APA Crisis in Human Rights & Ethics


A Human Rights and Ethics Crisis Facing the World's Largest Organization of Psychologists

Accepting Responsibility, Understanding Causes, Implementing Solutions

Kenneth S. Pope, Ph.D., ABPP

THIS PREPUBLICATION DRAFT WAS UPDATED & REVISED JULY 2018.

PLEASE NOTE: This is a prepublication draft of an article that is in press in EUROPEAN PSYCHOLOGIST

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ABSTRACT: A crisis of human rights and ethics has engulfed the American Psychological Association, leading the APA to confront culpability, accept responsibility, and "apologize for this stain on our collective integrity."  What steps led to this continuing crisis and its still unfinished business?  How has the APA gotten so ethically lost that the president-elect announced at the annual meeting that they were there to reset their moral compass?  This article documents key events, decisions, and policies that help us answer those questions.  It places this crisis of human rights and ethics in the context of the rollback of human rights in most countries of the world and the growing public support, particularly in the U.S., for torture.  It explores factors that can weaken our defense of human rights and ethics, such as our shared human tendency to confuse the map with the territory, legal duties with ethical duties, guild ethics with professional ethics, and effective methods with ethical methods.  It looks at cultural, racial, and religious aspects.  It highlights our need to search actively for opposing views and disconfirming information to help us overcome confirmation bias, GroupThink, WYSIATI (What You See Is All There Is) bias, and false consensus.  It examines the hazards of euphemism and ambiguity, as well as the unfilled promise of prohibitions, policies, and public pronouncements.  It notes continuing controversies, including proposals to roll back reforms and three lawsuits alleging false and defamatory statements made with actual malice.  The article suggests 6 principles to avoid repeating mistakes of the past.

 

            Keywords: human rights, torture, American Psychological Association, Nuremberg, professional ethics

 

              We've yet to fully grasp the corrosive damage and still unfinished business underlying a decade of newspaper coverage bearing shock-the-conscience titles like "Psychologists Implicated in Torture" (Goodman, 2007); "Psychologists and Torture" (Boston Globe Editorial Board, 2008); "Psychologists 'Protected CIA Torture Programme'; Professional Body Admits It May Have Contributed to Violations of Human Rights After Scathing Internal Report Into Post 9/11 Collusion With Pentagon" (Crilly, 2015); "Psychologists Who Greenlighted Torture" (New York Times Editorial Board, 2015); "How America's Psychologists Ended Up Endorsing Torture; New Revelations Reveal a Surprisingly Cozy Relationship Between the American Psychological Association and the Department of Defense" (2015); "Psychologists Met in Secret With Bush Officials to Help Justify Torture; Newly Disclosed Emails Reveal American Psychological Association Coordinated With Officials in CIA and White House to Help Ethically Justify Detainee Program" (Jalabi, 2015); and "Psychologists Are Facing Consequences for Helping With Torture," Eidelson, (2017a).

 

            What steps led the world's largest organization of psychologists into this continuing human rights and ethics crisis, which would include confronting culpability, accepting responsibility, and apologizing "for this stain on our collective integrity" (Kaslow & McDaniel, 2015; see also Voice of America, 2015)?  What caused the highly respected American Psychological Association (APA), which had done so much good, to get so ethically lost that the president-elect announced to the governing council at the annual meeting: "We're here today to reset our moral compass" (quoted by Wilhelm, 2015; see also Aldhaus, 2015; Hanlon, 2015; O'Neill, 2016, p. 228)?

 

            This article highlights key decisions, trends, policies, and public statements that can help us as we struggle to answer those questions and avoid repeating the mistakes made during what has been called the "darkest period" in the APA's history dating back to its founding in 1892 (Hanlon, 2015).  This history suggests that fundamental principles were forgotten or swept aside.  Holding these principles firmly in mind and emphasizing them in undergraduate, graduate, and continuing education programs can guide and strengthen our efforts to avoid the wrong turns of the past.  Looking at how the crisis began and has evolved up to the present also gives us a chance to think through not only what we have to say about these historic events but also what the events have to say about each of us as individuals.  Knowing what we know now, what would or could we have done differently?  What can each of us do to become a more vigilant, prepared, and effective supporter and defender of human rights and ethics?  How can we escape the role of passive—and enabling—bystander when human rights and ethics are at stake?

 

            Reviewing this history can also help us remember what actually happened in this not yet fully resolved crisis and avoid lapsing into revisionism, denial, institutional amnesia, dismissing it as fake news or false narratives, or trying to "move past it" when "move past it" means "pretend it never happened" or "forget about it."  Santayana reminds us that freeing ourselves from the past hinges on memory: "Progress…depends on retentiveness….  Those who cannot remember the past are condemned to repeat it" (1905/2017, pp. 103).

