When patients sacrifice their money and personal privacy so that medical students can perform physical exams and develop their skills, society has implicit expectations about what the students will do with the knowledge they gain from encounters with patients. Some would say that there's an implicit promise from the doctor—like the Hippocratic Oath—when the patient is making those sacrifices in order for the doctor to do good. Then the question is, “Does doing good include getting involved in interrogations?” Dr. Howe asked.
Even if society is willing, in theory, to say that it will make these sacrifices so that students can be trained to become doctors to heal medical and psychiatric problems and also to save lives by participating in some way in interrogations, “it does not necessarily mean that it should fly, even if most psychiatrists would go along with it. Additional ethical assessment is necessary,” he said.
Contrary to the position taken by key experts, the American Psychological Association's approach to this issue appears to be different. That organization's Presidential Task Force states that psychologists can “serve in the role of supporting an interrogation” and make use of confidential information in medical records of detainees or prisoners to advise interrogators, as long as it is not used to the detriment of the individual's safety and well-being.
The task force's report does warn psychologists working in a national security-related setting that they should “clarify their role in situations where individuals may have an incorrect impression that psychologists are serving in a health care provider role.”
In addition, psychologists should refrain from mixing potentially inconsistent roles with the same individual, in those cases when the roles “could reasonably be expected to impair the psychologist's objectivity, competence, or effectiveness. … or otherwise risk exploitation or harm to the person with whom the professional relationship exists.”
In the panel discussion, Dr. Bloche argued that the American Psychological Association's statement “allows for a wholesale breach of confidentiality.”
However, Stephen Behnke, director of ethics for the American Psychological Association, said in an interview that there should be an absolute barrier between work that is treatment related and work related to interrogations.
“Under no circumstances should the two be mixed,” Mr. Behnke said.
He pointed out that his association had provided its task force report to the U.S. government and that training is needed.
But overcoming the obstacle of health care providers serving as consultants to interrogators by creating separate schools or training for each type, “doesn't really address what the real problems are,” Dr. Howe said.
The real problems are determining how humans should treat other humans—and who should decide, he asserted.