COUNCIL OF REPRESENTATIVES
ACTION ITEM #2

AUGUST 8 & 10, 2018

XII.

ETHICS

PSYCHOLOGISTS MAY PROVIDE TREATMENT TO DETAINEES OR MILITARY PERSONNEL
IN NATIONAL SECURITY SETTINGS (NBI #35B/AUG 2017)
SUMMARY
Council is asked to
address the roles of psychologists in national security settings to allow psychologists, in addition to
treating military personnel, to treat detainees if they are working in a health care role for the express
purpose of providing psychological treatment, independent of whether they are working directly for the
detainee or an independent third-party.
The proposed resolution was introduced as a Council new business item in August 2017. The Ethics
Committee was assigned as the lead referral group and the Board of Professional Affairs (BPA), Board for
the Advancement of Psychology in the Public Interest (BAPPI), Policy and Planning Board (P&P) and
Committee on Legal Issues were assigned as referral groups.
STRATEGIC GOALS/OBJECTIVES
a, d, e, and f).
FINANCIAL IMPLICATIONS
There are no direct costs associated with adoption of the Main Motion.
IMPLEMENTATION
If approved by Council, the revised resolution will be included in APA Policy Manual and the 2009, 2013
and 2015 Council policies will be amended as stipulated. The resolution will also be posted on the APA
website and disseminated to APA boards and committees, APA division and state, provincial and
territorial psychological associations and reflected in relevant correspondence with the U.S.
Government.
RECOMMENDATION
The Board of Directors and Council Leadership Team recommend approval of the substitute motion. A
detailed rationale from the Board regarding the substitute motion can be found in Exhibit 3.
The Ethics Committee, as the assigned lead group, believes the main motion is consistent with the APA
Ethical Principles of Psychologists and Code of Conduct Ethics Code , 2002, as amended in 2010 and
2017.
BPA believes there is insufficient evidence to assess the consequences of approval of the main motion.
45

 P&P believes the NBI addresses the policy implications of barring psychologists from settings rather than
the behavior of psychologists in those settings that will engender further consideration by Council.
BAPPI opposes the main motion.
Detailed feedback from the referral boards and committees is provided as Exhibit 1.
MAIN MOTION
That Council adopts the following Resolution to A
Resolutions that Address the Roles of Psychologists in National Security Settings as APA
policy:
WHEREAS the American Psychological Association (APA) is an accredited nongovernmental organization (NGO) at the United Nations (UN);
WHEREAS the U.S. ratified the Third Geneva Convention, relative to the treatment of
Prisoners of War, in 1955;
WHEREAS the UN Security Council, of which the US is one of the five permanent
members, adopted a report from the UN Secretary-General and Commission of Experts,
concluding that the Geneva Conventions has passed into the body of customary
international law in 1993;
WHEREAS the U.S. Supreme Court ruled on June 29, 2006, in Hamdan v. Rumsfeld that
America's armed conflict with al-Qaeda was non-international in character and, as such,
was governed by Geneva Conventions;
WHEREAS the Deputy Secretary of Defense issued a policy on July 7, 2006, mandating
that military personnel adhere to Common Article 3 of the Third Geneva Convention in
all dealings with detainees;

of war must at all times be humanely treated. Any unlawful act or omission by the
Detaining Power causing death or seriously endangering the health of a prisoner of war
in its custody is prohibited, and will be regarded as a serious breach of the present
Convention. In particular, no prisoner of war may be subjected to physical mutilation or
to medical or scientific experiments of any kind which are not justified by the medical,
1
;

detaining prisoners of war shall be bound to provide free of charge for their
maintenance and for the medical attention required by their state of health 2

1

Retrieved from http://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.32_GC-IIIEN.pdf p. 97
2
Ibid, p. 97

