Steven H. Miles - The Torture Doctors: Human Rights Crimes and the Road to Justice

THE TORTURE DOCTORS

HUMAN RIGHTS CRIMES
& THE ROAD TO JUSTICE

STEVEN H. MILES, MD

2020 Georgetown University Press. All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system, without permission in writing from the publisher.

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Library of Congress Cataloging-in-Publication Data

Names: Miles, Steven H., author.

Title: The Torture Doctors : Human Rights Crimes and the Road to Justice / Steven H. Miles, MD.

Description: Washington, DC : Georgetown University Press, 2020. | Includes bibliographical references and index.

Identifiers: LCCN 2019018296 (print) | ISBN 9781626167520 (hardcover : alk. paper) | ISBN 9781626167544 (ebook : alk. paper)

Subjects: LCSH: TortureMoral and ethical aspects. | PhysiciansProfessional ethics. | Political prisonersMedical careMoral and ethical aspects. | Human rights.

Classification: LCC RA1122.8 .M55 2020 (print) | LCC RA1122.8 (ebook) | DDC 179.7dc23

LC record available at https://lccn.loc.gov/2019018296

LC ebook record available at https://lccn.loc.gov/2019980385

This book is printed on acid-free paper meeting the requirements of the American National Standard for Permanence in Paper for Printed Library Materials.

21 209 8 7 6 5 4 3 2 First printing

Printed in the United States of America.

Cover design by Jeff Miller, Faceout Studio.

Cover images by Shutterstock and by Danil Novsky, Stocksy.

I will go for the benefit of the ill,

while being far from all voluntary and destructive injustice.

Oath of Hippocrates, 450 BC

This book excavates a widespread, yet barely explored, medical specialty: the torture doctor. This is a work of medical anthropology. It describes how physicians collaborate with governments to create, inflict, and conceal practices that are intended to inflict severe pain and suffering. It recounts how human rights activists have pushed reluctant governments and medical associations to bring torture doctors to imperfect and rarely imposed forms of justice.

I am a recently retired professor of internal medicine. I practiced medicine and taught medical ethics for thirty-five years. The American Society of Bioethics and Humanities gave me its Lifetime Achievement Award. Work with refugees took me to places ripped apart by war and torture. I have met many torture survivors. They are even among the professors and students of my teaching hospital in Minnesota. They work in grocery stores, as journalists, or as taxi drivers. The US Office of Refugee Resettlement estimates that 500,000 torture survivors live in the United States, a total roughly equal to the number of persons with Parkinsons disease. Think about that number; every adult knows someone with Parkinsons disease. Stigma makes torture survivors invisible. Many are ashamed to tell their histories. Many people, even doctors, do not inquire about the cause of a persons nightmares or scars. Silence pushes torture below its rightful place on the national agenda, inhibiting survivors rehabilitation and delaying reform of governmental and medical community policies.

People often ask those of us who rehabilitate survivors or who study torture, Why on earth would you do that? The question usually means that the topic is too distasteful or painful to contemplate. Ironically, many people who ask this question relax at home by watching torture for entertainment on a crime procedural or spy drama. For six years I served on the Board of the Center for Victims of Torture in Minneapolis. The center staff are as skilled as they are gracious and profound. I do not know of any who consume torture for entertainment.

In May 2004 I saw photographs of US soldiers abusing prisoners in Iraq. Questions came to mind: Where were the doctors of Abu Ghraib prison? Why had they not intervened when they saw the injuries? I sought the answer by reading tens of thousands of government pages that had been declassified by the American

My interests then went global. I tracked the practices of torture doctors and the efforts to punish them around the world. I set up a website, The Doctors Who Torture Accountability Project. I am deeply grateful to Jay Lieberman, Mike Engelstad, and Laurie Walker, who designed the website. In 2015 I wrote an ebook, Doctors Who Torture: The Pursuit of Justice, which drew from some of the material on the website as I continued to compile information. The website was decommissioned at the end of 2017. Its files and many more are transferred to this book. My global study conformed with my experience in the United States; torture doctors rarely face accountability.

This book builds on two pathbreaking books that are now decades old. The American Association for the Advancement of Science published The Breaking of Bodies and Minds: Torture, Psychiatric Abuse, and the Health Professions in 1985. These books built on the anecdotes of their time and pointed to the need for study and reform.

Writing a book inevitably becomes an obsession. I am indebted to my wife, Joline Gitis, who is the special kind of person who can live with someone who pursues this kind of topic. Our gardens and dogs and horses (and I suppose cats) keep our home in equilibrium. Don Jacobs, my editor at Georgetown University Press, was encouraging and helpful. Sarah Deamer labored on the citations. The editors, production staff, and copyeditors at Georgetown University Press were supportive and skilled. I am grateful to the staff of Minneapoliss Center for Victims of Torture and of the Human Rights Program at the University of Minnesota Law School. I am deeply grateful for the support of the faculty and staff of the University of Minnesotas Center for Bioethics, who understood that this work is integral to the field of medical ethics. Each of these institutions embodies the humanity and intellectual energy of civil society. That spirit is the target of torture. That spirit alone will vanquish it.

Faustino Blanco Cabrera did not set out to be a torture doctor, but when his government turned to torture, that is what he became.

In 1976 Lieutenant Dr. Cabrera worked in the prisons of Argentinas military junta during its Dirty War. His job was to assess prisoners undergoing torture and tell the guards when to ease up on those who were supposed to live. He provided minor medical care to prisoners under torture who were supposed to live for a bit longer. He created and signed death certificates falsely asserting that imprisoned men or women who had been murdered by the state had died of natural causes. In 1983 the military junta fell from power and Cabrera slipped into private practice as a psychiatrist.

Twenty-three years later, in 2006, Cabreras work as a torture doctor was discovered. He was tried and sent to prison. He was soon mysteriously freed and abandoned his family to move to another part of Argentina, where he practiced for six more years.

An Argentine court tried Cabrera for torture, falsification of death certificates, and crimes against humanity. At the time his second trial began, one of Cabreras psychiatry patients was a man with posttraumatic stress disorder (PTSD) from being tortured by the same junta that had employed Cabrera. The mans daughter was also one of Cabreras patients. Her mental illness had resulted from the terror of living in hiding during her fathers imprisonment. Until Cabreras arrest, neither father nor daughter knew that their own physician had worked for the torturing regime that had traumatized them. In 2013 the daughter sat quietly in court watching her psychiatrist being sentenced to seven years in prison for being an accomplice to the terror that caused such suffering to her and her father.