Tortured Logic

"The end excuses any evil."
--Sophocles, "Electra" (409 B.C.)

"No man is justified doing evil on the grounds of expediency."
--Theodore Roosevelt, "The Strenuous Life" (1900)

Last week, I was having dinner with a good friend who is an extremely bright and thoughtful person. I shared with him how shocking it is to me that our country is having a rational debate about whether or not it's permissible to torture people. "It's unfathomable to me that some people think it's morally defensible to torture people in the name of defending our freedoms," I said. "If we can't draw a bright moral line about torturing, then where can we? Torture is never the right thing to do."

"Oh, yes it is," he replied, causing me to choke on my sushi. "What if some guy abducted your beloved wife and son, had them locked up somewhere with a bomb that was rigged to explode in two hours, and the police captured him. Wouldn't you torture him to get the information you needed to save their lives?"

"I don't know what I would do," I replied, "but I'd like to believe that nothing ever justifies torture. Expediency is a slippery slope."

As the cartoon character Pogo once said, "We have met the enemy and he is us." Sometimes, people do the darkest acts in the name of helping protect their loved ones. Sweet and precocious young Anakin Skywalker goes to the Dark Side and becomes the evil Darth Vader in hopes of gaining enough powers to protect his beloved wife from dying in childbirth.

In this column, I want to focus on the morality and efficacy of torture more than the political and legal concerns. What does torturing people say about us as human beings, and how does it involve us as health professionals? And if doctors, nurses and psychologists torture people or participate in executions, how does that affect people's visceral perceptions and experiences of us as healers rather than as torturers? If we physicians are causing suffering rather than relieving it, and if we destroy lives rather than save them, what kind of corrosive effects does that create?

According to Leonard Rubenstein, executive director of Physicians for Human Rights, "Torture can also compromise the integrity of health professionals." As Harvard psychiatrist Robert J. Lifton wrote in The New England Journal of Medicine, "The participation of doctors [in torturing] can confer an aura of legitimacy."

There are important reasons why the most sacred medical oaths and doctrines, including the World Medical Association Declaration of Tokyo, prohibit doctors from participating in torture in any way. All physicians take the Hippocratic Oath, which states, "I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrongdoing."

In an op-ed column in the Washington Post, "The Stain of Torture," by Dr. Burton J. Lee II, former personal physician to President George H.W. Bush, the doctor wrote:

It's precisely because of my devotion to country, respect for our military and commitment to the ethics of the medical profession that I speak out against systematic, government-sanctioned torture and excessive abuse of prisoners during our war on terrorism. I am also deeply disturbed by the reported complicity in these abuses by military medical personnel. This extraordinary shift in policy and values is alien to my concept of modern-day America and of my government and profession. Military leaders have long been aware that torture inflicts lasting damage on both the victim and the torturer. The systematic infliction of torture engenders deep hatred and hostility that transcends generations. And it perverts the role of medical personnel from healers to instruments of abuse.

But according to Dr. David Tornberg, deputy assistant secretary of Defense for health affairs, (as quoted in the New England Journal of Medicine) a medical degree is not a "sacramental vow"--it is only a certification of skill. When a doctor participates in interrogation, "he's not functioning as a physician," so the Hippocratic Oath no longer applies. This makes no sense at all, since it is precisely because of the physicians' skills and training that they are asked to participate in torture. Worse, it debases and degrades the humanity of our profession and the sacred vows and oaths that we take. By speaking out against torture in all its forms, we can reclaim our role as healers.

For those who defend the need to torture in certain circumstances, there is a presumption that it works. Yes, it's bad, they may say, but if it's the lesser of two evils and necessary to protect our loved ones, then it can sometimes be justified. However, a recent report by the National Intelligence University states that there is no evidence that torture works in providing useful information. Worse, it often leads subjects to provide misinformation.

Douglas Johnson is executive director of the Center for Victims of Torture in Minneapolis. He says, "We care for people who the rest of the community would consider innocent victims of torture, but all of those survivors would tell you that they would have said anything--anything at all that was wanted of them--to get the torture to stop. And so, they'll confess, they'll give the information that's fed to them, because the person who most needs a confession is the torturer. Without that confession, the torturer has no justification for what they've done. And the only way that torture states manage the morale and the minds of their torturers is that a confession emerges. And that's one of the key reasons why truth doesn't emerge from torture. Anything could emerge. Sometimes it's a danger."

