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The role of doctors in torture: from middle age to Abu Ghraib

International Politics volume 59, pages 1065–1081 (2022)Cite this article

Abstract

Torture is a practice as old as humanity itself, although its objectives have changed throughout history. The participation of medical personnel in the exercise of torture has been common in some historical moments. During the middle ages, torture was the instrument used by justice to obtain confessions, but doctors did not regularly participate in it. For the first time, the Constitutio Criminalis Carolina (1532) is the body of laws that requires the official presence of a doctor in the torture sessions, acting as another judicial official. The twentieth century represented a drastic change in the role of the health professional in relation to torture, who began to play an active part in this process. Torture methods changed drastically, going from the classic methods of inflicting physical pain, to other more modern methods, in which psychological and psychiatric techniques and psychotropics predominate. The Nazi doctors applied mind control techniques with psychotropic drugs to prisoners. In dictatorial countries, such as the former Soviet Union and China, punitive psychiatry was used to punish political dissidents, and in the South American dictatorships, doctors actively collaborated in the exercise of physical torture. The paradigm of torture changed with the events of Abu Ghraib, and the use of torture was justified by the democratic authorities as a war weapon against terrorism. To avoid the participation of health professionals in torture, additional actions are required, such as promoting extra ethical training in doctors, and close monitoring for compliance with all international covenants, agreements and treaties against torture.

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Abbreviations

APA:

American Psychological Association

CIA:

Central Intelligence Agency

CPSU:

Communist Party of the Soviet Union

DINA:

National Intelligence Directorate

HRW:

Human Rights Watch

UN:

United Nations

References

  • Alloza, A. 2000. La vara quebrada de la justicia. Madrid: Los libros de la Catarata.

    Google Scholar 

  • Alonso, M.P. 1982. El proceso penal en Castilla (Siglos XIII-XVIII). Salamanca: Ediciones Universidad de Salamanca.

    Google Scholar 

  • Amnesty International. 2021. https://www.amnesty.org/en/what-we-do/torture/.

  • Appelbaum, P. 2001. Abuses of law and psychiatry in China. Psychiatric Services 52: 1294–1298.

    Article  Google Scholar 

  • Basoglu, M., M. Livanou, and C. Crnobaric. 2007. Torture vs. other cruel, inhuman, and degrading treatment: Is the distinction real or apparent? Archives of General Psychiatry 64: 277–285.

    Article  Google Scholar 

  • Bleckwenn, W.J. 1930. Narcosis as therapy in neuropsychiatric conditions. JAMA 95: 1168–1171.

    Article  Google Scholar 

  • Bloch, S. 1991. Political misuse of psychiatry in the Soviet Union. In Psychiatric ethics, 2nd ed., ed. S. Bloch and P. Chodoff, 493–517. Oxford: Oxford University Press.

    Google Scholar 

  • Bloche, M.G. 1986. Uruguay’s military physicians. Cogs in a system of state terror. JAMA 255(20): 2788–2793.

    Article  Google Scholar 

  • Bloche, M.G., and J.H. Marks. 2005a. Doctors and interrogators at Guantanamo bay. New England Journal of Medicine 353(1): 3–6.

    Article  Google Scholar 

  • Bloche, M.G., and J.H. Marks. 2005b. When doctors go to war. New England Journal of Medicine 353(1): 6–8.

    Article  Google Scholar 

  • Boccia, A., C. Portillo, and C. Arestivo. 2006. Médicos, ética y tortura en el Paraguay. Asunción: Arandura Editorial.

    Google Scholar 

  • Bukovsky, V., and Gluzman, S. 1974. A manual of psychiatry for dissenters. https://static1.squarespace.com/static/57798b38414fb50acf42cc9b/t/57999a6bf7e0ab03ddd9d351/1469684460903/A+Manual+on+Psychiatry+for+Dissenters.pdf.

  • Chodoff, P. 1974. Involuntary hospitalization of political dissenters in the Soviet Union. Psychiatric Opinion 11: 5–19.

    Google Scholar 

  • Chodoff, P. 2001. Mal uso y abuso de la psiquiatría: Visión general. In La ética en psiquiatría, ed. S. Bloch, P. Chodoff, and S.A. Green, 63–66. Madrid: Editorial Triacastela.

    Google Scholar 

  • Cuerda, E. 2018. Medicina y Totalitarismos. In Un ensayo sobre los totalitarismos, nacionalismos y populismos, ed. F. Navarro, G. Sichar, E. Cuerda, and E.D. Nihilista, 413–441. Ultima Línea: Málaga.

