Journal of Bioethical Inquiry

, Volume 13, Issue 3, pp 449–460 | Cite as

Why Did U.S. Healthcare Professionals Become Involved in Torture During the War on Terror?

  • Myles Balfe
Original Research


This article examines why U.S. healthcare professionals became involved in “enhanced interrogation,” or torture, during the War on Terror. A number of factors are identified including a desire on the part of these professionals to defend their country and fellow citizens from future attack; having their activities approved and authorized by legitimate command structures; financial incentives; and wanting to prevent serious harm from occurring to prisoners/detainees. The factors outlined here suggest that psychosocial factors can influence health professionals’ ethical decision-making.


Doctor Deviance Torture War on terror Psychologist Healthcare professional 



I would like to thank the three reviewers for their very helpful and constructive comments.


  1. Adams, G., D. Balfour, and G. Reed. 2006. Abu Ghraib, administrative evil and moral inversion: The value of putting cruelty first. Public Administration Review 66(5): 680–693.CrossRefGoogle Scholar
  2. Aradau, C., and R. Van Munster. 2007. Governing terrorism through risk: Taking precautions, unknowing the future. European Journal of International Relations 13(1): 89–115.CrossRefGoogle Scholar
  3. Bandura, A. 2002. Selective moral disengagement in the exercise of moral agency. Journal of Moral Education 31(2): 101–119.CrossRefGoogle Scholar
  4. Beck, J. 2014. Do no harm: when doctors torture. The Atlantic, December 12. Accessed October 1, 2015.
  5. Blass, T. 1999. The Milgram Paradigm after 35 years: Some things we now know about obedience to authority. Journal of Applied Social Psychology 29(5): 5955–5978.CrossRefGoogle Scholar
  6. Bufacchi, V., J. and Arrigo. 2006. Torture, terrorism and the state: A refutation of the ticking-bomb argument. Journal of Applied Philosophy 23(3): 355–373.Google Scholar
  7. Bush, G. 2001. Text of Bush’s act of war statement. BBC News, September 12. Accessed October 1, 2015.
  8. Calkins, L. 2010. Detained and drugged: A brief overview of the use of pharmaceuticals for the interrogation of suspects, prisoners, patients and POWs in the US. Bioethics 24(1): 27–34.CrossRefPubMedGoogle Scholar
  9. Crelinsten, R. 2003. The world of torture: A constructed reality. Theoretical Criminology 7(3): 293–318.CrossRefGoogle Scholar
  10. Gawande, A. 2006. When law and ethics collide-why physicians participate in executions. New England Journal of Medicine 354(12): 1221–1229.CrossRefPubMedGoogle Scholar
  11. Godlee, F. 2009. Rules of conscience. British Medical Journal 338: 7704.Google Scholar
  12. Grodin, M., and G. Annas. 2007. Physicians and torture: Lessons from the Nazi doctors. International Review of the Red Cross 89(867): 635–654.CrossRefGoogle Scholar
  13. Hajjar, L. 2009. Does torture work? A sociolegal assessment of the practice in historical and global perspective. Annual Review of Law and Social Science 5: 311–345.CrossRefGoogle Scholar
  14. Haque, O., and A. Waytz. 2012. Dehumanization in medicine: Causes, solutions and functions. Perspectives on Psychological Science 7(2): 176–186.CrossRefPubMedGoogle Scholar
  15. Harrington, J. 2013. The faithful executioner. London: Picador.Google Scholar
  16. Harris, S. 2002. Factories of death: Japanese biological warfare, 1932-1945 and the American cover-up. London and New York: Routledge.CrossRefGoogle Scholar
  17. Hoffman, D., Carter D, Viglucci, C, Benzmiller, H, Guo, A, Latifi, S, Craig, D. 2015. Report to the special committee of the board of directors of the American Psychological Association independent review relating to APA ethics guidelines, national security interrogations and torture. Chicago and Washington DC: Sidley Austin. Accessed May 24, 2016.
  18. Hooks, G., and C. Mosher. 2005. Outrages against personal dignity: Rationalizing abuse and torture in the war on terror. Social Forces 83(4): 1627–1646.CrossRefGoogle Scholar
  19. IMAP/OSF. 2013. Ethics abandoned. Medical professionalism and detained abuse in the ‘War on Terror’. New York: Columbia University.Google Scholar
  20. Keller, A., S. Dougherty, S. Allen, et al. 2014. Doing Harm. Washington DC: Physicians for Human Rights. Accessed May 25, 2016.Google Scholar
  21. Kelman, H. 2005. The policy context of torture: A social-psychological analysis. International Review of the Red Cross 87(857): 123–134.CrossRefGoogle Scholar
  22. Koch, T. 2006. Weaponising medicine: ‘Tutti Fratelli’ no more. Journal of Medical Ethics 32(5): 249–255.CrossRefPubMedPubMedCentralGoogle Scholar
  23. Lifton, R. 1988. The Nazi doctors: Medical Killing and the psychology of genocide. New York: Basic Books.Google Scholar
  24. Lifton, R. 2004. Doctors and torture. New England Journal of Medicine 351(5): 415–416.CrossRefPubMedGoogle Scholar
