No Comment — December 18, 2009, 10:48 am

A Medical Murder in Pinochet’s Chile

Last week, a twenty-seven-year-old murder mystery was solved, grabbing headlines around the world. Former Chilean President Eduardo Frei died under mysterious circumstances in 1982, at the age of 71, as he was busily investigating accusations of human rights abuses including torture and “disappearings” by his successor, General Augusto Pinochet. A week ago Monday, a Chilean investigating judge ruled his death a homicide and charged six individuals as conspirators. The New York Times reports:

An autopsy report blamed septic shock after stomach hernia surgery, but a new autopsy this year by University of Chile pathologists identified two chemicals in his body that attack the digestive system — one that is used in mustard gas and another found in rat poison. ”He was injected with toxic substances, which produced other complications that deteriorated his immune system,” Judge Alejandro Madrid told reporters Monday. ”That was the cause of death.”

But one fact remarkably escaped attention in most English-language reporting, even while it played heavily in Spanish-language accounts: the criminal inquiry concluded that Frei was murdered by a conspiracy of doctors. The key figure named is a surgeon, accused of having administered the lethal toxins during medical procedures he supervised at a hospital. As the prosecutors charge, this doctor had close ties to the Chilean military and intelligence community and was prepared to do their bidding. Three of the other defendants are also doctors, who, according to prosecutors, knew of the plans and their implementation and stood by silently. They are charged as co-conspirators. The prosecution charges that the doctor was coopted by General Pinochet’s intelligence services and told to silence forever one of the most credible voices raised against him, a former president and a political conservative. One of the dark secrets that made the long and brutal Pinochet dictatorship so effective was its cooption of the medical profession. The enlistment of a group of doctors to murder a former president marks one of the high points of this scheme.

Of course, the involvement of healthcare professionals in human rights abuses is not simply a matter of historical interest. In America’s era of state-sponsored torture, healthcare professionals including medical doctors also played a decisive role. In the Justice Department’s torture memoranda, while reviewing specific torture techniques, lawyers repeatedly note that doctors will be present to insure that the techniques are not applied in such a way as to cause death or the failure of vital organs. In thousands of pages of documents discussing the application of torture techniques, the names of medical professionals who participated in the torture sessions consistent with the guidance given by the Justice Department memos are simply blacked out, with the government citing the doctors’ “right to privacy.”

Similarly, so-called Behavioral Science Consultation Teams (BSCT) containing other healthcare professionals (psychologists and psychiatrists mainly) were deeply involved in the design and implementation of torture protocols for individual prisoners. Healthcare professionals were also involved in implementing a forced-feeding regime for prisoners held at Guantánamo (and potentially other prison sites), in violation of clear international guidelines provided by the Declaration of Malta. A suspiciously large number of these hunger-strikers have met death in detention under dubious circumstances initially dismissed by the Bush Administration as “suicides.” That characterization is longer credible, and the government’s failure to undertake serious investigations into those deaths today heightens concern about them.

This deep involvement of healthcare professionals in a system of torture and abuse is a profound crisis for the professions involved, and so far their response has been disgraceful. All have embraced pious statements opposing torture, and all have scurried away from actual accountability. In California, Louisiana, and Alabama, complaints have been brought against individuals known to have participated in the systematic torture and mistreatment of prisoners in direct violation of rules of ethics. One key figure in the nightmare at Guantánamo has actually emerged as the head of a medical school in Ohio. In each case, the ethics oversight board has dismissed the complaint without conducting an investigation of any sort, frequently stating that it has “full discretion not to investigate” cases it does not wish to investigate. Others in the medical profession point to government secrecy surrounding the torture programs and suggest that any efforts to investigate the role that doctors played in them would be futile. A substantial faction within the professions, led by doctors with suspicious ties with the Pentagon and the intelligence community, insists on a “safe harbor” under which doctors are entitled to rely on assurances from the government that what they do is legal. That is an effort to implement the Bush Administration’s scheme to obliterate professional ethics, which prohibit involvement in torture in any form, and prohibit doctors from even being present while torture is being conducted. It parallels efforts that were undertaken by Pinochet in Chile, in fact.

The objective of these professional organizations appears to be to avoid the issue and hope that it is forgotten. This aspiration does them no credit, and it may well backfire. As President Bachelet said last week, the disclosure of the murder of President Frei “goes to show that though it may take a while, justice always prevails.” The healthcare professionals who participated in the Bush-era torture schemes will also eventually be exposed. By obstructing proper investigations and accountability, professional associations will not stop this process, but they do risk further serious damage to their own reputations, and those of their members. Have they joined in a conspiracy of silence?

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Ashley arrived for her prenatal appointment at Black Hills Obstetrics and Gynecology, in Rapid City, South Dakota, wearing a black zip-up hoodie and Converse sneakers.1 To explain her absence from work that morning — a Tuesday in April 2015 — she had told a co-worker that she was having “female issues.” She was twenty-five years old and eight weeks pregnant. She had been separated from her husband, with whom she had a five-year-old son, for the better part of a year. The guy who’d gotten her pregnant was someone she’d met at the gym, and he’d made it abundantly clear that he wanted nothing more to do with her. Ashley found herself hoping that the doctor would discover some kind of fetal defect, so that her decision would be easier. She glanced across the waiting room at a television playing a birth-control ad and laughed darkly. “Jesus, Lord, it would be so nice if someone just pushed me down a flight of stairs.”

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The baby was due in November, when Ashley, who was a nurse, hoped to be enrolled in a graduate program to become a nurse practitioner. Getting pregnant as a teenager had forced her to put that dream on hold, but she had thought that she was finally ready; she had even submitted her application shortly before the March 15 deadline. For the first time in her adult life, Ashley felt as if her plans were coming together. Then she missed her period.

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