guild interests…

Posted on Thursday 16 July 2015

Much of what I write about here has to do with the corruption of the medical record by industry funded clinical trials that have distorted both the efficacy and the safety of our treatments – specifically in psychiatry. But the topic has really been the erosion of the medical ethic of the authors and editors that have allowed [and placed] these studies in our literature. We’re fortunate to be in a time when there’s a palpable movement afoot to do something about it. This post is also about ethics, but in a related professional arena – organized psychology.

After 911, the country was united in a surge of patriotic zeal that the Bush Administration used to take us into a war with Iraq that we would have declined in other circumstances. The prisoner abuse at Abu Ghraib prison and torture at Guantanamo Bay were among the many disillusioning revelations that came out of that war. We learned that two DoD contract psychologists, Jim Mitchell and Bruce Jessen, had a central role in the development and implementation of the enhanced interrogation techniques [AKA Torture]. Less widely known, the APA [American Psychological Association] also had a part in this story – specifically addressing the ethical obligations of the psychologists involved in the interrogation process.

Last Friday, the APA released an independently commissioned report focusing on the details – specifically the actions of the APA’s Presidential Task Force on Psychological Ethics and National Security [PENS] in 2005 and the years that followed. Here are a few snippets from the Press Release and 500+ page report. It’s not pretty:
American Psychological Association
June 10, 2015

… The Hoffman report contains deeply disturbing findings that reveal previously unknown and troubling instances of collusion,” said Dr. Susan McDaniel, a member of the Independent Review’s Special Committee. “The process by which the Presidential Task Force on Psychological Ethics and National Security [PENS] was created, the composition of the membership, the content of the PENS report and the subsequent activities related to the report were influenced by collusion between a small group of APA representatives and government officials.

The Hoffman report states that the intent of the individuals who participated in the collusion was to “curry favor” with the Defense Department, and that may have enabled the government’s use of abusive interrogation techniques. As a result, the 2005 PENS report became a document based at least as much on the desires of the DoD as on the needs of the psychology profession and the APA’s commitment to human rights…
Sidley Austin law firm
by Douglas Hoffman
Commisioned by the American Psychological Association
June 2015

«from the Hoffman Report, page 14»

APA’s motive to please DoD

The very substantial benefits APA obtained from DoD help explain APA’s motive to please DoD. and show that APA likely had an organizational conflict of interest, which it needed to take steps to guard against. DoD is one of the largest employers of psychologists and provides many millions of dollars in grants or contracts for psychologists around the country. The history of DoD providing critical assistance to the advancement and growth of psychology as a profession is well documented, and includes DoD’s creation of a prescription-privileges "demonstration project" in which psychologists were certified to prescribe psychiatric drugs within DoD after going through a two-year training course. While APA took one significant step in 1991 that disappointed many military psychologists — refusing to allow DoD ads in APA’s publications because of DoD’s discriminatory position regarding gays and lesbians in the military — APA had lifted its advertising ban in 2004. And by the time of the PENS Task Force, contemporaneous internal discussions show that improving APA’s already strong relationship with DoD was a clear priority for officials working on the PENS Task Force.

In addition, at the time of the task force’s creation, DoD was in the midst of developing policy about how psychologists and psychiatrists could participate in interrogations and other intelligence-collection activities. APA wanted to positively influence DoD regarding this policy so that psychologists would be included to the maximum degree possible, and psychologists would not lose the lead role to psychiatrists. APA used the pro-DoD task force composition and report to show its strong support to DoD, with the hope or expectation that APA would be rewarded with a very prominent role for psychologists in this new policy. And in fact, the policy did provide a very prominent role for psychologists, a fact celebrated by the APA officials who had worked most closely on the task force…

«from the Hoffman Report, page 9»

lV. SUMMARY OF THE INVESTIGATION’S CONCLUSIONS

Our principal findings relate to the 2005 task force, which was formally empaneled by the APA President and was called the Presidential Task Force on Ethics and National Security, or "PENS." The task force finalized a report on June 26, 2005 containing 12 ethical guidelines that were adopted as official APA ethics policy by the APA Board on an emergency basis less than one week later.

Our investigation determined that key APA officials, principally the APA Ethics Director joined and supported at times by other APA officials, colluded with important DoD officials to haw APA issue loose, high-level ethical guidelines that did not constrain DoD in any greater fashion than existing DoD interrogation guidelines. We concluded that APA’s principal motive in doing so was to align APA and curry favor with DoD. There were two other important motives: to create a good public-relations response, and to keep the growth of psychology unrestrained in this area.

