Explore: The Journal of Science and Healing
Volume 5, Issue 1 , Pages 1-7, January 2009

A Return to Sanity

Article Outline

 

The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty, and we must rise with the occasion. As our case is new, so we must think anew, and act anew.

—Abraham Lincoln, Second Annual Message to Congress, December 1, 18621

By the time you read this, America will have a new president. Whether it turns out to be Senator Barack Obama or Senator John McCain, the change will afford us an opportunity to reflect on our recent past, and where we may be headed.

I consider the past eight years a nightmare. There are many areas of our cultural terrain where wreckage is strewn, too many to address here. I want to focus on two areas that have a direct impact on the mission of this journal: the distortion of science, and the official endorsement, at the highest levels of government, of torture.

Explore is “the journal of science and healing.” The relevance of distorted science to this publication is straightforward: bad science leads to bad medicine. The importance of torture may not be apparent, but it too is directly relevant to what we stand for at Explore. As I explained in a previous editorial, “Where Were the Doctors?,”2 beginning shortly after September 11 and the invasion of Afghanistan, healthcare professionals have been pressured and bullied into participating in these heinous and often lethal activities in American military prisons and black sites around the world, in violation of the ethical codes of professional societies worldwide. No journal that stands for healing can ignore these protorture developments, simply because torture and healing cannot coexist.

If we grasp the importance of the degradation of science during the past eight years and the trampling of the ethical and moral codes to which we have sworn, in the future we can say to those in power, “Never again!”

Back to Article Outline

Desecration 

As hundreds of prominent scientists have observed, science during the past four years has been corrupted by petty politics, special interests, cronyism, intimidation and denigration of experts within science as “elitists,” the substitution of theology for scientific evidence, falsification of scientific findings by bureaucratic hacks, and mendacity masquerading as truth, all on a scale not seen in our lifetime.3, 4

“Thomas Jefferson would be appalled,” wrote Boyce Rensberger in Scientific American in 2005. “More than two centuries after he helped to shape a government based on the idea that reason and technological advancement would propel the new United States into a glorious future, the political party that now controls the government has largely turned its back on science … [rejecting] the most reliable sources of information and analysis available to guide the nation… . Large swaths of the government in Washington are now in the hands of people who don't know what science is.”5

In 2004, the Union of Concerned Scientists issued two reports dealing with scientific integrity in policy making. These documents expressed “embarrassment and disgust” over the way the administration was misusing science. They charged that the Bush administration has ignored the recommendations of advisory panels and that it “suppresses, distorts and manipulates” scientific work. The reports included a long list of specific instances to back up their charges. They were signed by 48 Nobel Laureates, 62 National Medal of Science recipients, and 127 members of the National Academy of Sciences.6 John H. Marburger, III, President Bush's science advisor, called the charges “false,” “wrong,” or “a distortion.” Marburger's defense was valiant, but he was in a distinct minority; to date, the reports of the Union of Concerned Scientists have been signed by 15,000 US scientists.7, 8, 9

While President Bush has endorsed the efforts by Christian conservatives to include the teaching of “intelligent design” as an alternative to evolution in public school science classes, the rankings of American schools have dropped to 21st in the world in the teaching of science and 25th in the world in the teaching of math.10, 11 The United States is the only country in the industrialized world where children are less likely to graduate from high school than their parents were. 12 The anti-intellectualism championed by those in power the past eight years has become an acute embarrassment. One fifth of our citizens believe the sun orbits the Earth. Twenty-nine percent of Americans between ages 18 and 24 cannot find the Pacific Ocean on a map; 11% cannot find the United States.13 For America's sake, we must scrape science up off the floor and reclaim it. We must insist that the new president steer another course in science.

One widely supported approach he can take is to quickly appoint a science adviser who is a nationally respected leader in science and who also has management and policy skills. This individual should be given cabinet-level rank, as recommended by nearly 180 organizations that independently represent the scientific, academic, and business arenas. Without proper scientific and technical input, it will be impossible to properly chart the future regarding energy security, climate change, science education, and healthcare. Among the groups supporting this recommendation are the American Association for the Advancement of Science and the Association of American Universities.14

Some stains on the national fabric, however, will take longer to remove.

Back to Article Outline

A Torturing Nation 

The seven years following September 11, 2001, will go down in history as the period in which torture was officially injected into the American experience. During this period the unthinkable happened: we became a torturing nation. Torture was sanctioned at the highest levels of government in secret meetings and clandestine memos that have since come to light.15, 16

This is the sort of fact that, when fully faced, threatens to overwhelm the imagination. Despots and dictators engaged in torture, we believed, not Americans. It is simply is not in our character to do so, we said. Our leaders rejected torture even before we were a nation. During the American Revolution, General George Washington prohibited the torture of captured enemy soldiers, even though American soldiers were being executed following capture. The prohibition of torture remained in place throughout every presidency until that of George W. Bush, who changed the definition of torture and energetically embraced it to the astonishment of all civilized nations.