 

           Searching the past to learn how we can become better at promoting and protecting human rights seems fiercely urgent because those rights now face widespread attacks and those attacks meet little resistance.  The UN High Commissioner for Human Rights reports:

Time and again, my office and I have brought to the attention of the international community violations of human rights.…  Time and again, there has been minimal action….  Today oppression is fashionable again; the security state is back, and fundamental freedoms are in retreat in every region of the world. (Zaid, 2018)

            Governments often violate human rights without paying a price.  Individuals who try to prevent or expose those violations can face threats, assaults, prison, torture, or death.  The Amnesty International Report 2017/18: The State of the World's Human Rights warns that "the cost of speaking out against injustice continues to grow" (Amnesty International, 2018, p. 13).  Survey data show a "34% global rise in attacks against human rights activists last year" (Kelly, 2018).  In the past year alone, hundreds of human rights defenders were killed, and hundreds more threatened or detained (United Kingdom Mission to the United Nations, 2018).

 

Torture

 

            As attacks on both human rights and defenders of human rights grow, one human rights violation—torture—continues to gain wider support.  In annual surveys asking people in the U.S. whether "the use of torture against suspected terrorists in order to gain important information" was justified, the Roper Center for Public Opinion Research (2015) found that the percentage of those saying that torture is rarely or never justified fell from 53% in 2004 to 47% in 2015, while the percentage of those saying that it is sometimes or often justified climbed from 43% to 51%.  A 2016 Reuters/Ipsos poll found that just short of two-thirds of U.S. adults believed that torturing "suspected terrorists to obtain information about terrorism" could be justified.  A mere 15% said it should never be used, while 38% said it is sometimes justified and another 25% said it is often justified (Kahn, 2016; see also Mayer & Armor, 2012).  Surveying 17,000 people in 16 countries, the International Committee of the Red Cross (ICRC) found that the percentage of those saying that torture should not be used "to obtain important military information" had fallen from 66% in 1999 to 48% in 2016 (ICRC, 2016, p. 10).

 

            This growing public support for torture provides a context for the human rights and ethics crisis.  Does the stronger support in the U.S., compared to most other countries, help explain why it was a U.S.-based organization of psychologists that became entangled in this controversy?  A 2015 Pew Research Center survey of 38 nations found that 58% in the U.S. believed torture was justified to prevent terrorist attacks, and that only 5 other countries showed larger percentages of support: Nigeria, Kenya, Israel, Lebanon, and Uganda (Wyke, 2016).  Similarly, a 2016 International Committee of the Red Cross (2016) survey of 16 nations found only 2 other countries (Nigeria and Israel) had smaller percentages of people answering "no" when asked "Can a captured enemy combatant be tortured to obtain important military information?" (p. 10).  Thirty percent in the U.S. had answered "no" to this question.  Mindful of the growing support for torture, which is stronger in the U.S. than in most other countries, and the fierce urgency of finding ways to avoid repeating past mistakes, we turn now to major markers in this human rights and ethics crisis.

 

The Unfilled Promise of Prohibitions and Public Pronouncements

 

            Professions profess their values, making clear what they stand for.  Professionals adopt policies and elect leaders who will express those values and keep their profession on track.  U.S. psychology's history includes strong public stands supporting human rights and opposing torture.  These formal stands intensified during the post-9-11 period when, as the newspaper articles cited earlier showed, the APA's professed commitment to human rights started to come under sharp questioning.

 

            Responding to the 9-11 terrorist attacks on civilian men, women, and children, the U.S. interrogated suspected terrorists at the Detention Centre at Bagram Airbase in Afghanistan; Abu Ghraib Prison in Iraq; Camps Delta, Iguana, and X-Ray at Guantánamo Bay Naval Base; and other sites.  The APA saw psychologists as central to these interrogations, explaining to the U.S. Senate Select Committee on Intelligence that "conducting an interrogation is inherently a psychological endeavor…. Psychology is central to this process" [emphasis in the original] (APA, 2007b).  The APA's strong advocacy for psychologists' involvement in the U.S. interrogation programs, in sharp contrast to the American Psychiatric Association's stance, convinced the Pentagon to include psychologists when designing interrogation methods.

Pentagon officials said they would try to use only psychologists, not psychiatrists, to help interrogators devise strategies to get information from detainees at places like Guantanamo Bay, Cuba.  The new policy follows by little more than two weeks an overwhelming vote by the American Psychiatric Association discouraging its members from participating in those efforts (Lewis, 2006).

            In "Advocacy As Leadership," the American Psychiatric Association president described a stark difference in ethical values to explain why his organization took a different stance from the APA's:

I told the generals that psychiatrists will not participate in the interrogation of persons held in custody.  Psychologists, by contrast, had issued a position statement allowing consultations in interrogations.  If you were ever wondering what makes us different from psychologists, here it is.  This is a paramount challenge to our ethics....  Our profession is lost if we play any role in inflicting these wounds (Sharfstein, 2006, p. 1713).

            The public was assured that psychologists would keep all interrogations safe, legal, and ethical, in line with the APA's strong stance opposing torture and other violations of human rights.  For example, an APA Ethics Office statement in Psychology Today underscored what psychologists would achieve in all interrogations: "The ability to spot conditions that make abuse more likely uniquely prepares psychologists for this task.  Adding a trained professional ensures that all interrogations are conducted in a safe, legal, ethical, and effective manner…" (Hutson, 2008; italics added).

