From reviewing various blog posts we seem to agree that torture is never justifiable, which is a position I agree with.

Unfortunately it seems that some medical professionals do not agree and are even prepared to use their skills to assist in interrogation (see NY Times article on a Red Cross report into the CIA interrogation of suspected terrorists). It is unclear from this report whether any of these medical professionals were physiotherapists. It is not impossible to believe that a physiotherapist was involved. If this were the case do you feel that such a physiotherapist should be punished by your professional body?

I also found this philosophical discussion of the ethics of medical involvement in torture very interesting in its exploration of the definition of torture which helps clarify that normal physiotherapy treatment shouldn’t be considered torture… however are there circumstances where this definition may apply? e.g. the treatment of an uncooperative elderly patient?

“Torture is the deliberate infliction of pain or other severe distress by one sentient being on another who is in captivity and involves using that being as a means to an end to which the being has not consented”

This paper also raises 3 ways in which the medical professional may be involved

(a) he attempts to heal the victims of torture;
(b) he himself engages in torture either by advising or by actually carrying it out;
(c) he examines possible victims knowing or suspect-ing that torture will follow.

There may be ways of involvement which we can justify such as option A and others ways of involvement which are less clear cut such as option C. A potential scenario for option C for a physiotherapist could be where you are asked to examine a prisoner to determine whether they could weight bear on an injured leg, where you suspect that enforced standing could then be utilised as a torture technique. In such circumstances what would you do?  Do you diagnose that the prisoner could not weight bear even when your professional opinion would be that they could?


5 thoughts on “Torture

  1. That’s a great post, Tony, and the links are really interesting, thank you.
    To answer the question you pose in your final paragraph, I find that my instinct in this circumstance is to tell a blatant untruth and make the (erroneous) clinical judgement that the prisoner is unable to weight-bear; I somehow can’t square it with my conscience to do otherwise…
    And your earlier point about consent and physiotherapy is certainly valid: if someone has a brain injury which affects their judgement and decision-making, then informed consent is a perplexing concept. But I for one certainly want them to be able to benefit from physiotherapy, even though they may want to take the easy route of doing nothing.

  2. Pingback: Week 4: Reflection | Chantelle van den Berg

  3. Hi Tony. Thanks for highlighting yet another way to think about this topic. To be honest, I hadn’t really explored the scope of medical complicity in torture. When reading the 3 points you take from the paper, I was tempted to extrapolate from this specific instance and look for a general principle that might go something like: “How far would you go towards challenging an authority that doesn’t have your patient’s best interests at heart”?

    What do you think?

  4. Hi Michael, Interesting principle… I guess this goes back to our earlier discussions on morality and the concept of moral courage. I guess it would also depend on the degree to which you feel the patient’s best interests are being compromised. e.g. you may be prepared to accept a limit on the number of treatment sessions imposed by your employer even though you know that more sessions would result in a better outcome…. but not being allowed to offer an expensive treatment technique because of the age or life style of a patient… more tricky I imagine!

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