Back to Article Outline

If This is Not Wrong, Nothing is Wrong 

Most of us believe that some actions are so vile that Americans would simply not participate in them as a matter of principle. In our brief history as a nation, however, our revulsion toward things that are evil has sometimes been slow in developing.

The great example is slavery. Although some of the Founding Fathers who signed the Declaration of Independence fiercely opposed slavery and spoke out against it, many did not. For complex reasons, some managed to tolerate the contradictions involved in slave ownership in spite of those lofty passages in the Declaration of Independence to which they affixed their signatures: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”

Criticism of our past is a delicate task that must be done respectfully. Above all, one must be careful to avoid the errors of presentism, the tendency to interpret past events in terms of modern values and concepts. But criticism is necessary, because only by meticulously examining our history can we acquire the vigilance necessary to avoid repeating past mistakes in the future.

Our current debate over torture parallels America's century-long agony over slavery. Slavery was condemned as inherently immoral, inhumane, and evil by a significant proportion of the population; so too is torture. Slavery was defended by labyrinthine arguments, legal gyrations, pragmatism, and as sheer necessity by its proponents; so too with torture. Both sides saw slavery in terms of absolutes not subject to bargaining or compromise; torture is currently viewed in the same way. And torture is likely to be banished from America the same way the country rid itself of slavery—through the courage and vision of a bold leader.

If a single American can be credited with bringing the nation to its senses on slavery, it is Abraham Lincoln. During his bid in Illinois for the U.S. Senate in 1858, he and his opponent, incumbent Stephen Douglas, engaged in seven historic, grueling debates.17, 37, 38, 39, 40, 18 The main point of contention was slavery. Lincoln believed slavery should be excluded from the western territories because it violated the principle of fundamental human equality. If slavery is not wrong, he said, nothing is wrong. Douglas, however, advocated popular sovereignty as the way to decide the issue. Settlers in the territories should vote on whether they wanted slaves. For Douglas, the issue was legalistic and political. He believed Lincoln's endorsement of black citizenship was a scandalous denial of states' rights and the constitutional protection of private property. He said, “I am opposed to negro citizenship in any and every form… . I am in favor of confining citizenship to white men, men of European birth and descent, instead of conferring it upon negroes, Indians, and other inferior races.” This country, he insisted, was founded on “the white basis.”17(p38) In other words, blacks could never become citizens because they are black.17(p39)

Although Lincoln tied himself in knots early in the debates in trying to respond to Douglas point by point, he became clear and resolute as the debates proceeded. The problem with Douglas's reasoning, he said, was that slavery was the problem.17(p38) Douglas's complex arguments about states' rights and private property were a smokescreen hiding what everyone knew was the pivotal issue: slavery itself. Lincoln appealed to transcendent truths and moral laws. Some things are inherently wrong, he maintained, among which are the buying and selling of other human beings. One does not vote on that which is evil; one rejects it because it is evil. By appealing to universal principles, Lincoln essentially leapfrogged Douglas's labyrinthine legalisms and appealed to the better angels of human nature.

Although Douglas won the 1858 election and retained his Senate seat, the debates catapulted Lincoln to national fame. He ran against Douglas for the presidency in 1860 and defeated him. On January 1, 1863, Lincoln issued the Emancipation Proclamation, freeing all slaves behind confederate lines. Douglas did not live to see “the inferior races” he so deplored become free citizens. He died of typhoid fever in Chicago in 1861.

Back to Article Outline

Enablers of Torture 

Unfortunately there was no Lincoln present when government officials met in the White House on several occasions in 2003 to discuss “enhanced” interrogation methods. According to an ABC News report in April 2008, among those present were Vice President Dick Cheney and his counsel, later chief of staff, David Addington; Attorney General John Ashcroft; President Bush's national security advisor, Condoleezza Rice; Secretary of Defense Donald Rumsfeld; the Defense Department's general counsel, William J. Haynes II; Secretary of State Colin Powell; and CIA Director George Tenet.16, 19(pp45-49) No appeals to transcendent truths or moral laws, such as Lincoln used in his scalding denunciation of slavery, were reported from these meetings. No one stood up and said that if torture is not wrong, nothing is wrong, as Lincoln said of slavery. Instead, the participants descended to the gutter of hollow, self-serving legalisms, just as Douglas did in his debates with Lincoln. President Bush enthusiastically defended this strategy. “As a matter of fact,” he told Martha Raddatz, the ABC News White House correspondent, “I told the country we did that [approved harsh interrogation methods]. We had legal opinions that enabled us to do it.”19(pp45-49)

One of the enhanced methods of interrogation given the green light in these meetings was water boarding or simulated drowning. Following World War II, Japanese prison officials who tortured American captives with this technique were prosecuted as war criminals by the United States. That water torture could be sanctioned in the White House six decades later indicates how wildly our moral compass had begun to spin.

