Punishing physicians who torture: a work in progress.

BACKGROUND: There are only a few anecdotal accounts describing physicians being punished for complicity with torture or crimes against humanity. A fuller list of such cases would address the perception that physicians may torture with impunity and point to how to improve their accountability for such crimes. METHODS: We performed a multilingual web search of the records of international and national courts, military tribunals, medical associations (licensing boards and medical societies), medical and non-medical literature databases, human rights groups and media stories for reports of physicians who had been punished for complicity with torture or crimes against humanity that were committed after World War II. RESULTS: We found 56 physicians in eight countries who had been punished for complicity with torture or crimes against humanity. Courts punish crimes. Medical societies punish ethics violations. Fifty-one physicians (85%) had been punished by the medical associations of five countries. Eleven (18%) had been punished by domestic courts. International courts had imprisoned two (3%) physicians. Several were punished by courts and professional associations. There are open cases against 22 physicians. CONCLUSIONS: Punishments against physicians for crimes against humanity are becoming institutionalized. Medical associations must lead in shouldering responsibility for self-regulation in this matter. Physicians have supervised torture ever since medieval "Torture Physicians" certified that prisoners were medically capable of withstanding the torture and of providing the desired testimony. Revelations of sadistic medical experiments on prisoners during World War II turned the world against physician torturers and led to the "Doctor's Trial" at Nuremberg, a trial that held physicians accountable for crimes against humanity. This paper describes the largest case series of physicians who have been punished for abetting torture or other crimes against humanity committed after World War II. We wanted to: 1) describe and categorize the hearing procedures, 2) identify the roles of punished physicians, 3) categorize acts for which physicians are punished, and 4) describe the political cultures in which punishments arise. Our larger aim was to learn whether punishments against physicians for abetting torture or crimes against humanity occur under sufficiently diverse environments as to inform generalizable public policy to punish and perhaps to deter this kind of medical misconduct.