We also found that in the three years following the adoption of the 2005 PENS Task Force report as APA policy, APA officials engaged in a pattern of secret collaboration with DoD officials to defeat efforts by the APA Council of Representatives to introduce and pass resolutions that would haw definitively prohibited psychologists from participating in interrogations at Guantanamo Bay and other U.S. detention centers abroad. The principal APA official involved in these efforts was once again the APA Ethics Director, who effectively formed an undisclosed joint venture with a small number of DoD officials to ensure that APA’s statements and actions fell squarely in line with DoD’s goals and preferences. In numerous confidential email exchanges and conversations, the APA Ethics Director regularly sought and received pre-clearance from an influential, senior psychology leader in the U.S. Army Special Operations Command before determining what APA’s position should be. what its public statements should say. and what strategy to pursue on this issue…
I’ve only read the 73 page Executive Summary, but the facts are pretty clear. In response to the revelations of the involvement of psychologists in the torture of prisoners, the APA quickly gathered a Task Force to clarify the APA’s ethical guidelines. The Ethics Director assembled a Task Force heavily weighted with DoD psychologists and created guidelines with vague generalities that essentially allowed the DoD to continue doing what they were doing. The dissenting non-DoD psychologists on the Task Force were lied to about some future specific limits on the interrogations. All of this was done in close [private] consultation with the DoD itself, a collusion that continued for the duration of the Bush Administration. It was a sham, motivated by currying favor with the DoD in a guild competition with psychiatry; an attempt at mitigating against bad PR; but it had nothing to do with the manifest topic – the ethics of the torture program. Input from the representative body or general membership of the APA was carefully avoided.

This report documents how guild interests can corrupt the basic values of the guild itself. In spite of the dark side revealed here, the APA deserves praise for commissioning this report and revising ethical guidelines based on the findings. Psychiatry could learn a thing or two from this example. A similar investigation into the widespread participation of academic psychiatrists in the authorship of jury-rigged industry-funded clinical trials and other drug marketing collusions is long overdue…

see also:
  1.  
    July 16, 2015 | 2:05 PM
     

    I don’t think that this shows that “guild interests can corrupt the basic values of the guild itself”. Guilds are after all political organizations, potentially as power hungry as the Democrats or Republicans. It shows how a political faction in a guild biased by conflicts of interest with another political faction (in this case the DoD) can set policy for everyone in that guild. In the American Psychiatric Association front line members are very poorly represented and the more pressing issues are managed care, collaborative care, and maintenance of certification. In every case the same dynamic is operating and the membership has very little say. The rules are structured so that the organization operates like an oligarchy. Drug advertising has nothing to do with the current sad state of clinical psychiatry.

  2.  
    July 16, 2015 | 2:43 PM
     

    George,
    I didn’t actually mention the American Psychiatric Association in this post…

  3.  
    July 16, 2015 | 3:16 PM
     

    I took your reference to monolithic psychiatry to include the APA as the only organization that could commission a similar report reflecting on guild ethics – but I suppose there are others.

  4.  
    EastCoaster
    July 16, 2015 | 7:54 PM
     

    Behnke is a lawyer in addition to being a psychologist. He’s probably not as bad as John Yoo whose legal opinions contradict clearly articulated case law which he himself had taught at Berkeley. That’s not just immoral. In a technical sense it’s a violation of legal ethics too.

  5.  
    July 16, 2015 | 8:07 PM
     

    Eastcoaster,

    Point taken. In a sense, Behnke is in a league with Bybee and Yoo. He simply left out things rather than rationalized them away. An aside, here’s a recent Yoo-ism

  6.  
    EastCoaster
    July 16, 2015 | 10:07 PM
     

    I don’t mean to digress too much here, so please bear with me. Yoo left things out too. In discussing presidential powers he simply left out Youngstown Steel, the defining case on the limits of presidential power in war time.

    Now, I have a friend who has done a lot of pro bono work on behalf of Guantanamo detainees. (My friend decided to move back home to Montana a few years ago, but he lived and worked in DC for about 20 years.) He had a friend who was involved in some of this stuff and found himself at a party among the Georgetown set that Yoo attended. And he went straight up to Yoo and called him a war criminal. But nobody else joined in. People are ashamed of all kinds of things they shouldn’t be, but as a culture we’ve given up on righteous shaming. It didn’t do anything, because he was a lone voice, and when you are the lone voice you risk looking like a crank. But if “polite society” decided that Yoo wouldn’t be welcome at its parties, he wouldn’t be given honoraria to give lectures, etc. then we might have different results.