One brief flicker of conscience was reported from the White House meetings on harsh interrogation. “Ashcroft was troubled by the discussions,” ABC News reported. “He agreed with the general policy decision to allow aggressive tactics and had repeatedly advised that they were legal. But he argued that senior White House advisers should not be involved in the grim details of interrogations, sources said. According to a top official, Ashcroft asked aloud after one meeting: ‘Why are we talking about this in the White House? History will not judge this kindly.' ” But Ashcroft was concerned with appearances, not moral imperatives, and in any case his objections were too little, too late, and were brushed aside. Condoleezza Rice spoke for the majority when she told the CIA representatives, “This is your baby. Go do it.”20

The baby grew fast. Five years later, military lawyer Major David J.R. Frakt (Air Force Reserve) was assigned to represent one of the torture victims at Guantánamo Bay. In a pretrial hearing in June 2008, he boldly called the men who crafted the legal opinions that so delighted the president “enablers of torture.” They included, Frakt said, legal counselors John Yoo, Jay Bybee, Robert Delahunty, Alberto Gonzalez, David Addington, and William J. Haynes II, as well as Vice President Dick Cheney and Secretary of Defense Donald Rumsfeld.19(p45)

We have not yet found our moral footing following these high-level sanctions. As of this writing (late October 2008), our leaders still have not repudiated torture, in spite of scores of homicides that have been attributed to harsh interrogation in US detention centers and black sites. President Bush continues to defend these methods. He has recently stated he will never close Guantánamo Bay prison before leaving office, even though it has become an internationally reviled symbol of America's fight against terrorism, and even though key members of his cabinet are said to be in favor of doing so. Closing Guantánamo, the White House says, would involve too many political and legal risks.21

Legalisms again. What would Lincoln say? General Washington?

Meanwhile, reports Anthony Lewis, the Pulitzer-winning journalist, the enablers of torture are “doing fine.” As of this writing, President Bush, Vice President Cheney, and David Addington remain in office. Jay Bybee, who issued the legal opinion that said the president has unlimited power to order the use of torture, was nominated and confirmed as a judge of the United States Court of Appeals for the Ninth Circuit before his torture role became known. Legal scholar John Yoo, who wrote the infamous “torture memos” advocating the legality of torture and that enemy combatants could be denied protection under the Geneva Conventions, and who is believed to have laid the legal foundation for the nation's warrantless wiretapping program, is enjoying his professorship at the University of California, Berkeley, law school. The school's dean, Christopher Edley, Jr, said in April 2008 that although he was “troubled” by the torture memos, Yoo was protected by tenure rules and academic freedom and that he could not be fired unless he was convicted of war crimes.19, 48, 22

Some of the stoutest defenders of American ideals of justice for the past seven years have been American lawyers, many of whom have volunteered their time in the struggle against torture. An outstanding example is Major David J.R. Frakt, already mentioned, who was charged with defending Guantánamo prisoner Mohammed Jawad.

Jawad, an Afghan, is accused of throwing a grenade at a convoy of American soldiers in Kabul in 2002, wounding two. He was 17 years old at the time. Jawad attempted suicide while imprisoned in Guantánamo in 2003. Five months later he was subjected to the “frequent flier program” at Guantánamo, which meant that every three hours, day and night, he was shackled and moved to another cell, 112 times over 14 days. The prison authorities did not believe he had any valuable information; they did not even bother to question him during his harassment. So why was he treated with sadistic sleep deprivation? “The most likely scenario,” Frakt said, “is that they simply decided to torture him for sport, to teach him a lesson, perhaps to make an example of him to others.” In his defense of Jawad, Frakt courageously addressed President Bush's order of February 7, 2002, that prisoners detained as alleged Al Qaeda or Taliban members and supporters were not to be given the protections of the Geneva Conventions. “America lost a little of its greatness that day,” said Frakt. “We lost our position as the world's leading defender of human rights, as the champion of justice and fairness and the rule of law.”23

Lincoln would not have been amused by the cute term “frequent flier program,” and he would not have been deceived by the misleading term “water boarding,” which gives no hint of the partial suffocation and near drowning involved. The president who helped America confront the evil of slavery would likely have thundered against these and other techniques used at Guantánamo and Abu Ghraib, such as forced stress positions, exposure to harsh lights and extreme hot and cold temperatures, whipping with cables, burning with cigarettes, hanging from iron bars by handcuffs, electrical shocks, sexual humiliation, nudity, intimidation by dogs, beatings, mock executions, and the murders that have resulted from these “enhanced” methods. These practices are even more reprehensible when one realizes that, according to a Red Cross report, military intelligence officers themselves estimate that somewhere between 70% and 90% of those whom they detain have been picked up by mistake and are guilty of nothing at all, “except the crime of living in an occupied country and stumbling into a foreign-administered hell.”24

Back to Article Outline

Aftermath 

In 2008, the American humanitarian group Physicians for Human Rights published “Broken Laws, Broken Lives.”25 This report describes practices used to bring about long-lasting pain, terror, humiliation, and shame for months on end for 11 prisoners in American prisons in Iraq, Afghanistan, and Guantánamo Bay. None of the detainees were ever charged with a crime or told why they were detained. This account reveals how torture destroys bodies, minds, and lives—the aftermath of the “enhanced interrogation” regime authorized by the president after being concocted by those under him.

