Certifying fitness for corporal punishment

Junior doctors seeking work experience abroad can find themselves in difficult situations. Here one doctor, who was working in rural Africa, describes what he did when he was asked to certify that a young man was medically fit for a beating. A philosopher, a psychiatrist, and a representative from Amnesty International give their views.

White lies

The BMJ issue highlighting the problems of torture brought back memories of my own relatively minor experience. Before completing my hospital training in England I took some time out to work in a remote African hospital. My role included that of local police surgeon. I remember a young boy, probably in his teens, being brought to me by the police. I forget what he was accused of, but the punishment was to be a beating with a stick. As police surgeon I was required to sign a document certifying that he was fit enough to receive the punishment. It seemed very barbaric and he looked very frightened, but my inadequacy with the language and the presence of two policemen made it impossible to find out his views on the issue.

I was in a dilemma. On one hand, I could not let the boy go through this brutal punishment as it went against what I considered right, and I felt that by signing the piece of paper I would be condoning the action; on the other hand, I could not show disrespect for local law.

In the end I listened to his chest and lied. I said that he had a chest infection and was not fit enough to be beaten. The young man received a course of unnecessary amoxicillin and—I hope, although I cannot be sure—no beating. Nor can I be certain what the alternative punishment was … probably some time in jail. I wonder which …