The Code is inadequate, insists Nimisha Patel

Historically, psychological knowledge and skills have been used in developing methods of torture, and have been shown to be used in interrogation for ‘national security’ purposes in Guantánamo, Abu Ghraib and elsewhere in the ‘war on terror’. In the current controversy about the involvement of health professionals in such interrogations, several professional health bodies have felt it necessary to make explicit their position on the matter.

Health professionals’ positions

The British Medical Association has stated unequivocally that there is no role for physicians in interrogations for national security.(1) Similarly, the Royal College of Psychiatrists(2) condemns psychiatric participation in the interrogation of detainees, whether in military or civilian settings, quoting the Surgeon General’s statement that ‘it is a gross contravention of medical ethics, as well as an offence under applicable international instruments and UK law for health personnel to engage, actively or passively, in acts which constitute participation in, complicity in, incitement to or attempts to commit torture or other cruel, inhuman or degrading treatment or punishment’.(3) Without publicly engaging in the debate, the BPS has published its first ever Declaration concerning torture (currently under revision).(4)

Whilst a step in the right direction, the question remains: what should the BPS do to prevent psychologists’ involvement in torture? The organisation might argue that its Declaration and its recently revised Code of Ethics and Conduct is sufficient. Rather than embark here on a detailed critique of these documents, it is important to examine their status.

Status of the Code

First, although the Declaration is an important statement, it has no legally or professionally binding authority. In short, it is a statement of good intent, and on its own, not an enforceable rule or standard.

Neither is the Code a set of rules, but a framework for ethical decision-making. It omits any mention of the legal status of torture; it fails to make explicit a health professional’s obligations in this matter under international law.

Torture and other forms of ill treatment are prohibited in international law and under customary international law. Thus, any complicity in torture, or an act of torture, whatever the form or circumstances, is a criminal act, and in some situations a crime against humanity.

The BPS fears that acknowledging obligations under international law in the Code would ‘legalise’ it. It would not; however, the acknowledgement would inform and protect the organisation as well as psychologists facing difficult decisions in the course of their work. Whilst psychologists may face disciplinary action if their conduct is in breach of the Code, they should be aware that if their conduct amounts to torture or other ill treatment, they may face criminal or civil prosecution too.

Ways forward

In meeting its public health obligation, the BPS needs an explicit organisational commitment to preventing torture by upholding and promoting standards in international law. This requires it to go beyond the current Declaration and Code by making explicit reference to obligations under international law within the Code. It should raise awareness within the psychological community about the legal obligations of psychologists, the relevant ethical rules and guidance already published, and the nature of torture, along with its health impact and the ineffectiveness of torture as a method in interrogations.

Clear mechanisms should be created to support those who may face difficulties (for example, with their employers) as a result of compliance with such ethical codes; and to those who wish to report breaches by others.

For effective implementation of the Code regarding torture, appropriate mechanisms should be ensured to investigate and punish relevant breaches, and to assist legal mechanisms for redress; and to make publicly available decisions made about such breaches.

Lastly, psychologists have a public health duty to inform policy makers of relevant psychological evidence on the harmful effects of torture and of its ineffectiveness as a method for obtaining reliable and valid information.

References

1. M Wilks (2005). A stain on medical ethics, Lancet, 366: 429-431
2. See Royal College of Psychiatrists press release.
3. Surgeon General (2005). Medical support to persons detained by UK forces whilst on operations. Surgeon General Policy Letter Number 01/05, London. 
4. BPS (2005). Declaration of the British Psychological Society concerning torture and other cruel, inhuman or degrading treatment or punishment. The Psychologist, vol. 18, no.4: p. 190.

Dr Nimisha Patel is Head of Clinical Psychology at the Medical Foundation for the Care of Victims of Torture, and Senior Lecturer in Clinical Psychology at the University of East London. She is the author of ‘Torture, Psychology and the “War on Terror”: A Human Rights Framework’, in R Roberts (ed)., Just War: Psychology, Terrorism and Iraq. Ross-on-Wye: PCCS books (in press).