Q: How did working with the victims of torture become the main focus of your professional life? A: I was invited to chair the board of the Rehabilitation and Research Centre for Torture Victims in Copenhagen from February 1990. At the time I didn't think that I would be doing anything other than chairing the meetings, but then I attended a meeting at the University of Tromso in northern Norway and became aware of the psychiatric abuses that had been going on in eastern Europe. It was really then that it came home to me that the medical profession--my profession --had debts to pay. I also realized that my particular background, both in academia and in professional organizations, serving for example as president of the Standing Committee of Doctors in the European Economic Community (now European Union), could be put to good use. And so I said to myself: is a challenge that I cannot refuse Q: You started out by tackling the issue from a medical ethics perspective, but later on focused more on assistance for victims. How did that transition occur? A: I realized that there was a limit to what could be achieved by making declarations about doctors and torture. The experiences of eastern Europe with psychiatric abuses, and then in Algeria, Northern Ireland and Latin America where military doctors were involved, showed me that it was not enough to tell doctors that they should stay away from torture. The truth is that if they are part of a hierarchy, as is the case with military doctors or prison doctors, they risk getting involved. It is very difficult for individual doctors to stand up against a system that is using torture because it means exposing the system itself, which can then turn against the doctor. While it's a good thing to have doctors exposing torture, in reality it almost never happens. On the other hand there is a great deal that can be done for the victims of torture. This was already understood back in 1980 at the Rehabilitation and Research Centre in Copenhagen, and also at the Harvard Refugee Trauma Program in Boston. Clearly, helping the victims of torture is an obvious approach for the medical profession to take, whereas the writing of resolutions against torture is not. Q: Are you saying that the various declarations made against torture had tittle or no effect? A: Well, I think they had some effect. I am sure that the Amnesty International campaign in 1972 and 1973 put the issue on the global agenda and prompted the United Nations to talk about it. But just going after the health professionals to encourage them not to take part in it ... as I said before, it's easy to say but it's not easy to do. Sometimes doctors face a genuine dilemma. Q: What do you mean ? A: Well, our profession obliges us to do whatever we can to relieve pain or to save the lives of people but if you do that, knowing full well that you are just helping to keep that person alive for the next day's torture, then you are in a double bind. The World Medical Association's declaration in Tokyo in 1975 states that doctors should never be present where torture takes place or is threatened and they should never lend their knowledge to this practice--before, during or after. So, in fact, in this situation our basic obligation to preserve life doesn't apply. Q: How did ICAR get started? A: In 1991 the International Rehabilitation Council for Torture Victims organized a symposium on torture in Budapest, Hungary, and we invited representatives from all eastern European countries, including Dr Camelia Doru from Romania. That symposium inspired Dr Doru to set up the ICAR Foundation in Bucharest to treat Romanian nationals who had suffered during the communist repression. Now ICAR also offers assistance to victims of torture and other human rights violations who come to Romania from other repressive regimes, mainly from the Middle East and other parts of eastern Europe. …