    Google Scholar 

  • Di Cesare, D. 2016. Tortura. Barcelona: Gedisa.

    Google Scholar 

  • Eitinger, L. 1991. Torture - A perspective on the past. Journal of Medical Ethics 17(Suppl): 9–10.

    Article  Google Scholar 

  • Escudero, J.A. 2005. Estudios sobre la Inquisición, 31. Segovia: Marcial Pons Historia.

    Google Scholar 

  • Fiorelli, P. 1953. La tortura giudiziaria nel diritto comune. Milan: Giuffrè.

    Google Scholar 

  • Foucault, M. 1979. Discipline and punish: The birth of the prison. New York: Vintage Books.

    Google Scholar 

  • Friedlander, H. 1995. The origins of Nazi genocide: From euthanasia to the Final Solution. Chapel Hill: University of North Carolina Press.

    Google Scholar 

  • Gluzman, S. 1991. Abuse of psychiatry: Analysis of the guilt of medical personnel. Journal of Medical Ethics 17(Suppl): 19–20.

    Article  Google Scholar 

  • Human Rights Watch. 2002. China: End political abuse of psychiatry. World Psychiatric Association Should Act in Yokohama. http://www.hrw.org/press/2002/08/china081302.htm.

  • Iacopino, V., and Xenakis, S.N. 2011 Neglect of medical evidence of torture in Guantanamo bay: A case series. PLoS Medicine 8: e1001027.

  • Innocent IV, Pope. 1252. Decretal Ad extirpanda.

  • Jadresic, A. 1980. Doctors and torture: An experience as a prisoner. Journal and Medical Ethics 6: 124–127.

    Article  Google Scholar 

  • Kamen, H. 2013. La Inquisición Española: Mito e Historia. Barcelona: Editorial Crítica.

    Google Scholar 

  • Kirschner, R.H. 1984. The use of drugs in torture and human rights abuses. American Journal of Forensic Medicine and Pathology 5: 312–315.

    Article  Google Scholar 

  • KUBARK Counter Intelligence Interrogation. 1963. https://nsarchive2.gwu.edu/NSAEBB/NSAEBB27/docs/doc01.pdf.

  • Lee, M., and B. Shlain. 1985. Acid dreams: The complete social history of LSD: The CIA, the sixties, and beyond. New York: Grove Press.

    Google Scholar 

  • Lehmann, H.E. 1993. Before they called it psychopharmacology. Neuropsychopharmacology 8: 291–303.

    Article  Google Scholar 

  • Lifton, R.J. 1986. The Nazi doctors: Medical killing and the psychology of genocide. New York: Basic Books.

    Google Scholar 

  • Lifton, R.J. 2004. Doctors and torture. New England Journal of Medicine 351(5): 415–416.

    Article  Google Scholar 

  • López-Muñoz, F., and C. Álamo. 1998. Historia de la Neuropsicofarmacología Una nueva aportación a la terapéutica farmacológica de los trastornos del Sistema Nervioso Central. Madrid: Ediciones Eurobook, S.L. and Servicio de Publicaciones de la Universidad de Alcalá.

    Google Scholar 

  • López-Muñoz, F., C. Álamo, and E.F. Domino. 2014. History of psychopharmacology. Arlington: NPP Books.

    Google Scholar 

  • López-Muñoz, F., C. Álamo, M. Dudley, G. Rubio, P. García-García, J.D. Molina, and A. Okasha. 2007. Psychiatry and political-institutional abuse from the historical perspective: The ethical lessons of the Nuremberg Trial on their 60th anniversary. Progress in Neuro-Psychopharmacology and Biological Psychiatry 31: 791–806.

    Article  Google Scholar 

  • López-Muñoz, F., C. Álamo, P. García-García, J.D. Molina, and G. Rubio. 2008. The role of psychopharmacology in the medical abuses of the Third Reich: From euthanasia programmes to human experimentation. Brain Research Bulletin 77: 388–403.

    Article  Google Scholar 

  • López-Muñoz, F., C. Álamo, and N. Martínez Morán. 2020. El papel de los médicos en la tortura: La Psicofarmacología como herramienta de abuso de poder. In Cuando la Medicina no cura. La participación del personal sanitario en torturas, genocidios y experimentos al margen de los códigos éticos, 2nd ed., ed. E. Cuerda and F. López-Muñoz, 169–202. Madrid: Delta Publicaciones.