In his preface to the report, Major General Antonio Taguba (US Army, retired), who led the US Army's official investigation into the Abu Ghraib prisoner abuse scandal in 2004, wrote, “After years of disclosures by government investigations, media accounts, and reports from human rights organizations, there is no longer any doubt as to whether the current administration has committed war crimes. The only question is whether those who ordered the use of torture will be held to account.”26

Back to Article Outline

The Moral Failure Continues 

In a previous editorial, “Where Were the Doctors?” as mentioned, I explored how healthcare professionals have cooperated with the torture of prisoners in America's military prisons and black sites.2 I noted that the American Medical Association, the American Psychiatric Association, the American Nurses Association, and the World Medical Association have longstanding prohibitions against any degree of involvement with torture, including being in the same room where torture is being conducted. I am happy to report that the American Psychological Association has also just recently adopted this position.27

But the issue of physician involvement in torture is not resolved. Bioethicist Jonathan Marks, of Pennsylvania State University at University Park and the College of Medicine in Hershey, and M. Gregg Bloche, professor of law at Georgetown University, recently obtained documents from the US Army under the Freedom of Information Act that reveal the military's ongoing plans for continued physician involvement in torture. Marks and Bloche report in the New England Journal of Medicine in September 2008 that the military wants doctors and psychologists to evaluate the psychological strengths and vulnerabilities of detainees and assist in integrating these factors into a successful interrogation.28 With shameless audacity, the Army documents suggest that the presence of a physician in an interrogation may benefit the prisoner by helping establish rapport. This compassionate kind of torture will presumably elicit more useful information than the uncompassionate, red-meat kind of abuse that has been exposed in Guantánamo and Abu Ghraib. This is the sort of thing for which the expression “putting lipstick on a pig” was invented. The notion of kinder torture is an insult to the intelligence of anyone who has read reports of fatal interrogations in which “behavioral science consultants” were involved.29

Marks and Bloche believe the Army's policy encourages physicians, nurses, psychiatrists, and psychologists to reject the ethical positions of their professional organizations. They say, moreover, that “[The Army's position] undermines the notion of psychiatrists as healers, and undermines trust in the profession.” This is a candidate for the understatement of the century.

The Army's stance is brazenly irrational. Although the military documents obtained by Marks and Bloche state that the “behavioral science consultants” are not to perform any duties they believe are illegal, immoral, or unethical, these duties have already been defined by the above-mentioned organizations as flagrant violations of their codes of ethics.

Undeterred, the Army is forging ahead. Marks and Bloche report that between July 2006 and October 2007, five Army psychiatrists were put through the “behavioral science consultation” training course.

Back to Article Outline

Another Kind of Bankruptcy 

Currently we are in the throes of the bankruptcy of credit institutions nationwide. But there is more than one kind of bankruptcy. Our official installation of torture threatens to bankrupt us morally as well. In fact, our financial and moral crises may be related.

The most frequently cited cause for the current financial meltdown is greed. On this, the two presidential candidates agree. “CEOs got greedy,” says Senator Barack Obama.30 Senator John McCain has also roasted Wall Street for its “unbridled greed.”31 Moreover, some analysts are attributing greed to millions of home buyers, who purchased overpriced property with loans they could not afford.32 Even Alan Greenspan, former chairman of the Federal Reserve, who was lauded as “The Oracle” when the economy was booming, points a finger at greed.33 Testifying before a hostile congressional committee on October 23, 2008, he conceded that his failure to take any action in preventing irresponsible, subprime mortgage lending played a role in generating the financial crisis. He said he made “a mistake” in his hands-off regulatory philosophy, and that he has “found a flaw” in his ideology. But he appeared to attribute the financial crisis mainly to greed, saying, “Those of us who have looked to the self-interest of lending institutions to protect shareholders' equity … are in a state of shocked disbelief.”34 In other words, the desire of a company to protect itself—its reputation, its future—was supposed to prevent actions that could threaten the interest of shareholders. Self-interest as a firewall to greed? Can The Oracle be serious?