 

            The APA backed its stance that psychologists were central to the interrogations and would keep them safe, legal, and ethical (see Pope, 2011 for additional examples and discussion) with a series of strong anti-torture policies.  The APA's public statements against torture had begun long before.  For example, in the mid-1980s the APA adopted "Against Torture: Joint Resolution of the American Psychiatric Association and the American Psychological Association" (APA, 1985) and the "Resolution Against Torture" (APA, 1986, p. 661).  After 9-11, the APA repeatedly restated its anti-torture policy in a "Reaffirmation of the 1986 Resolution Against Torture" (APA, 2006, pp. 459), a new "Resolution Against Torture" (APA, 2007a, p. 448), a "Reaffirmation of the APA Position Against Torture" (APA, 2008, p. 412), an amendment to the "Reaffirmation of the APA Position Against Torture" (APA, 2009, pp. 425-426), and a "Resolution to…Safeguard Against Acts of Torture…in All Settings" (APA, 2016, pp. 378-380).  The APA's commitment was not just to oppose torture but to advance all human rights.  The "APA Vision Statement" set forth a vision of the APA as "the primary resource for all psychologists" and "champion of the application of psychology to promote human rights" (APA, 2009, pp. 451).

 

            The APA mapped out its anti-torture and human rights values in formal policies and public assurances, but as Korzybsky reminds us: "A map is not the territory it represents…"  (1933/2010, Kindle location 1179).  Mistaking the map for the territory is a slip I often find myself making and I believe this error was widespread during this period, helping to create this continuing crisis of human rights and ethics.  It is easy for us to think that our work is done once we choose good leaders and adopt policies that state our values clearly and forcefully.  Leaders and non-leaders alike may forget that policies, prohibitions, and public statements are necessary but not sufficient, that maps may mislead because they fail to match the territory itself.  It is as if we try to shift our own ethical responsibility away from ourselves and onto written and spoken words.  But we can't outsource our ethical responsibility, even to the best policies and leaders.  The inescapable ethical duty stays with each of us.  When fundamental ethics are at stake, it falls to each of us to ask "Does the map accurately reflect the territory?"  The territory itself may show a spreading "stain on our collective integrity" that is missing from the map.

 

            Like the APA, the U.S. mapped out public policies prohibiting torture and public assurances from leaders that the U.S. would not torture and was leading the fight to rid the world of torture.  Griffen (2015) wrote that the "US had the most restrictive ban against torture, compared to the definitions of the World Health Organization [and] the United Nations" (see also "Legal Prohibition Against Torture," 2004; "Summary of International and U.S. Law Prohibiting Torture and Other Ill-treatment of Persons in Custody," 2004).  President Bush insisted early on that "the United States is committed to the world-wide elimination of torture and we are leading this fight by example" (2003) and later gave assurance that was strong, absolute, and unambiguous: "I want to be absolutely clear with our people and the world: The United States does not torture.  It's against our laws and it's against our values" (2006).

 

           Our shared human tendency to assume the map matches the territory complicated the crisis and made it harder for us to sort through our ethical responsibilities when they conflicted with our duties to the state, which is the focus of the next section.

 

When the Demands of the State Eclipse Ethical Responsibilities

 

            When caught committing an ethically questionable act, U.S. politicians frequently follow a familiar script.  They proclaim that they have broken no law, as if following the law placed their behavior safely beyond question.  This strategy cleverly confounds legal and ethical standards.  It exploits our difficulty untangling legal and ethical duties and the ways in which the power and demands of the state—expressed through laws, regulations, and legal authority—can eclipse ethics.

 

            U.S. psychology struggled to speak clearly on the relation between ethical responsibilities and the demands of the state during this period.  But a key principle was downplayed, denied, and distorted: That obeying the orders of the state never allows us to escape our ethical responsibilities. 

 

            On August 21, 2002, the APA adopted a revised ethics code allowing the state's demands to trump ethics.  The code made a sharp break with how the APA had previously balanced ethics and state power over the many decades of its history.  The APA took an extremely radical stand that whenever our "ethical responsibilities" cannot be reconciled with state authority, "psychologists may adhere to the requirements of the law, regulations, or other governing legal authority" (APA, 2002, section 1.02, p. 1063).  An earlier draft required this abdication of ethics to be "in keeping with basic principles of human rights" both in the code's introduction and in the enforceable section.  However, the APA adopted the new code only after cutting that requirement out of the code's enforceable section.

 

            No other profession followed the APA's lead during the eight years that the APA promoted, the APA Ethics Committee endorsed, and psychology students were taught this new code's approach of allowing the law to eclipse ethics.  Less than a year after the APA adopted the new code, Dr. Kati Myllymaki, president of the World Medical Association (WMA), issued a stark reminder:

At Nuremberg in 1947, accused physicians tried to defend themselves with the excuse that they were only following the law and commands from their superiors….   This defence was condemned…and the court announced that a physician could not deviate from his ethical obligations even if legislation demands otherwise. (WMA, 2003)

