Adding Ethics to Our Checklist

Abstract

Another article on the Doctors' Trial at Nuremberg. Old news. We all studied it—surgeries without anesthesia, horrendous and lethal medical experiments on prisoners, and additional horrors too terrible to categorize. Thank heaven that things are different now, following the Belmont Report's 1 strict ethical requirements for medical research, including informed consent and the vigilance of institutional review boards. But Drs. Anne Craig and Sukumar Desai actually do have quite a bit to say that is new, not the least of which is that“Germany hadthe most ethically and legally advanced regulations of any nation at the time (and that) … did not prevent crimes against humanity by part of the medical profession.” The authors also discuss the financial, behavioral, and psychological factors that lulled good physicians into such brutality. Sadly things are not as different now as we would wish. On December 9, 2014, The US Senate Select Committee on Intelligence released its disturbing Report on the Central Intelligence Agency's (CIA)Detention and Interrogation Program, which disclosed the astonishingextentto whichsomeUS healthprofessionals were directly involved in developing, monitoring, and implementing an extensive program of torture while earning $81 million in the process. The program inflicted harm, pain, and suffering, intentionally induced mental illness and disease, carried out invasive medical procedures for nonmedical reasons, and performed medical experimentation without informed consent. Medical care was often offered to enable continued torture. Physicians for Human Rights, in their excellent analysis of the Senate Select Committee on Intelligence report, Doing Harm: Health Professionals' Central Role in the CIA Torture Program, 2 cites at least eight categories of abuse by health care professionals. Ethicist Alessandra Hirsch 3 observes that the behaviors