As health professionals whose work is devoted to promoting health and well-being, we, the undersigned, believe that torture and cruel, inhuman, or degrading treatment are ethically and morally repugnant wherever and whenever they are inflicted. As the American Medical Association's Code of Medical Ethics provides, "Physicians must oppose and must not participate in torture for any reason."[1] Similarly, "the American Psychiatric Association and the American Psychological Association condemn torture wherever it occurs."[2]

We believe it is our duty, therefore, to express with one voice our grave concern over the mounting evidence of both physical and psychological torture and ill-treatment inflicted by United States forces on prisoners and detainees in Afghanistan; Iraq; Guantanamo Bay, Cuba; and elsewhere.

We are particularly disturbed by the pattern of reported abuse: physical torture, such as beatings and shackling in stress positions, and psychological torture, such as mock executions, sleep and sensory deprivation, prolonged isolation, forced nudity, cultural and sexual humiliation, use of dogs to instill terror, threats of violence or death against detainees or their loved ones, and more. The US military itself has identified the deaths of at least 28 detainees as confirmed or suspected homicides.[3] We are deeply concerned that, even as evidence of abusive treatment accumulates, current policies may continue to authorize the use of psychological torture and that these methods may still be in use.

We are also concerned by the evidence that some US military medical personnel have played a role in torture and ill-treatment of prisoners and detainees, and that current military guidelines do not absolutely prohibit it. Complicity in torture and abuse comprises a severe breach of ethical duties that threatens to erode the culture and traditions of our profession as a whole.

Guided by the ethical tenets of our profession and fundamental principles of human rights, we urgently call on all relevant authorities within the United States government to:

* Take all steps necessary to ensure that US personnel do not engage in torture or cruel, inhuman or degrading treatment of prisoners and detainees in US custody.
* Establish an independent, bi-partisan commission, empowered to investigate fully all allegations of torture and ill-treatment; to determine how and to what extent official decisions and policy have led to such practices; to determine whether and to what extent medical personnel have been complicit; and to recommend steps necessary to prevent torture and abuse going forward.
* Rescind and reverse all legal opinions and policies that permit or condone torture and cruel, inhuman or degrading treatment and/or extraordinary rendition that puts detainees at risk.
* Establish and publicly disclose interrogation rules that are consistent with the prohibition against torture or cruel, inhuman, or degrading treatment.
* Ensure accountability up the chain of command for all those responsible for torture and ill-treatment by US personnel.
* Ensure that all personnel who report evidence of torture and abuse to the appropriate authorities are protected from adverse consequences to their status or careers.
* Promote ethical practice by military medical personnel, including policies affirming health professionals' ethical obligations not to participate in torture or ill-treatment in any way, training for medical personnel in their ethical duties regarding torture and abuse, training for medical personnel in appropriate treatment and care for prisoners of war, and protecting military health professionals' clinical independence.