Why massive, destructive greed should cause shocked disbelief in anyone who has been minimally conscious for the past eight years is mysterious (think Enron, Abramoff, Halliburton, no-bid war contracts, billions of war appropriations that have gone missing, golden parachutes, etc). Greed is one of the most universal and predictable constants of human nature. Are our leaders so lily pure that they are surprised when greed goes nuclear? I'm reminded of Mark Twain's satirical comment, “Sometimes I wonder whether the world is run by smart people who are putting us on, or by imbeciles who really mean it.”35

Greed's cousin is hubris, the excessive pride and self-confidence about which the Greeks warned. Hubris stalked Wall Street hand in hand with greed in the run-up to our financial catastrophe. And there is no better term than hubris for the insouciance and arrogance with which the enablers of torture defiled the White House chambers and desecrated our country's honor.

Back to Article Outline

Greed and Medicine 

The greed machine that overtook the financial world began casting its shadow on the institutions of medicine years ago. As author and columnist Judith Warner states, “About three decades ago, it became possible to make serious money as a university researcher. Not that the money was so bad before… . It was respectable. But it wasn't Wall Street-type money.”36 The big change took place in the early 1980s, when legislation was passed allowing universities to patent their publicly funded research results and then grant exclusive licenses to pharmaceutical companies to manufacture and market the resulting products. The royalties on drugs and medical devices developed by faculty researchers were split between the researchers and their departments. Enterprising faculty researchers began start-up companies and often sold them for huge sums. University professors became dual citizens, with one foot in the ivory tower of academia and the other foot in industry.36

“Greed became respectable,” says Marcia Angell, the former editor in chief of the New England Journal of Medicine and a professor of global health and social medicine at Harvard Medical School. The feeling developed that “the world is divided into winners and losers. In medical research this just has had enormous implications.”37

Because of the huge sums that were involved, deception and manipulation of science followed greed as naturally as night follows day. An example appears to be Dr Charles B. Nemeroff of Emory University, one of the nation's most prominent psychiatrists. Dr Nemeroff was the principal investigator on a government-financed study of antidepressant drugs made by GlaxoSmithKline. He repeatedly promised to keep his consulting fees from Glaxo below $10,000 a year in compliance with federal and university conflict-of-interest rules. But he took far more than that, mostly for giving talks promoting the company's drugs to other physicians. According to Senator Charles Grassley, who is investigating conflicts of interest among leading researchers, Nemeroff failed to report some half a million dollars in fees and expenses from Glaxo while he led the study.38 He earned $2.8 million in fees from 2000 to 2007 and had at one point consulted for 21 drug and device companies simultaneously.36

Consulting for dozens of companies and becoming wealthy in the process is not illegal and is even admired by those who think there's nothing wrong in knowing how to game the system. But opening the floodgates of greed can distort science and ultimately clinical medicine. Consider a 2006 paper by Nemeroff and his coauthors that extolled the virtues of a controversial device used to treat depression, made by Cyberonics, Inc of Houston, Texas.39 The company not only paid Nemeroff and his coauthors for writing the paper but also gave an unrestricted grant to Dr Nemeroff's department. One of the paid coauthors was an employee of the company. When the undisclosed financial ties came to light, they created a scandal. “I can't believe that anyone in the public or in academia would believe anything except that this paper was a piece of paid marketing,” said Claudia R. Adkison, an associate dean at Emory.40 In the wake of the controversy, Nemeroff resigned as editor of the journal Neuropsychopharmacology, which published the paper—but only after he was exposed by The Wall Street Journal.41

No one knows how many Nemeroffs there are, but evidence being uncovered by Senator Grassley suggests they abound. “You have to remember,” explains Mike Adams, a consumer health advocate and critic of unethical practices in conventional medicine, commenting on the Nemeroff incident, “that virtually everyone in conventional medicine—from doctors to journal editors to FDA advisory panel members—claim they operate with such supreme intellect that they are immune to financial influence, and thus there is no need for them to even disclose conflicts of interest. Conventional medicine is an industry that believes it is above the laws of ethics, and that it should operate with impunity, without any serious scrutiny or disclosure. They seem to demand, ‘How dare you question our judgment?’ while simultaneously pocketing cash from pharmaceutical companies or medical device manufacturers. The arrogance is astonishing.”42 Well, not exactly. The problem is rampant, as Adams correctly indicates, but not everyone in conventional medicine has sold out.