46

 WHEREAS Chapter III, Article 30, of the Third Geneva Convention mandates that
of the
3
Power on which they depend and, if possible, of their nationality
WHEREAS the Detainee Treatment Act of 2005 4 incorporates standards of the Eighth
Amendment to the U.S. Constitution, including an adequate response to the medical
and psychological care needs of prisoners;
WHEREAS military health care providers - physicians (including psychiatrists), specialists,
nurses and physician assistants - are currently providing the full spectrum of health care
to detainees, in accordance with their prof
psychologists excluded as a result of APA policy;

conduct its operations in strict compliance with the antitrust laws of the United States,
laws which specifically prohibit any agreement or understanding restricting the scope of
services provided by specific providers or types of provider, the locations in which
psychologists may practice, or the classes of employees, patients, or collaborators with
whom a psychologist may practice;
WHEREAS the 2009 Petition Resolution policy, which is incorporated and clarified in the
2013 and 2015 Council Resolutions, prohibits psychologists from working at detention
settings deemed by APA policy to be operating in a manner inconsistent with the U.S.

treatment to military per
provided by psychologists, in direct contradiction to the Third Geneva Convention, as
well as the 2005 Detainee Treatment Act 5;
THEREFORE, BE IT RESOLVED that the 2009 Petition Resolution Pol

National Security Settings and Reaffirmation of the APA Position Against Torture and
Other Cruel, Inhuman, or Degrading Treatment of Punishment, (Adopted by COR August
2013, as Amended by COR August 2015), be amended as follows
(bracketed/strikethrough material to be deleted; underlined material to be added):

violation of, either International Law (e.g., the UN Convention Against Torture and the
Geneva Conventions) or the US Constitution (where appropriate), unless they are
working directly for the persons being detained or for an independent third party
working to protect human rights, or they are working in a health care role for the
express purpose of providing psychological treatment to detainees or military
personnel. [7][ii]*
*Footnote references (Fn. 7 from the original 2009 Petition Resolution Policy, and Fn. ii
from the incorporation into the
3

Ibid, p. 103
Retrieved from https://www.dni.gov/index.php/ic-legal-reference-book/detainee-treatment-act-of-2005
5
Retrieved from http://www.apa.org/independent-review/psychologists-interrogation.pdf p. 6
4

47

 Settings and Reaffirmation of the APA Position Against Torture and Other Cruel,
Inhuman, or Degrading Treatment of Punishment), are to be deleted since they will be
incorporated into the text.
[7. It is understood that military clinical psychologists would still be available to provide
treatment for military personnel]
ii. [It is clarified by a footnote in the Member Petition Resolution "that military clinical
psychologists would still be available to provide treatment for military personnel. ]
BE IT FURTHER RESOLVED that the following policies:
a)

006 and 2013 Council Resolutions to Clarify the Roles
of Psychologists Related to Interrogation and Detainee Welfare in National Security
Settings, to Further Implement the 2008 Petition Resolution, and to Safeguard Against
Acts of Torture and Cruel, Inhuman, or Degrading Treatment or Punishment in All

b)
the APA Position Against Torture and Other Cruel, Inhuman, or Degrading Treatment of
Punishment, (Adopted by COR August 2013, as Amended by COR August 2015)
Be amended as follows. Insert in a) at the end of paragraph 2, and in b) at the end of
added):
Such communications to officers of the U.S. Government shall reflect current APA policy
and clarify the appropriateness of qualified psychologists serving in a health care role for
the express purpose of providing psychological treatment to detainees or military
personnel in any national security setting.

SUBSTITUTE MAIN MOTION
(as originated by the Board of Directors)
That Council adopts the following Resolution to A
and 2015 Resolutions
that Address the Roles of Military Psychologists in National Security Settings as APA policy:
WHEREAS the American Psychological Association (APA) is an accredited non-governmental
organization (NGO) at the United Nations (UN);
WHEREAS the U.S. ratified the Third Geneva Convention, relative to the treatment of Prisoners
of War, in 1955;
WHEREAS the UN Security Council, of which the US is one of the five permanent members,
adopted a report from the UN Secretary-General and Commission of Experts, concluding that
the Geneva Conventions has passed into the body of customary international law in 1993;
WHEREAS the U.S. Supreme Court ruled on June 29, 2006, in Hamdan v. Rumsfeld that
America's armed conflict with al-Qaeda was non-international in character and, as such, was
governed by Geneva Conventions;
48

