Physician involvement is tyranny

The complicity of physicians in torture is not a new or isolated phenomenon. Sordid examples have been painstakingly documented around the world at various times: Argentina, Mexico, South Africa, Israel, Turkey and now Iraq. This week’s issue of the Journal of the American Medical Association reports on physician participation in human rights abuses in Iraq.

The most common abuses in Saddam Hussein’s Iraq in which physicians were a party included the “non-therapeutic amputation of ears,” “removal of a (dead or alive) patient’s organs” and falsification of death reports or medical records – presumably to cover up these transgressions. Some physicians even admitted to the delivery of “mercy” bullets to survivors of torture. Approximately half of physicians acknowledged peer participation in methods of torture (though less than 2 percent admitted to personal involvement).

Physicians have long been at a curious and revealing nexus of technology and morality, science and politics. As such, they have been referred to as “weathervanes” of society’s predisposition. But they are not only barometers. They are also tools, corruptible because they are subject to the same reputation smears and torture tactics in which they might be manipulated to participate. According to the Journal of the American Medical Association article, among the most common reasons for physician collusion was fear of payback in the same denomination by other physicians, paramilitary groups in league with Saddam, (like Fedayeen Saddam) or other Baathist cronies.

Wholly tyrannical regimes like Saddam’s co-opt physicians as participants in torture because tyrannical regimes co-opt society. Tyranny is, by definition, completely pervasive, and it only exists successfully – that is, for long periods – by commandeering all the institutions, memories and morality of its citizens. Medical doctors are part of the fabric of modern societies. They are therefore appropriated, too.

The use of physicians in torture is a boon for regimes like Saddam’s. Since doctors are visible and usually venerated members of society, their collusion with any oppressive government lends it the guise of omnipotence and omnipresence and helps to blur what might otherwise be unambiguous distinctions between right and wrong.

The authors of this week’s article in the Journal of the American Medical Association surmise that ethics education might give future physicians the strength to refrain from participation in such clear moral lapses. This is a reflexive recommendation. The gaping discrepancy between recognition of peers’ participation and acknowledgement of personal complicity in the report support the notion that Iraqi doctors knew their behavior was wrong. It is not that doctors are weak but that tyranny entirely implemented is strong.

Abram Burgher is a University medical student. He welcomes comments at [email protected]