An ethics lesson for psychologists: don't participate in torture

The Senate’s Report on the CIA’s Detention and Interrogation Program (commonly known as the torture report) released in December 2014, confirmed that doctors and psychologists were complicit in the torture of detainees.

Two psychologists, unnamed in the report, but confirmed to be James Mitchell and Bruce Jessen, designed some of the “enhanced interrogation” techniques. Other psychologists monitored interrogations.

US Senate Report on CIA Detention Interrogation Program.By US Senate Select Committee on Intelligence via Wikimedia Commons

A few weeks after the release of the report the president of the American Psychological Association (APA) stated that because Jessen and Mitchell are not members of the APA, the organization has no jurisdiction over them and cannot sanction them in any way. But Mitchell and Jessen weren’t the only psychologists to violate ethical standards, and the APA has yet to fully denounce psychologists' participation in torture.

Why the organization has not taken any action against any psychologists, including those within its own ranks who worked closely with government officials, is anyone’s guess.

But it raises two interesting questions.

Do the ongoing and significant financial ties between Department of Defense and the APA play a role? And what are psychology students and medical students taught about military medical ethics?

CIA detainees by year detained, including those subjected to ‘enhanced interrogation’ techniques.Senate Committee on Intelligence via Reuters

APA allowed psychologists to take part interrogations until 2013

Enhanced interrogation techniques (EITs) included practices like waterboarding, cramped confinement, sleep deprivation, and requiring detainees into “stress positions,” among others. Medical staff monitored the health of detainees during interrogations. Without their presence, the DOD would have had no way of even remotely claiming these interrogations were safe.

The use of these enhanced interrogation techniques was authorized in a series of memos from Justice Department in 2002 and 2005. One of the memos stated that Taliban detainees did not qualify as prisoners of war, therefore the Geneva Convention did not apply.

In 2005 the APA hurriedly issued a report justifying and allowing psychologists to participate in interrogations in the war on terror. (To be clear, these interrogations were not simply asking a prisoner a question and hoping for a response, but included sessions in which shackled prisoners were taunted, exploited, threatened, and physically harmed in a multitude of ways.)

No doubt this was done partly to protect those psychologists who’d already participated in “enhanced interrogations,” but also to continue to allow psychologists to do so. Although many psychologists protested, including members of the APA, this decision cemented and furthered the longstanding ties between the APA and the defense department.

The report was rescinded in 2013, but the APA still allows psychologists to participate in interrogations in some circumstances. Many activists within psychology and otherwise feel that because of this, nothing has changed.

The APA’s 2005 decision also stood in sharp contrast to the American Medical Association (AMA) and the American Psychiatric Association. In 2006 both organizations issued strong statements prohibiting physician participation in interrogations as a violation of medical ethics.

When the AMA and the American Psychiatric Association issued these statements almost instantly physicians were pulled off of interrogation teams given that they could no longer monitor them or participate in them in any way whatsoever.

However, given that there were no prohibitions about the participation of psychologists on interrogation teams, they remained in those sessions and possibly still do to this day, even though the Obama administration declared an end to torture years ago.

Had the APA followed the lead of the AMA and the American Psychiatric Association and prohibited psychologists from participating, the entire interrogation program may likely have ended years earlier than it did.

Why? Because the Department of Defense knows that having some health-care personnel present during interrogations confers a certain amount of legitimacy to interrogations and allows them to proceed.

The Pentagon.Michael Baird, CC BY-SA

The APA and the DOD – a long and close relationship

The relationship between the Department of Defense (DOD) and the APA goes back decades. During both world wars, the APA recruited psychologists into military service to evaluate new recruits, assist in treating soldiers with post-traumatic stress and provide guidance on interrogating captured enemy soldiers.

Over the last half century the DOD has funneled hundreds of millions of dollars to psychologists for research and assistance. Today, the Veterans’ Administration is the single biggest provider of psychology internships in the country. And 7% percent of APA members work for or with the DOD.

No matter how extensive the ties between the DOD and psychology, psychologists should know that participation in torture violates every accepted international ethical code of conduct and the duties of health care personnel in particular.

Possible changes to military ethics policies

In late March, Vice News reported that the federal committee advising the Secretary of Defense on health policy recommended changes to military ethics guidelines. One suggested change would:

“allow military healthcare workers to bow out of performing medical procedures that would violate their profession’s code of ethics, or their religious and moral beliefs. Personnel that decline to participate in the procedures should not face retribution.”

This is important because in the past any health-care worker in the military who refused to participate in force-feedings or other procedures considered unethical by virtually every ethical code faced significant consequences. These could include court martial or dishonorable discharge with loss of all veterans' benefits.

But the potential change means it is critical for psychologists (and other health-care workers) to know what their military ethical responsibilities are.

Military medical ethics aren’t being taught in schools

The next generation of practitioners appear to know little about military psychologists’ ethical responsibilities.

When my colleagues and I surveyed 185 students in 20 clinical psychology graduate programs in 2014, we found that 74% had received less than one hour of instruction about military medical ethics. We conducted a similar study of medical students in 2007 and found that 94% had received less than one hour of instruction about military medical ethics.

Students aren’t being taught about their ethical obligations under the Geneva ConventionArchives New Zealand, CC BY-SA

In answer to particular questions about the appropriate treatment of prisoners, situations in which the Geneva Conventions apply, and scenarios in which military personnel are expected to disobey unethical orders from superiors most of the clinical psychology students responded incorrectly.

The students also didn’t know that international codes of conduct mandate that they refuse unethical orders from superiors and that the only things they can demand from prisoners are name, rank, and serial number – even if they think that a certain prisoner has valuable information.

Based on our findings, we came to two main conclusions. Psychology students learn little about the professional standards that constrain unlawful and unethical practices. At the same time, these students have a misplaced sense of complacency about their knowledge of such matters.

This is troubling, since psychologists who don’t understand their ethical obligations are less prepared to disobey unethical orders. They’re more likely to comply when they’re ordered to assist in interrogations that violate international standards.

Psychologists who are asked to participate in unethical behavior need to refuse and speak out against such requests. The continued existence of the detention center at Guantanamo, where abuse continues in the form of force-feeding, will likely go down as one of our nation’s most egregious ethical lapses. The role of health-care providers in this setting is especially troubling.

J Wesley Boyd does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations.