Guest Post: Against Violence Under the Cloak of Care

Posted on 20/04/2011 by

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By Mirjam Eikelboom
Originally published on WLCentral.org

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President Obama recently stated that Private Manning’s conditions comply with the Pentagon’s basic standards. Given that those standards apparently permit Private Manning to be subjected to plainly unconstitutional conditions, it is clear that the Department of Defense must adapt its standards to meet the demands of the constitution. – American Civil Liberties Union

“AGAINST VIOLENCE UNDER THE CLOAK OF CARE”

Second open letter to the president of the American Medical Association

Dear Dr. Wilson,

There has been a disappointing and disturbing silence in answer to the registered letter I sent to you and the American Medical Association you represent. In this letter, sent on February 23rd, 2011, I asked the AMA to take all measures in their power to stop the abuse of medical terminology and the medical profession assisting in torture. More specifically, I asked you to speak out against the sale of the torturous ‘prevention of injury’ procedure used on Bradley Manning to the greater public as a form of justified “care”.

We know from professional literature on extreme forms of abuse that it is attractive to many perpetrators to shift labels to conceal the real nature and seriousness of their actions. These relabeling techniques help them to shrug off responsibility, to maintain their position in society and to further disempower their victims by confusing them (see professional literature on e.g. the phenomenon of gaslighting). The following three articles show us how important it is to continue to correctly label the treatment of Bradley Manning as torture and as inappropriate:

Pioneers of Torture
The National Shame of the US Military’s ‘Slow Torture’ of Bradley Manning
Stanford prison experiment

And although the AMA has so far remained guilty by association, two other US groups of medical professionals have given their frank professional condemnation:

Psychologists for Social Responsibility
Physicians for Human Rights

Also non medical professionals have made clear condemnations of what is going on:

Private Manning’s Humiliation
Manning, Obama and U.S. moral leadership

My reason for writing you once more is my deep conviction that it is a serious case for alarm that the AMA hasn’t come forward in this case yet, in order to clearly draw the line on abuse and torture. The loss in this case is partially to Bradley Manning (who now has to depend on medical staff that have shown they have no defense against being compromised or corrupted) but also to your organization and the medical profession in general.

When I did my physiotherapy training, years ago, the Hippocrates Oath was summarized as “heal, do not harm”. As we were working in an atmosphere where integrity was the norm and the level of patient care was high, we used this sentence to carefully dissect each case, to discover what were the interested parties and their opinions. It was used to teach us that the world view, wishes and judgement of the patient would not always match that of others – but in the end should prevail in any medical decision. This to prevent “violations under the cloak of care”: situations where a patient is so overpowered by medical staff or hospital atmosphere that he accepts a treatment he doesn’t feel good about, because he can’t succeed in getting heard.

I would never have dreamed that there would come a time where I have to evoke the same oath at the other end of the spectrum, the end it was originally intended for! Hippocrates crafted this oath to clearly divide between warriors (who in the period also used to tend to wounds) and unarmed “real” medical staff. And by his oath, he made non-violence, and the ethics and the level of trust that is resultant from them, the foundation of the medical professions.

My question to you is: Would anybody in the US seriously want a doctor who is not ultimately and primarily motivated by patient care, but rather by greed, status, professional pride, career opportunities or whatever other motivations there can be? What does it mean for the medical profession in general if doctors agree, as in the case of Bradley Manning, to completely leave patient interests out of the equation and instead tend to their own salary, the will of the Quantico commander and greasing of the working relations with the army and the government? Is he the one and only exception from the right treatment? Or is he an example of a deep lack of ethics and professionalism that should alarm each and every person who will ever needs the services of a doctor in the United States?

And my second question to you is: Is there any amount of money, any award, any job promotion, any image in the outside world, which can compensate you for loss of professionalism or integrity? Can anything compensate for losing those elements so essential to the profession: compassion, honest relationship with the patient, and ultimately also power to heal – where healing is difficult?

It is my deep conviction that any medical professional who is not trained and supported by his professional peer-group (I mean you, the American Medical Association!) to protect his patients in the face of such flagrant abuses, such as Bradley Manning faces right now, is certainly unfit to perform the much more delicate balancing act which is necessary to prevent the “violations under the cloak of care”. Someone who is complicit in torture (even if it is just one single act) has crossed a boundary, and that crossing will affect their professional stance towards all their other patients, and more fundamentally, their regard for human life.

These observations become even more a cause of concern when I look at the poor state of mental health-care in your country: by far the richest country in the world. I remind you that US prisons contain more than five times the amount of inmates in prisons in any other country. And I have been told that one of the causes behind this grim overall picture is the fact that many people who are badly in need of psychiatric care end up, without much care at all, somewhere in the prison system.

The American government has tried to hush away concerns for Bradley Manning, declaring that his treatment is in no way unusual. Is it possible that this is indeed the shocking truth? That Bradley Manning’s case is just exceptional because it has grabbed the limelight? Does he represent many others who have no name to the world; those who are routinely degraded, abused, kept in solitary confinement – or in other ways tortured – by the American prison system?

And is this then the truth about the American Medical Association: That they have never stood up and asked for proper treatment and proper patient care for all these psychiatric patients? That they have never told the United States that it could and should do better? That they have allowed society to go muddle along with unsatisfactory “solutions” that are seen as cheap or convenient? That doctors and other medical staff are in fact complicit and jointly responsible for the broad acceptance of this completely failed “prison” system, and concurrent horridly low levels of psychiatric care?

Could that be the shameful truth and the real answer, when I ask you why you haven’t sent me a decent reply yet?

And yes, I am not an American and not a paying member of your Association. If that’s your reason to not answer me – let me know your price and I will pay your fee! Because, even from the other end of the world, it is unbelievably hard to see a medical organization that does not have the necessary pride and professionalism to join these ranks:

The UN rapporteur on torture
Amnesty international
Human Rights Watch
the ACLU
Yale and Harvard law schools

I hope that the AMA will now come to its senses and strongly condemn the treatment of Bradley Manning (No 9. on the TIME Person of the Year list).

Awaiting your reply,

Yours Sincerely,

Mirjam Eikelboom

Other ways to support Bradley Manning here.

Previous WL Central coverage on Bradley Manning here.

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Posted in: Activism