10/02/2011

Oath Betrayed: America's Torture Doctors, Second Edition Review

Oath Betrayed: America's Torture Doctors, Second Edition
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Words failed me when I completed reading Steven Miles' Oath Betrayed. They come no more easily now as I write this review. My dread in putting into words what and how the material in his book has made me feel as a health care professional is compounded by yet another "sucker punch." The latest blow came with the recent release of the four secret memos in response to litigation by the ACLU that were used by the Bush administration to justify torture. But silence of any kind, whether born of fear, intimidation, coercion, apathy, or revulsion is simply unacceptable. Malfeasance and evil deeds thrive on silence and when our words disappear, they must be found and employed.
Dr. Miles speaks of the silence and complicity of physicians and nurses. As a health care professional of 42 years, it pains me to have the knowledge of both brought to my attention and bubble up from those dark places where I like to keep things like horrors hidden. I am a health care professionals. By virtue of my commitment to the social good and special knowledge that I possess as a result of my education, I have a relationship with society that is unique. As part of my social contract I am expected to be trustworthy, competent and to do no harm. In return society affords me and all health professionals a special status. We are honored as caregivers and trusted to alleviate suffering and save lives. To be a health care professional is a privilege.
Other reviewers have most eloquently described and reviewed this book's first edition on medical complicity in the torture and deaths, and their cover-ups in the Afghanistan and Iran during the Bush years. They have spoken of its content and unfailing scholarship, as well as of Dr. Miles' passion. I am unsure how my own review will add to those voices except to say that I agree with all of them. The book is exquisitely written, and constitutes one of those "keepers" for one's bookshelves.
Perhaps my contribution can be that of celebrating those who did and who do breach the silences. It is easy to be horrified and express outrage from the comforts of our homes. It is easy to engage in moral obviation. It is far more difficult to speak up when faced with the withdrawal of one's professional and personal esteem and approbation. That requires the courage, not only to overcome fear and aversion to do what is morally right, but to face the anger and hateful slurs of those who would attribute disloyalty or lack of patriotism for our actions when we speak.
So yes, this book is about the most odious aspects of humanity and the cowardly silence of many. But it also stands as a celebration of those few in this book who had the courage to fight the silence and expose it. The book, even by virtue of having been researched and written by this brave man gives the rest of us hope.


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The news that the United States tortured prisoners in the war on terror has brought shame to the nation, yet little has been written about the doctors and psychologists at these prisons. In Oath Betrayed, medical ethics expert and physician Steven H. Miles tells how doctors, psychologists, and medics cleared prisoners for interrogation, advised and monitored abuse, falsified documents--including death certificates--and were largely silent as the scandal unfolded. This updated and expanded paperback edition gives newly uncovered details about the policies that engage clinicians in torture. It discusses the ongoing furor over psychologists' participating in interrogations. Most explosively this new edition shows how interrogation psychologists may have moved from information-gathering to coercive experiments, warning all of us about a new direction in U.S. policy and military medicine--a direction that not so long ago was unthinkable.

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