Torture, coercive interrogations and physicians

As healers, physicians’ everyday actions are guided by the AMA’s Code of Medical Ethics, which has articulated the enduring values of the medical profession for more than 160 years. In light of the new U.S. Senate report on interrogations, now is a good time for physicians to make sure they understand their ethical obligations regarding torture and interrogation.

The Code offers specific policy regarding what physicians should and should not do in situations involving torture or coercive interrogation. With regard to torture, several key principles from Opinion E-2.067 must be observed:

  • Physicians must oppose and must not participate in torture for any reason. Participation in torture includes, but is not limited to, providing or withholding any services, substances or knowledge to facilitate the practice of torture. Physicians must not be present when torture is used or threatened.
  • Physicians should only treat individuals when it is in the patient’s interest, not to verify health so that torture can begin or continue.
  • Physicians should help provide support for victims of torture and whenever possible strive to change situations in which torture is practiced or the potential for torture is great.

The opinion also notes that physicians who follow their calling as healers in treating torture victims should not be persecuted.

For interrogation, physicians must avoid being involved in anything that uses coercion (defined as “threatening or causing harm through physical injury or mental suffering”). Physicians have five ethical obligations under Opinion E-2.068:

  • Physicians should only perform physical and mental assessments of detainees to determine the need for and to provide medical care. When doing so, physicians must disclose the extent to which others have access to information included in medical records. Treatment must never be conditional on a patient’s participation in an interrogation.
  • Physicians must neither conduct nor directly participate in an interrogation. Being involved in interrogation undermines the physician’s role as healer and thereby erodes trust in the individual physician and in the medical profession.
  • Physicians must not monitor interrogations with the intention of intervening in the process. This constitutes direct participation in interrogation.
  • Physicians should not participate in developing effective interrogation strategies except for general training purposes. These strategies must not threaten or cause physical injury or mental suffering and must be humane and respect the rights of individuals.
  • Physicians must report their observations to the appropriate authorities if they have reason to believe that interrogations are coercive. If those authorities are aware of coercive interrogations but have not intervened, physicians are ethically obligated to report the offenses to independent authorities that have the power to investigate or adjudicate such allegations.

“We firmly believe that U.S. policies on detainee treatment must comport with the AMA’s Code of Medical Ethics and the World Medical Association’s Declaration of Tokyo, which forcefully state medicine’s opposition to torture or coercive interrogation and prohibit physician participation in such activities,” AMA President Robert M. Wah, MD, said.

“The AMA will continue to advocate that no doctor is asked to go against the ethics of the profession,” Dr. Wah said.

Get additional ethical insights

Archived articles in the AMA’s online ethics journal Virtual Mentor further explore the issue of physician obligations concerning torture and interrogations. Insights from physicians and other experts in the field include:

  • The role of physicians in interrogations. Physicians have recognized responsibilities to patients and society. This article explores the question of whether honoring the societal responsibility allows a physician to participate in interrogation and if so, to what extent.
  • Torture and human rights. Involvement in torture—before, during and even afterward—puts physicians in morally compromised positions, no matter whether civil, military or judicial systems have approved it. This article discusses how physicians in the military, especially those called on to care for prisoners, should heed the counsel of their professional organizations and avoid all complicity with torture.