Doctors Who Torture

Buenos Aires

Last July at the Libertad (Freedom) prison in Uruguay was unusual. Miguel Angel Estrella, an Argentine pianist (and now Argentina’s Ambassador to UNESCO), was giving a concert in the same prison where he had been imprisoned and tortured 32 years earlier.

He dedicated the concert to the 50 inmates currently imprisoned. After he was liberated, Estrella had testified against Dolcey Britos, a psychologist who had masterminded the psychological torture of prisoners at Libertad.

Estrella was liberated thanks to an unprecedented international campaign on his behalf. A friend since my youth, he told me in New York about the ordeal he went through while he was a prisoner in Uruguay. A professional pianist, he was subjected to a most unusual and frightening punishment. He was beaten repeatedly on his hands and threatened with amputation, a spiritual death for a pianist.

He told me: “They [the torturers] concentrated on my hands like sadists. They applied electricity under my nails, without stopping and later they hung me from my arms. After two days of torture I hurt all over, and didn’t have any sensation left in my hands. I touched things and didn’t feel anything.

“The last time I was tortured they threatened to cut off my hands with an electric saw, saying, ‘We are going to chop off your hands, finger by finger, and then we are going to kill you, as the Chileans killed Víctor Jara [a famous Chilean folk singer and guitar player who was killed after being tortured, his hands repeatedly smashed before his death]‘.”

The goal of Estrella’s torture was to break him psychologically, to destroy his self-esteem and his hope. Such a carefully orchestrated torture raises the question of how health professionals — including psychologists and psychiatrists — could have participated in it.

When questioned by Dr. Maxwell Gregg Bloche, an American physician and lawyer who investigated the role of Uruguayan military physicians for the American Association for the Advancement of Science, Britos claimed that his role was only that of “diagnostic consultant” to the psychiatrist in the prison.

Estrella, despite all his suffering, was lucky. He survived and is now an internationally known pianist, humanitarian and Argentina’s Ambassador to UNESCO. This is not the case for thousands who are still tortured while in prison, in some cases with the collusion of medical personnel.

It is now known that both German and Japanese doctors killed thousands of people under the excuse that they were conducting medical research. The Nuremberg tribunal of war crimes brought to trial 23 German defendants, some of them physicians, who were accused of crimes involving experimentation on human subjects.

Aside from using human beings to conduct experiments, there are several ways in which medical personnel participate in torture. They range from assessing the prisoner’s health status before initiating torture to determining how much longer it is possible to continue with torture without endangering the prisoners’ survival.

It also involves reviving prisoners who have been made unconscious by pain and punishment, and actively participating in the interrogation process. That professionals who are trained to do everything in their power to alleviate suffering would instead contribute to carrying out torture is one of the most tragic perversions of the medical mandate.

It is a fundamental problem in medical ethics. In the case of physicians, their participation in torture is one of most blatant violations of basic tenets established some 2,500 years ago by Hippocrates.

What is the psychology behind doctors’ participation in torture?

Richard Goldstein and Patrick Breslin offered one explanation: “Most physicians involved in torture seem to be caught up in vast government machines and descend gradually into the torture chamber, propelled by a combination of fear, weakness and self-delusion that is all too depressingly human.”

Norberto Liwsky, an Argentine physician who had been abducted by the Argentine military and who was tortured with the complicity of a medical colleague named Héctor Jorge Vidal, told me, “No one participates in torture without first going through a process of justifying unethical values, even before he enters the torture chamber.”

Whatever the explanation, however, it doesn’t diminish its terrible consequences or the horror of the act itself. Medical associations worldwide need to be more vocal in their condemnation if this sad phenomenon has the possibility of being eliminated.

Dr. César Chelala is an international public health consultant and a co-winner of an Overseas Press Club of America award.

This article is timely as it can be seen in the broader context of the Indian state. Here is an excerpt from the Asian Human Rights Commission:

Torture in India

India has not ratified the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, but has signed the Convention on 14 October 1997. A draft Bill against torture is in consideration by the government.
On the existing domestic law:

Torture is not criminalised in law as a separate or special offense. Provisions in the Indian Penal Code, 1860 (sections 330 & 348) penalises acts that can also be considered as torture, with seven and three years of imprisonment respectively if proven guilty. But the offense attracts no particular relevance if the crime is committed by a police officer. The temporal treatment of the law is to deal with a regular offense. The two provisions also falls short of covering all aspects of torture, as defined in the Convention against Torture.

In addition, the reduced possibility of a proper forensic medical examination of a victim and the complete absence of a witness protection mechanism facilitates easy acquittal of the criminal. The Indian Evidence Act, 1872 also does not have any provisions in dealing with the aspect of torture.
On compensation:

An act of torture, if proved, does not require the perpetrator to pay compensation to the victim. The right against torture is not a fundamental right. The courts in India, thus far have taken a minimalistic view on compensatory claims concerning acts of torture. A claim for compensation is dealt within the realm of personal injury claims. Awards of compensation vary widely from court to court throughout the country.
On witness protection:

There is no specific law concerning witness protection in India. The only possible measure is for the court to impose a condition at the time of considering a bail application. The usual practice is to impose conditions like the accused shall not interfere with the witness or the evidence in the case. But there is no safe and watertight framework within which compliance to these conditions could be guaranteed. It is a common practice in India for the accused to try to threaten the witnesses and or tamper with the evidence in a case.
The magnitude of the problem:

Torture is practiced as a routine and accepted as a means for investigation. Most police officers and other law enforcement officers consider torture as an essential investigative tool, rather than an unscientific and crude method of investigation. Policy makers and bureaucrats believe that there is nothing wrong in punishing a criminal in custody, not realising the fact that a person under investigation is only an accused, not a convict and further, that even a convict cannot be tortured. This is due to the lack of awareness about the crime, its nature and about its seriousness. Torture is practiced by the all sections of the law enforcement agencies, the paramilitary and military units. Torture, as a form of violence is used for social control.

Trauma from torture affects an individual’s capacity to act prudently and further to respond normally to incidents. Torture — metal or physical or a combination of both — is practiced in every police station (12,441 police stations in the country). Given the fact that a victim of torture and a witness — which includes the perpetrator, since the perpetrator is also a witness — suffers from mental trauma from an act of torture, arguably, the police stations in the country are manned by individuals suffering from mental trauma associated with torture.

Concern regarding the widespread use of torture in India has been expressed by domestic as well as international experts, particularly the thematic mandate holders under the UN framework. The National Human Rights Commission of India has repeatedly recommended to the Government of India to ratify the Convention against Torture and to criminalise the act of torture in the country. The Commission said “[d]aily the Commission receives petitions alleging the use of torture, and even of deaths in custody as a result of the acts of those who are sworn to uphold the laws and the Constitution and to ensure the security of its citizens. Such a situation must end, through the united efforts of the Government…”

As early as 1981, the Supreme Court of India has said “…[n]othing is more cowardly and unconscionable than a person in police custody being beaten up and nothing inflicts deeper wound on our constitutional culture than a state official running berserk regardless of human rights” Kishore Singh V. State of Rajastan (AIR 1981 SC 625).

The UN Human Rights Committee as early as 1997 has expressed its concern about the widespread use of torture by the law enforcement agencies in India. (CCPR/C/79/Add.81). Similar concerns were expressed by the Committee on Elimination of Racial Discrimination (CERD/C/IND/CO/19) in 2007 and theCommittee on Economic Social and Cultural Rights (E/C.12/IND/CO/5) in 2008.