Ethics Violations by Medical Staff at Abu Ghraib Alleged

U.S. military medical personnel grossly violated medical ethics at the Abu Ghraib prison near Baghdad, helping to design interrogation techniques, turning their backs on abuse by guards, failing to protect the rights of detainees and hiding evidence of abuse, a Minnesota bioethicist charges in today’s issue of the journal Lancet.

Some even went so far as to revive prisoners for further torture and falsify death certificates of prisoners who died during interrogation, according to official documents examined by Steven H. Miles of the University of Minnesota.

The failings of the medical staff are perhaps even more disturbing than the abuses by guards, Miles said Thursday. “Medical personnel are the first and last bulwark against human rights abuses,” he said. “It is up to physicians and medics to intervene” to protect prisoners. Not only did they not intervene at Abu Ghraib, but they also participated in the abuse.

Their “offenses do not merely fall short of medical ideals; some constitute grave breaches of international or U.S. law,” Miles wrote.

In an editorial accompanying the article, journal editors said the events at Abu Ghraib should serve as a “wake-up call for the Western world to rediscover and live by the values enshrined in its international treaties and democratic constitutions.”

About two dozen military intelligence soldiers and civilian contractors will be implicated in the abuses at Abu Ghraib, but no physicians or other medical personnel. Unnamed military officials Thursday told Associated Press, however, that medical personnel who knew of the abuse or participated will be charged.

Miles, who examined media reports and the records of official government inquiries, noted that several of the government reports had not yet been released.

The crucial shortcomings of medical personnel, he said, included failure to maintain medical records, conduct routine medical examinations and provide proper care for disabled or injured prisoners. Medical personnel and information were also used to devise and implement psychologically and physically coercive interrogations. Death certificates and medical records were falsified.

The article noted that in November 2003, Iraqi Maj. Gen. Abed Hamed Mowhoush suffocated after interrogators slid him into a sleeping bag and a guard sat on his chest. A prison surgeon stated that he died of natural causes. Only after news media coverage did the Pentagon revise the death certificate to show the cause of death as “homicide” due to “blunt force injuries and asphyxia.”

In another case, a beaten prisoner died after guards tied him to the top of his cell door and gagged him. The death certificate stated that he died of “natural causes ... during his sleep.”

Other problems noted by Miles included a physician who allowed untrained guards to suture a prisoner’s wounds and a medic who inserted an IV tube into the corpse of a prisoner to make it appear that he had been receiving medical treatment.

An Army spokesman did not deny the incidents cited by Miles. He pointed out to Associated Press that most of Miles’ examples came from military inquiries and were being investigated.

Miles agreed that the personnel involved should receive both professional and military sanctions, but he argued that that would not be enough. “We really have to move from sanctions to reform,” he said.

Among possible solutions, he said, are better training of medical personnel and better reporting mechanisms.

External oversight also needs to be improved, he added. The International Committee of the Red Cross provides some oversight, he said, but when its staffers reported problems two years ago, they were shut out of the prison.