Oath Betrayed: America’s Torture Doctors (review)

In his classic account of the French-Algerian War, The Battle of the Casbah, French General Paul Aussaresses, a fierce defender of the utility of torture, recounts this exchange with a doctor (“an old friend of mine from my school days in Bordeaux”) over the body of a man Aussaresses has just tortured to death:

“I was talking to the prisoner and he fell ill,” I said unconvincingly.

“He told me he had tuberculosis. Can you see what’s wrong with him?”

“You were talking to him? But he’s drenched. You must be kidding!” said the doctor.

“No, I wouldn’t do such a thing.”

“But he’s dead!”

“It’s possible,” I answered, “but when I asked for you he was still alive.”

Since the doctor was still complaining I lost my cool and said: “And so? You want me to say that I killed him? Would that make you feel better? Do you think I enjoy this?”

“No, but then why did you come to get me if he’s dead?”

I didn’t answer. The doctor finally understood. I had called him so he would send the body to the hospital and get it out of my sight once and for all.¹

There is no evidence the doctor ever reported the General’s crime.

As Steven H. Miles reports in Oath Betrayed: America’s Torture Doctors,² “oversight” is hardly unique. Miles, a Professor of Medicine at the University of Minnesota Medical School, systematically and compellingly details the myriad of instances in which US doctors, nurses, and other health professionals have collaborated with the purveyors of the “war on terror” to violate not only the Hippocratic Oath, the professional ethical strictures, and the Geneva Conventions but also the country’s highest ideals.

By now, much of what Miles recounts is familiar to those who have followed the vagaries of torture perpetrated at the behest of top US leaders, rationalized by their lawyers, and implemented by far too many security officials. Mental health professionals helped devise torture techniques, physicians and psychiatrists monitored the application of “coercive interrogation,” prison medics withheld treatment, and other health professionals repeatedly looked the other way or conducted cursory investigations of alleged mistreatment. All of this comes despite professional standards that unambiguously preclude such behavior. For example, the World Medical Association’s Declaration of Tokyo asserts that “[t]he physician shall not countenance, condone or participate in the practice of torture or other forms of cruel, inhuman or degrading procedures, whatever the offense of which the victim of such procedures is suspected, accused or guilty.”³

Miles builds his case carefully and thoroughly. He details, for example, nineteen cases of prisoners who died under torture, although the number is far higher by the US military’s own admission. As Human Rights First reported in 2006, of the nearly one hundred detainees who died in US custody in Iraq and Afghanistan between 2002 and 2006, thirty-four were considered homicides by the military and another eleven may well have been. Given that this study did not include Guantánamo Bay or so-called black site secret prisons, the number is no doubt even higher today.⁴ Miles also has the courage to name the names of health professionals he regards as responsible for abuse and neglect. He is particularly searing in his indictment of the reticence showed by the American Psychological Association and American Medical Association in the face of the involvement of medical professionals in torture.

But why should those in the helping professions be exempt from the common human failing to ignore one’s highest ideals and “go along to get along?” It is hardly unknown for physicians to serve the state—no matter how vicious—or even in some cases to lead that miscreant state, such as Papa Doc Duvalier and Radovan Karadžić. When I was Executive Director of Amnesty International USA, we tried repeatedly to find US doctors willing to bring professional charges...