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How Different Are the Associations’ Policies on Torture?

by John M. Grohol, Psy.D.
August 7, 2006

HungryBlues: Torture Experts Write APA Policy on Interrogations

HungryBlues states that both the American Medical Association and the American Psychiatric Association — two very large, prestigious associations of professionals within the U.S. — ban their members from participating in interrogations of detainees. But taking an actual look at the similarities and differences on their torture policies shows quite the opposite. Indeed, there appears to be little significant difference between the APA and AMA positions. The AMA states,

“Questions about the propriety of physicians participation in interrogations and in the development of interrogation strategies may be addressed by balancing obligations to individuals with obligations to protect third parties and the public.”

The APA article goes on to observe,

From rules that APA and AMA share comes what both associations allow: Psychologists and physicians may consult to interrogations under strict ethical guidelines—namely, that the interrogation is not coercive and that the roles of health-care provider and consultant are never mixed.

Specifically, the AMA states,

Physicians may consult to interrogations
by developing interrogation strategies that do not threaten or cause physical injury or mental suffering and that are humane and respect the rights of individuals.

while the APA states,

It is consistent with the APA Ethics Code for psychologists to serve in consultative roles to interrogation and information-gathering processes for national-security related purposes.

As you can see, those aren’t significantly different. Both associations prohibit their members from directly participating in interrogations.

The psychiatric association didn’t bother to elucidate a theoretical framework for their ethical stance, so their report on the matter is much briefer and focuses on simply “doing no harm.” (Psychiatrists appear to be less concerned about contributing to society as a whole by preventing harm.)

The summary from the APA article pretty much sums up the three associations’ positions:

[…T]he psychiatrists’ position statement is not “an ethical rule” and that a military psychiatrist following orders “wouldn’t get in trouble with the APA [American Psychiatric Association]” for participating in interrogations. This clarification from the president of the American Psychiatric Association places the psychiatric association alongside APA and AMA in terms of enforcement actions: Military psychologists, physicians and psychiatrists, following orders, abiding by clear prohibitions against coercive interrogations, acting strictly as consultants to interrogations and not as caregivers, and reporting coercive or abusive acts to the appropriate authorities, will not be subject to discipline from their professional associations.

So why does the HungryBlues blog article suggest that the three associations have completely different stances on this issue as a foundation for its argument that somehow the APA stance was formed solely because of the makeup of the members of the committee that helped formulate it?

Understanding how large organizations work sheds light on the APA’s committee choices. If you need to study and formulate a response to a situation in an organization, typically you assign a subgroup of people to work on it. Most people choose that subgroup of people based upon their experiences and background. You wouldn’t want a sensation and perception psychologist necessarily on a panel about interrogation — that’s not the psychologist’s expertise and it makes no sense for the purpose of the panel.

The APA’s choices for the committee appear appropriate, tapping psychologists whose expertise would be valuable to understanding the issue under consideration.

Another misperception is that psychologists and doctors are governed by only one principle — do no harm. But in fact, psychologists are governed by five main principles, two of which are relevant to this discussion:

Principle A — psychologists do no harm

Principle B — psychologists use their expertise in, and understanding of, human behavior to aid in the prevention of harm to society (The Principle doesn’t explicitly say this last part, but it can be taken away from the principle in intent, at least according to the APA itself.) Psychologists consult with, refer to, or cooperate with other professionals and institutions to the extent needed to serve the best interests of those with whom they work.

So taken within this context, it’s not surprising to see that:

1. The APA endorses members who consult with the military (or work for them) on interrogation techniques

2. The APA sees this as a part of psychologists’ role within society

3. The APA’s position is not significantly different from the AMA, and not as different as you might believe from the American Psychiatric Association (an association made up mostly of practitioners, not researchers and clinicians like the APA).

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This entry was posted on Monday, August 7th, 2006 at 7:46 am and is filed under General, Policy and Advocacy, Psychology. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

10 Responses to “How Different Are the Associations’ Policies on Torture?” (Pingbacks/trackbacks not shown below)

The Pentagon seem to believe that there is a difference between the APA’s position and the other medical associations. So much so that they are now will only seek the help of psychologists and not physicians saying that psychologists traditionally fulfill the type of role the Pentagon envisions for its “behavioral consultants” during interrogations (my emphasis).