According to Dr. Steven Miles, a professor of medicine and author of the book "Oath Betrayed: Torture, Medical Complicity, and the War on Terror," "One of the fascinating things about the ticking-time-bomb scenario is that it has elicited bad information, which has sent our troops on dangerous and fatal missions. The sole source for the information that bioweapons were being developed jointly by Saddam Hussein and Al Qaeda came from a guy that we kidnapped in Sweden, took to Egypt and tortured, and that made it to the U.N. and was part of the authorization to go to war."

His views were echoed by Sen. Joseph Biden last month at a Democratic debate at Dartmouth College: "I met up here in New Hampshire with 17 three- and four-star generals, who said, 'Will you make a commitment you will never use torture?' It does not work, and it's part of the reason why we got the faulty information on Iraq in the first place, because it was engaged in by one person who gave whatever answer they thought there were going to give in order to stop being tortured. It doesn't work. It should be no part of our policy ever. Ever."

Earlier this month, according to the Washington Post, there was a reunion of about two dozen World War II veterans in Washington who participated in the interrogation of Nazi prisoners of war. "Many of the proud men lamented the chasm between the way they conducted interrogations during the war and the harsh measures used today in questioning terrorism suspects," the paper reported." Henry Kolm, an MIT physicist whose interrogation of Hitler's deputy, Rudolf Hess, occurred over a chessboard, said, "We got more information out of a German general with a game of chess or ping-pong than they do today, with their torture."

Alberto Mora is the former Navy general counsel who opposed the administration's policy on torture. In 2006, while accepting the JFK Profiles in Courage Award, he said: "We need to be clear. Cruelty disfigures our national character. It is incompatible with our constitutional order, with our laws, and with our most prized values. Cruelty can be as effective as torture in destroying human dignity, and there is no moral distinction between one and the other. To adopt and apply a policy of cruelty anywhere within this world is to say that our forefathers were wrong about their belief in the rights of man, because there is no more fundamental right than to be safe from cruel and inhumane treatment. Where cruelty exists, law does not."

"Torture" is defined in the Military Commissions Act of 2006 as "an act specifically intended to inflict severe physical or mental pain or suffering upon another person within his custody or physical control for the purpose of obtaining information or a confession, punishment, intimidation, coercion, or any reason based on discrimination of any kind." According to The Washington Post, methods of torture that have been used by the CIA include waterboarding (mock drowning), exposure to extreme cold (including induced hypothermia), stress positions, extreme sensory deprivation and sensory overload, violent shaking, striking, sexual humiliation, prolonged isolation, prolonged sleep deprivation, threats of harm to individuals and to their family and friends, among others.

The Third Geneva Convention states, "No physical or mental torture, nor any other form of coercion, may be inflicted on prisoners of war to secure from them information of any kind whatever. Prisoners of war who refuse to answer may not be threatened, insulted, or exposed to any unpleasant or disadvantageous treatment of any kind." The issue of dual loyalty--the need for military doctors to follow orders and also to be bound by principles of medical ethics--was clearly dealt with in this and other international treaties, including the Nuremberg tribunals in which "orders are orders" was not a valid defense by military personnel against war crimes.

According to several sources, including a recent report, "Leave No Marks," by Physicians for Human Rights and Human Rights First, increasing evidence indicates that physicians and other health professionals, including psychologists, have been involved in torturing detainees in Guantánamo Bay, Iraq and Afghanistan. These activities range from participating in torture, watching it behind one-way mirrors, patching wounds, treating collapsed prisoners, turning over medical records to interrogators, and covering up and even falsifying deaths due to torture so they appeared to be from natural causes. Dr. David Auch, commander of the medical unit that staffed Abu Ghraib during the time of the abuses made notorious by soldiers' photographs, said military intelligence personnel told his medics and physician assistants not to discuss deaths that occurred in detention.

Psychologists may advise interrogators on how best to exploit fears and weaknesses in those that they are torturing. I was disappointed that the American Psychological Association (APA) did not pass a proposed moratorium earlier this year banning psychologists from being involved in coercive interrogations. According to Dr. Miles, "[The APA] very specifically stated that physicians or psychologists could work in secret prisons with an option of leaving if they wanted, but not with an obligation to call attention to the abuses within secret prisons."

As Douglas Johnson said during a recent interview, "I think it's important to understand that in today's world there are more health-care professionals involved in the design and structuring of torture than there are those who are involved in providing care for survivors of torture around the world."

If we're not careful, we become that which we most fear. When we torture people, even if we win the battle, we've already lost the war for hearts and minds. Especially our own.