 WHEREAS the Deputy Secretary of Defense issued a policy on July 7, 2006, mandating that
military personnel adhere to Common Article 3 of the Third Geneva Convention in all dealings
with detainees;

must at all times be humanely treated. Any unlawful act or omission by the Detaining Power
causing death or seriously endangering the health of a prisoner of war in its custody is
prohibited, and will be regarded as a serious breach of the present Convention. In particular, no
prisoner of war may be subjected to physical mutilation or to medical or scientific experiments
of any kind which are not justified by the medical, dental or hospital treatment of the prisoner
6
;

prisoners of war shall be bound to provide free of charge for their maintenance and for the
medical attention required by their state of health7

war shall have the attention, preferably, of medical personnel of the Power on which they
depend and, if possible, of their nationality 8
WHEREAS the Detainee Treatment Act of 2005 9 incorporates standards of the Eighth
Amendment to the U.S. Constitution, including an adequate response to the medical and
psychological care needs of prisoners;
WHEREAS military health care providers - physicians (including psychiatrists), specialists, nurses
and physician assistants - are currently providing the full spectrum of health care to detainees,
a result of APA policy;
WHEREAS It is the unquali
operations in strict compliance with the antitrust laws of the United States, laws which
specifically prohibit any agreement or understanding restricting the scope of services provided
by specific providers or types of provider, the locations in which psychologists may practice, or
the classes of employees, patients, or collaborators with whom a psychologist may practice;
WHEREAS the 2009 Petition Resolution policy, which is incorporated and clarified in the 2013
and 2015 Council Resolutions, prohibits psychologists from working at detention settings
deemed by APA policy to be operating in a manner inconsistent with the U.S. Constitution or

th care provided by psychologists, in

6

Retrieved from http://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.32_GC-III-EN.pdf p.
97
7
Ibid, p. 97
8
Ibid, p. 103
9
Retrieved from https://www.dni.gov/index.php/ic-legal-reference-book/detainee-treatment-act-of-2005

49

 direct contradiction to the Third Geneva Convention, as well as the 2005 Detainee Treatment
Act10;
THEREFORE, BE IT RESOLVED
Unlawful Detention Settings wit
Reaffirmation of the APA Position Against Torture and Other Cruel, Inhuman, or Degrading
Treatment of Punishment, (Adopted by COR August 2013, as Amended by COR August 2015), be
amended as follows (bracketed/strikethrough material to be deleted; underlined material to be
added):
, or in violation of,
either International Law (e.g., the UN Convention Against Torture and the Geneva Conventions)
or the US Constitution (where appropriate), unless they are working directly for the persons
being detained or for an independent third party working to protect human rights, or they are
working in a health care role for the express purpose of providing psychological treatment to
detainees or military personnel. [7][ii]*
*Footnote references (Fn. 7 from the original 2009 Petition Resolution Policy, and Fn. ii from the
incorporation into the
Reaffirmation of the APA Position Against Torture and Other Cruel, Inhuman, or Degrading
Treatment of Punishment), are to be deleted since they will be incorporated into the text.
[7. It is understood that military clinical psychologists would still be available to provide
treatment for military personnel]
ii. [It is clarified by a footnote in the Member Petition Resolution "that military clinical
psychologists would still be available to provide treatment for military personnel. ]
BE IT FURTHER RESOLVED that the following policies:
c)

2006 and 2013 Council Resolutions to Clarify the Roles of
Psychologists Related to Interrogation and Detainee Welfare in National Security Settings, to
Further Implement the 2008 Petition Resolution, and to Safeguard Against Acts of Torture and
Cruel, Inhu

d)
Position Against Torture and Other Cruel, Inhuman, or Degrading Treatment of Punishment,
(Adopted by COR August 2013, as Amended by COR August 2015)
Be amended to include the following clauses (underlined material to be added):
BE IT RESOLVED that military psychologists are recognized as providers of mental health
treatment to detainees in all national security settings if they are able to do so in full
adherence to the Ethical Principles of Psychologists and Code of Conduct (Amended
able to obtain
any information or ask any questions necessary to act competently and ethically.

10

Retrieved from http://www.apa.org/independent-review/psychologists-interrogation.pdf p. 6

50

 BE IT RESOLVED that APA strongly encourages the Department of Defense to make
independent psychologists working for the detainees or for a human rights organization
available as health care providers to detainees at sites identified in the 2015 resolution
as operating outside of, or in violation of, the U.S. Constitution or international law.
BE IT RESOLVED that APA recommits to its anti-torture policy dating back to 1985
(incorporated into the Ethics Code as Standard 3.04 (b) as part of the implementation of
the 2015 Council policy) and to continue to take strong action to oppose torture or
cruel, inhuman, or degrading treatment or punishment of detainees held in U.S. custody
and to safeguard their welfare.

