Several hundred Iraqi prisoners have mounted a class action lawsuit in American court against psychiatrists from the Fleet Hospital at Camp Delta, Guantanamo Bay. According to the complaint, psychiatrists at the prison hospital regularly conveyed data about prisoners’ “mental health and vulnerabilities” to the Behavioral Science Consultation Team (Biscuit) in order to integrate mental health care with the system of psychological and physical coercion.” Several trial lawyers contacted by Unconfirmed Sources agreed that such a medical torture and interrogation machine would constitute a flagrant violation of current US malpractice laws, and could mean millions of dollars to the victims or their next-of-kin.
Injury Lawyers 4U, a consortium of leading personal injury lawyers-no loans, no credit, no catch-who will be representing the Guantanamo prisoners, claimed that: “The use of medical personnel to facilitate abusive interrogations and the calibration of levels of pain inflicted on patients violates medical ethics.” More than the pain, distress, and possible morbidity from abusive interrogations, Injury Lawyers claimed that the deterioration of the therapeutic alliance conveyed to his clients a strong sense of “the practitioner’s emotional detachment.”
Pentagon lawyers claim, however, that this deterioration is owing to the doctor’s fear of litigation. “The emphasis of the doctor-patient interaction shifts from concern for the interrogation of the prisoner to concern with the legal vulnerability of the practitioner.” Thus, in a “bitter irony,” litigation, exacerbates the very problem it is designed to solve: “rather than protecting the practitioner from lawsuits it may create a climate of provocation in which lawsuits are even more likely to occur, due to the bad feelings engendered by the impaired therapeutic alliance.”
Frequent attention in the media to interrogation methods together with the issue of malpractice may increase the level of paranoia among practitioners, in which doctor-patient relationships become torturer-prisoner relations or-at worst-defendant-litigant relations; and medical services are viewed as some kind of weapon with concomitant conventions and protocols.
The Pentagon referred to one prisoner whose condition was probably aggravated by being left in intense isolation by doctors trying to avoid the malpractice liability incurred in treating him. “The patient’s regular interrogator was unavailable, so a guard asked the psychiatrist who usually worked with him to turn out the lights in the cell. He said, ‘Are you out of your mind?’ Cpl. Latos recalled. ‘I have never seen this patient before, I could get creamed.'” As a result, the patient’s cell was flooded with light 24 hours a day for three months, and he ended up talking to nonexistent people, hearing voices, and crouching in a corner of the cell covered with a sheet. The “creaming” the psychiatrist feared, according to the Pentagon was a malpractice suit.
At the request of Donald Rumsfeld, an August 2002 Defense Department memo laid down new ground rules for what constitutes medical malpractice for psychiatrists at US military prisons. If an Army psychiatrist “knows that severe psychological trauma will result from his treatment,” but if causing such harm “is not his objective, he lacks the requisite specific intent even though he did not act in good faith.” The doctor is guilty of malpractice only “if he acts with the express purpose of inflicting harm or suffering on a patient within his control.”
In other words, malpractice is not malpractice if the specific intent of the doctor is not to inflict harm, but rather some other objective, such as extracting information. Injury Lawyers objects that no psychiatrist would acknowledge outright sadism. Abuse of the mentally ill throughout history has always been justified as a necessary tool in the “war” against some sort of demonic possession, they claim.
The enlistment of doctors in the service of the torture of prisoners is hauntingly reminiscent of the work of Dr. Josef Mengele, the Nazis’ “Angel of Death” at Auschwitz. In that case, instead of receiving one lump sum, plaintiffs received malpractice payments over time, and non-economic damages and legal fees were capped at $250,000. the Bush administration claims that, if meaningful tort reform applied the same standards today, psychiatrists at Guantanamo would pay less than $10,000 this year in malpractice premiums, their Abu Ghraib colleagues less than $9,600. Dr. Strange, a former Navy psychiatrist for the Fleet Hospital, said that premiums for his three-doctor interrogation group jumped on Jan. 1 from $47,000 to $75,000. As a result, he said, the Navy has put off hiring new staff, even though it recently opened a new camp. Other groups at the prison are deferring equipment purchases.
The Guantanamo malpractice suit claims that the indefinite detention of prisoners who had no idea when or if they would be released prescribed by psychiatrists at the Fleet hospital clearly led to widespread mental health problems, including dementia and suicidal behavior, and these were aggravated by increasingly “refined and repressive” treatments, including experimental medications, designed to break the will of the approximately 550 prisoners at the camp.
Injury Lawyers 4 U said that Biscuit’s methods were “from the Dark Ages” of medicine and had long since been abandoned by Western psychiatry. Making the patient dependent on the therapist-through the use of humiliating acts, solitary confinement, temperature extremes, use of forced positions and even beatings-is now considered counterproductive at best and at worst, “an intentional system of cruel, unusual and degrading treatment and a form of torture.”
According to Injury Lawyers 4 U, one regular procedure during the Middle Ages was making uncooperative mental patients strip to their underwear, having them sit in a chair while shackled hand and foot to a bolt in the floor, and forcing them to endure strobe lights and loud rock and rap music played through two close loudspeakers, while the air-conditioning was turned up to maximum levels. “But it’s now generally accepted that the risk of adverse side effects in such treatments is far greater than their benefits,” they said, “and their use at Guantanamo is a clear case of medical malpractice.”
At a press conference, President Bush condemned the lawsuit as more evidence of the ongoing malpractice litigation crisis which Bush has vowed to address in his second term. “Despite the best efforts of drug company lobbyists and the AMA, the number of claims and suits is still epidemical [sic].” This alarming situation has triggered widespread (and not always realistic) fear among medical practitioners.
Bush called the Guantanamo malpractice suit “a perfect example of the out-of-control litigiousness of our society.” He recalled that John Kerry once blamed him for failing to head off a flu vaccine shortage he knew was coming. Bush said the Guantanamo suit illustrates the “broken medical-malpractice liability system that Democrats falsely claim to want to fix, while voting ten times against reforming” that is the real reason so few companies make flu vaccines, and not the incapacity of profit driven corporations for developing money-losing treatments even in the interest of national health.
Bush said that fear of malpractice litigation has resulted in a likely influenza pandemic. “A minimum of 25% of the population will become ill” and “10% to 35% of the workforce may be absent from work. Mortality is likely to be high-estimated at 1% of the total population. The global death toll could be between 50 and 100 million.”
Bush suggested that a good part of the blame for this impending holocaust lies in the increasingly adversarial nature of the doctor-patient relationship created by the epidemic of frivolous lawsuits like the one mounted this week by the Guantanamo prisoners. “US drug companies are afraid to sell flu vaccine, because if a batch happens to be ‘contaminated’-because of cost cutting measures or for whatever reason-and ends up killing people, they’re liable to be sued and lose money on their initial investment.”
“In an atmosphere in which both parties are frankly suspicious of one another,” he said, “it is difficult to build a mutually supportive relationship.”