Torture and Future US Physicians

Posted on | October 31, 2007 | Comments Off on Torture and Future US Physicians

How are we failing?

I spent two years as a Senior Fellow in The Humanities with the World Medical Association (WMA). This global organization sprung to life after the Nuremberg trials, with a major goal to help prevent physicians around the world from ever again being co-conspirators in torture. During my stint, I was studying the patient-physician relationship in six countries around the world – the US, UK, Germany, South Africa, and Japan. What I discovered was that in all countries patients and their physicians dominantly described their relationship as three things – compassion, understanding and partnership. The results reassured me about my chosen profession, and seemed miles away from torture.

And that is why a recent study of 1,700 students at eight U.S. medical schools conducted by Harvard affiliate Cambridge Health Alliance was so disturbing. To start with, more than a third of the students didn’t know that the Geneva Conventions prohibit doctors from threatening patients or restricting them of food and water. When the survey queried their tolerance levels for being complicit with torture, it got worse. The students were asked about their willingness to perform three actions:

1. Threatening to inject psychotropic drugs without intending to really do it

2. Injecting a harmless saline solution while saying it was a lethal substance

3. Killing a detainee with an injection

Strikingly, six percent of the students said they’d do all three, and 25 percent said they’d do the first two, but not the third.

The AMA’s Code of Ethics says that all three are unethical for physicians. All of which is to say that:

1. Some of those we select for medical school are poor choices (we’ve known that for some time).

2. Medical students are human beings and not immune to the emotions, agressive national loyalities or perceived threats of the day.

3. Curriculum to actually support physicians as moral and ethical leaders in society are largely absent (94 percent of the students in this study spent less than one hour during their training on this topic).