Conflicts of interest also involve—surprise!—government-connected scientists. Angell cites a study of 200 government panels that issue practice guidelines, which found that more than a third of the authors had financial interest in the drugs they recommended. Moreover, Angell reports that many members of the 16 standing committees that advise the Food and Drug Administration on drug approvals have financial ties to drug companies. Although these individuals are supposed to recuse themselves from participating in decisions about drugs made by companies with which they have a financial relationship, the FDA often waives this requirement.36

These issues involve more than one's philosophy of government, private enterprise, and getting ahead. They are life-and-death issues. The poster drug illustrating this fact is perhaps Vioxx, Merck's best-selling arthritis drug, which may have led to more than 27,000 heart attacks and sudden cardiac deaths from 1999 through 2003.43 According to Richard Horton, editor of The Lancet, writing in 2004, “The licensing of Vioxx and its continued use in the face of unambiguous evidence of harm have been public health catastrophes. This controversy will not end with the drug's withdrawal. Merck's likely litigation bill is put at between $10bn and $15bn. The company has seen its revenues and its capitalization slashed. It has been financially disabled and its reputation lies in ruins. It is not at all clear that Merck will survive this growing scandal.”44 The greed-greased parallels of the Merck fiasco with the recent failure of financial institutions such as Bear Stearns, Lehman Brothers, AIG, Freddy Mac, and Fannie Mae are unmistakable.

This is only a snapshot of how medicine, from research to clinical practice, has been corrupted by greed and sums of money that are breathtaking. Those wishing a more complete dissection of this situation may consult Dr Angell's book The Truth About the Drug Companies: How They Deceive Us and What to Do About It,45 and On the Take: How Medicine's Complicity with Big Business Can Endanger Your Health,46 by Jerome P. Kassirer, MD, who, like Angell, is a former editor in chief of the New England Journal of Medicine.

Back to Article Outline

Beyond Politics 

Some readers may view these comments as a political polemic and therefore unsuitable for a medical journal. But it is impossible to practice any form of healthcare today without being enmeshed in political and governmental decisions. Today the lines between politics, government, and the healing professions are blurred in the extreme. Political and governmental decisions increasingly influence everything we do. It is our constitutional right—and responsibility—to push back when, in our opinion, things go off track. George Orwell said, “If liberty means anything at all, it means the right to tell people what they do not want to hear”—and “people” includes our leaders.47

We are currently grappling with something far more serious than politics: sanity itself. My dictionary tells me that “insane” means “a state of mind that prevents normal perception, behavior, or social interaction.”48 By that definition, we cannot consider ourselves currently sane as a nation, because the failure of ethical norms in key areas of our society has led to the breakdown of normal functioning on a colossal scale.

Consider torture once again. The outrage healers feel toward our government's official installation of torture transcends politics. Though not in healthcare, Andrew Sullivan, the conservative author and political commentator, expresses this transpolitical aspect well. Commenting on the above-mentioned 2008 report “Broken Laws, Broken Lives,” he said, “I started this war not as a Bush-hater, but as a Bush-defender. I started it dismissing the first rumors of torture at [Guantánamo]… . But … with every new revelation and every spurious defense and every new lie, it is impossible not to feel anger. In fact, in my view, it is vital to feel anger. And not to let it subside.”49

Anyone who is unwilling to stand up for the integrity of science and for the ethical norms that have guided our profession since the birth of the Hippocratic oath should consider another profession.

Back to Article Outline

A Challenge to the New President 

No one has ever discovered how to rid a society of greed. It appears to be cyclical. We see it now, just as we saw it in the 1980s during the savings and loan scandals. It manifested spectacularly during the robber-baron era, when businessmen and bankers ruthlessly dominated their respective industries and amassed huge personal fortunes.

As far as returning ethics to medicine is concerned, the outlook is hopeful. Rules governing transparency and conflict of interest are already on the books, but they need to be enforced. Instead of additional rules governing our profession, we need a reawakening of conscience that would make more rules unnecessary.

It is our government that influences most decisively the standards of conduct in our society. Profit at the top may not always trickle down, but corruption does. Whatever our political affiliation, it is our duty as citizens to elect leaders whose integrity and honesty are exemplary.

But there will be no quick fix. Individuals, governments, and professions do not become insane overnight. Insanity is usually a gradual process, and so too is the return to sanity. There is one action, however, that the new president can promptly take to help set the recovery in motion.

Our new commander in chief should immediately abolish torture and return to the Geneva Conventions. This would announce to the world that we are returning to a standard of conduct that guided America for all our history except for the past few years. This would help restore our self-respect and would inspire the world to admire this nation once again as a beacon of justice.

All healthcare professionals should support this demand, but not only for humanitarian reasons. For as long as torture remains, its enablers will continue trying to drag physicians, nurses, psychiatrists, and psychologists into its maw as facilitators and legitimizers. If we permit this to happen, we will become enablers of the enablers of torture and unworthy of being called healers.

