Despite close ties between the American Psychological Association and the military, a new study reveals that graduate psychology students receive little teaching on understanding military medical ethics and are, to a great extent, unaware of their obligations under the Geneva Conventions.
The findings from the latest study, published in the International Journal of Health Services, are troubling, given that psychologists have had “extensive involvement in the interrogation process of suspected terrorists,” according to the researchers.
Led by Dr. J. Wesley Boyd, assistant clinical professor of psychiatry at Harvard Medical School in Boston, MA, the team notes that the American Psychological Association (APA) has maintained a close relationship with the Department of Defense (DOD) and the Veterans Administration (VA).
They add that jobs with the VA and DOD “have been described as ‘growth careers’ for psychologists of the future,” and that the Health Care Personnel Delivery System allows civilian clinical psychologists to be drafted into military service, even when a general draft is absent.
Under the Geneva Conventions, threatening, coercing, humiliating, degrading, injuring or murdering prisoners of war is banned, but the researchers say psychologists who have assisted with interrogations of prisoners may not have been aware that they were violating international agreements.
For example, the team cites President George W. Bush’s two terms in office, when the US government classed prisoners as “detainees” or “enemy combatants,” rather than “prisoners of war” so the Geneva Conventions did not apply, despite many ethical and legal analysts’ disagreement.
Dr. Boyd says:
“The abuses at Abu Ghraib and Guantanamo galvanized much of the world against the United States. The fact that Guantanamo is still open and continues to flout international law – most recently by force-feeding detainees – will likely go down as one of our country’s most egregious ethical lapses.”
The Geneva Conventions were designed to protect people who are not taking part in hostilities – such as civilians, health workers and aid workers – and those no longer participating – such as wounded, sick and shipwrecked soldiers and prisoners of war.
Since 2000, seven new ratifications have brought the total number of States Party to 194, making the Geneva Conventions universally applicable.
To investigate how aware today’s graduate psychology students are of their ethical obligations, the researchers surveyed 185 students at 20 different programs in clinical psychology.
Overall, they found that 74% of students had received less than 1 hour of teaching about military medical ethics, and 97% had received 5 hours of instruction or less.
Additionally, only 37% of the students correctly answered that the Geneva Conventions apply regardless of whether war has been declared, and 50% did not know the Geneva Conventions forbid ever demeaning, threatening or depriving prisoners of food or water for any length of time.
Of the study participants, 43% were also unaware that the Geneva Conventions state that physicians should “treat the sickest first, regardless of nationality.”
Other findings revealed that 48% of the students could not say when they would be required to disobey an unethical order from a superior. But the researchers say the students’ confusion may be rooted in two contradictory policy documents backed by the APA. One is a 2005 presidential task force report that allows psychologists to use the “Nuremberg defense” – the stance taken by Nazi doctors at Nuremberg, who stated they were merely following orders – and the other is a 2008 APA policy referendum stating that psychologists must strictly comply with international human rights conventions.
The researchers also found that only 5% of the students were aware that Congress authorized the Health Care Personnel Delivery System (HCPDS) in 1987, which allows for Congress to draft psychologists and other health care personnel for military service in a matter of weeks, if needed.
Due to the existence of the HCPDS and the close ties between the APA and the military, the researchers argue that all clinical psychologists should be aware of the Geneva Conventions and military medical ethics.
“Psychologists need to know about these matters to ensure they don’t inadvertently become pawns of the US military establishment,” says Dr. Boyd, “and also to hold their colleagues who have committed crimes in the name of patriotism accountable for their actions.”
The study has one major limitation, however, in that the representativeness of the sample is unknown; in some cases, the researchers say they were unable to calculate response rates from certain schools, and they add that their “observed response rate likely underestimates the true response rate, perhaps dramatically.”
Still, they do note that the responses to each survey question varied little between institutions.
Though the team urges further research into these matters, they are not conducting further studies at the present time. However, Dr. Boyd told Medical News Today that they are currently “brainstorming.”