And they are not the only ones to believe a difference exists. So does former APA president Philip Zimbardo, who knows a little about the subject as the architect of the infamous 1971 Stanford ‘prison’ experiment which demonstrated how easily people will resort to brutality if they believe the ’system’ allows it.

Other who have expressed concerns about the APA’s policy include Jean Maria Arrigo, a civilian psychologist who served on the APA task force and founder of the Intelligence Ethics Collection at the Hoover Institution at Stanford University and Steven Reisner, a psychologist and senior faculty member at Columbia University’s International Trauma Studies Program. To date over 1,500 psychologists, many APA members, have signed the petition calling “upon the American Psychological Association to direct its members to desist from participating in and consulting to interrogations at Guantánamo and similar facilities” at http://www.thepetitionsite.com/takeaction/483607021?ltl=1150467493

“Understanding how large organizations work sheds light on the APA’s committee choices. If you need to study and formulate a response to a situation in an organization, typically you assign a subgroup of people to work on it. Most people choose that subgroup of people based upon their experiences and background. …[T]he APA’s choices for the committee appear appropriate, tapping psychologists whose expertise would be valuable to understanding the issue under consideration.”

The drug companies run the same argument to defend their paying prominent psychiatrists to run drug trials, and/or speak about particular drugs at conferences.

Seems to me you are pulling the AMA quote out of context without acknowledging the whole statement:

http://www.ama-assn.org/ama/pub/category/16446.html

New AMA ethical policy opposes direct physician participation in interrogation

For immediate release
June 12, 2006

Statement attributable to:
Priscilla Ray, MD
Chair, AMA Council on Ethical and Judicial Affairs

“After careful consideration and broad input from experts, the American Medical Association has adopted ethical guidelines that limit physician participation in interrogation. The new AMA policy clearly states that physicians who engage in any activity that relies on their medical knowledge and skills must continue to uphold medical ethics.

“Physicians must not conduct, directly participate in, or monitor an interrogation with an intent to intervene, because this undermines the physician’s role as healer. Because it is justifiable for physicians to serve in roles that serve the public interest, the AMA policy permits physicians to develop general interrogation strategies that are not coercive, but are humane and respect the rights of individuals.

“The practice of medicine is based on trust, and physicians are expected to care for patients without regard to personal characteristics. The development of this new ethical policy removes ambiguity for physicians who must make decisions about their involvement in interrogations.

“This policy builds on previous AMA efforts to assist physicians in the military who encounter such issues.”

Here is a source for Ian’s first point:

June 7, 2006
Military Alters the Makeup of Interrogation Advisers
By NEIL A. LEWIS
New York Times

WASHINGTON, June 6 — Pentagon officials said Tuesday that they would try to use only psychologists, and not psychiatrists, to help interrogators devise strategies to get information from detainees at places like Guantánamo Bay, Cuba.

The new policy follows by little more than two weeks an overwhelming vote by the American Psychiatric Association discouraging its members from participating in those efforts.

Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, told reporters that the new policy favoring the use of psychologists over psychiatrists was a recognition of differing positions taken by their respective professional groups.

The military had been using psychiatrists and psychologists alike on behavioral science consultation teams, called “biscuit” teams because of the acronym, to advise interrogators on how best to obtain information from prisoners.

But Dr. Steven S. Sharfstein, recent past president of the American Psychiatric Association, noted in an interview that the group adopted a policy in May unequivocally stating that its members should not be part of the teams.

Yahoo News: Psychologists adopt anti-torture policy

Thu Aug 10, 6:50 PM ET

NEW ORLEANS - The American Psychological Association took a stand against torture Thursday but kept an existing policy saying that it’s ethical for psychologists to assist in military interrogations.

Critics said the new policy, adopted at the group’s convention, does not go far enough to keep its members from becoming embroiled in practices that could violate the principles of human rights.

“The ultimate question is, should psychologists participate in national security interrogations, and the answer is no,” said Leonard Rubenstein, executive director of Physicians for Human Rights. “It’s a question that other medical groups have addressed and the APA has not.”

