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Ethicist questions medical workers' role in abuse

Abu Ghraib should be 'wake-up call for the Western world'

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(CNN) -- A leading bioethicist charges in a prestigious British medical journal that U.S. military medical personnel are complicit in abuse of detainees in Iraq, Afghanistan and Guantanamo Bay, Cuba, and suggests an inquiry into their behavior in places such as Baghdad's Abu Ghraib prison, is in order.

An editorial in The Lancet was accompanied by an article that cites government documents and news reports that found medical personnel responsible for treating prisoners at the Abu Ghraib prison in Iraq "failed to protect detainees' human rights, sometimes collaborated with interrogators or abusive guards and failed to properly report injuries or deaths caused by beatings."

The Pentagon denied the allegations, saying the article was drawn from "carefully selected media reports" and excerpts of testimony from congressional hearings, "not first-hand investigative work or accounts."

Dr. Steven H. Miles, a professor in the center for bioethics at the University of Minnesota Medical School in Minneapolis, said his review of the documents revealed that medical staff failed to maintain medical records, conduct routine medical examinations or properly care for disabled or injured detainees.

He also cited "isolated reports that medical personnel directly abused detainees."

In one case, a medic inserted a catheter into the body of a prisoner who died under torture "to create evidence that he was alive at the hospital," Miles writes.

And he writes about the family of an Iraqi man taken into custody by U.S. troops who was found months later in a hospital. "He was comatose, had three skull fractures, a severe thumb fracture and burns on the bottoms of his feet."

But the man's U.S. medical report made no mention of the injuries, saying only that heat stroke had caused him to suffer a heart attack, which resulted in the coma, Miles said.

The Pentagon said Thursday evening that it is investigating "all aspects of prison and detainee operations," and said medical care provided to prisoners is based on standards "comparable to those for U.S. personnel.

"Presently, we are unaware of any instance in which medical personnel failed to render medical aid to injured detainees," the statement said.

It continued, "The lives of dozens, if not hundreds, of insurgent Iraqis and terrorist detainees have been saved by superior care and treatment provided by U.S. military medical personnel."

Miles alleges the medical system was directly involved in the interrogations: "Army officials stated that a physician and a psychiatrist helped design, approve, and monitor interrogations at Abu Ghraib."

The bioethicist cited the case of Iraqi Maj. Gen. Abed Hamed Mowhoush, who died last November when his head was pushed into a sleeping bag while interrogators sat on his chest.

A surgeon said that he died of natural causes. But months later, a death certificate released by the Pentagon called the death a homicide by asphyxia.

Though acts of torture and degrading treatment at Abu Ghraib were widely known among the approximately 70 medical personnel there, Miles said, there is no indication that any of them reported abuse, degradation or signs of torture before January's Army investigation.

On January 24, 2004, U.S. Central Command ordered a broad administrative investigation into detainee operations in Iraq, according to the Defense Department. On January 31, Maj. Gen. Antonio Taguba was appointed to lead the investigative team.

"I'm just deeply saddened" about that failure, Miles said Thursday by telephone from Reykjavik, Iceland. "What I don't get is why they didn't make a noise. ... This just doesn't represent the military people I know."

Miles also called for an investigation by an independent, non-U.S.-based coalition.

He said Army investigations have looked only at "a small set of human-rights abuses," but have not investigated reports from human rights organizations, focused on the role of medical personnel or examined detention centers that were not operated by the Army.

"The U.S. military medical services, human-rights groups, legal and medical academics, and health professional associations should jointly and comprehensively review this material in light of U.S. and international law, medical ethics, the military code of justice, military training, the system for handling reports of human-rights abuses, and standards for the treatment of detainees," he said. "Reforms stemming from such an inquiry could yet create a valuable legacy from the ruins of Abu Ghraib."

"I think, ultimately, we are all in danger when the fabric of international law is weakened," he added.

The latest U.S. Army report on questionable practices by the military intelligence brigade at Abu Ghraib is expected to be released as soon as next week. Known as the Fay report, it is the result of a broader investigation commissioned in April to determine if senior commanders ordered the interrogation techniques.

It will recommend that two dozen personnel face disciplinary action, military sources told CNN Wednesday.

So far, seven soldiers from the 372nd Military Police Company have been charged with abuse.

The personnel to be named in the report are said to mainly be members of the 205th Military Intelligence Brigade, but also a small number of civilian contractors and personnel from other government agencies, according to a military official who saw portions of the report.

Personnel who participated in the abuse will be recommended for disciplinary action by the report.

The editorial that accompanied Miles' article in The Lancet said the problem among health-care workers of dual loyalty -- to patients and to their employers -- is well recognized, but ethical codes require that all medical personnel "must first and foremost be concerned about their patients and bound by principles of medical ethics."

"Health-care workers should now break their silence," the editorial said. "Those who were involved in or witnessed ill-treatment need to give a full and accurate account of events at Abu Ghraib and Guantanamo Bay. Those who are still in positions where dual commitments prevent them from putting the rights of their patients above other interests should protest loudly and refuse cooperation with authorities."

The editorial concluded, "Abu Ghraib should serve as an 11th-hour wake-up call for the Western world to rediscover and live by the values enshrined in its international treaties and democratic constitutions."

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