            Predictably, an ethics code allowing state power and authority to override ethical responsibilities has evoked a scalding cascade of criticism, for example:

made clear that obeying commands from superiors didn't remove personal accountability.  Doctors couldn't deviate from their ethical obligations even if a country's laws allowed or demanded otherwise....  It's surprising, even shocking, to find that the same code isn't shared by psychologists, at least in the United States. (Godlee, 2009, p. 7704)

Most concerning of all, the APA allows its members the "Nuremberg defence" that "I was only following orders."…  The implication is that psychologists are permitted to assist in torture and abuse if they can claim that they first tried to resolve the conflict between their ethical responsibility and the law, regulations or government legal authority.  Otherwise they can invoke the Nuremberg defence. (Burton & Kagen, 2007, p. 485)

During the decade of "enhanced interrogations," both CPA and APA revised their codes of ethics.  APA's changes made it easier to cooperate with the U.S. Department of Defense.  CPA's went in the opposite direction, strengthening the link between professional ethics and respect for international law. (O'Neill, 2016, p. 228)

APA's misplaced loyalty to the state directly undermined the health and human rights of patients at Guantanamo Bay. APA policy...allowed psychologists to participate in practices termed "enhanced interrogation" and was used by the US Department of Defence and others to justify, expand, and prolong torture ostensibly approved by experts from healthcare profession. (Ahalt, Rothman, & Williams, 2017)

            The continuing criticism confronting the 2002 ethics code's controversial section 1.02 presented the APA with a challenge: How to respond to criticism and critical but unwanted information, which is the focus of the next section.

 

Criticism and Critical Information

 

            During the post-9-11 period, the APA has faced criticism not just from individuals but also from human rights organizations and related associations. For example, Amnesty International, Physicians for Human Rights, the Center for Constitutional Rights, and 10 other organizations sent an open letter condemning the APA for "providing ethical cover for psychologists' participation in detainee abuse" (American Friends Service Committee, et al., 2009).

 

            The APA has confronted not only criticism but also information and evidence—coming from diverse sources—that contrasted with APA's public stance.  For example, soon after the detainee interrogations began, reports from newspapers, humanitarian organizations, and the U.S. government contradicted the APA's assurances that psychologists were keeping interrogations safe, legal, and ethical.  The New York Times spotlighted the 2003 and 2004 reports by the International Committee of the Red Cross discussing psychologists' role in abuses at Guantánamo.  The Central Intelligence Agency (CIA) Inspector General (2004) noted that an array of psychologists, both outside and on-site, provided assurance that waterboarding causes no lasting psychological harm (U.S. Central Intelligence Agency, Inspector General, 2004; see also Davis, 2011; Mayer, 2008).  McCoy (2006) documented how "Guantánamo's integration of psychologists into routine interrogation perfected the CIA's paradigm, moving beyond a broad-spectrum attack on human senses, sight and sound, to a customized assault on individual phobias or cultural norms, sexual and religious" (Kindle locations 3390-3392).  James Risen, a Pulitzer Prize-winning investigative reporter for the New York Times, uncovered primary source documents that included emails secured by a CIA-connected researcher.  He reported that the APA's actions conflicted with its anti-torture policies and public statements.  "The emails reveal how the American Psychological Association (APA), the nation's largest professional group for psychologists, put its seal of approval on those close ties [among leading psychologists and CIA and Pentagon officials] and thus indirectly on torture" (Risen, 2014a, p. 178; see also Risen, 2014b, 2015).

 

            A vital principle that passed into hibernation during the post 9-11 period is that we need to do more than just welcome criticism and critical information.  We need to actively search for them, and evaluate them carefully, openly, and non-defensively.  Hunting for facts, views, and possibilities that call into question what we assume, suspect, or believe helps us overcome such shared human tendencies as confirmation bias, GroupThink, WYSIATI (What You See Is All There Is) bias, and false consensus.  I'm guessing this is one of the hardest principles for all of us to practice.  And it can be much harder during times of great stress and uncertainty, such as the years falling in the shadow of the 9-11 attacks.

 

            In late 2014, the APA turned away from its stance of rejecting criticism and critical information that conflicted with its policies and public statements.  During the post 9-11 years the APA had held out a vision of itself as "champion of the application of psychology to promote human rights" (APA, 2009, p. 451) and as establishing and maintaining "the highest standards of professional ethics" (APA, 2004, Article 1; see also APA, 2005, p. 2) despite steps like adopting an ethics code (APA, 2002) that contained a loophole—one rejected by the Nuremberg courts—allowing members to escape their ethical duties whenever those duties stood in irreconcilable conflict with the demands of the state.  However, in October 2014, the APA took a decisive step requiring considerable courage and leadership.  It commissioned "a definitive, independent and objective review" (APA, 2014) to be conducted by David H. Hoffman, a former Inspector General, federal prosecutor, and Supreme Court clerk, who had directed hundreds of investigations, and advised numerous public and private entities on ethics and compliance matters.

 

           The Independent Review Report (Hoffman et al., 2015a, 2015b) and the six binders of emails and other supportive documentation that accompanied it described in detail how the "APA intentionally decided not to make inquiries…thus effectively hiding its head in the sand" and "remained deliberately ignorant" (p. 11).  Prior to the Independent Review Report, the New Jersey Star-Ledger Editorial Board published an editorial, "Doctors Without Ethical Borders," which summarized a separate study—conducted and released prior to the Hoffman Report—of emails and other documents, and condemned the APA's "See No Evil" policy, as had Boulanger (2009) much earlier (see also LoCicero, 2018).

