Juan Luís González

Ladies and gentlemen, dear friends. It would be easy to dismiss the problem of torture by saying that torturers are depraved psychotics. However, it is the view of the Medical Association of Chile, of which I am the president, that a society that allows torture to exist and to persist and become part of the system is a sick society.

Thus, our association believes that the system of institutionalized torture in Chile is ultimately the responsibility of the Chilean society. Torture became a frequent practice throughout Chile following the coup d'état by General Pinochet in 1973.

While formal reports of torture in a frightened society are few, such reports in Chile are compiled by the Vicaría de la Solidaridad of the Catholic church in Santiago and have come to the attention of the international community. Other groups, such as the Chilean Commission on Human Rights and the National Commission Against Torture, which was formed at the end of 1982, also assist in documenting torture and repression. Physicians are actively involved in these groups, and many have been the object of government reprisals.

The National Commission Against Torture is chaired by a physician, Dr. Pedro Castillo, who is also the national counselor of the Medical Association of Chile and a former prisoner of conscience of the National Academy of Sciences' Committee on Human Rights. Another physician, Dr. Ramiro Olivares of the Vicaría de la Solidaridad, who has documented dozens of cases of torture, was arrested in May 1986. Although he was subsequently released, he was rearrested in December under the antiterrorism law and has been held without trial since then. ⁷

The Medical Association of Chile also receives many oral reports of torture; most of the victims are afraid to put them in writing. While we investigate these reports and know that torture has been a tool used by the government in Chile during the past 13 years, we are restricted by the government in our effort to find witnesses and verify the facts.

It is within this societal context that the Medical Association of Chile has taken a strong position against torture, including the establishment, in November 1983, of a code of ethics with respect to torture. Within the last four years, there has been an awakening of the national conscience in Chile that has become increasingly forceful. One consequence has been that by the end of 1981 the Medical Association of Chile had begun to elect its own officers. Prior to this, since General Pinochet came to power, such officers were appointed by the government to all the professional associations.

These internal elections have allowed the struggle against torture to take place within the association's institutional framework. The leaders, democratically elected in accordance with the historical traditions of professional associations, have assumed the responsibility of increasing people's awareness of the system of torture and of working to stop its practice. For example, in an important effort to combat the participation of physicians in torture or cruel, inhumane, or degrading treatment of prisoners, the association incorporated into its ethical code a section specifically prohibiting the direct or indirect participation of physicians in such practices.

The association's decision to denounce torture and the collusion of physicians in torture led to investigations by the association's Department of Ethics of physicians accused of participating or colluding in the torture of detainees. The first of these investigations was begun four years ago. Today, the cases of 15 physicians accused of participating in abuses of political detainees have been investigated; almost all have been expelled from our association.

The importance of the work to expose participation of physicians in torture is not a matter of the number of cases that can be verified. The importance is the establishment of proof that physicians, in direct contradiction of the most fundamental precept of medical ethics, participate in such monstrous activity.

To accuse a physician of being a torturer or of colluding in torture is such a serious claim that our work must be carried out with the utmost discretion and prudence. To create even one small doubt about the integrity of a physician is a very serious matter that could make life very difficult for the physician and for his or her family.

For this reason, our private investigations are long, painstaking, and often tedious. We also require maximum discretion from those who may learn about our investigations. When charges are finally made, they must be beyond challenge. According to the statements provided by torture victims, torture usually happens when the prisoners are blindfolded, making identification of the torturer practically impossible.

In addition, medical certification procedures used by the prisons allow acts of torture and secret detention to appear legal. According to Chilean law, every person who is detained in prison or a public place of detention is to be examined by a physician upon entering and leaving. By studying the legal dossiers of the courts, we have learned that there are physicians in secret detention centers who certify that the person has not been physically mistreated or is in good physical condition. This is done without performing the exam or by performing a very superficial one.

These health certificates serve other purposes as well. More significantly, they can reveal the degree of torture a prisoner can withstand, so that the torturer will know how much and what kind of torture can be inflicted. These health certificates are usually signed illegibly, making it impossible to identify the physician who attended to the prisoner. Because this procedure has been accepted by the courts without any apparent objection, the governing board of the Medical Association of Chile met with the chief justice of the supreme court to discuss its concern regarding this practice.

The human rights activities of the Medical Association of Chile include support for physicians who are victims of repression; presentation of a declaration to the World Medical Association in Venice, together with the Argentine Medical Confederation, supporting respect for human rights of physicians and condemning the participation of physicians in torture; dissemination of information about torture through the association's information channels and, when it is possible, through the press; and promotion of ethics, awareness, and behavior.

In summary, the work of the Medical Association of Chile has been to gather information on—and promote awareness of—the involvement of physicians in torture; to disseminate information about the ethical stance of the association against torture in the hope of preventing other physicians from becoming involved; to incorporate into our ethical code an article taken from the 1975 Declaration of Tokyo condemning torture; to support physicians in other institutions working in defense of human rights; and to promote the discussion of ethical topics at conferences and in publications.

Recently, the Medical Association of Chile asked the Chilean government to establish an ethical code for law enforcement officers. For the future, we see it necessary to abolish the participation of physicians in torture. We have said that our position is not to classify torturers as psychotics, but to see torturers as the result of a sick society.

It is heartening to see the rebirth of ethical values and the search for what is the historical, honorable, and dignified tradition of our country. The Medical Association of Chile believes it must continue the activities it has started and provide moral and material support to institutions fighting to abolish torture. We believe that the only true solution for our country is to return to democracy. Thank you very much.