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.