Such communications to officers of the U.S. Government shall reflect current APA policy and
clarify the appropriateness of qualified psychologists serving in a health care role for the express
purpose of providing psychological treatment to detainees or military personnel in any national
security setting.
BACKGROUND/HISTORY

amendment to Resolution 23B (Resolution to Amend the 2006 and 2013 Council Resolutions to Clarify
the Roles of Psychologists Related to Interrogation and Detainee Welfare in National Security Settings,
to Further Implement the 2008 Petition Resolution, and to Safeguard Against Acts of Torture and Cruel,
Inhuman, or Degrading Treatment or Punishment in All Settings) which was passed by Council in August
of 2015. That resolution included a prohibition against working in national security detention facilities
being d
change that prohibition to specifically permit psychologists to wo

The Agenda Planning Group referred the item to the Ethics Committee as the lead group, with the
Committee on Legal Issues (COLI), Policy and Planning Board (P&P), Board of Professional Affairs (BPA),
and Board for the Advancement of Psychology in the Public Interest (BAPPI) as referral groups. The
Ethics Committee reviewed this item during its October 2017 meeting and determined that comments
from other APA Boards and Committees were needed prior to developing a final recommendation. P&P
considered the NBI at its November 2017 meeting and offered initial reflections and questions for
clarification. The Ethics Committee requested feedback from the referral groups at their 2018 Spring
Consolidated Meetings. The Committee reviewed the comments received from referral groups at their
April 27-29, 2018 meeting and determined that the main motion is consistent with the Ethics Code as
amended in 2010 and 2017 and should be brought to the Council for consideration at its August 2018
meeting.

51

 EXHIBITS
1. NBI 35B/Aug 2017,
Psychologists May Provide Treatment to Detainees or Military Personnel in National Security Settings
2. Feedback from Assigned Referral Groups
3. Board Rationale for Substitute Motion

Lindsay Childress-Beatty, JD, PhD
Ethics Office

52

 EXHIBIT 1

That Council approves the following resolution to
resolutions that address the roles of psychologists in national security settings:

s 2009, 2013 and 2015

WHEREAS the American Psychological Association (APA) is an accredited non-governmental organization (NGO)
at the United Nations (UN);
WHEREAS the U.S. ratified the Third Geneva Convention, relative to the treatment of Prisoners of War, in 1955;

53

 WHEREAS the UN Security Council, of which the US is one of the five permanent members, adopted a report
from the UN Secretary-General and Commission of Experts, concluding that the Geneva Conventions has passed
into the body of customary international law in 1993;
WHEREAS the U.S. Supreme Court ruled on June 29, 2006, in Hamdan v. Rumsfeld that America's armed conflict
with al-Qaeda was non-international in character and, as such, was governed by Geneva Conventions;
WHEREAS the Deputy Secretary of Defense issued a policy on July 7, 2006, mandating that military personnel
adhere to Common Article 3 of the Third Geneva Convention in all dealings with detainees;

be humanely treated. Any unlawful act or omission by the Detaining Power causing death or seriously
endangering the health of a prisoner of war in its custody is prohibited, and will be regarded as a serious breach
of the present Convention. In particular, no prisoner of war may be subjected to physical mutilation or to
medical or scientific experiments of any kind which are not justified by the medical, dental or hospital treatment
1

shall be bound to provide free of charge for their maintenance and for the medical attention required by their
state of health; 2

attention, preferably, of medical personnel of the Power on which they depend and, if possible, of their
nationality; 3
WHEREAS the Detainee Treatment Act of 20054 incorporates standards of the Eighth Amendment to the U.S.
Constitution, including an adequate response to the medical and psychological care needs of prisoners;
WHEREAS military health care providers - physicians (including psychiatrists), specialists, nurses and physician
assistants - are currently providing the full spectrum of health care to detainees, in accordance with their

