There are many reasons why doctors can get drawn into directly torturing, participating in torture or covering up for those who perpetrate torture on people in custody.
1. Some of them may be employed in detention centres, asylum/refugee centres, prisons etc. and have a loyalty to their ‘boss’. There is an unquestioning following of orders even though it is against basic principles of medical ethics.
2. Some of them may believe that they are doing their work in a larger national interest. The dehumanisation of people in custody can happen because of the general language that is used. Words like terrorist, worm, dog, snake, scum, pest, parasite etc. that is used by people rather than names can reduce the human interaction and leads to ‘othering’ of the person in custody.
3. Sometimes there are tangible and intangible rewards that accrue out of participating in torture. A junior doctor may feel validated if he is asked for his opinion by a senior doctor or official or given the responsibility to elicit information etc. This can make the physician overcome any qualms that he may have about his actual actions.
4. There may be subtle underlying threats or overt pressure to participate in torture. Physicians maybe threatened with violence or loss of job. They may be made to feel that their lives or that of their families would be at risk if they fail to follow orders.
5. There may not be adequate support for the individual healthcare provider from his or her association such as the doctors association, nursing association etc. If there is regular interaction of healthcare providers with their peers, there are spaces to share concerns and also identify collective ways of addressing the concerns.
6. Often medical ethics is neglected in the training of healthcare providers and they may actually be unaware of what constitutes torture and may buy into the arguments of those around them. For instance, if a senior official talks about his own experience where his kindness was met with treachery, then kindness is seen as a weakness. Toughness is attributed value.
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