The APA adopted as policy long-standing international human rights standards for the prevention of torture and other cruel, inhuman and degrading treatment or punishment.

“The Association unequivocally condemns any involvement by psychologists in torture or other forms of cruel, inhuman or degrading treatment or punishment. This APA policy applies to all psychologists in all settings,” a statement released by the organization said.

An APA policy issued last year said that while psychologists should not get involved in torture or other degrading treatment, it was ethical for them to act as consultants to interrogation and information-gathering for national security purposes.

[…]

This morning I posted a rebuttal to your criticism of my Hungry Blues post:

John Grohol Issues Misleading APA Damage Control

(Note: I recently moved Hungry Blues to my own domain, which is why the link, above, will take you to a different website than the one you link to in your post.)

To understand the APA’s stance on this issue (and don’t confuse my trying to understand this as either speaking for the APA or defending their position), one has to understand the history of the APA (which I’m sure you do, so this is just for our readers who may or may not know APA’s history). It’s very existence and growth was due to its influence and help with the U.S. military during World War I in intelligence testing.

In 1918, in his APA presidential address, the psychologist Robert Yerkes said:

In this country, for the first in the history of our science, a general organization in the interests of certain ideal and practical aims has been effected. Today, American psychology is placing a highly trained and eager personnel at the service of our military organizations. We are acting not individually but collectively on the basis of common training and common faith in the practical value of our work (Yerkes, 1918).

Without the military’s help at that time, and later in WWII and its acceptance of psychologists as legitimate professionals in healthcare, there’s some question as to whether the psychological profession would have become the recognized and respected professionals and clinicians they are today.

More recently, the military was also the first governmental agency to allow psychologists to prescribe medications. This was an important stepping-stone to gaining prescription privileges in a state-by-state effort. While gaining very slow acceptance, the APA owes the military a hat tip in this effort for opening the door.

Which is not to say that the APA should just blindly accept whatever the military wants psychologists to do. I don’t see their position of anything of the sort. I don’t believe for a moment that two large, unwieldy beaucracies such as the APA and military could ever conspire in a quid-pro-quo relationship of this nature. I’m just noting that the history of the APA plays an important role into understanding the dynamics of this organization (as compared to the AMA, for instance) and the U.S. military. Ignoring the history could lead one to believe that they are acting out of shallow, short-term motives.

Which brings me to an interesting hypothetical… If a psychologist, consulting indirectly in the training of interrogators, can help them understand how to obtain information more quickly and with less pain inflicted upon an enemy prisoner, is that in the benefit to our nation’s defense and security?

I think part of our challenge, too, in today’s discussion of issues like these is that we focus on the present, short-term situation (”enemy combatants,” which is a slippery slope if I’ve ever heard one), and ignore serious wars like WWII where such training and consultations, to defeat Nazism, was essential to the military’s operation.

As an aside, I should note that the APA’s informational article (of which I can’t see how anyone didn’t realize I was quoting from it, given I was linking to it in the first paragraph, but a lesson learned for me nonetheless) about the comparisons between organizations was written before the AMA clarified and tightened its own standard. I should also note that I think, tellingly, you said it all in your comment right here:

The proper interpretation of the AMA language, I believe, is that AMA members may participate in developing general strategies that will help interrogators respect the human rights of detainees. [emphasis added]

It’s all a matter of beliefs and interpretation as to how much these policies differ. Because until someone is called up on disciplinary action in both of these organizations for the same issue, we’ll never know how much they really differ in reality.

Yerkes, R.M. (1918). Psychology in relation to the war. Psychological Review, 25: 85-115.

Oh, and sorry Ben I didn’t reply quickly enough to your last comments, so that you felt you had to go and deride and slander me while I was traveling for business. Yes, I will always focus on posting new stories to my blog over replying and approving comments, sorry.

John, Thank you for letting my comment through, finally. And for responding.