WHEREAS It is the unqualif
strict compliance with the antitrust laws of the United States, laws which specifically prohibit any agreement or
understanding restricting the scope of services provided by specific providers or types of provider, the locations
in which psychologists may practice, or the classes of employees, patients, or collaborators with whom a
psychologist may practice;
WHEREAS the 2009 Petition Resolution policy, which is incorporated and clarified in the 2013 and 2015 Council
Resolutions, prohibits psychologists from working at detention settings deemed by APA policy to be operating in
a manner inconsistent with the U.S. Constitution or international law
y for the
1

Retrieved from http://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.32_GC-III-EN.pdf p. 97

2

Ibid, p. 97

3

Ibid, p. 103

4

Retrieved from https://www.dni.gov/index.php/ic-legal-reference-book/detainee-treatment-act-of-2005

54

 or providing treatment
to military personnel, effectively restricts detainees access to health care provided by psychologists, in direct
contradiction to the Third Geneva Convention, as well as the 2005 Detainee Treatment Act; 5
THEREFORE, BE IT RESOLVED that the 2009 Petition Resolution Policy, Psychologists and Unlawful Detention
Settings with a Focus on National Security and its incorporation into Statement 1, ¶ 1 of the Policy Related to
Other Cruel, Inhuman, or Degrading Treatment of Punishment, (Adopted by COR August 2013, as Amended by
COR August 2015), be amended as follows (bracketed/strikethrough material to be deleted; underlined material
to be added):
psychologists may not work in settings where persons are held outside of, or in violation of, either
International Law (e.g., the UN Convention Against Torture and the Geneva Conventions) or the US
Constitution (where appropriate), unless they are working directly for the persons being detained or for
an independent third party working to protect human rights, or they are working in a health care role
for the express purpose of providing psychological treatment to detainees or military personnel. [7][ii]*
*Footnote references (Fn. 7 from the original 2009 Petition Resolution Policy, and Fn. ii from the
incorporation into the Policy
Reaffirmation of the APA Position Against Torture and Other Cruel, Inhuman, or Degrading
Treatment of Punishment), are to be deleted since they will be incorporated into the text.
[7. It is understood that military clinical psychologists would still be available to provide
treatment for military personnel]
ii. [It is clarified by a footnote in the Member Petition Resolution "that military clinical
psychologists would still be available to provide treatment for military personnel. ]
BE IT FURTHER RESOLVED that the following policies:
a) 2015 Resolution to Amend the 2006 and 2013 Council Resolutions to Clarify the Roles of
Psychologists Related to Interrogation and Detainee Welfare in National Security Settings, to Further
Implement the 2008 Petition Resolution, and to Safeguard Against Acts of Torture and Cruel,
Inhuman, or Degrading Treatment or Punishment in All Settings , and
b)
s and Reaffirmation of the APA
Position Against Torture and Other Cruel, Inhuman, or Degrading Treatment of Punishment,
(Adopted by COR August 2013, as Amended by COR August 2015)
Be amended as follows. Insert in a) at the end of paragraph 2, and in b)
, ¶ 1, the following text: (underlined material to be added):

Such communications to officers of the U.S. Government shall reflect current APA policy and clarify
the appropriateness of qualified psychologists serving in a health care role for the express purpose
of providing psychological treatment to detainees or military personnel in any national security
setting.

5

Retrieved from http://www.apa.org/independent-review/psychologists-interrogation.pdf p. 6

55

 recognize the role of military to serve in a health care role to provide
treatment for detainees in all national security settings.

 

WHEN SUBMITTING A NEW BUSINESS ITEM IT IS IMPORTANT TO:
Provide adequate information so that someone unfamiliar with the issue can understand the need
for item and what it will accomplish.
Do your homework: make certain that what you are proposing does not replicate existing
Association policy, that it is consonant with current Association priorities, and that it is fiscally
realistic.

 

 

 

 

 

IDENTIFY THE CORE VALUES, IF ANY, TO WHICH THE ITEM IS
AIMED BY PLACING A CHECK MARK TO THE LEFT OF EACH RELEVANT GOAL, OBJECTIVE OR

CORE VALUE.