 

            The Independent Review Report also documented ways in which criticism was rejected and critics disparaged (see also Elkins, 2016; Gómez, Smith, Gobin, Tang, & Freyd, 2016; Pope, 2016; Thomas, 2016, 2017).  APA member Jean Maria Arrigo serves as a vivid example.  The Independent Review Report (2015a&b) described how she was attacked in a highly personal manner that included claims about her supposedly "troubled upbringing."  The Guardian reported how she had been "largely ignored and the subject of a smear campaign for sounding alarms about psychologists' post-9/11 torture complicity" (Ackerman, 2015).  The American Association for the Advancement of Science (AAAS) honored her with the AAAS Scientific Freedom and Responsibility Award because she "confronted systematic efforts by the American Psychological Association (APA) to allow and conceal the involvement of psychologists in the torture and abuse of detainees" (Korke, 2016).  To its credit, the APA finally formally acknowledged that this whistleblower faced not only "efforts to discredit, isolate, and shun" that were "orchestrated movements by those in positions of power" but also "harsh, hostile personal criticism and attacks" (Watt, 2015).  And to her credit, Jean Maria Arrigo has continued to speak out and bring to light new information about this continuing crisis (e.g., Franz & Arrigo, 2017).

 

            If we are to prevent a future crisis of human rights and ethics, the events of this period suggest we must be ready to speak up, as Jean Maria Arrigo did, despite the costs, an act that may require moral courage (Pope & Vasquez, 2016, Chapter 10: "Moral Distress and Moral Courage"; Pope, 2017, Chapter 7: "Finding Moral Courage and Putting It To Work"); listen respectfully to whistleblowers, critics, and those with contrary views and unwanted news; and avoid the role of passive—and enabling—bystander whenever whistleblowers, critics, and the bearers of bad news are threatened, bullied, or attacked.

 

Ethics, Effectiveness, Euphemisms, and Ambiguity

 

            U.S detainee interrogations have been described as "harsh," "rough," "aggressive," "enhanced," "extreme," "coercive," "abusive," or "torture-lite."  These terms carry multiple meanings.  Sometimes they point to a large, vague group of accusatory or aversive interrogation techniques that might—or might not—include torture.  Other times they seem to hide torture behind euphemism (Bennett, Lawrence, & Livingston, 2006; Council of Europe, 2007, p. 3; Henley, 2007; McGreal, 2012).

 

            More than other countries, the U.S. tends to use ambiguous categories and euphemisms to describe its interrogations.  A comparison of news articles from leading publications in seven countries found striking differences in reporting the 2004 Abu Ghraib prison story:

At one extreme, American journalists overwhelmingly avoided torture to describe Abu Ghraib, emphasizing instead more ambiguous, and arguably more innocuous, terms such as abuse or mistreatment.  At the other extreme, German, Italian, and Spanish journalists tended to define what happened at the prison as torture rather than as abuse or mistreatment.  (Jones & Sheets, 2009, p. 278; see also Downie, 2004; Graber & Holyk, 2009; Rosen, 2014; Umansky, 2014)

            Ambiguity and euphemism create a fog of conceptual confusion around the interrogation techniques.  The confusion makes it easier to assume that the central ethical question is: "Do the techniques work saving American lives?"  According to this view, if techniques work, using them is not just ethical but an ethical duty.  A member of the APA's special ethics task force explained "the real ethical consideration" underlying this duty.  To address such ethical considerations, the APA created a select "blue ribbon" committee (James 2008, Kindle location 3163) of experts—the Presidential Task Force on Psychological Ethics and National Security—who would craft the APA's ethical policies in this area.  The task force member noted that the idea of psychologists inflicting pain seems

at first blush, something that would be wrong because we do no harm.  But the real ethical consideration would say…by producing pain or questioning of somebody, if it does the most good for the most people, it's entirely ethical, and to do otherwise would be unethical. ("Military Psychologist Says Harsh Tactics Justified," 2009; see also Richey, 2007)

            More recently, a group of six university-based psychologists presented a similar view based on consequentialist ethics, deontological ethics, virtue ethics, and efficacy.  They concluded "that psychologists, in order to behave consistently with their moral obligations to the community, to their ethical duties, in order to minimize harm, and to act virtuously may, in certain circumstances, need to participate in torture" (O'Donohue, et al., 2014, p. 121; see also O'Donohue, Maragakis, Snipes, & Soto, 2015; for critiques and opposing views, see Arrigo, DeBatto, Rockwood, & Mawe, 2015; Eisenhower, 2017).

 

            Evaluating these claims requires renewed commitment to clarity.  To defend human rights and ethics effectively, we must scrub euphemism and ambiguity out of what we say and write.  We need to know the difference between torture and other interrogation techniques, some of which may be accusatory or aversive, that do not violate human rights.  If we humans each possess inherent, inalienable rights—as opposed to human privileges or perks that the state can give or refuse—then perhaps an ethical analysis of whether torture "works" falls into the same category as asking whether genocide or slavery "works" for a country, is useful in defending the country, or benefits a majority of its citizens.

