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The US medical establishment is failing to enforce professional ethics among doctors who serve in the US military, charges a letter signed by doctors from 16 countries that was published in last week's Lancet. The letter compares military doctors working in the Guantanamo Bay detention camp to doctors who helped the South African police question detainees in the apartheid era.
“The attitude of the US medical establishment appears to be one of ‘See no evil, hear no evil, speak no evil,'” the letter says, pointing out that no military doctor has been charged or disciplined for offences committed in what President George Bush describes as the war on terror (Lancet 2007;370:823 doi: 10.1016/S0140-6736(07)61402-0). “The failure of the US regulatory authorities to act is damaging the reputation of US military medicine,” it says.
The letter is signed by 260 people, almost all of them doctors, from 16 countries. Many also signed a letter that appeared in the Lancet in March 2006, criticising doctors who participated in the force feeding of prisoners at Guantanamo Bay.
Among the letter's organisers are David Nicholl, a neurologist at Birmingham's City Hospital, and the psychiatrist William Hopkins, of the Medical Foundation for the Care of Victims of Torture.
The letter is timed to coincide with the 30th anniversary of the death of the anti-apartheid activist Steve Biko. His death in police custody was at first attributed to a hunger strike but was shown at an inquest to have been caused by head injuries. The inquest also uncovered evidence of gross negligence and the falsification of records by two doctors working with the police, Ivor Lang and Benjamin Tucker.
South African regulatory authorities initially failed to take action, but an eight year campaign by South African doctors ultimately resulted in Dr Tucker being struck off, while Dr Lang received a reprimand. The case “was instrumental in the rehabilitation of the South African Medical and Dental Council and the Medical Association of South Africa,” the Lancet letter argues.
The letter concludes that “doctors in Guantanamo and elsewhere have made the same mistake as Tucker who, in 1991, in expressing remorse and seeking reinstatement, said ‘I had gradually lost the fearless independence . . . and become too closely identified with the organs of the State.'”
Dr Nicholl has lodged formal complaints with the state medical boards of Georgia and California against the former hospital commander at Guantanamo Bay, John Edmondson of the US navy, and has notified the American Medical Association (AMA) that Captain Edmondson is a member. The complaints allege that Captain Edmondson violated the Declarations of Tokyo and Malta, to which the AMA is a signatory, by participating in the force feeding of prisoners.
The California board replied that it had no jurisdiction, while the Georgia board said it had not found enough evidence to support prosecution. The AMA had not replied after 18 months, the letter states.
Dr Nicholl said that he did receive a “bland” response from the AMA after the Lancet letter went to press, suggesting that he contact the relevant state medical boards. “Of course, I already did that,” he said.
The AMA did not return calls from the BMJ for comment.