Back to Article Outline

References 

  1. ShapiroLincoln A. Second annual message to Congress, December 1, 1862. In:  Fred R editors. The Yale Book of Quotations.. New Haven, Conn: Yale University Press; 2006;p. 462
  2. Dossey L. Where were the doctors? (Torture and the betrayal of medicine). Explore (NY). 2006;2:473–481
  3. The editors. Bush-league Lysenkoism. Scientific American Web site. April 2004. http://www.sciam.com/article.cfm?id=bush-league-lysenkoismAccessed October 22, 2008
  4. Mooney C. The Republican War on Science. New York, NY: Basic Books; 2006;
  5. Rensberger B. Science abuse. Scientific American Web site. September 2005. http://www.sciam.com/article.cfm?id=science-abuseAccessed October 22, 2008
  6. Revkin AC. Bush vs. the laureates: how science became a partisan issue. The New York Times Web site. October 19, 2004. http://www.nytimes.com/2004/10/19/science/19poli.htmlAccessed October 25, 2008
  7. Reports: scientific integrity in policymaking. Union of Concerned Scientists Web site. September 9, 2005. http://www.ucsusa.org/scientific_integrity/abuses_of_science/investigations_and_surveys/reports-scientific-integrity.htmlAccessed October 24, 2008
  8. Vance A. Scientists horrified by Bush's bad science. The Register Web site. July 12, 2004. http://www.theregister.co.uk/2004/07/12/bush_bad_science/Accessed October 24, 2008
  9. Restoring scientific integrity in policymaking: scientists' sign-on statement. Union of Concerned Scientists Web site. February 8, 2005. http://www.ucsusa.org/scientific_integrity/abuses_of_science/scientists-sign-on-statement.htmlAccessed October 24, 2008
  10. Froomkin D. Bush backs Rove, Palmeiro, “intelligent design.” washingtonpost.com. August 2, 2005. http://www.washingtonpost.com/wp-dyn/content/blog/2005/08/02/BL2005080201070.htmlAccessed October 24, 2008
  11. Didion J. A fateful election. New York Review. November 6, 2008:10.
  12. Kristof N. Obama and the war on brains. New York Times Web site. November 9, 2008. http://www.nytimes.com/2008/11/09/opinion/09kristof.html?ref=opinionAccessed November 9, 2008
  13. Global goofs: U.S. youth can't find Iraq. CNN.com. November 22, 2002. http://archives.cnn.com/2002/EDUCATION/11/20/geography.quiz/index.htmlAccessed March 21, 2008
  14. Revkin AC. Science advice for the next president. New York Times http://dotearth.blogs.nytimes.com/2008/10/31/science-advice-for-the-next-president/. Dot Earth blog. October 31, 2008. Accessed October 31, 2008.
  15. Warrick J. CIA tactics endorsed in secret memos. washingtonpost.com. http://www.washingtonpost.com/wp-dyn/content/article/2008/10/14/AR2008101403331.htmlAccessed October 22, 2008
  16. Froomkin D. White House torture advisers. washingtonpost.com. April 10, 2008. http://www.washingtonpost.com/wp-dyn/content/blog/2008/04/10/BL2008041002069.htmlAccessed October 22, 2008
  17. Oakes J. They soared above the din. The New York Review. October 23, 2008:55.
  18. Guelzo AC. Lincoln and Douglas: The Debates that Changed America. New York, NY: Simon and Schuster; 2008;
  19. Lewis A. Official American sadism. The New York Review. September 25, 2008:55.
  20. Greenburg JC, Rosenberg HL, de Vogue A. Bush aware of advisers' interrogation talks. ABC News Web site. April 11, 2008. http://abcnews.go.com/print?id=4635175Accessed October 23, 2008
  21. Myers S. Bush decides to keep Guantánamo open. The New York Times Web site. October 20, 2008. http://www.nytimes.com/2008/10/21/washington/21gitmo.html?ref=usAccessed October 22, 2008
  22. Gammon R. The torture professor. East Bay Express News http://www.eastbayexpress.com/news/the_torture_professor/Content?oid=727134. May 14, 2008.
  23. Frakt DJR September 25. Quoted in: Lewis A. Official American sadism. The New York Review. 2008;55(14):45
  24. Ross O. Detainees suffer terror at U. S. hands. CommonDreams.org. May 12, 2004. http://www.commondreams.org/headlines04/0512-10.htmAccessed October 25, 2008
  25. Hashemian F, Rubenstein LS, Taguba A, Iacopino V, Strawczynshi J. Physicians for Human Rights Web site. Broken laws, broken lives: medical evidence of torture by the U. S. personnel and its impact. June 2008. http://brokenlives.info/?page_id=69Accessed October 25, 2008
  26. Taguba A. Preface to broken laws, broken lives: medical evidence of torture by the U. S. Personnel and its impact. Physicians for Human Rights Web site. http://brokenlives.info/?page_id=69Accessed October 25, 2008
