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Lawyers will appeal ruling that cleared Guantanamo doctor of ethics violations

BMJ 2005; 331 doi: http://dx.doi.org/10.1136/bmj.331.7510.180-b (Published 21 July 2005) Cite this as: BMJ 2005;331:180
  1. Janice Hopkins Tanne
  1. New York

    Lawyers representing four Yemeni detainees at the US Guantánamo naval base in Cuba have said that they would appeal a ruling of the Medical Board of California. The board dismissed a complaint made on behalf of the detainees against John Edmondson, who is the US army doctor in charge of medical care at the base. More than 500 detainees are being held there.

    Doctors who serve in the US military must hold valid state licences, as Dr Edmondson does in California. State boards have responsibility for investigating allegations of unprofessional conduct.

    Lawyers for the international firm of Allen & Overy, working pro bono, complained to the medical board about Dr Edmondson, who is commander of the US Navy Hospital at Guantánamo. They alleged that Dr Edmondson and the personnel he supervised engaged in conduct that might be in violation of medical ethics and that was “unprofessional” as defined by the California Medical Practice Act.

    In their complaints, the detainees said that personal medical information had been shared with interrogators, they had been refused necessary medical attention until they cooperated with interrogators, medical personnel had participated actively and passively in physical abuse, and medical personnel had failed to provide basic consideration to patients in providing medical care. They also said that information about their medical conditions was given to behavioural scientists working with the interrogation teams.

    Candis Cohen, spokeswoman for the medical board, said, “The board has reviewed and closed this complaint because no evidence was found by the [army] surgeon general of medical mistreatment of the patients. Therefore the medical board cannot take any action because we have no jurisdiction to take action against a military physician practising on a military base, absent an action first by the military itself.”

    The army's surgeon general, Kevin Kiley, reviewed and approved the findings and recommendations of a team investigating medical operations on detainees at Guantánamo and at US facilities in Afghanistan and Iraq. The team found “a dedicated and committed cadre of medical personnel whose goal and desire were to provide high quality health care for each patient they treated, regardless of status. While medical personnel faced numerous challenges in a stress-filled environment, the interviewees continually described the compassionate and dedicated care they provided to detainees.” However, lawyers for the Yemeni detainees claim that the investigation did not investigate or interview the detainees but relied on a questionnaire of medical personnel in Cuba, Iraq, and Afghanistan.

    Reports that military interrogators at Guantánamo Bay have used aggressive measures to question detainees have appeared in the New England Journal of Medicine (2005;353:6-8), the Lancet (2004;364:1851), and the New York Times (www.nytimes.com, 15 Jul, “Head of hospital at Guantánamo faces complaint”).

    According to the law firm's complaint, a representative of the International Committee of the Red Cross met representatives of the US Department of Defense's task force for Guantanamo Bay in October 2003 and discussed isolation in cage type cells and the effect on detainees' mental health of controls on their basic needs. The Red Cross representative also complained that a link existed between the interrogation team and the medical team—a breach of confidentiality.

    This week Lieutenant Commander Chris Loundermon, spokesman for the US Southern Command, which controls US operations in the Caribbean and South America, said that the command “operates a safe, humane, and professional detention centre at Guantanamo” and that “all detainees are treated humanely and to the extent appropriate and consistent with military necessity in accordance with the Third Geneva Convention of 1949.”

    In a press conference Dr Kiley stressed that medical personnel were entirely separate from “behavioural science consultation teams” who advised interrogators on questioning detainees and that medical teams did not share information with them.

    Dr Kiley said in the press conference, “My sense is that interrogations that are safe, legal, and ethical within the confines of our operations—that medical advice and recommendations that are also safe, legal, and ethical—are probably appropriate. I would suggest that there are those who probably don't agree with that.”

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