 

Professional Ethics and Guild Ethics

  

          A key question that helps reveal the depth of an organization's ethical commitment is: Has the organization set its moral compass to protect itself over public interest?  The set-point of the moral compass divides professional ethics from guild ethics.  Sometimes professions seem virtually identical to guilds.  Both may be made up of deeply dedicated, highly skilled members.  Membership in both may come only after years of training and tests that supposedly show expertise or at least competence.  Both may point with pride to their lofty ideals and aspirations, their rich history, their impressive accomplishments, their leadership, and their record of significant contributions to the public good.  But professional ethics protect the public against the abuses of professional power, specialized knowledge, and prominent positions.  They place protecting the public interest above advancing the profession's self-interest.  They hold members truly accountable for violating these values.  Guild ethics, on the other hand, place members' interest above the public interest when both come into conflict.  They tend to blur or evade accountability when it clashes with self-interest.  Guild ethics are written to masquerade as professional ethics, exploiting our tendency to mistake the map for the territory.  Guild ethics can find ways around even the most absolute, unambiguous prohibitions, discover loopholes in seemingly solid standards, and offer the appearance but not the reality of fair, just, and meaningful mechanisms of accountability.

 

            The APA's vulnerability to a human rights and ethics crisis in the post-9-11 era may have been created in part by having shifted from a professional ethics code to a guild ethics code almost a decade earlier, and later revising the ethics code to express an even more extreme version of guild ethics.  The 1992 revision of the APA ethics code marked the start of this trend.  Bersoff (1994), the APA's former legal council and later an APA president, wrote frankly about his own assessment as well as summarizing the judgments of others who had reviewed the code.  He wrote that "commentators agreed that the 1992 code" seems "to protect the profession rather than the public" (p. 382), adding that "as almost all the reviewers pointed out, the code is full of such lawyer-driven 'weasel words' as reasonable and feasible" (p. 383).

 

            Carolyn Payton was a widely known and respected psychologist who wrote a landmark evaluation of the code.  Payton had been the first woman and first African-American to serve as director of the Peace Corps.  She had served on the APA Policy and Planning Board, the Committee on Women in Psychology, the Committee on Lesbian, Gay and Bisexual Concerns, and the Public Policy Committee, and had received the APA award for Distinguished Professional Contributions to Public Service among other honors.  Placing the new code into historical context, Payton noted that "all previous codes seemed to have been formulated from a perspective of protecting consumers.  The new code appears to be driven by a need to protect psychologists.  It reads as though the final draft was edited by lawyers…" (p. 317).  She described how the code provided loopholes that opened wide avenues of escape from accountability and enforcement: "The forcefulness of the proscriptions on harassment, e.g., is diminished in…Standard 1.12, which brings up the qualifier 'knowingly'…as in psychologists do not knowingly engage in harassment.  Try using the argument of ignorance with the Internal Revenue Service" (p. 320).

 

            For more details and documentation of the APA's shift from professional ethics to guild ethics, and how the APA adopted a more extreme version of guild ethics in a subsequent revision of the code, please see Pope (2016), upon which this section is based.

 

Practicing Humility

 

            The chronicle of this continuing crisis of human rights and ethics is by no means settled and complete (Handelsman, 2017, p. 282).  Jennifer Gómez (2015) and the Ethnic Minority Interest Caucus of the APA Council of Representatives (2015) are among those who raised an issue that has yet to receive enough attention or an adequate response: that the torture that psychologists helped enable—and in some instances helped design and implement—fell disproportionately on those who, in the United States, would be considered cultural, racial, and religious minorities.  Gómez, Smith, Gobin, Tang, and Freyd (2016) remind us that various psychology associations such as

the American Middle Eastern/North African Psychological Network (2015), the Asian American Psychological Association (Pituc, 2015), the Association of Black Psychologists (2015), the National Latina/o Psychological Association (n.d.), and the Society of Indian Psychologists (Morse et al., 2015), have condemned APA for its lack of protection of minorities in this context. (pp. 533-534)

            It seems worth exploring why the APA has apologized specifically to "Psychology Colleagues," stating that the APA is "deeply sorry" that "these events have cast a pall on psychology and psychologists in all countries, with the potential to negatively affect perceptions of the integrity of our discipline worldwide" (Kaslow & McDaniel, 2015) but has never apologized specifically to victims and their families for the torture it helped enable, and for the long-term effects of that torture. 

 

            The American Middle Eastern/North African Psychological Network (2015) asked the APA to "formally apologize to communities of color" who were disproportionately harmed by the APA's acts and failures to act during this period.  So far the APA has declined.

 

            Controversies continue on many fronts.  Eidelson (2015) documented attempts to attack and discredit the Independent Review Report, its authors, and those who support it.  His examples include "attack[ing] the patriotism of Hoffman and those who have criticized psychologists' participation in abusive detention and interrogation operations," denouncing the report as a "classic attack of cowards," and accusing those who had a hand in publishing and releasing the report of being "a willing co-conspirator to the likes of al Qaeda and ISIS."   