    The Internet can descend into vitriolic screaming matches with no standards of argumentation, but sometimes I wonder whether “being polite” is part of the problem. But of course, we can’t all be shouting the truths from the rooftops all the time like prophets.

    The American Psychological Associations’ statements about torture were out a long time ago — even before the report about collusion. (The Guardian reported that there was a smear campaign against a psychologist who stood up to this.) But all those regular, run-of-the-mill psychologists in the community or lower-tier academic positions didn’t exactly stand up and denounce it at the time. Only now.

  7.  
    Bernard Carroll
    July 16, 2015 | 11:07 PM
     

    I think James C. Coyne did. Check out his Facebook and Twitter.

  8.  
    July 17, 2015 | 12:18 AM
     

    Regarding others psychologists in the American community standing up in relation to this human rights issue, this (very long, apologies – and understanding if removed) detailed post from a US / international psychology listserve:

    Moving forward in this disturbing revelation from the Hoffman report, it is UPLIFTING to note the work done by Stephen Soldz and Steven Reisner (from Psychologists for Social Responsibility – http://www.psySR.org) to hold APA and its perpetrators to task – this is not as long as 500+ pg Hoffman report, but encouraging – and must be applauded. Here it is:

    On Jul 10, 2015, at 7:45 PM, Stephen Soldz wrote:

    Folks,

    As you know, St even Reisner and I met with the APA board on July 2. We agreed to confidentiality until the report was public, which happened today. We, therefore, are distributing the Opening Comments that Steven and I made at that meetings. We believe that they provide a guide with which to judge APA’s actions in the coming weeks. Feel free to distribute. [Apologies for cross-posting.]

    Opening Comments of Stephen Soldz and Steven Reisner to the American Psychological Association Board, July 2, 20115

    Last October, James Risen published allegations of American Psychological Association (APA) complicity in the Bush era torture program in his book Pay Any Price: Greed, Power, and Endless War. In the wake of these allegations, the APA Board in November 2014 commissioned an independent investigation of these allegations. This allegation was conducted by Chicago attorney David Hoffman of Sidley Austin LLC and his colleagues.
    In late June, 2015, as they prepared to rece ive the Hoffman Report, the APA Board asked to meet with us (Steven Reisner and Stephen Soldz). We presume we were asked because over the last nine years we have been leaders of the movement to remove psychologists from abusive and sometimes torturous national security interrogations. Further, we have researched and published extensively on these issues and extensively shared the results of our research with Hoffman and his team. Most recently, we were the psychologist coauthors of the report All the President’s Psychologists: The American Psychological Association’s Secret Complicity with the White House and US Intelligence Community in Support of the CIA’s ”Enha nced” Interrogation Program , which was featured in a May 1, 2015 New York Times article.

    The Board requested and we agreed to keep the substance of our discussions confidential until the report became public. However, with the public release of the report, we are now free to speak. Below are our opening comments to the Board.

    Stephen Soldz Comments:

    Thank you for having us here. I wish it was under less disturbing circumstances. We have come to discuss with you what we believe needs to be done by the American Psychological Association (APA) in the wake of the imminent release of the Hoffman Report. The conditions of confidentiality requested by the Board and agreed to by us have precluded our being able to discuss our ideas with our colleagues who have joined us for the last decade in our attempts to unveil the web of collusion beneath APA’s policies and actions regarding psychologist participation in sometimes abusive national security interrogations. However, our ideas have benefited from hundreds of hours of discussion with colleagues regarding the steps necessary to put APA on an ethical course. We believe that these ideas reflect those of many others besides ourselves, though we also consider it vital that the voices of those many others be actively heard as we proceed.

    I would like to make some opening comments, following which Steven Reisner will describe our ideas for the initial steps needed for APA to right itself and weather the storm that is just over the horizon. We would like to emphasize that these comments and ideas were put down less than 48 hours after we obtained access to the 500+ page Report. Neither of us has even read the entire report, much less absorbed it. Thus, these ideas are preliminary and may well be supplemented by others as we fully absorb the report and discuss with colleagues what should be done.

