To the Editor:
Re “Even Nightmares Are Classified” (“Lasting Scars” series, front page, Nov. 13):
Your reporting reminds us all of the indelible scars the United States torture program has left on its victims. During the Obama administration, we in the human rights and medical communities held out hope for transparency and accountability about the appalling treatment of detainees; instead, we’ve had to rely on investigative journalists and detainees themselves to get a full accounting of torture’s lasting effects on both body and mind.
With a Trump presidency now on the horizon, there’s a real fear that the United States could descend back into the bleak days when medieval, barbarous practices like waterboarding were greenlit at the highest levels of government. This spring, Donald Trump said of waterboarding: “I love waterboarding. I think it’s great.”
Waterboarding and other forms of torture are violations of United States and international law, and are fundamentally at odds with long-established international standards.
As physicians and medical professionals, we’ll be watching closely to see whether or not Mr. Trump carries through on his campaign promises of bringing back torture. If so, we’ll be ready to fight him at every step.
Physicians for Human Rights
To the Editor:
Your indictment against the United States government, military medicine and military mental health, and even civilian psychiatry for its lack of oversight, is exquisite. At the very least, your exposé suggests a new low for the institutional abuse of psychiatry in the United States military.
The tormented accounts by the psychiatrists and others who expressed feeling torn between prisoner-patients, who suspected that the psychiatrists were accomplices in torture, and interrogators, who accused psychiatrists of protecting the prisoner-patients, are reminiscent of many of the responses I received from former Army psychiatrists in a post-Vietnam War study.
Those psychiatrists who served after 1968 and after America repudiated the war were typically bitter, disillusioned and deeply regretful because, while by then most were against the war and earnestly sought to reduce psychiatric suffering, their soldier-patients nonetheless opposed treatment as if they were agents of a persecuting military.
It was a rich and troubling example of ethical tensions arising from so-called dual agency.
But this was not the case for the psychiatrists at Guantánamo, at least by the standards of the American Psychiatric Association. In 2006, the A.P.A. officially “reiterated” its position that psychiatrists’ primary obligation is to prisoner-patients, including serving as their advocate. They are furthermore prohibited from participating in or facilitating torture and are obligated to report evidence of torture to those in a position to take corrective action.
But what’s especially suggested by the article is that in being subordinates in the military hierarchy, the psychiatrists in Guantánamo were not confident as to how to oppose institutional pressure that they know which “side” they were on and act accordingly.
In 1993, I openly advocated that the A.P.A. actively monitor the regulations, policies and treatment doctrine affecting psychiatrists in the uniformed services, but to no avail. The circumstances in Guantánamo suggest that this should be seriously reconsidered.
Otherwise, there remains, as was the case in Vietnam, an unreasonable burden of conscience borne alone by each psychiatrist who serves.
NORMAN M. CAMP
The writer, a retired colonel in the Army Medical Corps, is a clinical professor of psychiatry at the Medical College of Virginia, Virginia Commonwealth University.