How Bradley Manning's Treatment Is Tarnishing the Military Psychiatry Profession

Human Rights

My colleague Mike Konczal and others have discussed how the abuse of Bradley Manning delegitimizes our institutions, making a mockery of the justice system and casting a shadow over the state. The press has also been compromised in the failure of reporters to adequately cover the story and speak plainly about the seriousness of Manning’s conditions and the responsibility of those in power to stop it. But at least one other institution is also compromised: the medical profession.

Military psychiatrists involved in the treatment of Manning — which amounts to torture — face a dilemma that threatens to tarnish the good name of their profession. To dismiss health care professionals involved in such situations as sadistic instruments of evil does not help us understand their painful position. The questions are not easy. Are military doctors really doctors first, obeying the oath their profession? Or are they soldiers obeying a chain of command? What line must be crossed before one role overtakes the other?

To recap: Manning has been placed under a prevention of injury order (POI) that requires him to be isolated in a small cell for 23 hours a day with little exercise and to be checked every five minutes. Recently, the regime included enforced nudity for long periods, an order that seems to have originated with a sarcastic remark made by Manning about the absurdity of his treatment (following a public outcry, he has been give a “smock”). The Guardian has examined official records at Quantico which reveal that military psychiatrists have made at least 16 separate recommendations to military commanders that Manning be taken off the POI restrictions because he was not a danger to himself. But brig officials ignored the recommendations and have taken it upon themselves to continue, and increase, the harsh restrictions. Susan McNamara, a member of the advocacy group Physicians for Human Rights, concluded that Manning’s treatment looked like an extension of the notorious interrogation practices used against terror suspects in Guantanamo.

As the Guardian’s Ed Pilkington points out, the Quantico psychiatrists deserve credit for continuing to insist that the treatment regime should be changed. But is that enough?

Doctors in the US have been voicing their concern for some months, pointing out that even if military psychiatrists don’t officially sign off on the treatment, they may still be complicit and in violation their duty to protect the health of the patient. Psychologists for Social Responsibility wrote a letter to Defense Secretary Robert Gates in January, 2010, demonstrating that conditions like those Manning has been subjected to have been known to be traumatic and debilitating to prisoners since 1890.

It is understandable that scenarios like war can blur the boundaries for doctors. Medics in foreign war zones are asked to care for people who have maimed and killed their fellow soldiers. Health care professionals in the prison system give life-saving treatment to convicted murderers. One could hardly blame a doctor for experiencing turmoil under such circumstances.

But what happens when doctors are asked by the highest authorities to do harm or facilitate abuse? We now know that Defense Secretary Donald Rumsfeld called for military interrogations that required military doctors to be involved in monitoring and even administering torture. Andrew Sullivan noted in 2006 that at  Guantanomo, doctors were made to agree to torture in advance and to live by the motto: “No blood, no foul.” They practiced the art of sleep deprivation, hypothermia, withholding food and treatment of injuries, among other abuses.

As Sullivan reminds us, the abuses at Guantanomo were supposed to teach us something: “Once you allow the torture of prisoners for any reason, as this President did, the cancer spreads” writes Sullivan. “In the end it spreads to healers as well, and turns them into accomplices to harm.”

We have a different president now. And the cancer is spreading. Under Obama’s watch,  you don’t have to be a “foreign combatant” to be tortured in a U.S. facility. You can be an American citizen awaiting trial. The doctors involved in Manning’s treatment are not in a war zone. Nor are they dealing with a convicted criminal.

The world is watching.  A significant 2009 resolution by the United Nations Human Rights Council outlines the role and responsibility of medical and other health professionals in “torture and other cruel, inhuman, or degrading treatment or punishment.” It urges statesto act to prevent health workers from becoming involved in torture and degradation and to protect those who voice their objections. The resolution incorporates standards set by the medical profession into international human rights law. For the first time in a United Nations document, the Hippocratic oath is presented as the global ethical norm.

The recent resignation of P.J. Crowley, the state department official who voiced disapproval of Manning’s treatment, has sent a message to people who speak freely from their conscience: Do so and you will lose your job. That is quite chilling, and it will require not only extraordinary courage, but committed support from the public, to enable the psychiatrists at Quantico to speak freely about what they are witnessing and what they are asked to facilitate.

President Obama, along with members of Congress, are currently failing these doctors by condoning the torture of Manning. If the doctors speak out and are censured, the offense will be compounded.

Do doctors save lives? Or do they participate in acts which they know to be a violation of the standards of their profession? Where are the boundaries for doctors serving the state? We are waiting for the psychiatrists at Quantico to tell us.

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