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Divided Loyalties: Professional Standards and Military Duty (Part 3)

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Date and time
Friday, February 11, 2011

Topic: Ethical, Legal, and Professional Obligations of Medical/Mental Health There has always been some tension between the ethical, legal, and professional obligations of professionals and the requirements of military service. This tension has been increased by the War on Terror. Physicians, mental health professionals, lawyers, and law enforcement/corrections officers serving in the military have been placed in situations in which their professional ethics, obligations, and legal duties may contradict military necessity or directives, or even place the role of professional in direct conflict with the role of military personnel. As the management of armed conflict, the law of war, and the professionalization of the military has increased, this tension has similarly increased. Military professionals have been asked to bring their expertise, skills, and professional talents to the prosecution of military action not just as military personnel but as doctors, mental health professionals, lawyers, and law enforcement/corrections officers. Doctors and mental health professionals are charged with supervising and controlling interrogations, lawyers are asked to provide legal opinions and advise on the treatment of prisoners, and law enforcement and corrections officers must guard and control prisoners. While performing these duties military necessity can impose conflicting duties and concerns. The need for information, validation, or security may require different loyalties and focus than the professional duty. The need for information about an upcoming attack that could save the lives of comrades may directly contradict the need for care or treatment of a prisoner. This symposium brought together professionals, ethicists, theorists and practitioners from medicine, mental health care, the law, law enforcement, and the military to explore these complicated and timely issues in an open and frank discussion.

Cassandra Burke Robertson is an associate professor at Case Western Reserve University, in Cleveland, Ohio, where she teaches Civil Procedure, Professional Responsibility, and International Civil Litigation. She received a law degree from the University of Texas at Austin, as well as joint master's degrees in Middle Eastern Studies and Public Affairs. Professor Robertson's scholarship focuses on organizational theory and institutional choice within a globalizing practice of law.
Deborah D. Ascheim, MD, is an Associate Professor in the Departments of Health Evidence & Policy and Medicine/Cardiovascular Institute at The Mount Sinai School of Medicine in New York. She joined the Physicians for Human Rights (PHR) Board in January 2008, and has been doing medical evaluations for the PHR Asylum program since 2005. She is the Clinical Director of Research and Director of the Clinical Research Unit at the International Center for Health Outcomes & Innovation Research (InCHOIR) at Mount Sinai, and is board certified in cardiovascular disease and internal medicine, with a specialization in congestive heart failure. Her work has been published in journals such as *The New England Journal of Medicine*, *Thyroid, Journal of Cardiac Failure*, and *The Annals of Thoracic Surgery*. Dr. Ascheim graduated from New York University Medical School and completed her internship and residency in Internal Medicine, as well as her fellowship in Cardiovascular Diseases, at the New York-Presbyterian Hospital/Weill Cornell Medical Center. She completed a post-graduate fellowship at Columbia University College of Physicians & Surgeons and remained on faculty as an attending Cardiologist in the Heart Failure Center at Columbia P&S and the Mailman School of Public Health from 1995-2008. Dr. Ascheim completed her undergraduate studies at the Brearley School, graduating cum laude from Wellesley College.
George Annas is the Edward R. Utley Professor and Chair of the Department of Health Law, Bioethics & Human Rights of Boston University School of Public Health, and Professor in the Boston University School of Medicine, and School of Law. He is the cofounder of Global Lawyers and Physicians, a transnational professional association of lawyers and physicians working together to promote human rights and health. After graduating from Harvard Law School, he clerked for Justice John V. Spalding of the Massachusetts Supreme Judicial Court, and came to Boston University in 1972 as the Director of the Center for Law and Health Sciences at the law school. Professor Annas is the author or editor of sixteen books on health law and bioethics, including *American Bioethics: Crossing Human Rights and Health Law Boundaries* (2005), *The Rights of Patients* (3d ed. 2004), *Some Choice: Law, Medicine, and the Market* (1999), *Standard of Care: The Law of American Bioethics* (1993), and *Judging Medicine* (1987), and a play, entitled *Shelley's Brain* that has been presented to bioethics audiences across the U.S. and in Australia. Professor Annas has been called "the father of patient rights," "the doyen of American medico-legal analysts," and a "national treasure." Professor Annas wrote a regular feature on "law and bioethics" for the Hastings Center Report from 1976 to 1991, and a regular feature on "Public Health and the Law" in the *American Journal of Public Health* from 1982 to 1992 and since 1991 has written a regular feature on "Legal Issues in Medicine" for the *New England Journal of Medicine*, now under the title "Health Law, Ethics, and Human Rights." He is a fellow of the American Association for the Advancement of Science, a member of the Institute of Medicine, cochair of the American Bar Association's Committee on Health Rights and Bioethics (Individual Rights and Responsibilities Section) and a member of the Committee on Human Rights of the National Academies. He has also held a variety of government regulatory posts, including Vice Chair of the Massachusetts Board of Registration in Medicine, Chair of the Massachusetts Health Facilities Appeals Board, and Chair of the Massachusetts Organ Transplant Task Force.
Steve Reisner, Ph.D. is an international consultant on trauma and its treatment and an activist in the effort to stop torture. He is Assistant Professor of Clinical Psychiatry at the New York University Medical School, and is on the faculty at The Psychoanalytic Institute at NYU. Dr. Reisner is a founding member of the Coalition for an Ethical Psychology, a group dedicated to upholding international standards of human rights in psychological practice and research and supporting psychologists' who work to combat the effects of political violence and oppression internationally. Dr. Reisner is advisor on psychological ethics for Physicians for Human Rights, which won the Nobel Peace prize in 1999. With PHR and the Coalition, Dr. Reisner has been working to change the policy of the American Psychological Association supporting psychologists’ participation in coercive or abusive military/intelligence interrogations at places like Guantánamo, Bagram, and CIA ‘black sites.’ Dr. Reisner’s publications have appeared in the *Journal of the American Psychoanalytic Association*, *Studies in Gender and Psychoanalysis*, in the Web-Journal, the *Scholar and Feminist Online* (), and elsewhere. He was profiled in *Newsweek* magazine for his work to stop health professionals from complicity in government-sponsored torture. Because of this work, Dr. Reisner was the recipient of the New York State Psychological Association’s “Beacon” Award. Dr. Reisner is a practicing psychoanalyst and couple’s therapist in New York City.