Canadian Psychological Association

Contradictions between healthcare ethics and military work have been documented in historical analyses of German psychological associations supporting the Holocaust and American Psychological Association (APA) involvement in the 1991 Gulf War.[5]

Healthcare professionals "are faced with special dilemmas because of the obligation to support their government and national defense, while traditionally maintaining the Hippocratic Oath".[6] Just-war ethics define a list of criteria to justify violence and killing as a last resort. Although CPA had a lengthy Code of Ethics based on medical ethics, in 1992 it published a major article on military and weapons work in its quarterly newspaper.[7] This detailed policy provided official support for CPA members to be involved in activities including warfare and weapons research. It stated that Principle 1: Respect for the Dignity of Persons in the code (the first, and highest-priority principle) could actually be used as a means-end justification for violence and killing:

"There may be circumstances in which the possibility of—serious detrimental consequences to themselves or others—might disallow some aspects of the rights to privacy, self-determination, and personal liberty... As such, principle 1 can be seen to be consistent with the possibility of a just-war position."[7]

But a volume on "Professions and War" at the Center for the Study of Ethics in the Professions questioned using Principle 1: Respect for the Dignity of Persons to justify killing them: "Unfortunately, while this conclusion may be an attempt to maintain the status quo and protect the military funding of CPA members, it is seriously flawed from the points of view of logic and ethics. There is nothing in this passage about military work, and the title refers to the dignity of persons, not to killing them".[8] It also required selective mis-quoting and wording omissions from CPA's own code of ethics: "Although the conclusion does not follow and flies in the face of established standards for health care professionals, it is also based on a misrepresentation of the CPA code. The ethics committee deleted two sentences from the passage it quoted to justify its position... Despite numerous requests for clarification or correction however, CPA and its ethics committee have never offered any retraction or explanation for the omission of these key phrases."[8]

In contrast, in the wake of psychologists designing and participating in torture at locations including Guantanamo Bay detention camp,[9] the code of ethics for American psychologists was eventually updated to prevent exactly this kind of politicized interpretation. In 2010, APA's Council of Representatives voted to amend their Code of Ethics "to make clear that its standards can never be interpreted to justify or defend violating human rights."[10] Similarly, when health care and medical personnel from the International Committee of the Red Cross (ICRC) are involved in military operations, it is to treat the wounded, not to help the war effort: "The ICRC is an independent, neutral organization ensuring humanitarian protection and assistance for victims of armed conflict."[11]

CPA's Committee on Ethics (CoE) then considered whether there was any limit at all on military actions by CPA members. Weapons of mass destruction such as nuclear or chemical weapons by definition harm large numbers of innocent civilians, and therefore exceed the military, proportionate targets allowed under Just War Ethics.[12]

CPA's president had sent out a letter on May 27, 1991, stating that relating CPA's code of ethics to armed forces and nuclear weapons work was "not supported by our interpretation of the ethical principles, and that there were strongly held opposing political views in the Association".[8] Then in a letter on February 27, 1992, the Chair of the CPA Committee on Ethics stated in a letter to the CPA Section on Social Responsibility that CPA did not intend to limit involvement with military activities or even weapons of mass destruction such as nuclear weapons: "Your further comments/questions (including your request to consider nuclear weapons work) will need to be considered... there will be no further immediate consideration of this matter by the Committee on Ethics."[13]

Three years later this lack of a policy was clarified and formalized with no limits. The Ethics Committee of CPA made a policy statement in support of work on nuclear weapons and weapons of mass destruction in a letter dated March 31, 1995: "It is impossible to decide, in the abstract, that such work is a de facto violation of principles set out in the current Canadian Code of Ethics for Psychologists...Any blanket statement about the work of psychologists relating to the development of weapons of mass destruction would be inappropriate".[8]

This was an amazing policy, that Canadian psychologists could contribute to the mass-killing of innocent bystanders and children. Even psychologists complicit in the Holocaust did not have a formal policy like this,[5] when gas chambers were used in asylums and "claimed the lives of an estimated 275,000 psychiatric patients, prisoners and mentally retarded persons".[14] The gas chamber technology was perfected in asylums before it was instituted in the death camps, and was a key step between "the administrative mass killing of mental health patients and the subsequent emergence of genocide as an official instrument of Nazi public policy".[14]

What human costs and ethical transgressions would occur if psychologists had free rein to do any type of research or treatment on humans, as long as it was in the national interest? Lifton (1986) had already provided one answer to this question with his book The Nazi Doctors: Medical Killing and the Psychology of Genocide.[15] Then just 6 years after CPA's statement in support of any type of military work including weapons of mass destruction,[8] the al-Qaeda September 11 terrorist attacks in the US happened. Even though the American Psychological Association did not have a code of ethics providing carte blanche on military work like CPA, American psychologists designed torture methods including waterboarding for the CIA after 9/11.[16]

American Psychological Association (APA) involvement in torture programs during the Bush presidency has been extensively documented by New York Times reporter James Risen in his book Pay Any Price: Greed, Power, and Endless War and by psychologists Stephen Soldz and Steven Reisner, authors 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 "Enhanced" Interrogation Program".[17]

A 2014 Senate Intelligence Committee Report condemned the CIA's use of psychologists to develop, operate (i.e. torture) and assess its torture of suspects.[16] Those psychologists have since been the subject of legal trials.[18] According to the Washington Post, lawyers for the psychologists argued that they were just paid contractors and were not responsible; their defense was that they were comparable "to the low-level technicians whose employers provided lethal gas for Hitler's extermination camps".[19]