This piece was originally published in Newsweek. A link to the article is here.

Comments

[mellen]

yes, it's true that it doesn't work and that is probably our best argument. But also, what about all the mistakes? For every time you get someone who actually knows where the "ticking bomb" is, there are probably a hundred innocent someones who couldn't tell you where the bomb is to save their lives. Is this ok? Are they just collateral damage? Because when you set up a torture system, the innocents have no recourse. Right now, we are leaving it up to Pres Bush to decide who to torture. Do even the rightest of the righties feel comfortable with his ability to get it right? We are pretty sure by now that there are "mistakes" imprisoned in Gitmo. If they ever should get out, who could blame them for retaliating?

[CriminallySane]

""Oh, yes it is," he replied, causing me to choke on my sushi. "What if some guy abducted your beloved wife and son, had them locked up somewhere with a bomb that was rigged to explode in two hours, and the police captured him. Wouldn't you torture him to get the information you needed to save their lives?""

And if the guy was capable of holding out for two hours and ten minutes?

[disgustedcitizen]

Excellent piece. You say everything that I feel but can not express so clearly. I am sick of hearing that "What if someone kidnapped your love one..." argument. The kidnapper is more likely to give you false information under torture then the truth.

Torture, even that our leaders are discussing torture, diminishes this country and its people. This country has survived over 2oo years without resorting to state sponsored torture and it will survive many more. While terrorists can destroy our cities, and kill our people, but they can not destroy the United States. Only we, the people, can do that.

[sandpiper]

Please excuse the effusiveness of my preceding post, Dean. I had not troubled to read your bio.

Trouble is, there's just so much CAPS-LOCK mania, overall amateurishness, and illiterate venomous spewing on the web lately that I had just about turned the damned thing off...

Thanks again!

[sandpiper]

What a magnificent piece -- clear, informative, and relatively concise, considering the complexity of the topic!

After a lifetime as a professional editor, I'm accustomed to misspellings, usage problems, non-sequiturs, typos and other kinds of drivel that crave an editor's hand, particularly on the internet -- even (gasp!) on HuffPost. But not here.

I had to put the figurative blue pencil back behind my ear. Your article is cogent, persuasive, and a true pleasure to read, despite the grim subject matter.

I've read many items on the torture issue, and yours is far and away the most erudite.

Hope is reborn. Thanks!

[Guitarsandmore]

Moving suspects offshore to another country that does authorize the use of torture fits right in with the right wing conservative standard operating procedures for moving a business just far enough off shore to where the U.S. business laws do not apply either. Torturing the U.S. constitution, tax laws, and American people all blur together when the end justifies the means and the end goal is only to protect profits.

Due process of law is one of the corner stones of freedom and democracy and without it we are just a bunch of knee jerk reactionaries responding on an emotional level from watching too many videos of Americans having their heads sawn off by terrorists in the middle east.

Collin Powel has argued that Americans should be made to abide by American Law when visiting foreign countries that have underage girls available for prostitution. I have no argument with that but if this is true than all I am asking for is consistency with the law. If one law becomes universal for Americans than they all do.

[Doofus]

While it may be morally indefensible,
and I'm not sure that it always is
given certain 'greater good' scenarios,
what about the innumerable studies that
indicate test subjects are willing to
perform torture just about any time
they're told to, by 'appropriate'
authority figures?

'Oh, I would never torture anyone!
Unless you give me those *green* M&Ms.'

[Dap]

Truth-In-Fact be told: (And I had this argument with Sam Harris two years ago on Huffington Post) Torture *IS* never about the other guy (no matter what excuse/jus­tification­) it is always about us, who we are. It's just that simple.

[SamThornton]

Purely from a utilitarian standpoint, torture is counterproductive. No statement made under torture can be trusted. Most statements made under torture are false.

Torture fulfills one of two objectives: 1) assure higher authorities that all possible measures have been taken so interrogators are absolved of blame; and 2) satisfy feelings of hostility and revenge toward those tortured.

Perhaps most significant is what the use of torture says about those who authorize torture. It shows first, their own perceived impotence in persuading others to see the justice in their actions. It also reveals profound character flaws, a basic lack of humanity in those who authorize or commit torture.

For our nation to regain the world respect which we think justified, all those in the chain of command who have authorized or practiced torture must be brought to account, from President Bush to the anonymous torturers of Guantanamo Bay.

Bush and his co-conspirators must be brought before the bar of justice to answer for their heinous crimes. Anything less and the terrorists win.