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Part II of our conversation with Steve Miles and Rosa Garcia-Peltoniemi about health care professionals’ involvement in torture, including a conversation about how terrorism is used to create fear and to rationalize torture. Read Part I here and Part III here.

How do doctors become perpetrators?

Rosa Garcia-Peltoniemi

Rosa Garcia-Peltoniemi

Rosa: As Americans we don’t ask about the issue of social class and economic inequalities when we come across other cultures. For example, in many countries, doctors do not earn as much as physicians in the United States. I think it adds to the risk at which doctors are in this situation for collaborating with the government or not standing up for human rights.

Steve: I’ve been doing a fair amount of research on this for another book. Governments don’t motivate docs by fear, they motivate them by careerism. A doctor has a position in government for their career, then is moved into a torture facility and at that point, what the doctor does is acclimate to the facility. They are not told to participate but does so to share the workload with colleagues. The fear excuse becomes a way after the torture is exposed of managing the moral dissonance of what the doctor did to say, I would have been killed, or I was coerced.

Rosa:  That is very interesting. I’m glad you’re looking into that in more detail. The other element that came up during my work in Turkey was terrorism. In Turkey in 1996, there was the Kurdish independence movement, which was designated a terrorist group by the state. We stayed in a hotel in Ankara that had been bombed 2 years before and a famous newspaper editor was killed right next to our hotel.

In the torture rehabilitation centers in Turkey there was an old guard that had been tortured. Then a new generation of professional providers came. The new people were children of torture survivors and shared an ideology with them. But they were subjected to terrorism and as they got married and had children, they were very concerned about the protection of their loved ones against terrorists and bombings.

I experienced a very dramatic consultation during my second visit to Turkey in November 1996. There was a disclosure by a new physician who said he realized that the person he was treating had intended to bomb a public place. Psychologically, what that did to him as a new father, thinking of himself in the grocery store if his client had set up a bomb. And of course he was talking about an unmentionable. After the disclosure, there was a long silence in the group, then yes, others said, I have that in my mind too. That gave me insight into something else that was happening in that country that is probably part of the equation for many folks, including in this country.

Steve Miles

Steve Miles

Steve:  To create a torturing society, they create a grand conspiracy against them: they are communists or counter-revolutionaries. Because this grand conspiracy is such a mysterious threat to the state, the state needs to develop a similar, silent secret policy in order to handle this. The next step is to create people who are part of the grand conspiracy outside of legal protections and create special institutions, to remove accountability in those institutions at which point torture unfolds. Terrorism is the ideal mechanism for creating grand conspiracies because you can make terrorists as invisible and powerful as you want.

We paid an enormous price because when we created an idea that terrorists were all powerful, we dismantled a system of international law that took 50 years to build. Ironically that dismantling is to the enormous comfort of people like Bashar al-Assad [president of Syria] and Kim Jong-il (former supreme leader, North Korea)]. They say, you guys get two buildings bombed in the United States and you have an executive order to torture.  I’m facing an authentic insurrection; I’m going to torture too. We destroyed the system for saying no.

Rosa:  We’ve decided torture is an effective interrogation tool, which really concerns me as a citizen. We’re not getting the intelligence we need. If we really needed that intelligence, we’re doing it very inefficiently when we need to submit someone to waterboarding nearly 200 times.

Steve: The interesting thing is that the torture interrogation movement is an anti-science movement. One thing that is fascinating is that torture really, it doesn’t work. We know it doesn’t work, we’ve conducted huge amounts of research that says it doesn’t work. That all goes by the board once we start using torture.  The health profession is a science-based movement and they have to adopt an anti-science stance in order to participate in this, which further discredits their claim to be clinicians.

Rosa:  I think that sums up where the APA [American Psychological Association] is.

Steve: APA never engaged the question: does torture work?

Rosa: No, and the way they did it is so objectionable to me.

Continue reading Steve and Rosa’s conversation – Part III here. (Part I is posted here.)