The AMA, according to Mother Jones reporter Justine Sharrock in the magazine's August edition, has been entirely silent on the issue-refusing to even look into allegations that American medical professionals have themselves become torturers of helpless detainees.
None of this is surprising to the throngs of Americans in chronic pain, struggling to survive in the relative freedom of the mainland US. For under a century long regime of opioid prohibition, the medical profession has become inured to the wails and cries of those in chronic pain who come under their putative care.
To American doctors and to doctors all over the world, in fact, the millions who come to them for help with chronic pain are "addicts"-people officially and societally designated as beneath contempt; people, not unlike "terrorists" who, it is apparently A.O.K., and even morally correct to abuse and neglect. So it is unsurprising that the destruction of medical ethics that has occurred under the War On Drugs would rear its ugly head on an island off the coast of the US in our War On Terror, where other helpless and hated captives are routinely abused by American medical personnel under color of US authority.
A now famous Stanford Prison experiment was conducted in 1971 by a team of researchers led by Psychology Professor Philip Zimbardo at Stanford University. Twenty-four undergraduates were selected out of 70 to play the roles of both guards and prisoners and live in a mock prison in the basement of the Stanford psychology building. Those selected were chosen for their lack of psychological issues, crime history, and medical disabilities, in order to obtain a representative sample. Roles were assigned based on a coin toss.
Prisoners and guards rapidly adapted to their roles, stepping beyond the boundaries of what had been predicted and leading to dangerous and psychologically damaging situations. One-third of the guards were judged to have exhibited "genuine" sadistic tendencies, while many prisoners were emotionally traumatized and two had to be removed from the experiment early.
After being confronted by Christina Maslach, a graduate student in psychology whom he was dating, and realizing that he had been passively allowing unethical acts to be performed under his direct supervision, Zimbardo concluded that both prisoners and guards had become too grossly absorbed in their roles and terminated the experiment after six days.
Ethical concerns surrounding the experiment often draw comparisons to the Milgram experiment, which was conducted in 1961 at Yale University by Stanley Milgram, Zimbardo's former college friend. Tom Peters and Robert H. Waterman Jr wrote in 1981 that the Milgram experiment and the Stanford prison experiment were frightening in their implications about the danger which lurks in the darker side of human nature.
The few doctors in the US willing to treat pain and thereby brave Federal criminal prosecution and the possibility of decades long prison sentences and personal ruin, apparently believe that they have somehow transcended this darker side of human nature and therefore do not see the need to engage in any meaningful examination of the millions of complaints of patients who report they are degraded, talked down to, medically neglected and routinely medically abandoned. And the AMA, not surprisingly, has turned a deaf ear to the patient's desperate cries, as well.
In a groundbreaking academic article called the Pitfalls of Pain Management that appeared in Practical Pain Management in 2005, the authors manage to carefully review the relevant Milgram and Zimbardo studies in the context of pain treatment under US Department of Justice supervision, but never manage to send out the SOS that patient abuse is actually occurring.
"psychologists are being recruited by Independent Medical Examiners (IME) panels to detect deception and malingering rather than focusing on assisting patients in finding the most appropriate focus for care.....These pain patients feel that medical appointments are more like interrogation sessions where they are under investigation and are dictated to about how to live and function rather than being 'listened to.'"
No alarm bells here, because the realities of having to operate within the context of a system that demands doctors separate out the worthy from the unworthy based on criteria set up by law enforcement, blinds even these otherwise insightful authors to the implications of their own observations.
Even Steven H. Miles, a bioethicist at the University of Minnesota Medical School, who is leading the clarion outcry about both the abuse of prisoners in Guantanamo and the AMA's silence in the face of what is clearly a serious breakdown in medical ethics under military direction, declined to send out a "call to arms" when the US turned its Drug War apparatus on domestic medical practice in the years following 9-11, telling me, as the head of the Pain Relief Network, "that's (doctors abusing patients in pain) been a problem for a long time," this, as he promptly terminated our discussion-as if the ongoing degradation of ethical standards and the resulting destruction of innocent human life is somehow less troubling than an acute episode such as we are now confronting at Guantanamo.
What the silence of Miles and of the AMA reveals is that the abusive behavior of American medical personnel did not spontaneously erupt during the War On Terror but had already become widely accepted in the circles of medical practitioners and ethicists over the course of the last nearly one hundred years of drug prohibition as concerns the non-treatment of pain.
So while Mother Jones' August '09 issue is dedicated to unearthing and examining the truly harrowing realities of death squads roaming Mexico and cartels operating, at last count, in some 250 American cities, while simultaneously covering the AMA's silence on doctor complicity in torture, the editors fail to make the connection between the prohibition of "hard drugs" i.e. pain medication, and the destruction of American standards for ethical medicine. The magazine's recommendation, it appears, is to decriminalize or legalize marijuana-a measure, that certainly needs doing, but which would have no curative effect on the more pernicious problem of the destruction of medical ethics under prohibition of "hard drugs," and the now widespread institutional acceptance of this ongoing, yet nevertheless, shocking state of affairs.
*Description of Prison studies courtesy of Wikipedia
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