From Nuremberg to Guantánamo: Medical Ethics Then and Now

On October 25, 1946, three weeks after the handing down of the verdicts of the International Military Tribunal at Nuremberg, the United States established Military Tribunal I for the trial of twenty-three Nazi physicians. The charges, delivered by Brigadier General Telford Taylor on December 9, 1946, form a seminal chapter in the history of medical ethics and, specifically, medical ethics in war. The list of noxious experiments condemned as war crimes and crimes against humanity on civilians and prisoners of war is by now more or less familiar—high-altitude experiments; freezing experiments; malaria experiments; sulfanilamide experiments; bone, muscle, and nerve regeneration and bone transplantation experiments; sea water experiments; jaundice and spotted fever experiments; sterilization experiments; experiments with poison and with incendiary bombs.

What remains less familiar is the moral mind of doctors or health care workers who ply their medical skill for morally questionable uses in war. In his 1981 work, The Nazi Doctors, Robert Jay Lifton took up that question, interviewing doctors, many of whom for forty years continued to distance themselves psychologically from their deeds.

The questions about moral distancing Lifton raised then (though not the questions about criminal experiments) have immediate urgency for us now. For military doctors, psychologists, and psychiatrists serve in U.S. military prisons in Guantánamo, Abu Ghraib, Kandahar, and until very recently, in undisclosed CIA locations throughout the world, where medical ethics are again at issue. And they serve in top positions in the Pentagon, as civilian and military heads of chains of command, who pass orders and regulations to military doctors in the field, in charge of the health of enemy combatants, as well as U. S. soldiers. Because we recently marked the sixtieth anniversary of the judgment at Nuremberg, I want to awaken our collective memory to the ways in which doctors in war, even in a war very different from the one the Nazis fought, can insulate themselves from their moral and professional consciences.

Lifton’s research is, in part, a follow-up study. It is about the conflict and moral residue that linger, close to a half a century later. The follow-up story of the medical and mental health personnel who are part of the Guantánamo detention center has not yet been told. The detention center is still in operation; and five years after its erection, there have been no trials of doctors and no charges brought. Nor is it clear that there should be charges and trials. But the absence of the spotlight makes it all the more imperative to sketch the current involvement of doctors and health workers in the operation of the Guantánamo center and to shed some light on their professional roles and on the psychological distancing mechanisms at work.

In October 2005 I visited the center with a small group of civilian psychiatrists, psycholog...