In your first four paragraphs you tell me why, perhaps, psychologists, out of a sense of indebtedness to the military for prescription privileges, may be more willing to support torture than psychiatrists and physicians. I don’t see how these historical circumstances should make me feel any better about a psychologist consulting interrogators about which phobias of a detainee to exploit or how long to enforce solitary confinement or at what point to desecrate the Koran or how long or at what point to hood a detainee.

In your arguments that follow your history, you continue to have some difficulty keeping quotations and attributions straight. In the passages I quoted from the respective policy statements of the AMA and the APA (psychological), it was the AMA—not the APA–statement that allowed its members two possible roles regarding detainees:

-impartial medical care
-”developing interrogation strategies for general training purposes.”

Psychologists who participate in interrogations as military Behavioral Science Consultants (BSCs) have only military standards and procedures to guide them—under which they are

authorized to make psychological assessments of the character, personality, social interactions, and other behavioral characteristics of detainees, including interrogation subjects, and, based on such assessments, advise authorized personnel performing lawful interrogations and other lawful detainee operations, including intelligence activities and law enforcement.

This describes participation for psychologists in individual interrogations—not general training.

You write:

If a psychologist, consulting indirectly in the training of interrogators, can help them understand how to obtain information more quickly and with less pain inflicted upon an enemy prisoner, is that in the benefit to our nation’s defense and security?

So inflicting some pain is acceptable? And just how much pain? Please explain what guidelines psychologists have for making such determinations? The APA has not provided any.

You write:

I think part of our challenge, too, in today’s discussion of issues like these is that we focus on the present, short-term situation (”enemy combatants,” which is a slippery slope if I’ve ever heard one), and ignore serious wars like WWII where such training and consultations, to defeat Nazism, was essential to the military’s operation.

Is it somehow short-sighted of me to object to the detention and torture of people not charged with any crime because we might need the ability to do similar things to the likes of Nazis later? Your logic sounds racist to me—as if our largely Arab and Muslim detainee population is somehow disposable for the sake of more “serious wars like WWII.”

Let me restate my point about your quotation methods. In your original blog post, you follow the phrase, “the AMA states” with a block quote. Anyone with even a small amount of academic training would assume that the block quote is something that the AMA has said. But instead, it is something that the APA’s Stephen Behnke said.

Further, I used the phrase, “I believe,” in order to advance an opinion about one particular phrase—not to characterize my entire, fact based argument. That is obvious in my writing. It is a fact that AMA policy only allows physicians to “participate in developing interrogation strategies for general training purposes.” You can quibble with me about what kind of training physicians are allowed to offer interrogators. It is clear, however, that physicians are not allowed to participate—directly or indirectly—in individual interrogations. Psychologists are allowed and they do.

The difference in policy is huge. It is has grave consequences. Psychologists are allowed to participate in individual interrogations in a non-healing capacity. “They employ their professional training not in a provider patient relationship, but in relation to a person who is the subject of a lawful governmental inquiry, assessment, investigation, interrogation, adjudication, or other proper action” (DOD Instruction, 6 June 2006). Psychologists have no professional guidelines for how to behave in this setting. They are supposed to oppose torture, but what constitutes torture has been left wide open for interpretation.

You can find all of my quotations and the sources for them back at the rebuttal I wrote on Hungry Blues.

You obviously are very vocal and impassioned about your point of view on this topic, and I’ve discovered that when people are like that — not that there’s anything wrong with it — it’s hard to carry on a two-way conversation on the topic. It’s more of a, “I’m right, and this is why, and you must be a racist if you believe otherwise.” When you start throwing around terms like “racist,” that’s where I see there’s little point in continuing the discussion.

Because that’s what I’m interested in having — a reasoned, give-and-take discussion on topics like this. Not a, “Well, if you defend the APA, you must be a mouthpiece for them. And a racist to boot.” Whatever you’re doing here is of no interest to me; lesson learned.

I make no aplogies for calling racism when I see it. However, if that point offends you, skip it and argue the facts. You have yet to address any of the evidence I’ve brought to the table.

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Last reviewed:
  On August 7, 2006
  By John M. Grohol, Psy.D.



I do not think there is any other quality so essential to success of any kind as the quality of perseverance. It overcomes almost everything, even nature.
-- John D. Rockefeller