 

GOALS AND OBJECTIVES (APPROVED BY COUNCIL AUGUST 2009)

EIGoal 1: Maximize Organizational Effectiveness

Obiectives

The structures and systems support the organization?s strategic direction, growth and
success.

a. Enhance APA programs, services and communications to increase member
engagement and value;

b. Ensure the ongoing financial health of the organization;

El 0. Optimize governance structures and function;

El d. Ensure that APA collects, maintains and manages accessible member and
professional data to allow for evidence-based decision-making. (Added by Council in
2015)

EGoal 2: Expand Role in Advancing Health

Obiectives

Key stakeholders realize the unique bene?ts provides to health and wellness and
the discipline becomes more fully incorporated into health research and delivery systems.

El a. Advocate for the inclusion of access to services in health care reform
policies
b. Create innovative tools to allow to enhance their knowledge of health
promotion, disease prevention, and management of chronic disease;
c. Educate other health professionals and the public about role in health;
d. Advocate for funding and policies that support role in health;
e. Promote role in decreasing health disparities;
f. Promote the application of knowledge for improving overall health and
wellness at the individual, organizational, and community levels.

56

 

EIGoal 3: Increase recognition of as a science

Obiectives

The central role in positioning as the science of behavior leads to increased
public awareness of the bene?ts brings to daily living.

a. Enhance prominence as a core STEM (Science, Technology,
Engineering, and

Mathematics) discipline;
b. Improve public understanding of the scientific basis for 
c. Expand the translation of science to evidence-based practice;
d. Promote the applications of science to daily living;
e. Expand educational resources and opportunities in 

 

APA CORE VALUES (APPROVED BY COUNCIL - FEBRUARY 2010)

The American Association commits to its vision through a mission based upon the
following values:

 :lContinual Pursuit of Excellence

 : Knowledge and Its Application Based Upon Methods of Science
EIOutstanding Service to Its Members and to Society

 :ISocia  Justice, Diversity, and Inclusion

 :lEthica  Action in All that We Do

GUIDELINES FOR COUNCIL RESOLUTIONS

These guidelines apply to all resolutions submitted to Council for consideration. The following
information must be provided: (1) The purpose and rationale for the resolution stated clearly, and
documenting its relevance to or (2) The issue?s importance to or
to society as a whole; (3) Representative scientific or empirical findings related to the resolution; (4)
The extent to which the resolution is consistent with core values, and the extent to which it
addresses human rights, health and welfare, and ethics; (5) The likelihood of the resolution having a
constructive impact on public opinion or policy.

Resolutions approved by Council are understood to reflect what APA values or believes and, in most
cases, does not commit APA to any action. If approval of the resolution requires that specific action be
taken, the following information must also be provided: (6) Suggestions on how it should be
implemented, if it is passed; (7) Breakdown of staff resources or association funds needed to
implement the resolution.

DESIGNATE 
Robert Resnick, Jeffrey Younggren, Deirdre Knapp, Avi Kaplan, Keely Kolmes,


 

57

EXHIBIT 2
Summary of Board and Committee Feedback on Main Motion of New Business Item 35B introduced August
2017.
ETHICS COMMITTEE (April 2018)
The Ethics Committee made the following statement as the lead group:

Resolutions to Clarify that Psychologists May Provide Treatment to Detainees or Military Personnel in
National Security Settings, is consistent with the Ethical Principles of Psychologists and Code of
Conduct with specific reference to Principle A: Beneficence and Non-Maleficence, Standards 3.01 (Unfair
Discrimination), and 3.04 (Avoiding Harm). Most significantly, they are consistent with Section 1.04 and
3.04(b) of the revised Ethics Code that has been effective since January 1, 2017 and which now read:
Section 1.04 (Informal Resolution of Ethical Violations): "If psychologists' ethical responsibilities
conflict with law, regulations, or other governing legal authorities, psychologists clarify the nature of the
conflict, make known their commitment to the Ethics Code, and take reasonable steps to resolve the
conflict consistent with the general principles and Ethical Standards of the Ethics Code. Under no
circumstances may this standard be used to justify or defend violation of human rights. (italics added)"
Section 3.04(b) (Avoiding Harm):
otherwise
engage in torture, defined as any act by which severe pain or suffering, whether physical or mental, is
intentionally inflicted on a person, or in any other cruel, inhuman, or degrading behavior that violates
3.04(a)."

