical personnel have in recent years violated these vital and long-standing ethical standards.
The essence of the extensive ethical and legal protections for human subjects is that the subjects, especially vulnerable populations such as prisoners, be treated with the dignity befitting a human being and not simply as an experimental guinea pig. The Nuremberg code and other guidance also call on the medical professional to treat persons with their best interests in mind and not to cause them pain in the service of a research goal. Doctors are required to use treatments that are expected to be effective and not to engage in speculative medicine at the expense of a human research subject.
The use of doctors to analyze the impact and effectiveness of various interrogation techniques puts them in the service of national security objectives and not in the service of therapeutic goals. The result has been a co-opting of health professionals by the national security apparatus and a violation of the highest medical admonition to “do no harm.” The misuse of scientific expertise for expedient and exploratory goals leads to a corrosion of the high standards of the profession.
This report details the documented activities of a number of as yet unidentified health professionals who engaged in a regime of human subject experimentation. Those who participated in these actions must be investigated and appropriately disciplined. But their actions not only reflect on themselves as individuals, they are a potential stain on the whole medical profession. The high esteem in which doctors are held is a partly a product of the public’s perception that the medical profession is vigilant about holding its members to the highest standards. Until the questions raised in this paper are answered, and those responsible are held accountable, the medical profession as a whole will be at risk of forfeiting some of the regard of their fellow citizens.