Now That's Trampling

Two health professionals violated fundamental medical ethics while developing and implementing a pervasive system of interrogation by torture.
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The juxtaposition on the front page of yesterday's New York Times was chilling. A photograph showed an irate town hall attendee screaming at Arlen Specter with the accompanying caption "You're trampling on the Constitution." Beneath, was an unrelated article entitled "Two US Architects of Harsh Tactics in 9/11's Wake." The "trampling of the constitution" refers to the debate about health care reform. "The architects of harsh tactics" refers to two psychologists who oversaw the development and implementation of an interrogation program utilizing torture.

In addressing two pivotal issues facing our country, health care reform and accountability for the implementation of our country's war on terror, we need to understand the stakes. We need to understand the process. We need to apply language correctly. Any plan for health care reform must be judged by whether or not it will promote access and quality in health care and control costs. Health care needs to be viewed as a basic human right. Clearly such debate will be intense, but to equate such discussions, as heated as they may get, with trampling on the Constitution, or turning our country into a Soviet socialist state is absurd and cheapens that document in which our country's core values are enshrined.

The real trampling of the Constitution (and the Hippocratic Oath) occurred when Doctors Jim Mitchell and Bruce Jessen and others did their best to turn our country into a Gulag-state (to use the Russian analogy), where suspects were detained without charge, sometimes in secret prisons, and subjected to torture and abuse including mock drowning, sleep deprivation, and sexual humiliation in the name of national security. These two health professionals violated fundamental medical ethics while developing and implementing a pervasive system of interrogation by torture.

The term "architect" is also misapplied. Architect infers having knowledge and a substantive plan. In fact, Jessen and Mitchell used their pseudo-expertise to milk a cash cow. They had never participated in actual interrogations, and their "blue-print" came from a Chinese torture manual whose purpose was to elicit false confessions. Ironically, before Mitchell and Jessen arrived to participate in the interrogation of a captured Al Queda leader, the previous interrogation team using conventional rapport building methods was eliciting useful information. So, Mitchell and Jessen's brutal tactics were not only morally flawed, they were tactically misguided.

While torture is not justified, even with terrorist suspects, many if not most of those detained at Guantanamo, Abu Ghraib, and elsewhere were likely not terrorists. They were civilians arrested in sweeps whose crime was being in the wrong place at the wrong time. Ultimately most were released without ever being charged, but not before many were subjected to methods of torture and brutality such as those promoted by Mitchell and Jessen.

Clearly we need comprehensive health care reform and we need to do it in a way that treats health care as a basic human right. We also need a comprehensive investigation of how and why we implemented a misguided policy of torture that ultimately made the world a far more dangerous place for ourselves and for innocent civilians tortured under despot regimes. This includes patients cared for at torture treatment centers such as the Bellevue/NYU Program for Survivors of Torture. For this reason, there needs to be accountability for those who developed and enacted this torture policy -- including health professionals like Mitchell and Jessen. Legislation currently proposed in New York State provides a mechanism for examining allegations of torture and abuse by health care professionals and consequence including loss of licensure. That's what needs to happen and without that the trampling continues.

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