February 25, 2024

US should stop physician participation in detainee force-feeding, say ethicists

Article in PLoS concludes with call to respect conscientious objection

The US government should rescind directives authorizing participation of health professionals in interrogation and force-feeding because they are inconsistent with professional ethics, argue ethicists in PLoS Medicine.

A 2015 report of the Defense Health Board found that the Department of Defense “does not have an enterprise-wide, formal, integrated infrastructure to systematically build, support, sustain, and promote an evolving ethical culture within the military health care environment.” 

The Board declared that health care professionals should not have to perform medical procedures that violate their professional code of ethics, State medical board standards of conduct, or the core tenets of their religious or moral beliefs.

In the wake of scandals about torture of detainees at Guantanamo Bay and other sites run by the CIA or the military, the government accepted most of the Board’s recommendations.

However, there were some loose ends. “The Board’s failure to call for a prohibition of any military health professional involvement in interrogation or force-feeding hunger strikers in its recommendations is a serious deficiency. It should also have recommended transparency and oversight in the reform process,” say Leonard S. Rubenstein, of Johns Hopkins University and co-authors in the PLoS article.

They conclude with a ringing call for respect for conscientious objection:

“Health professionals who have volunteered to serve for their country should never be asked or directed to violate their professional ethics, nor be allowed to be instruments in detainee abuse. To be true to their role in setting ethical standards for practice and creating an environment that enables health professionals to follow them, professional associations must do everything in their power to make sure that military rules do not require health professionals to choose between service to their country and ethical practice.”

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