J Med Ethics 2016;42:411-412 doi:10.1136/medethics-2016-103737
In the ethics classroom, medical involvement in torture is often discussed in terms of what happens or has happened elsewhere, in some imagined country far away, under a military dictatorship for example, or historically in Nazi Germany or Stalin's Russia. In these contexts, at a distance in space or time, the healthcare professional's moral dilemma can be clearly demonstrated. On the one hand, any involvement whatever in the practice of torture, countenancing or condoning as well as participating, is forbidden, formally by the World Medical Association 1957 Declaration of Tokyo, but more generally by the professional duty to do no harm. On the other hand, the professional duty of care, and more generally human decency and compassion, forbids standing idly by when no other professional with comparable skills is available to relieve the suffering of victims of torture. In such circumstances, the health professional's impulse to exercise their duty of care, albeit thereby implicitly countenancing or condoning torture, may be strengthened by the knowledge that to refuse may put their own life or that of a member of their family in danger. But then again, they may also be all too aware that in exercising their duty of care they may simply be ‘patching up’ the victims in order for them to be tortured again.
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