    Google Scholar 

  • López-Muñoz, F., C. Álamo, R. Ucha-Udabe, and E. Cuenca. 2004. El papel histórico de los barbitúricos en las curas de sueño de los trastornos psicóticos y maníacos. Psiquiatría Biológica 11: 242–251.

    Google Scholar 

  • López-Muñoz, F., and E. Cuerda-Galindo. 2016. Suicide in inmates in Nazis and Soviet concentration camps: Historical overview and critique. Frontiers in Psychiatry 7: 88. https://doi.org/10.3389/fpsyt.2016.00088.

    Article  Google Scholar 

  • López-Muñoz, F., E. Cuerda-Galindo, and M. Krischel. 2017. Study of deaths by suicide in the Soviet Special Camp Number 7 (Sachsenhausen), 1945–1950. Psychiatric Quarterly 88: 93–101.

    Article  Google Scholar 

  • López-Muñoz, F., R. Ucha-Udabe, and C. Álamo. 2005. The history of barbiturates a century after their clinical introduction. Neuropsychiatric Diseases and Treatment 1: 329–343.

    Google Scholar 

  • Lucius II, Pope. 1184. Decretal Ad abolendam diversarum haeresium pravitatem.

  • Maio, G. 2001. History of medical involvement in torture-then and now. Lancet 357(9268): 1609–1611.

    Article  Google Scholar 

  • Mallor, A. 1960. La Tortura. Buenos Aires: Editorial Sophos.

    Google Scholar 

  • Marco Igual, M. 2020. El abuso político de la psiquiatría soviética. Una mirada desde el siglo XXI. In Cuando la Medicina no cura. La participación del personal sanitario en torturas, genocidios y experimentos al margen de los códigos éticos, 2nd ed., ed. E. Cuerda and F. López-Muñoz, 259–317. Madrid: Delta Publicaciones.

    Google Scholar 

  • Martirena, G. 1991. The medical profession and torture. Journal of Medical Ethics 17(Suppl): 23–25.

    Article  Google Scholar 

  • McCoy, A.W. 2012. Torture and impunity: The U.S. doctrine of coercive interrogation. Critical human rights. Madison: The University of Wisconsin Press.

    Google Scholar 

  • McCullough, J. 2014. 24 (TV Milestones Series). Detroit: Wayne State University Press.

    Google Scholar 

  • Melgares, J. 1886. Procedimientos de la Inquisición, 108. Madrid: Editorial León Pablo Villaverde.

    Google Scholar 

  • Miles, S.H. 2004. Abu Ghraib: Its legacy for military medicine. Lancet 364(9435): 725–729.

    Article  Google Scholar 

  • Munro, R. 2002a. Political psychiatry in post-Mao China and its origins in the cultural revolution. Journal of the American Academy of Psychiatry and the Law 30: 97–106.

    Google Scholar 

  • Munro, R. 2002b. On the psychiatric abuse of Falun Gong and other dissenters in China: A reply to Stone, Hickling, Kleinman, and Lee. Journal of the American Academy of Psychiatry and the Law 30: 266–274.

    Google Scholar 

  • NSAEBB. 1963. https://nsarchive2.gwu.edu/NSAEBB/NSAEBB27/docs/doc01.pdf.

  • Beecher HK Papers. 1945. Countway Library HMS Boston H MS c 64 Series V.A. Ethical Subjects, Human Experimentation.

  • Perechocky, A. 2014. Los torturadores médicos: Medical collusion with human rights abuses in Argentina, 1976–1983. Journal of Bioethic Inquiry 11: 539–551.

    Article  Google Scholar 

  • Peters, E. 1985. Torture. New York: Basil Blackwell.

    Google Scholar 

  • Podrabinek, A. 1980. Punitive Medicine. Ann Arbor: Karoma Publishers.

    Google Scholar 

  • Rafecas, D. 2015. El crimen de tortura en el estado autoritario y en el estado de derecho. Buenos Aires: Ediciones Didot.

    Google Scholar 

  • Riquelme, H. 2001. Asedios a la memoria: La experiencia de psicólogos bajo las dictaduras militares en América de Sur. Santiago de Chile: Ediciones Chile América CESOC.

    Google Scholar 

  • Riquelme, H. 2002. Ética médica en tiempos de crisis: Los médicos y las dictaduras militares en América del Sur. Santiago de Chile: Ediciones Chile América CESOC.