The "enhanced interrogation" designed by psychologists[20] and used in locations such as Guantanamo Bay detention camp and the Abu Ghraib torture and prisoner abuse following 9/11 caused APA to do a new policy review in 2005:[9]  the APA Presidential Task Force on Psychological Ethics and National Security (PENS). The chair of the APA Ethics Committee reported on their findings:

"Like all of you, I have been deeply disturbed by reports of abusive and degrading treatment of prisoners and detainees. The PENS report makes clear that it is unethical and utterly antithetical to our role and values for a psychologist to engage in, direct, support, facilitate or offer training in any such activities. In my role as chair of the Ethics Committee, I will vigorously pursue the sanctioning of any psychologist found to have engaged in behaviors prohibited in the PENS report. I am confident that every member of the PENS Task Force fully supports me in this position."[21]

It was not just individual psychologists: APA leaders were complicit in torture and coverups.[17] In 2015 APA did a new independent review on psychologists involved with torture known as the Hoffman Report.[17] The 542-page report undermines the APA's repeated denials that any of its members were involved in torture: "For more than a decade, the American Psychological Association (APA) has maintained that a strict code of ethics prohibits its more than 130,000 members to aid in the torture of detainees while simultaneously permitting involvement in military and intelligence interrogations".[22] But APA was complicit; the report concluded "that the APA, despite growing evidence of detainee mistreatment, had secretly coordinated with Defense Department officials to promote ethics policies that matched the government's preferences."[19] 

APA's policies on professional ethics were used for a double standard: "Every word in APA policy was approved by Defense Department officials... It was all, as Mr. Hoffman calls it, pre-vetted. Everything was pre-vetted by the Defense Department to make sure that it did not in any way constrain the Defense Department psychologists, the military psychologists, active at Guantánamo and elsewhere, while sounding like it was opposing torture."[23]

This deception is similar to the mis-quoting of CPA's code of ethics in CPA's policy statement supporting just war[8] published in their Psynopsis newspaper.[7] Similarly, CPA uses weasel words like "prohibited weapons" to give a false reassurance (although it is not clear what they mean by prohibited weapons, or if any weapons are even prohibited at all). For example, the final paragraph in this 2020 letter states that CPA's position on weapons of mass destruction has always been that CPA would never adopt a policy that contravened its code of ethics or that contributes to the development of prohibited weapons.[24]

In APA, there have been questions of whether the officials involved should be fired[17] or face professional misconduct charges.[23] Following the release of the Hoffman Report on July 2, 2015, APA's ethics director "was removed from his position"[9] The "oustings" of three other longstanding senior officials—the CEO, Deputy CEO and communications director—were also announced by APA less than two weeks later.[25]

In spite of the Just War policies published in CPA's own Psynopsis newspaper,[7] CPA's Committee on Ethics (CoE) continues to make motherhood statements and to deny that it established policies allowing its members as a healthcare organization to be involved in warfare, armed force, and even weapons of mass destruction:[24]

The CoE has found no evidence supporting your allegations that, through the 1990's, the CPA "has made a series of policy statements that allow its members to contribute to armed force, killing and even weapons of mass destructions (sic) under some circumstances." ... CPA's position about torture and weapons of mass destruction has always been that psychologists are not to promote, contribute to, nor engage in any activity that contravenes international humanitarian law, which includes participating in the torture of persons, the development of prohibited weapons...

There is a Special Collection in the Norlin Library at the University of Colorado called the APA PENS Debate Collection to document APA's torture investigation.[23] In 2010, they asked for extensive documentation on the CPA policies on healthcare ethics, military work and weapons of mass destruction, which is archived in their permanent collection.[26][27]

Finally in 2017 the CPA code of ethics[28] prohibited work on weapons of mass destruction for the first time.[24]

Although these are CPA policies, they are the legacy of a few individuals who have written the policies and have been officials at CPA for some 30 years. If the leadership does not change for decades, it makes it hard for them to credibly deny knowledge of earlier policies[24] when they themselves were the architects.

• Carole Sinclair was the principal author on the original 1992 Psynopsis policy statement in support of just war,[7] and wrote the letter as chair of the Ethics Committee in 1992 stating that CPA would not be taking a position on nuclear weapons work.[13] She was also Chair in 2017,[29] 2019–2020,[30] and remains on the Ethics Committee in 2021.[31]
• Cannie Stark was CPA President in 1992[32] and is a member of the ethics committee in 2019–2020[30] and 2020–2021.[31]
• Janel Gauthier co-authored the letter above claiming that in spite of documentation including (a) the Just War policies published in CPA's own Psynopsis newspaper,[7] and (b) Carole Sinclair's letter stating that CPA would not be taking any position on nuclear weapons work,[13] that there is "no evidence... that, through the 1990's, the CPA "has made a series of policy statements that allow its members to contribute to armed force, killing and even weapons of mass destruction..."[24] He was president of CPA in 1997 and 1998,[32] was on the Ethics Committee in 2019–2020,[30] and was Chair of the Ethics Committee in 2020–2021.[31]

To encourage diversity, bring in fresh ideas, and avoid the concentration of power within a small group, this list of political term limits shows that many governments (and organizations[33]) have term limits.