M. Alfred Haynes

Professor Debreu, colleagues, and friends. To discuss ethics and ethical principles is an important intellectual exercise, but to see ethics personified in the form of Dr. González and the other special guests whom we have here today is a very sobering experience.

Health professionals are, by the very nature of their profession, likely to have a broader role in the arena of human rights than most other professionals. Recognition of this broader role has been a matter of careful consideration by the Institute of Medicine.

Physicians may be victimized without any regard to the practice of their profession. They are incidentally caught in the practice of torture and repression, and they deserve the consideration and concern of all persons who are unjustly treated.

In the second case, physicians may be victimized because they are performing their professional duties in accordance with a well-defined code of ethics under which we operate. This code is very clear with respect to what physicians should do. But some physicians have been victimized because they acted in accordance with these principles. They deserve our very special consideration.

In the third case, physicians may actually be in collusion with those who violate human rights. When, for example, as we have just heard, psychiatrists who have a special power to commit persons to mental hospitals allow their professional skills to be used for the purposes of illegally committing dissidents, this is an outrageous abuse of psychiatry and deserves our condemnation.

The fourth category includes the nonparticipant observers. I have chosen to define the nonparticipant observers as those health persons who, in the course of their duties, see the results of torture but refuse to keep silent. The case of Wendy Orr is a fine example. This young, white South African physician was assigned to treat detainees and prisoners. She saw the physical results of persons who were punished, whipped, kicked, and teargassed, and her medical superiors refused to investigate the prisoners' complaints.

She saw a lawyer who gave her two choices. She could, like the rest of her fellow physicians, ignore what she had seen or she could go to court and seek an injunction and possibly lose her job. She chose to be a nonparticipant observer and went to court and won a temporary restraining order against assaults by the police. Such persons deserve our commendation.

Finally, there are those I call the participant observers. You might wonder why I call them participants, because all they do is observe. In fact, they participate by their silence. Jacobo Timerman, the distinguished Argentine newspaper editor, said the holocaust will be understood not so much through the number of its victims as through the silence in which it existed.

The Institute of Medicine has decided not to be counted among those who participate by their silence and is exploring a variety of ways in which it can join other scientists in the defense of human rights.