The column by APA President Pedro Ruiz, M.D., in the January 17 issue in
which he described his trip to the U.S military base at Guantanamo Bay, Cuba
(GTMO), was disturbing, not so much by what was said but rather by what
wasn't. His stated intention in writing to the membership about this highly
controversial facility was to highlight the dedication and outstanding
performance under "trying circumstances" of health care personnel,
including psychiatrists, stationed at GTMO. Trying indeed, certainly for the
inmates, but also I'm sure for those same health care professionals who at
times have been required to force-feed inmates on hunger strikes or for the
mental health staff who were required to participate in interrogations.
Treatment of detainees at GTMO has come under widespread international
condemnation including from U.S. allies such as Great Britain and a wide range
of human-rights organizations including the International Committee of the Red
Cross. Both Human Rights Watch and Amnesty International have called for the
facility to be closed, and last June the U.S. Supreme Court determined that
President Bush did not have the authority to set up tribunals either under
military law or the Geneva Conventions.
None of this is mentioned in Dr. Ruiz's column. Rather he tells us what the
military briefers leading the tour told the delegation: for instance, that all
of the detainees had been "arrested while committing terrorist acts
against the United States." Really? What about the detainees who were
released after they were determined not to have been enemy combatants after
all? And if the others were already determined to have engaged in terrorist
acts, why the need for military tribunals or any further due process
whatsoever? The detainees who managed to succeed at suicide last year
presumably would have preferred a speedy execution rather than indefinite
detention, and, if numerous reports are to be believed, inhumane interrogation
methods, which include torture. Dr. Ruiz mentions suicide only along with
other "disruptive behaviors" managed on a special unit that the
group toured. He avoids the relevant and intense political, legal, and ethical
controversies surrounding treatment and incarceration at GTMO.
Dr. Ruiz manages to find space in his column for a detailed description of
the lunch menu on the day of his visit and seems satisfied with being told
during the meal "that this was the same lunch that all detainees at GTMO
had that day." Ironically, or perhaps conveniently, no mention is made
of those trying to starve themselves to death or those being forcibly fed by
medical staff.
Most remarkable, however, is the absence of any mention of the APA
Assembly's position statement on the participation of psychiatrists in
interrogations, which was triggered largely by the situation at the Guantanamo
Bay facility. The Assembly determined that it is unethical for psychiatrists
to participate in such procedures, and the AMA followed suit with a similar
statement.
Dr. Ruiz had an opportunity to provide some meaningful follow-up to these
important actions in his column. He still has time to do so before the end of
his term.