When one of us (Lifton) studied Nazi doctors during the late 1970s and early '80s, he found that their transgressions occurred in two general areas: their coercive, often fatal, experiments on human beings; and their participation in torture and killing. He is still haunted by their descriptions, and those of Auschwitz survivors, of what Nazi doctors actually did and how they came to do it.
As physicians concerned with maintaining humane medical standards, we know that it is critically important to learn all we can about the psychological and historical conditions conducive to medical evil.
The problem, unfortunately, has not been limited to the Nazis. We have been deeply troubled by each new revelation of collusion in torture by American doctors, psychologists, and mental health personnel. More than that, investigations by Physicians for Human Rights and others have made clear that members of our healing professions have also engaged in torture-related experiments on human beings.
This month, the American Civil Liberties Union (ACLU) filed suit against psychologists James Mitchell and Bruce Jessen, the architects of the CIA's torture program. The lawsuit argues that in addition to designing, overseeing, and personally conducting torture sessions, the two psychologists engaged in unethical research and experimentation on detainees.
In both the Nazi and American examples, the experiments were carried out in the name of "national security." A Nazi doctor whom I (Lifton) interviewed had at first opposed the harmful "research" but changed his mind and participated in typhus experiments with prisoners after being told by a Nazi medical bureaucrat that they were necessary for finding ways to prevent epidemics in German troops.
In the days following the attacks of September 11, 2001, the Bush administration turned to health professionals for assistance in authorizing and deploying practices the United States had long recognized as torture. Psychological and medical participation in torture was fueled in part by intense pressure for actionable "human intelligence" to identify impending terror attacks.
After encountering some resistance from CIA's own medical and psychological personnel, the agency turned to James Mitchell and Bruce Jessen to develop an "enhanced interrogation" program.
The two psychologists had no interrogation experience. But they claimed expertise based on their involvement in the military's SERE (Survival, Evasion, Resistance and Escape) program.
Mitchell and Jessen proposed that torture could produce a state of "learned helplessness," or profound psychological trauma, and that this would lead to compliance with interrogators and divulgence of intelligence. This was no more than a hypothesis and no scientific literature existed to support this claim. The SERE methods were derived from Chinese "thought reform" (or "brainwashing") and were originally used in the training of U.S. soldiers to resist torture and capture. These were, in effect, reversed by Mitchell and Jessen and others to become experiments in torture.
Mitchell and Jessen set out to test their hypothesis by conducting torture interrogations on CIA detainees. Their methods included waterboarding, prolonged sleep deprivation, water dousing, cramped confinement in boxes, various stress positions and forms of assault, and mock burial. They assured U.S. officials that their practices were "safe" and "effective," without evidence to support either claim.
Once this experimental program took off, CIA health professionals became intimately involved in monitoring torture and collecting data on detainees' reactions to such practices.
In exchange for providing the Bush administration with pseudoscientific license to torture, Mitchell and Jessen were paid over $1 million each, and given a $5 million indemnity agreement to cover legal costs in case of prosecution. Mitchell, Jessen & Associates, the company they formed in 2005, was paid $81 million.
What did the U.S. government get from its bargain with Mitchell and Jessen? An unproven and experimental interrogation program, with a patina of science through the involvement of psychologists. Yet this research regime, mandated by the Justice Department's now-discredited "torture memos," provided the Bush administration with legal cover to claim its practices did not cause a certain level of prohibited harm.
To be sure, nothing our psychologists and doctors have done has the proportions of Nazi killing and torture, nor is it based on so murderous a racial ideology. But the parallels are striking and disturbing.
German doctors in Auschwitz were mostly ordinary people who had killed no one until assigned to that camp. But they underwent a sequence of external and internal adaptation from the Nazified medical profession, to the Nazi military, and then to the death camps. We can understand the process as "socialization to evil."
Similarly, American physicians or psychologists participating in torture or experiments found themselves socialized to an American subculture, in which high-ranking political, intelligence, and military officials not only justified torture and experimentation but tried to render it a norm. Participating American doctors and psychologists could internalize the pseudolegal rationale and much of the corruption prevailing in that subculture. Some, like Mitchell and Jessen, claiming to be scientists, could add much to that corrupt and destructive norm.
Their actions violate fundamental ethical principles of informed consent and "do no harm," central tenets of the Nuremberg Code -- which Americans set up during the Doctors Trial after World War II. If these lessons from the past tell us anything it is that our laws and professional codes of conduct mean nothing in the absence of accountability.
America differs from Nazi Germany in retaining a fundamental right to confront our own misbehavior. We must act to reestablish our legal and ethical principles, confront violations of them, and restore the health of our own healing communities. The lawsuit against Mitchell and Jessen is an important step in this direction.