    I would like to begin with a very brief summary of what we take to be the gist of this report. The report documents in exhaustive detail the existence of a year’s long conspiracy to engage in collusion between senior leadership in the APA and the intelligence community, including the CIA and, most notably, the Department of Defense (DOD). This collusion involves a two-pronged strategy by the APA: First, there was a concerted attempt to generate so-called “ethical” policies on psychologist involvement in interrogations that would provide no constraints whatsoever on psychologists in the military working for DOD and other agencies. The second prong consisted of an elaborate deceptive and dishonest public r elations strategy to falsely portray APA policy as concerned with the protection of detainee welfare and human rights.

    This collusion included the development of apparently fine-sounding policy statements that were, as the report documents, virtually always vetted directly by DOD officials; manipulation of critics of APA policy to ensure that attempts to change that policy were toothless and did not in fact challenge DOD policies or practices; a strategic decision to turn heads away from increasing evidence on torture and other detainee abuse, including homicides, and on psychologist involvement in that abuse; and the dismissal and/or failure to investigate in any serious way ethical complaints against psychologists alleged to have participated in abusive interrogations, accompanied by repeated assurances from APA officials that all complaints would be comprehensively investigated. This collusion was accompanied by systematic manipulation of APA governance procedu res, the ac tive solicitation of opposition to critics by APA staff, and even the recording, in at least two known instances, of falsely claimed “unanimous” votes.

    This years-long collusion was accompanied by false statements from every Board and every elected President over the last decade denying the existence of the collusion described in such detail by Mr. Hoffman. The collusion was also accompanied by squelching of critics and, sometimes, by personal attacks upon them in the face of overwhelming evidence in the public record, including media reports and the results of multiple government investigations by Congress and other agencies. Most notable, are the vicious personal attacks upon PENS task force member and national hero Jean Maria Arrigo, who first revealed the collusion, attacks that in one case was distributed widely by the president of the Association; responses to those attacks went unanswered by that President or any other Association official. Other critics have been banned from state psychological association listservs; been attacked by an APA president in the official Monitor on Psychology as “opportunistic commentators masquerading as scholars;” been threatened with possible libel suits and ethics complaints; been disinvited from speaking to and writing for state psychological associations; been surreptitiously recorded by APA staff when having a private conversation with reporters; had venues where they were speaking criticized and even implicitly threatened with loss of accreditation; and called “clowns” in a national psychological newspaper by an individual given numerous awards by APA and its divisions and who is often in APA governance. This, sadly, is only a partial list of the attacks on critics. In none of these instances did people in APA leadership positions stand up to defend the right of critics to speak. These actions were all undertaken against those who sought to uncover the collusion that was denied by Association leadership, including this Board and the current CEO only a few months ago.

    That is the background to our meeting today to discuss how the APA should respond to the crisis facing the Association, the profession, and the country. I suspect that some of you have not yet fully grasped the magnitude of this crisis. As the result of its collusion, the APA is likely to become the public face of torture. The press storm will be fierce. Editorials will condemn the Association’s actions. Congress members will weigh in. Human rights groups, frustrated with the lack of accountability for torture, will be lining up to raise money off of suing the APA. There may be a decade of lawsuits, draining the budget and staff and elected officials’ time. Members will flee and young psychologists will be even more reluctant to join. And the Association’s 501©(3) nonprofit status may be threatened.

    More importantly, if not handled correctly, torture collusion will become the public face o f the profession we love. There is little doubt that the APA’s actions will go down in history books next to the chapter on the Tuskegee and Guatemalan syphilis experiments. The actions we take in the coming weeks, months, and years will determine how that chapter ends.

    I would like to end by outlining what I believe are the fundamental principles that should guide the APA’s actions forward. These are: contrition, accountability, transparency, inclusiveness, and genuine change. Notice that I did not list “healing” or “reconciliation.” Healing and reconciliation are needed, certainly, but this is not the time to talk of them. Before healing can start, we need painful surgery to remove the tumor that our work and the Hoffman Report demonstrate have been at the heart of the APA for the last decade.

    Now Steven will describe the preliminary steps necessary to start removing this tumor.

    Steven Reisner Comments:

    Following on Stephen’s comments I want to reiterate: There is a cancer on the APA. You here will have to decide whether to do the necessary surgery or whether you will preside over the death of the association:

    There are four issues here:

    1. The APA sacrificed its reputation and independence – perhaps its 501c3 tax exempt status – to align its policies with those of the CIA and the DOD. This was an active campaign, with constant behind the scenes consultation, in order to do the bidding of these agencies, first the CIA, then the DOD.

