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Doctors failed to inquire about Gitmo detainees' injuries, study alleges

Medical professionals treating them did not follow up on evidence of torture, a case review says.

By — Posted May 13, 2011

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Physicians and other health professionals at Guantanamo Bay failed to properly document and report evidence "highly consistent" with detainee allegations of torture, says a case review of nine detainees' medical records published in the April issue of PLoS Medicine.

Three of the detainees had documented physical injuries that were highly consistent with their allegations of abuse, including contusions, bone fractures, lacerations and peripheral nerve damage, said the study, written by two experts on the evidence of torture. The reviewers were hired as medical consultants by attorneys for some of the detainees.

The detainees said they were exposed to interrogation techniques such as sleep deprivation, extreme temperatures, stress positions, beatings, forced nudity, prolonged isolation and sexual molestation -- all recognized as torture by the United Nations Convention Against Torture as well as the U.S. government before 2002.

None of the detainees, held in the U.S. facility at Guantanamo Bay in Cuba since 2002, had any record of psychological problems before detention. Eight subsequently reported severe mental health problems, and seven had symptoms consistent with posttraumatic stress disorder. Many of these symptoms, such as nightmares and exaggerated startle responses, were specific to the detainees' torture allegations, said the study (link).

Physicians and other health professionals treating the detainees did not ask them how they were injured physically or psychologically, document any causes of the injuries or report suspicions of abuse, the authors said. The medical professionals' names were redacted from the records that researchers examined.

"Clearly, there was a practice of avoiding any cause of a symptom or injury that inferred the possibility of intentional harm," said Vincent Iacopino, MD, PhD, lead author of the study and co-author of the U.N.'s 2001 manual on investigating and documenting torture. "If [physicians] don't take action, what's likely to happen is that the actions will continue. And your failure to document becomes a part of the concealment process and the enabling of additional abuse. This is not to mention that every medical ethical principle stands against the participation in any form of willful harm to the people who come to you."

Call for accountability

The study is the latest evidence to document medical professionals' involvement with torture at Guantanamo Bay, said Steven H. Miles, MD.

"U.S. medical professionals were integral to both the design and the covering up and allowing the mistreatment of prisoners," said Dr. Miles, author of the 2006 book Oath Betrayed: Torture, Medical Complicity, and the War on Terror. "The article is new only in the extent that it adds independent data sets to what's already been massively confirmed by other sources of data and other observers."

Dr. Miles said an independent investigation, perhaps conducted by the Institute of Medicine, should further examine U.S. medical professionals' participation in torture and hold them accountable.

The U.S. Dept. of Defense did not comment to American Medical News by this article's deadline. In a statement to USA Today, Lt. Col. Tanya Bradsher said, "Detainees receive timely, compassionate, quality health care and have regular access to primary care and specialist physicians." The statement did not directly respond to the study's findings about past treatment of detainees or health professionals' failure to document and report potential abuse.

American Medical Association policy says "physicians must oppose and must not participate in torture for any reason" and that they should "strive to change situations in which torture is practiced." The Association wrote in support of President Obama's January 2009 executive order on humane treatment of detainees and reaffirmed its opposition to forced feeding in June 2009.

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