Guantánamo medical providers face dilemma


The Constitution Project was recently released to the public. According to this report, the torture and abuse of enemy combatants detained in Guantánamo was “unquestionably” committed. In this report, physicians, nurses and other healthcare providers who serve the United States in uniform were also implicated in doing harm.

It is time to stop placing our dedicated military healthcare providers who serve in Guantánamo in the middle of a national security dilemma. It is not possible for the military healthcare professional to ethically serve both detainee patients and the state in the unique circumstances presented by Guantánamo. The individual human-rights of a rational detainee, including the right to die if he so chooses, should not be subordinated to the interests of the state.

There are a number of enemy combatants on a hunger strike in Guantánamo. Some of those detainees participating in this hunger strike are forced, against their will, to submit to the insertion of a tube, via their nose and into their stomach, so that nutrient substances can be administered. An intravenous solution may also be administered via a catheter inserted into a vein. These are interventions done in large measure to prevent death.

Herein, lays the dilemma of dual loyalties for physicians and other healthcare providers who have as a most basic tenet of their profession ‘to do no harm’ to the individual human being. Some health professionals take the Hippocratic Oath that states that their professional purpose is to “do good” and to assist the patient in healing. Other professionals may not take a specific oath but also have an obligation “to do no harm.” Essentially, this means in most all areas of healthcare delivery, treatments or therapies administered to the patient only follow the oral and written consent of that patient.

The Hippocratic Oath does not draw distinctions between classes of people.

A healthcare professional who serves this nation in our armed forces also takes an oath of office when receiving a commission — an oath to the U.S. Constitution. The oath obligates the officer to support and defend the Constitution; and to bear true faith and allegiance to the same; and that officer will faithfully discharge the duties of the office that is about to be entered. Essentially, this means that the medical officer will follow the legal orders of those who are of a senior rank even though that officer is not a subject matter expert in medicine.

Additionally, a healthcare professional is eligible for a commission in the armed forces because of certain requirements that must be met in order to obtain a state license to practice medicine, nursing, psychology, etc. The state in which the commissioned healthcare professional is licensed has oversight of the healthcare professional in the area of ethical practice.

In the context of Guantánamo, it is not ethically possible for our military healthcare providers to best serve the interests of the individual detainee, the interests of the nation or the state of licensure. Based upon these complex issues alone, closing Guantánamo should be high on the administration’s agenda.

These opinions are mine alone and do not reflect the opinion of the Naval War College, the U.S. Navy, the Department of Defense, or the U.S. Government.

Albert J. Shimkus, Jr., a professor of national-security affairs at the Naval War College in Newport, R.I., is the former commanding officer and chief surgeon for both of the Naval Hospital at Guantánamo Bay and Joint Task Force 160, which administered healthcare to detainees.

Read more Other Views stories from the Miami Herald



    Jeff Bauman: All I want is a normal day

    It is a weekend for working around the house. My fiancée, Erin, and I have the baby’s room to paint and some IKEA furniture to assemble. I roll out of bed early — 10:30 — and get into my wheelchair. Erin is already making coffee in the kitchen.



    More lax gun laws coming our way

    In December 1983, Middlesex County, N.J., discontinued a policy that allowed police officers to fire warning shots at fleeing or aggressive suspects. The county was the only one in the state of New Jersey, and one of the last in the country, to permit such firearm discharges, which are considered too potentially dangerous to third parties to allow law officers to use.

 <span class="cutline_leadin">REBELS</span>: Ivan Marquez, left, heads the FARC delegation to the peace talks with the Colombian government in Havana. Jesus Santrich of the FARC stands next to him.


    Myths and realities about the Colombian peace process

    Some opponents of the peace process between the government of Colombia and insurgents have been circulating false versions about the talks underway in Havana and unbelievable myths about its actual scope. We will clarify the main legends right now.

Miami Herald

Join the

The Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere on the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

The Miami Herald uses Facebook's commenting system. You need to log in with a Facebook account in order to comment. If you have questions about commenting with your Facebook account, click here.

Have a news tip? You can send it anonymously. Click here to send us your tip - or - consider joining the Public Insight Network and become a source for The Miami Herald and el Nuevo Herald.

Hide Comments

This affects comments on all stories.

Cancel OK

  • Marketplace

Today's Circulars

  • Quick Job Search

Enter Keyword(s) Enter City Select a State Select a Category