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Kennedy Institute of Ethics Journal 13.2 (2003) 175-188
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Dilemmas in Military Medical Ethics Since 9/11
Edmund G. Howe
The attack on the United States by terrorists on 9/11 and the war with Iraq have raised new ethical questions for the military and for military physicians (Herman 2002; Elshtain 2003). How and when attacks may occur now is less predictable. Planes have been hijacked, and persons dressed as civilians may carry bombs to blow themselves and others up. These dangers pose an increased threat, and, thus, there is a need for new defensive measures. How far these measures should go is, however, greatly open to debate.
One of the most difficult ethical question raised for the military and military doctors by these developments is what interrogation methods are permissible when questioning captured terrorists. The licitness of different interrogation practices is, however, only one of the ethical problems potentially encountered by military physicians now having to treat terrorists and POWs. The following discussion presents the major concerns regarding this and other issues.
Treatment of Terrorists Who Have Been Captured
Interrogation and Inhumane Treatment
Some reporters claim that the U.S. already has sent terrorists to Jordan, Egypt, and Morocco so that they can be tortured and then be more likely to give information (Priest and Gellman 2002). They claim also that when the CIA has interrogated al Qaeda and Taliban prisoners at the U.S. occupied Bagram air base in Afghanistan, it has deprived them of sleep; forced them to assume "awkward, painful positions;" and "softened them up" with beatings (Priest and Gellman 2002; Editorial 2002).
It is open to controversy whether such techniques are ethical or legal. Some say that to call such practices inhumane "trivializes the torture that does take place in so many areas of the world" (Rivkin and Casey 2003). Other individuals argue that since terrorists lack the protection of the 1949 Geneva Convention it should be permissible to treat them differently from prisoners of war (POWs). Lawyer Alan Dershowitz believes, for instance, that after acquiring a "torture warrant" from the court, the government should be able to torture these prisoners [End Page 175] to try to gain information from them if doing so could save soldiers' and civilians' lives (Cohen 2003). As of the fall of 2001, 45 percent of one group of Americans polled agreed (Morse et al. 2002).
On the other hand, still other commentators assert that practices such as those described are "inhuman and degrading," and, thus, unlawful (Cooperman 2002). Individuals in this camp maintain that, notwithstanding the Convention, all approaches involving any kind of torture should be absolutely proscribed. They contend that once captured, these prisoners no longer pose a threat, and, thus, "universal values" require that they then be regarded only as fellow humans. They further contend that if torture is used, American society will have regressed to pre-civilized standards. This, in turn, would negate the very principles for which we are fighting (Amery 1980; Drinan 2001).
If certain interrogation practices are deemed unethical or illegal, military physicians have professional obligations as doctors and military obligations, like all soldiers, to oppose them. If they remain silent, they, like the rest of society, will be guilty of moral complicity (Feitlowitz 1998; Westermann 1996).
One criterion by which the ethical and legal permissibility of interrogation techniques might be judged is their long term effects on prisoners. Keeping prisoners in cramped positions can, for example, cause long-lasting and profound psychological harm. Sylvia Karcher, a therapist who works with patients who have been subjected to such treatment, relates, for instance, that after prisoners have stayed in cramped positions for extensive lengths of time, their physical postures become "ossified." Only by slowly inviting these patients to try to move and to talk about what they feel as they do can these prisoners finally reacquire the capacity to move normally. What they have lost, she says, is more than their capacity for physical movement. They have lost the feeling that they can choose. She states, "The capacity to choose and...