    Google Scholar 

  • Scott, G.R. 1959. The history of torture throughout the ages. London: Luxor.

    Google Scholar 

  • Senkmann, L. 2020. Tortura y participación médica en la represión durante la última dictadura militar en Chile y Argentina: Una comparación preliminar. In Cuando la Medicina no cura. La participación del personal sanitario en torturas, genocidios y experimentos al margen de los códigos éticos, 2nd ed., ed. E. Cuerda and F. López-Muñoz, 357–374. Madrid: Delta Publicaciones.

    Google Scholar 

  • Sontag, S. 2004. Regarding the torture of others. New York Times Magazine May 23: 25–29.

    Google Scholar 

  • Spencer, I. 2000. Lessons from history: The politics of psychiatry in the USSR. Journal of Psychiatric and Mental Health Nursing 7: 355–361.

    Article  Google Scholar 

  • Sterkowicz, S., and S.S. Lekarz. 1988. Kurt Friedrich Plötner, eksperymentator w Dachau. Przeglad Lekarski 45: 73–78.

    Google Scholar 

  • Tomás y Valiente, F. 2000. La tortura judicial en España. Barcelona: Editorial Crítica.

    Google Scholar 

  • U.S. Naval Technical Mission in Europe. 1945. Technical report no. 331-45: German aviation medical research at the Dachau concentration camp (Oct. 1945). Harvard Medical Library in the Francis A. Countway Library of Medicine.

  • United Nations Human Rights Office of the High Commissioner. 1984. Convention against torture and other cruel, inhuman or degrading treatment or punishment. Adopted and opened for signature, ratification and accession by General Assembly Resolution 39/46 of 10 December 1984. Entered into force 26 June 1987. https://www.ohchr.org/en/professionalinterest/pages/cat.aspx.

  • Vallejo Nájera, A. 1938. Biopsiquismo del fanatismo marxista. Revista Española de Medicina y Cirugía de Guerra 3: 189–195.

    Google Scholar 

  • Vallejo Nájera, A. 1939. Psiquismo del fanatismo marxista. Grupo de internacionales Norteamericanos. Revista Española de Medicina y Cirugía de Guerra 5: 30–44.

    Google Scholar 

  • van Voren, R. 2010. Political abuse of psychiatry. An historical overview. Schizophrenia Bulletin 36: 33–35.

    Article  Google Scholar 

  • Vesti, P., and N.J. Lavik. 1991. Torture and the medical profession: A review. Journal of Medical Ethics 17(Suppl): 4–8.

    Article  Google Scholar 

  • von Weber, H. 2005. La “Constitutio Criminalis Carolina” de 1532. Cuadernos de Política Criminal 86: 125–137.

    Google Scholar 

  • Welsh, S., and M.P. Deahl. 2002. Modern psychiatric ethics. Lancet 359: 253–255.

    Article  Google Scholar 

  • Windholz, G., and L.H. Witherspoon. 1993. Sleep as cure for schizophrenia: A historical episode. History of Psychiatry 4: 83–93.

    Article  Google Scholar 

  • World Medical Association. Declaration of Tokyo. 1975. https://www.wma.net/policies-post/wma-declaration-of-tokyo-guidelines-for-physicians-concerning-torture-and-other-cruel-inhuman-or-degrading-treatment-or-punishment-in-relation-to-detention-and-imprisonment/.

  • Zimbardo, P. 2012. El efecto Lucifer: El porqué de la maldad. Barcelona: Editorial Paidós.

    Google Scholar 

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Authors and Affiliations

  1. Research Center On Totalitarianisms and Authoritarian Movements (CITMA), Madrid, Spain

    Esther Cuerda-Galindo

  2. Faculty of Health, University Camilo José Cela, C/Castillo de Alarcón, 49, Villanueva de la Cañada, 28692, Madrid, Spain

    Francisco López-Muñoz

  3. Hospital 12 de Octubre Research Institute (I+12), Madrid, Spain

    Francisco López-Muñoz

Authors
  1. Esther Cuerda-Galindo
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  2. Francisco López-Muñoz
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Correspondence to Francisco López-Muñoz.

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Torture is the only illness created by man for man.

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Cuerda-Galindo, E., López-Muñoz, F. The role of doctors in torture: from middle age to Abu Ghraib. Int Polit 59, 1065–1081 (2022). https://doi.org/10.1057/s41311-021-00339-8

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Keywords

  • Torture
  • Doctors
  • Ethics
  • History