Medical Torture - Medical Ethics and International Law

Medical Ethics and International Law

It is generally accepted that medical torture fundamentally violates medical ethics, which all medical practitioners are expected to adhere to.

• The Hippocratic Oath makes explicit statements against deliberate harm not in the patient's best interests. These statements are often translated as "I will prescribe regimens for the good of my patients according to my ability and my judgement" and "to never deliberately do harm to anyone, for anyone else's interest." (Note: these statements are formulations of the ethical principles of beneficence and non-maleficence.)
• In response to the Nazi human experimentation on prisoners, which were declared at the Nuremberg Trials to be "crimes against humanity", the World Medical Association developed the Declaration of Geneva to supplant the dated Hippocratic Oath. The Declaration of Geneva requires medical practitioners to state " will maintain the utmost respect for human life from its beginning even under threat and I will not use my medical knowledge contrary to the laws of humanity".
• The Nuremberg Trials also led to the emergence of the Nuremberg code which explicitly outlines the boundaries of acceptable medical experimentation.
• Additionally in response to the Nazi atrocities, the Fourth Geneva Convention of 1949 outright prohibits the torture of prisoners of war and other protected non-combatants.
• The World Medical Association Declaration of Tokyo (1975) makes a number of specific statements against torture, including "The doctor shall not countenance, condone or participate in the practice of torture".
• Also the UN Convention Against Torture, which applies not only to medical staff, prohibits the use of torture under any circumstance. The text explicitly states there is no exception to this treaty under which torture is allowed.
• The UN Principles of Medical Ethics relevant to the Role of Health Personnel, particularly Physicians, in the Protection of Prisoners and Detainees against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (UN.1982) applies specifically to medical and other health workers but it has no implementation mechanism to ensure enforcement. It is up to state, provincial, and national bodies to enforce the standards in the document.
• The development of command responsibility established criminal liability for all people, including physicians, involved in crimes against humanity.

There remain gaps in regulation relating to medical torture in many countries:

• Government sponsored torture and organized violence, with the complicity and or participation of health personnel, is internationally prohibited yet these violations occur with impunity in a significant amount of cases. An example of this impunity is found in the Abu Ghraib prison torture and prisoner scandal as well as documented by Amnesty International.
• A higher standard of behaviour is expected of health professionals yet the UN Principles of Medical Ethics are not enforceable when governments are complicit in violations. This higher standard is reflected in the principles of beneficence, non-maleficence (above all do no harm), autonomy, justice, dignity and informed consent and these aren’t covered comprehensively by the UN Convention Against Torture.