BOARD OF PROFESSIONAL AFFAIRS (March 2018)
The following represents an Unapproved Minute from the Board of Professional Affairs Spring 2018 Meeting
which took place on March 23-25, 2018. As follows:
BPA Item No. 38.5. Treatment to Detainees or Military Personnel in National Security Settings (Council
New Business Item 35(B))
The Board of Professional Affairs (BPA) appreciates the opportunity to provide input and feedback on this
referral item. BPA held a thoughtful discussion with diverse perspectives about this request from the
Ethics Committee to review the proposed
Resolutions to clarify that psychologists may provide treatment to detainees or military personnel in
national security settings (NBI35(B)/August 2017)
olution endeavors to address
in a health care capacity with the express purpose of providing psychological treatment to detainees in

The specific language change is as follows:
Furthermore, based on current reports of the UN Committee Against Torture and the UN
Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment,
58

 it is also a violation of APA policy for psychologists to work at the Guantánamo Bay detention
directly for the persons being detained or
] (a) working in a health care
role for the express purpose of providing psychological treatment or detainees, (b) working
directly for the persons being detained, or (c) for an independent party working to protect
or providing treatment to military personnel.
BPA expressed several concerns in its discussion of this item, particularly that any change could be
perceived as APA providing a back door for psychologists assisting in exposing detainees to potential
information to properly assess the consequences of this change and, as such, BPA encourages the APA
Ethics Committee to request additional information to clarify some of the particulars. Questions BPA
encourages the Committee to consider:
1.
2.
an individual ignore any type of mandate that could come from, say, their superior officer in a
military context even in their role as a health care provider?
3. It is our understanding that specific military regulations around patient confidentiality are
different and, if this is correct, how would these mental health services be treated in that regard?

BOARD OF PSYCHOLOGY IN THE PUBLIC INTEREST (MARCH 2018)

2013, and 2015 Resolutions that address the roles of psychologists in national security settings
as specified in
, 2013, and 2015 To Clarify That
Psychologists May Provide Treatment to Detainees or Military Personnel in National Security Settings.
During the review of this item, BAPPI identified several issues as being problematic. Omission
of any mention of or lack of intent to address the issues that follow is of significant concern to
the Board:
Successful treatment depends upon a strong working alliance and trust. It is impossible to
provide a therapeutic relationship when the psychologist involved works for the organization
(i.e., the Military) that is detaining the individual.
Issues around confidentiality are of utmost concern.
For providers, there is a potential conflict of interest as the goals of their employers (i.e., the
needs would not be the same. Psychologists in military service at isolated
detention centers are likely to be particularly vulnerable to conflicts because of both physical
isolation and national security constraints. Clinical psychologists are allowed in GTMO under APA policy,
but they must be working directly for the detainee or a human rights organization.
The wording in the proposed main motion is quite like wording pre-Hoffman that allowed
59

 psychologists to work with detainees in these settings. Given the major controversy surrounding the
Hoffman Report, even the appearance of impropriety could be problematic.
victims or
imprisoned individuals. They may lack the competence to treat this severely traumatized population.
The following excerpt from a November New York Times article may be informative:
"In recent interviews, more than two dozen military medical personnel who served or consulted at
Guantánamo provided the most detailed account to date of mental health care there. Almost from the
start, the shadow of interrogation and mutual suspicion tainted the mission of those treating prisoners.
That limited their effectiveness for years to come.
Psychiatrists, psychologists, nurses and technicians received little training for the assignment and, they
to cross ethical boundaries, and were warned that the
organized resistance, could have political and national security implications.
Rotations lasted only three to nine months, making it difficult to establish rapport. In a field that
requires intimacy, the psychiatrists and their teams long used pseudonyms like Major Psych, Dr.
Crocodile, Superman and Big Momma, and referred to patients by serial numbers, not names. They
frequently had to speak through fences or slits in cell doors, using interpreters who also worked with
interrogators.

medical records note repeatedly.) At a place so shrouded in secrecy that for years any information
learned from a detainee was
We were not allowed to

Dr. Rosecrans said she held back on such questions when she was there in 2004, not suspecting abuse
wound you

The United States military defends the quality of mental health care at Guantánamo as humane and
appropriate. Detainees, human rights groups and doctors consulting for defense teams offer more
critical assessments, describing it as negligent or ineffective in many cases."
https://www.nytimes.com/2016/11/13/world/guantanamo-bay-doctors-abuse.html
The amendments cite the Geneva Convention/Detainee Treatment Act/8th Amendment for the
prospect that detainees are entitled to access to mental health care. This could be provided by independent
in which
care is provided by psychologists who work for the organizations that are detaining the prisoners.