 

            Five psychologists whose names appeared in the Independent Review Report filed suit in Ohio against the APA, David Hoffman, the law firm of which Hoffman is a partner, and several other parties whose names and addresses were yet to be determined.  The suit focuses on allegations of "unprivileged, false and defamatory statements made in the report with actual malice."  An appellate court upheld an Ohio trial court's dismissal of the suit on jurisdictional grounds (James et al. v. Hoffman et al., 2018).  That appellate decision may itself be appealed.  A second suit filed by the same plaintiffs against the same defendants in the District of Columbia (Behnke et al. v. Hoffman et al., 2017) has not yet been resolved.   The plaintiffs have filed a third suit in Massachusetts (Behnke et al. v. Soldz et al, 2018), adding a psychologist to the defendants named in the previous cases.

 

            The APA faces the continuing challenge confronting all organizations struggling to end a crisis: Once the spotlight of public attention that shines most intensely at the height of the crisis moves on, can it follow through on its promises of reform?  Can it avoid airbrushing history, retreating from commitments, and sliding back toward "the way things were before"?  Decades of research and case studies in organizational psychology have shown just how hard it is for organizations to follow through on their resolutions to reform made at the height of a major crisis.  With the passage of time, the urgency of reform fades and the urge to backtrack takes hold, even while the crisis continues.  Resistance to change hardens.  Powerful incentives inside and outside the organization, as well as organizational character, culture, dynamics, and other factors that led to and fed the crisis, allowing it to metastasize, reassert themselves, often with renewed force.  More and more the map of reform departs from the territory.

 

            Eidelson (2017b) discusses the APA's evolving response to this challenge in light of a letter from the APA to the editor of the Washington Post, responding to an article by Eidelson in that newspaper.  Eidelson writes that the letter holds the "APA blameless, portraying the profession's dark-side participation as solely that of 'two rogue psychologists.'" 

 

            Similarly, LoCicero (2018) highlights proposals scheduled for a vote by the APA's governing body.  One proposal focuses on the "definitive, independent and objective review" (APA, 2014)—one that stretched over seven months, included over 150 interviews, and examined 1,100 documents—that the APA had commissioned.  The APA had originally published Hoffman et al.'s Independent Review Report (2015a&b) on the APA website, but is now considering retracting it from the website.  The move to shut off website access would render inoperative citations and break links to the report as formally cited in years of scholarly articles and books that have relied on the APA's website as the authoritative source for the report that the APA itself commissioned and published on its site.  LoCicero writes:

This attempt to "See no Evil" should give us all pause.  Psychologists developed, implemented, and oversaw torture.  APA failed to provide ethical leadership to stop these actions....  We should all be demanding that APA take actions to be sure it never happens again—not take actions to bury this history.  Instead, our colleagues on the governing body are considering hiding this sordid part of our history.

            The APA is considering an even more decisive reversal of the promised reform: To remove a prohibition that the APA had adopted almost unanimously in response to the human rights and ethics crisis and had widely publicized.  On August 7, 2015, the APA Council voted overwhelmingly (157-1) to adopt Resolution 23B, which emphasized that it was

a violation of APA policy for psychologists to work at the Guantánamo Bay detention facility, "black sites," vessels in international waters, or sites where detainees are interrogated under foreign jurisdiction "unless they are working directly for the persons being detained or for an independent third party working to protect human rights" or providing treatment to military personnel. (APA, 2015)

This key reform prohibit psychologists working directly for the U.S. government (e.g., military psychologists employed by the Department of Defense, or psychologists working under contract for the C.I.A. or Homeland Security) from monitoring, conducting assessments, or engaging in other psychological interventions with detainees in settings like Guantánamo or Abu Ghraib.  Psychological services are to be provided only by psychologists working directly for the detainee or for independent organizations like the Red Cross or Amnesty International, and not by psychologists working as employees or agents of the government.

 

            This essential clarification of roles and responsibilities avoids potential ethical, clinical, and practical problems of conflicting roles.  Clear roles and responsibilities are critical in special settings in which the U.S. government asserts the right to hold detainees indefinitely—potentially for their entire lifetime (Jindia, 2018; Rosenberg, 2018; Ryan, 2018)—without charges or trial.  Clarifying roles and responsibilities so that clinical services are provided by independent organizations and those working directly for the detainees avoids the obvious dilemma faced by detainees asked to trust a therapist or other clinician employed by the same government that (1) has imprisoned them for an indefinite time without charges or trial, (2) has classified them as enemy combatants, and (3) is interrogating them in order to obtain accurate, actionable information, perhaps on an urgent, mission-critical basis to prevent an imminent terrorist attack.  It avoids the government "owning" the detainee's clinical chart.  It avoids issues of conflicting dual loyalty (e.g., to the detainee and to a critical mission).  Finally, if a detainee reports being tortured or subjected to other violations of human rights, it avoids putting the psychologist in the position of having to chart and formally report these allegations of human rights violations regarding fellow soldiers—perhaps the psychologist's commanding officers or supervisors—and others working for the government.