    2. There was an active campaign to undermine the will of the membership and of the council when they attempted to institute ethical restrictions on such activity. Simultaneously efforts were made to prop up and expand opposing efforts in support of such activity. Sometimes efforts were made to create opposing efforts to such activity. Thus APA ceased being a member-driven or democratic organization. The letter and spirit of the organizations by-laws were thwarted in favor of this secret agenda pushed by a staff that is supposed to be neutral and facilitative of the will of membership and governance. Instead staff manipulated the council and the membership.

    3. There was a public relations campaign directed to deceive the public and to manipulate governance. To the public the PR campaign made the false claims that APA was acting independently for human rights at the behest of its membership, while in fact it was doing the opposite. Within the organization there was a campaign to influence and manipulate those who opposed the policy or were uninformed and to bully those who would not be manipulated.

    4. All of this was done to advance a program of torture and abuse. It continued long after that program and the psychologists’ role in that program were public knowledge. If this level of manipulation and deception were done solely to secretly promote a government agenda, it would be a scandal; the fact that it was done to support torture and abusive monitoring of and research on detainees, is more than a scandal – it reaches the level of support for war crimes and crimes against humanity.

    The numbers of APA staff and members of governance involved actively in this disgrace is staggering. It began with a few and rapidly incorporated increasing numbers from top to bottom.

    Before I lay out what we believe APA must do, I want to make clear what you are dealing with. If the report is released on July 20th, there will be front-page articles in every major newspaper in this country and around the world on July 21st.

    The headlines will read: Report Finds APA Leadership Colluded Wi th Bush Administration in Support of Torture.

    What will the subheading read?

    “Many named remain in leadership positions”

    or

    “APA removes tainted leadership in response to investigation”

    This is not a PR problem. This is a survival of the association problem. And there is no good way to get through this. You will face numerous lawsuits and secondary investigations. You will face a hemorrhage of membership and the loss of public trust. And APA is going to lose its central leadership of the past decade and a half.

    ————–

    I will now follow on Stephen’s list of five essential categories of steps that must be taken if the association has a chance of surviving:

    Contrition,

    Accountability,

    Transparency,

    Inclusiveness

    Genuine Change

    Contrition

    · Let’s be clear that contrition is not a PR maneuver. Contrition requires thoroughgoing acknowledgement, remorse and change. APA must publicly acknowledge the depth and scope of this failure.

    · Apology to all affected – to the people harmed (detainees), it includes the public and the congress (for not upholding public trust and deceiving them), to the profession, members, former member and non-members for undermining our ethical foundations, opening us up to ridicule and scorn, and damaging our reputation. And to Jean Maria Arrigo.

    · I would like to see an op-ed written by APA leadership in the Times expressing this contrition.

    Accountability and Housecleaning

    · Staff involved must be fired

    · Members involved must be banned from governance

    · Bring ethics charges where appropriate.

    · More importantly, APA must publicly recommend state ethics charges where appropriate.

    · Make sure there is no hint of conflicts of interest in any part of governance or staff

    · Those found to be part of the collusion should be stripped of association awards, standing and honors.

    · And then you can give a special award to Jean Maria for being willing to stand up to an onslaught of power and manipulation that no one in this room was willing to stand up to.

    I will start with staff. I see that some of the people who need to go are in this room. That in itself tells me that you don’t really yet understand the seriousness of your situation. I want to say that this list is possibly incomplete, because I haven’t yet read every page of the report.

    Staff to be fired

    Anderson, Honaker, Gilfoyle, Farberman, Garrison, Kelly, Mumford, Behnke.

    Governance prohibition effective immediately

    Levant, Koocher, Banks, Dunivin, Moorehead-Slaughter, James, Deleon, Gelles, Newman, Gravitz, Shumate, Breckler, Strassberger, Sternberg, Matarrazo, and Anton

    Recusal for conflict of interest and investigation of role required

    Strickland

    APA needs to recommend to Division and State Association that they do the same.

    But housecleaning is a small piece of what is necessary for full accountability.

    How do we hold leadership and governance itself accountable?

    How do we answer the question, how did this happen and what must we do to insure it doesn’t happen again?

    We must have a thoroughgoing and independent institutional review. We need to appoint a blue ribbon panel to evaluate the organizational processes, structures, procedures and culture that allowed this to happen.