  25. London, L. 2005. Dual loyalties and the ethical and human rights obligation of occupational health professionals. American Journal of Industrial Medicine 47(4): 322–332.CrossRefPubMedGoogle Scholar
  26. Luban, D. 2007. Commentary: Torture and the professionals. Criminal Justice Ethics 26(2): 2–66.CrossRefGoogle Scholar
  27. Marks, J. 2005. Doctors of interrogation. Hastings Center Report 35(4): 17–22.CrossRefPubMedGoogle Scholar
  28. Mayer, J. 2005a. Outsourcing torture: The secret history of America’s extraordinary rendition program. The New Yorker, February 14. Accessed October 1, 2015
  29. Mayer, J. 2005b. The experiment. The New Yorker, July 11. Accessed October 1, 2015.
  30. Mayer, J. 2007. The Black Sites. The New Yorker, August 13. Accessed October 1, 2015.
  31. Mayerfield, J. 2008. In defense of the absolute prohibition of torture. Public Affairs Quarterly 22(2): 109–128.Google Scholar
  32. Miles, S. 2004. Abu Ghraib: its legacy for military medicine. The Lancet 364(9435): 725–729.CrossRefGoogle Scholar
  33. Miles, S. 2015. Doctors who torture: the pursuit of Justice. Amazon Digital Services.Google Scholar
  34. Miles, S., T. Alencar, and B. Crock. 2010. Punishing physicians who torture: A work in progress. Torture 20(1): 23–31.PubMedGoogle Scholar
  35. Miller Z. (2014). Obama: ‘We tortured some folks’. Accessed May 25, 2016.
  36. Mostad, K., and E. Moati. 2008. Silent healers: On medical complicity in torture. Torture 18(3): 150–160.PubMedGoogle Scholar
  37. Olson, B., S. Soldz, and M. Davis. 2008. The ethics of interrogation and the American Psychological Association: A critique of policy and process. Philosophy, Ethics and Humanities in Medicine 3(1): 3.CrossRefGoogle Scholar
  38. Oskie, S. 2005. Glimpses of Guantanao—Medical ethics and the War on Terror. New England Journal of Medicine 353(24): 2529–2534.CrossRefGoogle Scholar
  39. Perechocky, A. 2014. Los torturadores Medicos: Medical collusion with human rights abuses in Argentina, 1976–1983. Bioethical Inquiry 11(4): 539–551.CrossRefPubMedGoogle Scholar
  40. Pont, J., H. Stover, and H. Wolf. 2012. Dual loyalty in prison health care. Health Policy and Ethics 102(3): 475–480.Google Scholar
  41. Pope, K., and T. Gutheil. 2009. Psychologists abandon the Nuremberg ethics: Concerns for detainee interrogations. International Journal of Law and Psychiatry 32(4): 161–166.CrossRefPubMedGoogle Scholar
  42. Pope, K. 2011. Are the American Psychological Association’s detainee interrogational policies ethical and effective? Journal of Psychology 219(3): 150–158.PubMedPubMedCentralGoogle Scholar
  43. Reis, A., L. Amowitz, L. Kushner, A. Kushner, M. Elahi, and V. Lacopino. 2004. Physician participation in human rights abuse in Southern Iraq. JAMA 291(12): 1480–1486.CrossRefPubMedGoogle Scholar
  44. Risen, J., and M. Apuzzo. 2014. C.I.A., on path to torture, chose haste over analysis. New York Times, December 15. Accessed October 1, 2015.
  45. Rubenstein, L., and S. Xenakis. 2010. Roles of CIA physicians in enhanced interrogation and torture of detainees. JAMA 304(5): 5569–5570.CrossRefGoogle Scholar
  46. Senate Select Intelligence Report (SSIR). 2014. Committee study of the Central Intelligence Agency’s detention and interrogation program. Washington DC: Senate Select Committee on Intelligence. Accessed May 25, 2016.Google Scholar
  47. Shane, S. 2009. 2 U.W. architects of harsh tactics in 9/11’s wake. New York Times, August 11. Accessed October 1, 2015.
  48. Singh, J. 2003. American physicians and dual loyalty obligations in the ‘war on terror.’. BMC Medical Ethics 4(1): 4.CrossRefPubMedCentralGoogle Scholar
  49. Slevin, P., and J. Stephens. 2004. Detainees’ medical files shared. Washington Post, June 10. Accessed October 1, 2015.
  50. Soldz, S. 2011. Fighting torture and psychologist complicity. Peace Review 23(1): 12–20.CrossRefGoogle Scholar
  51. Sonntag, J. 2008. Doctors involvement in torture. Torture 18(3): 161–175.Google Scholar
  52. Tyler, T. 2004. Enhancing police legitimacy. Annals of the American Academy of Political and Social Science 593(1): 84–99.CrossRefGoogle Scholar
  53. Vesti, P., and N. Lavik. 1991. Torture and the medical profession: A review. Journal of Medical Ethics 17(1): 4–8.CrossRefPubMedPubMedCentralGoogle Scholar
  54. Zagorin, A. 2006. At Guantanamo, dying is not permitted. Time, June 30.,8599,1209530,00.html. Accessed August 28 2015.
  55. Zernike, K. 2004. Only a few spoke up on abuse as many soldiers stayed silent. New York Times, May 22. Accessed October 1, 2015.
  56. Zimbardo, P. 2007. The Lucifer effect: Understanding how good people turn evil. London: Random House Trade Paperbacks.Google Scholar

Copyright information

© Journal of Bioethical Inquiry Pty Ltd. 2016

Authors and Affiliations

  1. 1.Department of SociologyUniversity College CorkCorkIreland

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