Pentagon officials and APA leaders appear to be on the same page, or at least a nearby one, when it comes to psychiatrists' participation in detainee interrogations.

On June 6 Department of Defense officials announced that from here on they would seek the help of psychologists, but not psychiatrists, when they want advice on how to elicit information from detainees in Guantanamo Bay, Cuba, and other places where prisoner interrogations take place. The policy distinguishes between physicians and "behavioral consultants," whom it describes as primarily psychologists, saying that psychologists traditionally fulfill the type of role the Pentagon envisions for its" behavioral consultants" during interrogations.

This follows by a just a few weeks a decision by the APA Board of Trustees and Assembly to adopt a position statement prohibiting the participation of psychiatrists in detainee interrogations (Psychiatric News, June 16). The statement read, "No psychiatrist should participate directly in the interrogation of persons held in custody by military or civilian investigative or law-enforcement authorities.... [including] being present in the interrogation room, asking or suggesting questions, or advising authorities on the use of specific techniques of interrogation."

The American Psychological Association has taken a more permissive approach to detainee interrogations that allows participation beyond that sanctioned by APA, based on the principle that preventing harm to the public is an important consideration along with the obligation to do no harm. The position of the psychological association is that its members can advise interrogators on questions and techniques and develop interrogation strategies as long as doing so does "not threaten or cause physical injury or mental suffering." Psychologists are barred from direct participation and from assisting in interrogations that use coercion.

Assistant Secretary of Defense for Health Affairs William Winkenwerder Jr. indicated at a June 7 press conference that the American Psychological Association's stance is closer to the military's than is APA's, and this difference contributed to the Pentagon's decision to use psychologists as advisors during interrogations.

The Pentagon's June announcement clarifies what it sees as the roles for behavioral health personnel in interrogations and describes acceptable and unacceptable actions on the part of these personnel. It points out that military psychiatrists are not "ordinarily" to be used as consultants to interrogators, "but may be so assigned" in limited circumstances when psychologists are unavailable to advise interrogators.

On June 12 the New York Times weighed in on the issue of detainee treatment, with an editorial condemning some of the controversial practices that the military has allowed during interrogations. The editorial followed the suicide of three prisoners at Guantanamo. The editorial stated that the" only role for psychiatrists at [Guantanamo] seems to be to help prepare prisoners for interrogation" and suggested that psychiatrists and other medical personnel also take part in forced feedings and other inhumane practices in detention facilities.

Steven Sharfstein, M.D., immediate past president of APA, sent a letter to the newspaper taking issue with its conclusion regarding psychiatrists. Moreover, Sharfstein explained that after touring the Guantanamo Bay detention facility at the invitation of the Pentagon last October, it was clear that psychiatrists were providing patient care.

"Since then," he wrote, "the American Psychiatric Association has passed a clear, strong statement barring psychiatrists from participating in interrogations. It is our position that the only role for psychiatrists is that of healer, including psychiatrists who are in the military."

At its June meeting, the AMA House of Delegates debated the issue, arriving at much the same conclusion as did APA (see article on page 1). ▪