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Physician Accountability for War Crimes

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Physician Accountability for War Crimes Steven H. Miles, MD Professor of Medicine and Bioethics University of Minnesota No Conflicts of Interest. No commercial ... – PowerPoint PPT presentation

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Title: Physician Accountability for War Crimes


1
Physician Accountability for War Crimes
  • Steven H. Miles, MD
  • Professor of Medicine and Bioethics
  • University of Minnesota
  • No Conflicts of Interest. No commercial products
    mentioned.

2
Physicians and Torture a 10 year project.
  • MD Codes
  • (Compilations, Variations, Harmonization, Reform)
  • Publications (incl screening for torture)
  • War on Terror MDs
  • Book Publications
  • On-line Databases
  • Documentary
  • www.doctorsofthedarkside.com/

2007
2004
2009
2012
3
Nuremburg Nazi Medicine Trial, 1946-1947
  • 23 defendants
  • 7 death by hanging
  • 9 prison terms, 10 yrs to life,
  • 7 acquitted.

4
United Nations
Convention Against Torture, Cruel, Inhuman, and
Degrading Treatment
UN Principles Protection of Persons under
Detention
UN Principles Medical Ethics
1956
1948
1975
1988
2007
1984
1997
1980
1946
Clinical Societies Policies
WMA
Declaration of Geneva
No Licenses MDs fleeing prosecution
Declaration of Tokyo
Regulation in Armed Conflict
Duty of MDs to Document and Denounce
5
Study Population
  • Doctors punished for torture or war crimes that
    occurred after 1972 (date of Amnesty).
  • International or national courts, medical
    licensing boards.
  • Exclude acquittals but
  • Include physicians found guilty and then excused
    by amnesties, pardons, etc.
  • Not an exhaustive list.
  • Some torture doctors give self-incriminating
    testimony in exchange for immunity or amnesty.

6
Torture
  • . . . any act by which severe pain or
    suffering, whether physical or mental,
  • is intentionally inflicted on a person
  • by, or at the instigation, consent or
    acquiescence of a person acting in an official
    capacity.
  • It does not include pain or suffering arising
    only from, inherent in, or incidental to, lawful
    sanctions.
  • UN Convention Against Torture
  • (abridged)

7
Prevalence Of Torture Survivors
500,000 with Parkinson Disease
500,000 Torture Survivors in US
300,000 persons with Scleroderma in US
US Dept of Justice Office for Victims of Crime
2000
8
Prevalence of Torture in Some National or
Refugee Groups
500,000 torture survivors.
Bosnia?
Tibet
Afghanistan
Iraq
Gaza
Algeria
Senegal
Bhutan
Cambodia 75-79 Cohort
S. Leone
Sudan/Somalia Ethiop/Eritrea
Zaire
Timor
Zimbabwe
80-100 countries practice torture as
policy. Amnesty International, 2008. Refugees
from a given country have a higher torture
prevalence than nationals.
Redface high but percents are not known. Miles
SH. Compiled from multiple sources.
9
Torturing regimes need doctors.
  • Devise means to minimize scars, including
    psychosexual torture, (a response to human rights
    groups surveillance).
  • Keep alive those who are supposed to live.
  • Conceal the cause of death of those who die.

Half of torture survivors report seeing a
physician overseeing their torture.
10
Study Population
  • Doctors punished for torture or war crimes that
    occurred after 1972 (date of Amnesty).
  • International or national courts, medical
    licensing boards.
  • Exclude acquittals but
  • Include physicians found guilty and then excused
    by amnesties, pardons, etc.
  • Not an exhaustive list.
  • Some torture doctors give self-incriminating
    testimony in exchange for immunity or amnesty.

11
Miércoles, 21 de Febrero de 2007
EL PAIS  LA CAUSA CONTRA BIANCO POR LA REPRESION
EN CAMPO DE MAYO Dueño del destino de las
embarazadas Comparta esta nota con un amigo
Norberto Atilio Bianco cumplió funciones como
médico en el Hospital Militar de Campo de Mayo
con el grado de capitán del Ejército durante la
última dictadura militar. La Justicia lo condenó
en 2000 por la apropiación de dos menores de
edad, pero en diciembre del año pasado las
Abuelas de Plaza de Mayo sumaron a esa denuncia
otra por su responsabilidad en los secuestros y
desapariciones de los hijos de, por lo menos, 35
mujeres embarazadas que pasaron por Campo de
Mayo.
Siluetas de desaparecidos en el predio de Campo
de Mayo. Pudimos revertir el plan macabro
12
Google Translator
21 Feb 2007 ... Dueño del destino de las
embarazadas. www.pagina12.com.ar/diario/elpais/sub
notas/80690-26051-2007-02-21.html -
Translate this page
13
Wednesday, February 21, 2007
Nationgt THE CAUSE AGAINST THE REPRESSION IN
BIANCO CAMPO DE MAYO OWNER OF THE FATE OF
PREGNANT WOMEN     
Owner of the fate of pregnant women
Norberto Atilio Bianco served as physician at
the Hospital Militar de Campo de Mayo with the
rank of captain in the Army during the last
military dictatorship. Justice sentenced him in
2000 for the appropriation of two minors, but in
December last year, the Grandmothers of Plaza de
Mayo joined by another claim that its liability
in the abductions and disappearances of children
of at least 35 pregnant women who went to Campo
de Mayo.
Silhouettes of the missing at the site at Campo
de Mayo. "We will reverse the macabre"
14
Physicians Sanctioned for War Crimes / Torture
1975-2013
Yugoslavia
UK
Italy
Greece
Pakistan
Bangladesh
Brazil
Sri Lanka
Guyana
Rwanda
Chile
Uruguay
Sanctioned Hearing Open
Medical Board Domestic Court International
Court Died during crim trial
South Africa
Argentina
Combinations signify multiple events for one
person
15
Court Martial (one) 1975 The First
post-Nuremburg Case
  • After the Greek junta fell, Dr. Dimitri Kofas,
    supervisor of torture
  • Court martialed for dereliction of duty.
  • Imprisoned.

