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Psychiatric Times. Vol. 29 No. 3
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VANGUARD ISSUES IN PSYCHIATRY 

Condemning Torture and Abuse: A Call to Action

By Stephen N. Xenakis, MD | February 28, 2012
Dr Xenakis is Brigadier General (Ret), US Army. The author reports no conflicts of in­terest concerning the subject matter of this article.

Victims of abusive interrogation suffer with anxiety and depressive disorders, manifest brief psychotic disorders such as delusions and hallucinations, develop obsessive-compulsive disorder, and are at greater risk for suicide. Many are demoralized and hopeless. Statements made by detainees in an impaired mental state when interrogated have not been admissible in court proceedings.

Standing up for human rights has come front and center, as both a matter of national strategy and a measure of human decency. Historically, the human rights stance against torture has been unequivocal, one of the few absolutes in human rights law: It is never permitted, never excused, never to be balanced against national needs or interests—even in cases of national emergency. Torture is forbidden under the laws of war. It is considered a war crime under the Geneva Conventions.

(MORE: Are Animal Models Relevant in Modern Psychiatry?)

By reflecting on the ethical principles and traditions of our healing professions, a stronger case for national security can be put forward against torture and mistreatment:

• First, do no harm. Victims of torture and mistreatment breed political instability and discontent, weakening governments and societies.

• Beneficence. Torture and mistreatment violate the intents and purposes of medical healers, and participation in any way corrupts the ethical foundations of the practitioners and professions.

• Professional role. Physicians are not interrogators, any more than they are fighter pilots or infantrymen. The military and other government agencies have other professionals to do those tasks, and calling on physicians to fill such roles is irresponsible and ineffective.

• Trust. Physicians enjoy special trust and confidence across almost all societies. That trust is undermined with participation in harmful, coercive, and abusive conduct that is neither doctor-like nor appropriate.

In 1947, our nation and its allies tried and sentenced the Nazi physicians who violated basic principles of medical ethics. In 2003, the political dynamics and national sentiment induced physicians, including psychiatrists, a well as other health care professionals to commit actions that violated core ethics. Much has improved since the dark days of 9/11, but our nation has been damaged. Where once the symbol of our great democracy was the Statue of Liberty, it has now become the image of that poor hooded man in detention with wires strung from his hands and feet. We have damaged the lives of thousands of people who will suffer the consequences for many decades to come. Our men and women on the front lines are endangered because of the increased risk of retaliatory measures. We are not safer because of these misguided policies and how we have acted as a country. Physicians have a collective duty to oppose torture and abuse—to uphold historically shared beliefs and convictions.

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by Ronald Pies | March 16, 2012 9:36 PM EDT

I applaud Dr. Xenakis's principled position! --Best regards, Ron Pies

by Michael Champ | March 15, 2012 9:38 PM EDT

Hooah!

Also in this Special Report

Introduction: Controversies and Evolving Issues

Condemning Torture and Abuse: A Call to Action

A Delicate Brain: Ethical and Practical Considerations for the Use of Medications in Very Young Children

Who Was Karen Horney?

Antipsychotics for Behavioral Disturbance in Dementia? A Clinical Conundrum

Neuroscientific Mirages: Are We No More Than Our Brains?

Are Animal Models Relevant in Modern Psychiatry?

Enlightenment and Dimmed Enlightenment

VANGUARD ISSUES IN PSYCHIATRY

Introduction: Controversies and Evolving Issues

Condemning Torture and Abuse: A Call to Action

A Delicate Brain: Ethical and Practical Considerations for the Use of Medications in Very Young Children

Who Was Karen Horney?

Antipsychotics for Behavioral Disturbance in Dementia? A Clinical Conundrum

Enlightenment and Dimmed Enlightenment

Are Animal Models Relevant in Modern Psychiatry?





References

1. Thomas J. Mental health professionals in the “enhanced” interrogation room. Psychiatr Times.2009;26(11):1-2, 4-5.

2. Rubenstein LS, Xenakis SN. Doctors without morals. New York Times. February 28, 2010. http://www.nytimes.com/2010/03/01/opinion/01xenakis.html?scp=1&sq=doctors%20without%20morals%20march%201%202010&st=cse. Accessed February 14, 2012.


 
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