            This reform is based on more than considerations of potential ethical, clinical, or practical issues.  It is based on what has actually happened at Guantánamo, Abu Ghraib, and similar settings.  Two of the major problems concerned what has happened to the information that detainees disclosed to clinicians working for the government.

 

            First, a specific category of information seemed simply to disappear—it was never reported to the proper authorities nor was it recorded in the charts.  Researching this problem of information missing from charts, Iacopino and Xenakis (2011) found "that allegations by these nine detainees of torture were corroborated by forensic evaluations by non-governmental medical experts and that DoD medical and mental health providers at GTMO failed to document physical and/or psychological evidence of intentional harm."  Similarly, Clark (2006) wrote:

Although knowledge of torture and physical and psychological abuse was widespread at both the Guantánamo Bay detention facility and Abu Ghraib prison in Iraq, and known to medical personnel, there was no official report before the January 2004 Army investigation of military health personnel reporting abuse, degradation or signs of torture. Military medical personnel are placed in a position of a "dual loyalty" conflict.

            Second, other categories of information obtained by clinicians were supposedly protected by clear rules, policies, and assurances of confidentiality, thus creating a clear wall between clinical work and interrogations.  But despite outright denials of any breaches, clinical information was weaponized for use against detainees in interrogations (Bloche & Marks, 2005; Buckley, Rokadiya, Kessel, Porter & Dar, 2014; Clark, 2006; Fink, 2016; Institute on Medicine as a Profession, 2013; Lewis, 2004; Miles, 2004; Physicians for Human Rights, 2014).  Taking advantage of what they had learned either from clinical charts or in some cases directly from clinicians, some interrogators devised tactics based on diagnoses, phobias, sources of shame, religious beliefs, sexual issues, concerns for family members from whom they were separated, and other vulnerabilities that detainees had confided to therapists or other clinicians.

 

           The APA finds itself at a defining crossroad: One path continues the struggle to acknowledge and understand its continuing human rights and ethics crisis more fully, and to find ways to bring about a just and lasting resolution. The other path quietly reverses a core reform that it had adopted almost unanimously and publicized so widely. It shuts off the APA website access to the landmark Hoffman report, which prompted the reform efforts. The APA should continue to allow researchers, writers, policy makers, teachers, students, and all others to use the links found in the reference sections of so many articles and books, or to discover the report directly via the APA website. Proponents, skeptics, critics, and others should have continued access to the report and its volumes of supporting materials on the APA website. Instead of hiding the report by removing this prominent point of access, the APA should encourage everyone interested to (1) read the report itself and the 6 binders of supportive materials as they currently appear on the APA website rather than rely on secondary summaries and characterizations, (2) actively question, critically assess, and make up their own minds about the report's sources, assertions, and conclusions, and (3) contribute to scholarly investigations, debates, and appraisals of the report's strengths, weaknesses, controversies, and implications.

 

            More will be revealed as these complex controversies unfold, as investigative reporters and researchers turn up new information, and as the lawsuits in Ohio, Washington DC, and Massachusetts progress and reach resolution.  But the emails and other public and private documents from individuals and organizations—including confidential government papers that were later declassified—that have been released so far are instructive.  And we have learned from the fact-finding investigations by the CIA, newspaper reporters, human rights organizations, and others.  The facts at hand suggest that several principles may help us prevent a future crisis of human rights and ethics. 

 

            They also suggest that we need to practice humility.  I believe that all of us psychologists were seeking to "do the right thing" as each understood it, though in sharp disagreement about the best path.  But the events of this period remind us that however justly proud we are of a profession that has done so much good, none of us acted effectively to prevent the crisis.  Each of us could probably think of ways that we could have put in more time, more thought, or more effort—done some things differently—to prevent this crisis, or to lessen its harm.  Perhaps we can think of what more we can do from now on as the crisis continues to unfold.  We can also prepare psychologists to meet future challenges by making human rights a central focus of our undergraduate, graduate, and life-long education.  "Through a structured human rights education curriculum, psychologists would gain better access to knowledge and develop the necessary set of skills that would allow them to relate human rights to professional practice, and professional codes of ethics and conduct" (Experts Meeting: Human Rights Education and Fundamental Rights Awareness for Psychologists, 2016; see also Gauthier, 2009; Hagenaars, 2016; LoCicero, Marlin, Jull-Patterson, Sweeney, Gray, & Boyd, 2016; McFarland, 2015; Oomen, 2016; Plavšic, 2016).

 

            Recognizing the tragic and potentially deadly consequences if we fail to safeguard human rights and ethics, we can remember what our own history teaches us about the vital importance of the following principles:

 

            The post-9-11 period is not the first human rights and ethics crisis for psychologists—Geuter's book The Professionalization of Psychology in Nazi Germany, for example, reviewed historical archives to reveal how "psychologists cooperated with the army, state, party, and industry, and yet still seemed to believe that they were acting as reformers" of the Third Reich (1992, p. 284)—but if we take its lessons to heart, include them in our formal education, and put them into action, we may help it become the last.

 

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PLEASE NOTE: This is a prepublication version of an article that is in press in EUROPEAN PSYCHOLOGIST

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