Intended for healthcare professionals

Analysis Assessing torture

Interrogating the role of mental health professionals in assessing torture

BMJ 2010; 340 doi: (Published 29 January 2010) Cite this as: BMJ 2010;340:c124
  1. Derrick M Silove, professor of psychiatry,
  2. Susan J Rees, Queen Elizabeth 2nd Australian Research Council fellow
  1. 1School of Psychiatry, University of New South Wales, Australia
  1. Correspondence to: d.silove{at}
  • Accepted 24 December 2009

Derrick M Silove and Susan J Rees ask whether there is any scientific foundation for mental health professionals to claim special expertise in judging the so called torture threshold or in predicting the long term psychiatric outcomes of interrogation practices

Contemporary history is replete with accounts of health professionals being complicit in torture.1 The so called war on terror has shown how established ethical prohibitions against such involvement can be eroded when there is a real or perceived threat to a nation.2 Although torture occurs in more than a third of countries,3 until recently, it was assumed that it was confined to nations governed by regimes with scant regard for human rights. The war on terror marked a historical shift, with US military personnel being implicated in torture carried out in detention centres.4 5 Despite doctors and other medical workers being prohibited from participating in torture—for example, in the World Medical Association’s Declaration of Tokyo (1975)—overwhelming evidence has emerged that during the war on terror, doctors and psychologists were instrumental in advising on “enhanced interrogation techniques” that are known to have included torture.5

Health professionals in the interrogation room

How did mental health professionals become willing to participate in torture? The repeated reference to the psychological domain made in definitions of torture may have set the stage. The US Senate’s definition of torture referred to “severe physical or mental pain or suffering resulting in prolonged mental harm.”6 Later, during the war on terror, the US Office of Legal Council gave further weight to the psychological response to interrogation as a criterion for …

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