    The panel must recommend changes in processes, structures and procedures geared to preventing this kind of power manipulation from happening again. It must review APA’s overly close ties to military, intelligence agencies and government; it must in particular look at the potential for corruption in the directorates, in particular the ethics office, the ethics committee and the science directorate. It must investigate the APA voting processes and investigate the opaque entity that counts our votes: Intelliscan

    It must further address:

    · The power of staff and how it oversteps its institutional bounds

    · The progressive minimization of the oversight role and authority of Council and restore its authority and responsibility

    · Investigate how staff managed to impede the will of Council and prevent it from happening again (e.g., 1.02, statue of limitations).

    We need a committee of ethicists to redesign APA ethics policy and procedures. It may be true that 1.02 was not changed with torture in mind – the fact that it and other standards were weakened under the influence of APAIT is a second scandal unto itself that must be investigated. We also need to reopen ethics cases closed as part of this conspiracy. And if those to be investigated are no longer members, we must recommend state board investigation.

    There must be a financial accounting, including DOD, CIA and government money, awards, fellowships and quid pro quos.

    We must refer this report and its findings to the FBI and we must cooperate fully in any ensuing investigation.

    We must also refer the report to the appropriate Congressional committees, as per Senator Feinstein’s request. These committees include Senate Select CI, SASC, Senate Judiciary, and Senate Committee Health and human services and their counterparts in the House of Representatives. (Like the PENS report)

    Policy change

    All policies regarding APA and national security must be annulled, including the approval of operational psychology as a subspecialty.

    Review of the ethics of national security and operational psychology:

    Blue ribbon panel #2 to do a thoroughgoing independent ethical review of the role of psychologists in national security operations. JMA should be a part of such a panel, along with internationally recognized medical ethicists and human rights advocates.

    Moratorium on participation in national security interrogation and detention operations during the review process.

    No statute of limitation on TCID ethics charges, automatic ethics committee investigation for TCID charges when these arise in the context of national security operations, detention or interrogation activities.

    We need to develop guidelines for undertaking such investigations.

    For Non-members, APA has to recommend full investigation from the state boards in national security sites and offer them guidelines.

    Transparency

    Let this be the last time that APA discussions of such import are held in secret. We need to make all such discussions transparent and easily accessible. We also need to report in plain language:

    · The salaries and perks of staff

    · The lobbying APA does

    · Who gets to represent APA to congress and government and how such people are chosen.

    · Anything else members of council, the membership, or the public wants to know or should be informed of.
    We need to make all our deliberations and actions transparent, including these discussions.

    We should have APA books publish the Hoffman report; The American Psychologist and the Monitor should publish the Executive Summary.

    We should deposit the entire record of the Hoffman investigation deposited into the APA PENS Debate Collection at the archive of the University of Colorado at Boulder.

    And we should call for a Congressional investigation into the role of health professionals and health professional organizations roles in support of the torture program and invite the other health professional organizations to do the same.

    Inclusiveness

    All stakeholders must be represented in these discussions. These include the broader psychological community, including those who opposed now-tainted APA actions when they occurred and the hundreds or thousands who quit the APA because they recognized this complicity wh ile the elected leadership and staff d enied it. In addition, equally important stakeholders are the medical ethics community, human rights advocates, Congress (as seen by the expressed desire of Sen. Feinstein to review the report), and the broader public, as attested to by the extensive press interest in our April report. All of these have a stake in the decisions and initiatives you and we undertake today and in the coming weeks.

    Ultimately, and importantly, we must set aside a time in August for a lengthy Town Hall Meeting at the convention where we give the membership a chance to discuss these revelations

    Genuine Change – ???

    Stephen Soldz

    Boston Graduate School of Psychoanalysis

  9.  
    James O'Brien, M.D.
    July 17, 2015 | 1:05 AM
     

    We all know bias influences opinions, and that is really unavoidable. Both the positions of APA and the responses on this board illustrate that.

    For that reason positions on controversial issues aren’t really equivalent to junk science. I think this thread of reasoning is apples and oranges.

    What should not be tolerated is bias and COI distorting facts.

  10.  
    July 17, 2015 | 2:23 AM
     

    “But all those regular, run-of-the-mill psychologists in the community or lower-tier academic positions didn’t exactly stand up and denounce it at the time.”