  27. Peck P. New APA policy bars psychologists from helping in illegal interrogations. MedPage Today. October 3, 2008. http://www.medpagetoday.com/PublicHealthPolicy/MilitaryMedicine/11167Accessed October 23, 2008
  28. Marks JH, Bloche MG. The ethics of interrogations–the U.S. military's ongoing use of psychiatrists. New Engl J Med. 2008;359:1090–1092
  29. Miles SH. Oath Betrayed: Torture, Medical Complicity, and the War on Terror. New York, NY: Random House; 2006;31
  30. Obama B. Quoted in: Amanda Scott. Barack in Elko: “we need a president who will lead us out of this mess.” Obama Biden Web site. September 17, 2008. http://my.barackobama.com/page/community/post/amandascott/gGg4X3Accessed October 3, 2008
  31. McCain J. Quoted in: John Shovelan. McCain roasts ‘reckless, greedy’ Wall Street. ABC News Web site. September 17, 2008. http://www.abc.net.au/news/stories/2008/09/17/2366611.htmAccessed October 3, 2008
  32. Hanson VD. Public shares the blame in creating Dr. Frankenstein's Wall Street. The Salt Lake Tribune Web site. September 25, 2008. http://article.nationalreview.com/?q=NjkxZDJjMTViZDQ4NzhkMTRmNGRIZGNmZjgzMzhkZGU=Accessed December 3, 2008
  33. Canterbery ER. Alan Greenspan: The Oracle Behind the Curtain. Singapore: World Scientific Publishing Company; 2006;
  34. Scannell K, Reddy S. Greenspan admits errors to hostile house panel. Wall Street Journal Web site. October 24, 2008. http://www.careerjournal.com/article/SB122476545437862295.htmlAccessed October 26, 2008
  35. Twain M. Quoted in: Quinn J. Looming financial catastrophe: a real inconvenient truth. SeekingAlpha.com. August 24, 2008. http://seekingalpha.com/article/92303-looming-financial-catastrophe-a-real-inconvenient-truthAccessed October 25, 2008
  36. Warner J. Diagnosis: greed. New York Times Web site. October 9, 2008. http://warner.blogs.nytimes.com/2008/10/09/diagnosis-greed/Accessed October 25, 2008
  37. Angell M. Quoted in: Warner J. Diagnosis: greed. New York Times Web site. October 9, 2008. http://warner.blogs.nytimes.com/2008/10/09/diagnosis-greed/Accessed October 25, 2008
  38. Editorial. Drugs and disclosure. The New York Times Web site. October 10, 2008. http://www.nytimes.com/2008/10/11/opinion/11sat2.htmlAccessed October 25, 2008
  39. Neuropsychopharmacology. 2006;31:1345-1355Nemeroff C, Maybert HS, Krahl SE, et al. VNS therapy in treatment-resistant depression: clinical evidence and putative neurobiological mechanisms [abstract]. http://www.nature.com/npp/journal/v31/n10/full/1301190a.htmlAccessed October 25, 2008
  40. Adkison CR. Quoted in: Harris G. Top psychiatrist didn't report drug makers' pay. The New York Times Web site. October 3, 2008. http://www.nytimes.com/2008/10/04/health/policy/04drug.htmlAccessed October 25, 2008
  41. Psychiatric medical journal editor Nemeroff resigns after secret financial ties uncovered. NaturalNews.com. August 29, 2006. http://www.naturalnews.com/020213.htmlAccessed October 27, 2008
  42. Adams M. Quoted in: Psychiatric medical journal editor Nemeroff resigns after secret financial ties uncovered. NaturalNews.com. August 29, 2006. http://www.naturalnews.com/020213.htmlAccessed October 27, 2008
  43. Report: Vioxx linked to thousands of deaths. MSNBC Web site. October 6, 2004. http://www.msnbc.msn.com/id/6192603/Accessed October 25, 2008
  44. Horton R. Quoted in: Adams M. Merck caught in scandal to bury Vioxx heart attack risks, intimidate scientists and keep pushing dangerous drugs; Vioxx lawsuits now forming. NaturalNews.com. November 6, 2004. http://www.naturalnews.com/002155.htmlAccessed October 25, 2008
  45. Angell M. The Truth About the Drug Companies: How They Deceive Us and What to Do About It. New York, NY: Random House; 2005;
  46. Kassirer JP. On the Take: How Medicine's Complicity with Big Business Can Endanger Your Health. New York, NY: Oxford University Press; 2005;
  47. Orwell G. Animal Farm. New York, NY: Signet; 1956;preface
  48. Oxford American Dictionary. Mac OS X, version 10.5.5. New York: Oxford University Press Inc. Accessed October 25, 2008.
  49. Sullivan A. Disgrace. Physicians for Human Rights Web site. June 19, 2008. http://brokenlives.info/?tag=detaineesAccessed October 25, 2008

PII: S1550-8307(08)00345-5

doi:10.1016/j.explore.2008.11.001

Explore: The Journal of Science and Healing
Volume 5, Issue 1 , Pages 1-7, January 2009

Article Tools