The prevention of torture and the treatment of survivors are issues that concern an increasing number of physicians in their daily work.Every day, thousands of men, women, and children are subjected to violence and are forced to flee their homelands. There are more than 18 million refugees in the world and hundreds of thousands of persons seeking asylum, many of them in the United States. Physicians are often the first to interview these victims of abuse. Torture has serious and long-lasting health consequences. Thus, physicians can play a key role in documenting and preventing many forms of abuse and in treating survivors. In some areas, physicians may become the targets of arrest because of their work as clinicians or as influential members of their communities. They may also face disturbing ethical dilemmas as they witness torture or its results. As members of the medical profession, physicians have an obligation to their peers around the world.
This report reviews the current state of physicians' involvement in the prevention of international torture and in the treatment of its victims.We propose ways in which physicians can become involved by caring for survivors of torture and by providing expert testimony on behalf of victims who seek asylum. We discuss how the medical profession complements the efforts of individual physicians by providing an infrastructure to support and guide their work. Medical organizations can adopt and disseminate ethical principles that specifically address human rights and their violation. They can coordinate letter-writing networks for human rights, organize or sponsor fact-finding missions, and develop continuing medical education courses on topics such as the identification and treatment of victims of torture. We conclude that physicians can make a difference, both as clinicians and as advocates for the health of the public and the protection of human rights. The American College of Physicians will continue to advocate for the rights of persons and communities to live in dignity and peace, free of the fear of unjust imprisonment or torture.
*This paper, authored by Anne-Marie Audet, MD, MSc, SM, was developed for the Health and Public Policy Committee by the Human Rights and Medical Practice Subcommittee: Quentin D. Young, MD, Chair; Elias Abrutyn, MD; Carola Eisenberg, MD; Paul Plotz, MD; Herbert J. Rothenberg, MD; and Kim M. Thorburn, MD. Members of the Health and Public Policy Committee for the 1992-1993 term were Clifton R. Cleaveland, MD, Chair; Whitney Addington, MD; Robert A. Berenson, MD; Christine K. Cassel, MD; John M. Eisenberg, MD; Nancy E. Gary, MD; David J. Gullen, MD; Ernest L. Mazzaferri, MD; P. Preston Reynolds, MD, PhD; Cecil O. Samuelson Jr., MD; Gerald E. Thomson, MD; Mack V. Traynor Jr., MD; and Quentin D. Young, MD. This paper was approved by the Board of Regents on 18 July 1993.