Torture is a form of terrorism: there are no justifications for it
Editorials
Derek Summerfield
BMJ 2003;326:773-774 ( 12 April )
In the middle ages in Europe torture drew distinction from its association with confessed truth, repentance, and salvation, yet by 1874 Victor Hugo could write "torture has ceased to exist." But torture was always likely to outlive its obituarists, and Amnesty International has regularly recorded its use in more than half the nations on earth. Is "the war on terrorism" again legitimising torture as it was in the middle ages?
The accounts of torture victims are horrifying enough but at least these victims survived: Primo Levi reminded us in The Drowned and the Saved that the public record is denuded of the accounts of the drowned.1 In recent years, reflecting the authority imputed to instrumental reasoning and medical arguments, the anti-torture movement has publicised the physical or mental injuries that can result from torture. However, the ordinary citizen does not regard torture as repugnant because it may have medical consequences, but because its use (typically by the state against its own citizens) seems so extreme a violation of the collective values and morality that hold a social fabric together. Indeed the economist and Nobel laureate Amartya Sen points out that torture, political imprisonment, and assassinations seem more shocking and "wrong" than the failure of states to provide basic means of survival, even though such failures cause far greater loss of life.
Since 11 September 2001 public advocacy of torture no longer seems taboo. The Washington Times recently published a method for the efficient interrogation of Al Qaeda suspect Khalid Shaikh Mohammed, suggested by the president of the Freedom Research Foundation. This involved ventilation by nasal mask of a paralysed subject, with the ventilator turned off to provide transient suffocation whenever the interrogator was dissatisfied.2
The New York Times and International Herald Tribune last month published apparently well founded accounts of the techniques applied to Abu Zubaydah and other Al Qaeda suspects in US custody. These included deprivation of food, water, sleep, and light; covering subjects' heads with black hoods for hours at a time; forcing them to stand or kneel in unnatural positions in extreme cold or heat; keeping them naked; prolonged chaining or shackling; hooking them up to sensors during serial interrogations; and denial of medical attention. There have been persistent reports of beatings at some US operated centres, and a military pathologist has determined that the deaths of two prisoners at Bagram, Afghanistan, last December were homicides. At Bagram "disorientation is a tool of interrogation and therefore a way of life." At Guantanamo Bay, Cuba, where around 650 men continue to be held, largely in solitary confinement and beyond the jurisdiction of US law, there have been 20 suicide attempts so far. 3 4
US officials maintain that the
treatment of detainees does not violate international law. They are
wrong: this is torture by the definition in the World Medical
Association's Declaration of Tokyo (1975): "the
deliberate, systematic or wanton infliction of physical or
mental suffering, to force another person to yield information,
to make a confession, or for any other reason." It is
also in breach of article 5 of the United Nations Declaration of
Human Rights: "No one shall be subjected to torture or to cruel,
inhuman or degrading treatment or punishment." The UN
Committee against Torture ruled in the 1990s that similar
practices by Israel
where
they were called "moderate physical pressure" and
considered legitimatewere
indeed torture.5 The UN Committee
also denounced the "ticking bomb" defencethe
justification that information needs to be obtained quickly
to avert an atrocity. Yet this remains the central plank of
the argument US officials are using to justify what they are doing.
The US is also refusing to support the proposed International Criminal
Court unless US citizens have permanent immunity
The Federal Bureau of Investigation is
reportedly to interrogate tens of thousands of Iraqis resident in the
USA25 000
in San Diego aloneunder
an order from the Justice Department: are we witnessing a
re-emergent McCarthyism?6 US leaders and
other opinion formers appear to be legitimising a seige
mentality and demonisation of the "other"
(especially the Muslim other) which risks drawing ordinary
citizens into the normalisation of torture and other civil
violations in the name of "security." As a telling example
of this, a study of the behaviour of doctors during military dictatorships
in Argentina, Chile, and Uruguay concluded that they attended
normally to ethical issues like confidentiality, but could
collaborate with torture because they saw themselves as
patriotic.7 Have the doctors assigned to US
interrogation centres protested, for example, at the denial
of painkillers to Abu Zubaydah, though he had been shot
several times during capture?
To use torture to fight
"terrorism" and to use war to fight "weapons of mass
destruction" is perverse: torture is a form of terrorism,
and so are the bombs"shock
and awe"raining
down on the citizens of Baghdad as I write. What moral
authority can the USA claim in its prosecution of
"just" war when it has been the world's major arms
manufacturer and exporter to repressive regimes, with the UK
not far behind? One of those regimes was, until 1991, Saddam
Hussein's Iraq, where extrajudicial execution and torture were
always institutionalised.
Historically torture has targeted the poor and those who spoke for the poor. We need a mature understanding of the felt impact of Western led politics, economics, and culture as globalising forces, and of the stark fact that issues of human rights and social justice have weighed little in the geopolitical and business calculations at play. People without power in the non-Western world, even in their millions, are strategically unimportant and therefore ignorable.8
In addition to what they do for the
individual patient, doctors have a wider duty to speak out about the
social and political roots of suffering and disease. It is
arguable how seriously the profession en massenot
just Physicians for Human Rights or the medical section of
Amnesty Internationalhas
taken this part of its remit. After all, the social and
economic status of doctors has tended to place them closer to
the better off and influential than to those social sectors
for whom issues of equity really count. In challenging
terroristic violence in all its forms, what is at stake are
the imperatives not of medical ethics but of empowered citizenship.
Institute of Psychiatry, King's
College, London SE5 8AP (derek.summerfield@slam.nhs.uk
)
Footnotes
Competing interests: None declared.
1. | Levi P. The drowned and the saved. London: Penguin, 1988 . |
| 2. | Wheeler J. Interrogating KSM. Washington Times 2003; 5 Mar. |
| 3. | Van Natta D. A dark jail for Qaeda suspects. International Herald Tribune 2002;10 Mar. |
| 4. | Van Natta D. Questioning Terror Suspects in a Dark and Surreal World. New York Times 2003 March 9. |
| 5. | Summerfield D. What is the WMA for? The case of the Israeli Medical Association. Lancet 2003; 361: 424 [CrossRef][ISI][Medline] . |
| 6. | Vulliamy E. Passions stirred as intensity rises. Observer 2003;23 Mar:14. |
| 7. | Riquelme H. Entre la obedencia y la oposicion. Caracas: Neuva Sociedad, 1995 . |
| 8. | Summerfield
D. Raising the dead: war, reparation, and the politics of
memory. BMJ 1995; 311: 495-497
|
© 2003 BMJ Publishing Group Ltd
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