16
A Separate Issue MDs who are Senior Government
Officials
These physicians acted as senior government
officials, not as clinicians. There are 10 more.
17
Motivations
  • Careerism
  • Patriotism/ Political Affiliations.
  • National emergency.
  • Collegiality
  • Orders.
  • Fear.
  • Personality disorder.
  • Amilcar Lobo
  • Brazil, Psychiatrist
  • man has used torture and assas-sination for
    thousands of years and permitted it as long as it
    is socially organized. It is but a moment from
    the Inquisitions torture and murder of the Jews
    to the Nazis similar actions forty years ago.
    This is human nature I am not ashamed to be part
    of it.
  • Lobo A. A Hora do Lobo e a Hora do Carneiro The
    Hour of the Wolf and the Hour of the Sheep.

18
Governments Shelter Torture Doctors
  • Amnesties/Excuse crimes committed under orders.
  • Require military courts to screen cases.
  • Block access to records, military testimony.
  • Exempt military MDs from license punishments.
  • Establish government medical associations to
    supersede civilian medical societies.
  • Let delicensed MDs work in military hospitals.

19
Types of Hearings as of 2010s
Sanctioned N57
In Progress N18
Medical Associations Precede Court Actions
(court involvement is often second action against
an MD)
20
Courts vs. Medical License Brds
  • Crimes
  • Murder (incl. false death certificates)
  • Kidnapping
  • Torture rarely indicted because not codified.
  • Sanctions
  • Imprisonment
  • Damages to survivors
  • Revoke pensions
  • Ethics Violations
  • National codes
  • Declaration of Tokyo
  • Hippocratic Oath
  • Sanctions
  • Suspend license
  • Revoke licenses
  • Censure
  • Revoke awards.
  • Remove from Office.

21
Denouncing of Physicians
Camilo Azar Saba Suspended for six months by the
Medical Association for torture of prisoners at
barracks of Centro Nacional de Información.
Involved in case of Federico Santibanez.
Address Alto Las Condes, ubicada en Avenida
Kennedy 9001, piso 7, Mall Alto Las Condes.
Phone 6366666
Home
Web
Clinic
22
A Schematic History of Sanctions
Courts
Torturing regime
Create new med assns Employ sanctioned MDs In
gov hospitals
Political affinities
Medical Associations
Civil society
23
MDs Sanctioned for Torture
24
Few allegations proceed to sanctions.
Argentina 200 Allegations
12 Sanctions
Brazil 110 Allegations
22 Sanctions
Chile 80 Allegations
10 Sanctions
25
National Stages of MD Sanctions for Torture
  • Stage IV Systems for sanction-ing MDs for
    abetting torture.
  • Argentina, Brazil, Chile, Italy, Rwanda,
    Uruguay.
  • Stage III Punished a symbolic MD. Greece,
    India, Pakistan, South Africa, Sri Lanka, UK.
  • Stage II Condemn complicity in principle but no
    punishments of MDs. Egypt, US, Philippines,
    Venezuela, Uzbekistan
  • Stage I Suppress discussion of MD complicity
    with torture.
  • China, North Korea, Syria

26
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27
Doctors and Torture
  • Doctors are essential to resistance to torture.
  • stewards of norms against prisoner abuse
    (Declaration of Tokyo).
  • detect torture.
  • physicians are allied with civil dissent and
    testimony re torture.
  • Pressure other MDs to report and resist torture.
  • Doctors are essential to torturing regimes.
  • help minimize scars,
  • keep alive those who are supposed to live,
  • conceal the cause of death of those who die.

Half of torture survivors report that a MD
supervised the torture.
28
Health Professions Council of South Africa
Matter of W.J. Basson MD
29
Slides available on request Miles001_at_umn.edu
  • Miles SH, Alencar A, Crock BN. Sanctions against
    physicians for war crimes A work in progress.
  • Paper is available at IRCT.ORG.

30
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