#Human Rights
Medical staff

Dear colleague,

As some of you may know, I and over 260 other colleagues publıshed a letter ın the Lancet ın March 2006 deeply crıtıcal of the medıcal treatment beıng proovıded to prısoners beıng held ın Guantanamo Bay (http://jurist.law.pitt.edu/forumy/2006/06/guantanamo-and-medical-ethics.php).

I am plannıng to submıt an update on thıs ıssue to the Lancet for provısıonal publıcatıon on September 7th .

I aım to have at least 250 other co-sıgnatorıes on thıs letter to add weıght and also to mark the 30th annıversary of the death of the antı-apartheıd actıvıst Steve Bıko wıth whom there are strong parallels wıth the Guantanamo dısaster. I have been ın contact wıth Prof Trefor Jenkıns who ıs an authorıty on the Bıko case as well as Stephen Mıles who ıs an authorıty on medıcal treatment ın the War on Terror, both of whom have agreed to be signatories.

If you would lıke to be a co-sıgnatory please put your names e-maıl address and departmental address below.

ONLY qualified medical staff should co-sign this letter and you must put your full contact details otherwise you will NOT be included, and also so that I can e-mail you the finalised text prior to submission to the Lancet.

I would emphasıze I am not callıng for a boycott (I am a member of the Amerıcan Academy of Neurology) thıs letter ıs meant to be a shot across the bows for the medical establıshment for them to take responsıbılıty for enforcıng ınternatıonal declaratıons (such as the Declarations of Malta & Tokyo) that they have spent lıterally years developıng.

Many thanks for your tıme

Dr Davıd Nıcholl

From Steve Biko to Guantanamo- 30 years of medical involvement in torture

This week marks the 30th anniversary of the death of anti-apartheid activist Steve Biko while being detained by security police. Initially, the South African Minister of Justice suggested Biko had died of a hunger strike. The inquest revealed that he had died of the consequences of head injuries sustained during police interrogation, and identified gross inadequacies in the medical treatment from the two doctors responsible for his care including the falsification of records. The regulatory authorities failed to take firm action, and it was only grass-roots action by doctors that led, almost 8 years later to Dr Benjamin Tucker being found guilty of improper and disgraceful conduct and being struck off, whilst Dr Ivor Lang was found guilty of improper conduct and was given a caution and a reprimand(1).

There are strong parallels with the Biko case and the ongoing role of US military doctors in Guantanamo and the War on Terror. Last year, we suggested that the physicians in Guantanamo force-feeding hunger strikers should be referred to their professional bodies for breaching internationally accepted ethical guidelines(2). One of us (DJN) lodged formal complaints with the Medical Boards for Georgia and California as well as pointing out to the American Medical Association (AMA) that the former hospital commander at Guantanamo, Dr John Edmondson, was a member(3). After eighteen months, there has still been no reply from the AMA, the Californian authorities have stated that “they do not have the jurisdiction to investigate incidents that occurred on a federal facility/military base”, the Georgian authorities stated that the “complaint was thoroughly investigated” but “the Board concluded that there was not sufficient evidence to support prosecution”, yet an analysis of the same affidavit by the Royal College of Physicians concluded that “in England, this would be a criminal act” (Personal communications to DJN).

The UK government has refused a request from the British Medical Association for a group of independent doctors to assess the detainees(4) and, to date, there has been no formal report on the 3 alleged suicides in Guantanamo that took place in June 2006.

The resolution of the Biko case was instrumental in the rehabilitation of the South African Medical and Dental Council and the Medical Association of South Africa which had been subject to boycotts during the apartheid years. The failure of the US regulatory authorities to act is quite simply damaging the reputation of US military medicine. No healthcare worker in the War on Terror has been charged or convicted of any significant offence despite numerous instances documented including fraudulent record keeping in detainees who have died as result of failed interrogations(5). We suspect that the doctors in Guantanamo and elsewhere have made the same mistake as Dr Tucker who in 1991, in expressing remorse and seeking re-instatement said “I had gradually lost the fearless independence …and become too closely identified with the organs of the State, especially the Police force…I have come to realise that a medical practitioner’s first responsibility is the well-being of his patient, and that a medical practitioner cannot subordinate his patient’s interest to extraneous considerations.” (cited in1)
The attitude of the US medical establishment appears to be one of ‘See no evil, hear no evil, speak no evil’.

David J Nicholl, Department of Neurology, City Hospital, Birmingham, UK

Trefor Jenkıns, Emerıtus Professor, Division of human genetics, National Health Laboratory Service and University of the Witwatersrand, Johannesburg, South Africa

Stephen H Miles, Center for Bioethics, University of Minnesota, 504 Boynton Hall, 410 Church Street, Minneapolis, MN 55455, USA.


1. Jenkins T McLean GR. The Steve Biko affair: a case study in Medical Ethics. Developing World Bioethics 2003; 3(1): 77-102.
2. Nicholl DJ and 262 other doctors. Forcefeeding and restraint of Guantanamo Bay hunger strikers. Lancet 2006; 367:811.
3. Nicholl DJ. Guantanamo- a call for action. Good men need to do something. BMJ 2006; 332:854-855.
4. Nicholl DJ and 119 other doctors. Doctors at Guantanamo. The Times 18th September, 2006.http://www.timesonline.co.uk/tol/comment/debate/letters/article642161.ece
5. Miles, SH (2006) Oath Betrayed: Torture, Medical Complicity and the War on Terror. Random House, New York

The From Steve Biko to Guantanamo - 30 years of medical involvement in torture petition to Medical staff was written by Dr David Nicholl and is in the category Human Rights at GoPetition.