    It might be for the same reasons that all of us run-of-the-mill community and lower tier academic psychiatrists never stood up to managed care, PBMs, E&M coding, utilization review, and prior authorization. We are working – too many hours and seeing too many patients, we have business people constantly wasting our time and trying to manipulate us, and the political organizations that represent us are ineffective and represent the interests of the people at the top.

    Shaming – righteous or not is a common feature of social media. If it doesn’t happen there – I would guess the issue is too complex for the average shamer to understand.

  11.  
    berit bryn jensen
    July 17, 2015 | 4:06 AM
     

    Governments and organizations can be more or less democratic, at times dangerously close to fascist takeover – if and when no dissenters are willing to take upon themselves to alert the busy, most often scared clerks, shopkeepers, members of the public about power grabs. Recent (European/US) history teaches relevant lessons on the dangers of passive submission to power. Thank God there still are persons of courage and integrity – guardians of the tattered free-speech barriers that are keeping the ubiquitous fascists at bay, hampering the present system of wars, drone-killing and torture from imprisoning any more whistle-blowers – I hope.

  12.  
    EastCoaster
    July 17, 2015 | 6:34 AM
     

    GD: I know, people have work to do, and It’s hard to stand up for things — especially when you have a mortgage to pay and a family. But they’re still complicit

    As an aside, Social Media shaming is a different kind of thing, from say not letting Behnke speak at the Harvard Divinity School. Often Twitter stuff can be directed at the relatively weak, not the masses against the powerful, and this is probably not the right place to discuss it. I apologize for going so far afield from the original discussion.

  13.  
    berit bryn jensen
    July 17, 2015 | 6:39 AM
     

    John Yoo used the works of Carl Schmitt – “legalizing” what the Bush administration wanted – as Carl Schmitt legalized Hitler’s tyranny. Here, the going comparison from human rights professionals and lawyers is that APA leaders behaved as obedient bureaucrats in Nazi-Germany. “He’s dead, but he won’t lie down”.

  14.  
    Antipaxos
    July 17, 2015 | 6:40 AM
     

    Not unrelated …

    Perspective: Post-9/11 Torture at CIA “Black Sites” — Physicians and Lawyers Working Together.
    George J. Annas, J.D., M.P.H., and Sondra S. Crosby, M.D.
    N Engl J Med 2015; 372:2279-2281
    http://www.nejm.org/doi/full/10.1056/NEJMp1503428

  15.  
    Steve Lucas
    July 17, 2015 | 7:26 AM
     

    Corruption in medicine runs deep at all levels:

    Internationally:

    http://blogs.wsj.com/pharmalot/2015/07/07/world-health-organization-scolds-indian-company-for-clinical-trial-violations/?mod=WSJBlog

    Nationally:

    http://lowninstitute.org/news/how-the-american-medical-associations-secretive-panel-drives-up-healthcare-costs/

    Locally:

    http://www.foxnews.com/health/2015/07/11/detroit-area-cancer-doctor-gets-45-years-in-prison-for-fraud/?intcmp=latestnews

    We will all hear the logical fallacies of:

    Everyone is doing it.

    We built closer ties with the government.

    This was in the best interest of the public.

    The reality is these people and groups acted in their self interest, which is no different than prescribing a drug the sales rep recommends after bring a free lunch. People are petty and will act in their own self interest, sometimes with life threatening consequences for the patient, or in this case, the detainee.

    Steve Lucas

  16.  
    Steve Lucas
    July 17, 2015 | 7:57 AM
     
  17.  
    berit bryn jensen
    July 17, 2015 | 12:05 PM
     

    Man (humans) are not immune to flattery, ambition, greed, spineless, cowardly subservience to the powers that be. But common people, those of us far from the corridors of power, less exposed to its greatest temptations, are more likely to become low level executioners of criminal plans made by the big guys, or victims of them.

    Svetlana Aleksijevitj have written books about the Sovjet utopia and its break down. “War has no female face”, about women fighters in WWII, less recognized, less honored for their struggles and sacrifices than male soldiers.
    Time, Second Hand tells the stories of life and survival in and after the break up of the Sovjet Union. A survivor of the harshest gulag camps says: We could not have survived without the kindness of ordinary people, strangers…

    Democracy can not survive, without ordinary people caring enough to take the unavoidable risks of confronting illegitimate power. Bigger fish than John Yoo and the APA leadership should be prosecuted, one of them even decorated with a Nobel Peace Prize. Good grief.

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