Military Medicine on Trial

Since the fall of 2002 at the military prison at Guantanamo Bay (GITMO), and during the fall of 2003 and early winter of 2004 at the now infamous U.S. Army detention facility at Abu Ghraib, Iraq, several Iraqi, Afghan, Pakistani and other “enemy combatant” detainees were abused, tortured and in some cases, murdered. No one has ever been charged with any misconduct at GITMO. Seven low ranking Army National Guard soldiers were later convicted at Abu Ghraib. No commissioned officers have yet to be charged in that case. Neither have any of the military medical personnel that, at the very least, according to a report in both the January 2005 issue of New England Journal of Medicine and the August 2005 issue of the British medical journal, Lancet, collaborated with interrogators during the abuse and torture and in some cases, actually facilitated it. According to the Army’s own investigation of abuse at Abu Ghraib by Maj. Gen. Antonio Taguba in the summer of 2004, Lt. Col. Steven L. Jordan, head of the Joint Interrogation and Debriefing Center at Abu Ghraib, claims that medical personnel, at the request of the 205th Military Intelligence Brigade commander, Thomas M. Pappas, brought a bag of ice to put around a deceased detainee and also to insert an IV and fluid bottle into the same detainee in an effort to smuggle him out of the prison, unnoticed. This detainee later became known as the “ice man” and an investigation into the circumstances surrounding his death is currently underway. Col. Thomas Pappas took command of Abu Ghraib sometime in October or November 2003.

In the spring of 2003, Sgt. Frank “Greg” Ford, CA Army National Guard, was strapped to a gurney after accusing his fellow soldiers of torturing Iraqi detainees in Samara, Iraq, and flown to an Army hospital in Landstuhl, Germany for mental evaluation. His “medical evacuation” was approved and supervised by an Army Psychiatrist Cpt. Merle Madera, even though that same doctor had never filed any written reports requesting a medical evacuation or evaluation. In fact, Madera had previously diagnosed Ford as “normal,” in no need of further testing or hospitalization. However, she cooperated fully with both her commanding officer and the combat commander, Cpt. Victor Artiga, when she was ordered to change her diagnosis, to “mentally unstable,” and to get Ford “out of theater immediately.” Ford spent almost one year in various Army psychiatric facilities until his discharge from the Army in early 2004.

During the spring and summer of 2003, there was such an onslaught of soldiers arriving at the Landstuhl Regional Mental Health Facility for psychiatric evaluations from Iraq, that Chief of Psychiatry, Col. Charles Tsai, said that he advised them all to “take a number.” Tsai said that they all had similar stories. The soldier would make a formal complaint of detainee abuse or another serious violation of regulations to their commanders, and the next thing they knew, they were being “evac’d” to Landstuhl for a “mental eval.” Unless they were clearly delusional (most were not, he said) he wrote up a report recommending further examination stateside, to at least “get them out of harm’s way.”

According to Dr. Don Soeken, a clinical social worker and forensic expert that specializes in military and federal whistleblower cases, the doctors in the cases listed above are all “guilty of malpractice, and so are their bosses if they are doctors as well.” Soeken has testified in federal court over 80 times against doctors, often psychiatrists, that are used by their agencies to “go after” a whistleblower and have them declared mentally incompetent. Soeken goes on to say that another common scenario with both the military and federal civilian agencies, like NSA, CIA or the FBI, is the use of military or staff psychiatrists to certify a whistleblower “mentally unsuitable” so they can suspend and eventually revoke their security clearance. “In the case of someone that needs a security clearance as a requirement for his or her job, this is usually the end of his or her career” he added. “The case against Sgt. Ford is a classic example of how a federal agency uses the medical staff to do their dirty work.” “Even Col. Tsai, who at least did a partial examination of Ford and also found him mentally stable, should have done a more complete workup and not allowed Ford to be sent back to the states for possible further abuse by the system.”

With all of the notoriety Abu Ghraib and GITMO have received over the past year and a half, including several “investigations” by the Pentagon, why has there not been more of an outcry from the public about the obvious violations of the Hippocratic oath and other seemingly egregious behavior by care givers? According to the Pentagon, the American public should have no worries about military medical professionals. Assistant Secretary of Defense, William Winkenwerder, Jr. said in a Washington Post article early last year that, “We have no evidence of maltreatment by physicians, or of physicians participating in torture or torturous activity.” However, a contradictory statement is made by David N. Tornberg, Deputy Assistant Secretary of Defense for Clinical Program Policy, he actually says that, “When a doctor participates in an interrogation, he is acting as a combatant, so the Hippocratic oath does not apply.”

Lancet, quoting documents uncovered by the ACLU in their ongoing FOIA lawsuit with the Pentagon, also discovered incidents where U.S. Army doctors: held detainees down during interrogations, provided interrogators the medical records of detainees in order to facilitate an interrogation strategy, or in some cases, literally looked the other way as detainees were physically abused. According to both Soeken and M. Gregg Bloche, law professor at John Hopkins University and co-author of the New England Journal of Medicine report, these actions are clear violations of the Geneva Convention, the Hippocratic Oath and Army Regulations. They were both puzzled by the fact that nothing had come in the wake of the Lancet article and the NEJM report. In fact, Dr. Soeken was so outraged, that he said he is going to call for congressional hearings on the whole issue of military medicine and torture immediately. “I am very upset that the American public, but particularly, the U.S. Congress has failed to look into this disgraceful behavior by our military medical providers. Our soldiers deserve better.”

Indeed they do.

ã 2006 Dave DeBatto