60

 There are no factual allegations that the current APA provisions that allow for independent
psychologists (either those that serve the detainee directly or those working to protect human rights) is
resulting in insufficient access to psychologists and adopting the new resolution could result in the
Military taking the position that psychologists are being provided and therefore external psychologists
should be excluded.
There is no claim that any human rights organization or detainee advocate groups would support this
resolution.
An alternative to this proposal might be that if the psychological needs of detainees are not being met
that perhaps APA could organize a volunteer program for those willing to take leave from their current positions
and provide these services. These efforts could be coordinated with human rights groups.

POLICY AND PLANNING BOARD (April 2018)
The Policy and Planning Boa
resolutions. As such it is designated as a referral group on this item.
P&P recognizes that abuses do and have occurred and always occur in settings. P&P further understands that
international bodies can and have judged certain military sites as illegal. Hence, P&P understands why there is
concern when military psychologists are stationed in sites ruled illegal.
At the same time P&P understands that the present Ethics Code is directed toward the behavior only of
psychologists.
Consequently, P&P believes that this NBI addresses the policy implications of barring psychologists from settings
rather than the behavior of psychologists in those settings that will engender further consideration by CoR.
POLICY AND PLANNING BOARD (November 2017)
The Policy and Planning Board (P&P) has received a request from the Ethics Committee as the leader
referral group to offer its thoughts as one of the referees on NBI 35B/Aug 2017, Resolution to Amend
Detainees or Military Personnel in National Security Settings. P&P has been discussing the item and is
pleased to offer the following points. P&P offers them with the understanding that these represent its
initial reflections only.
examples
from experience since the adoption of the existing policy would strengthen the NBI.
P&P believes that the welfare and ethical treatment of detainees is of paramount importance. At the
same time P&P is concerned for the moral stance and reputation of the profession and the APA.
APA is experiencing significant organizational change. Relevant among these are the impending revision
of the Ethics Code.

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 Also, APA has received the report of the Ethics Commission. While the recommendations of the
of NBI35/Aug
2017 consider these recommendations.
Another report that P&P anticipates will be relevant to NBI35/Aug 2017 is the expected report of the
human rights task force.
P&P believes that there are varying and important beliefs about the existing policy that need critical
clarification:
Some members of COR and some members of the general membership believe that the policy
adopted in August 2015 changed the Ethics Code. (P&P believes it did not.)
Some members of COR believe that the 2015 policy intended to change the Ethics Code but did
not.
For the first time, an APA policy bars psychologists from specific sites making psychologists
vulnerable to ethics complaints for being on a site rather than for behavior. Legal counsel has
advised that APA may pass whatever policy it wishes; until its comportment with the Ethics
Code is tested, the policy remains in effect.

current thinking of the Ethics Committee on NBI35/Aug 2017.

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 A
AMERICAN


 

SYCHOLOGICAL
ASSOCIATION
MEMORANDUM
TO: APA Board of Directors
FROM: Committee on Legal Issues
DATE: May 25, 2018
RE: NBI 35B: Resolution to Amend Council?s 2009, 2013, and 2015 Resolutions to

Clarify the Roles of Related to Interrogation and Detainee Welfare
in National Security Settings

 

During its Spring 2018 meeting, COLI discussed the Council New Business Item 
?Resolution to Amend Council?s 2009, 2013, and 2015 Resolutions to Clarify the Roles of
Related to Interrogation and Detainee Welfare in National Security Settings.? We
appreciated that Drs. Kennedy and Harvey moved this item forward and agree that the
Resolution as originally approved should be revisited.

Level 1 Concerns:

COLI agrees with the suggested language explicitly allowing to provide treatment
services to detainees even when those individuals are ?held outside of. . .either International
Law. . .or the US Constitution.? We unanimously supported this provision.

Beyond approving the amendment, COLI encourages broadening the provision to also allow
to be involved in the practice and policy of humane interrogations. We recognized
that footnote 6 of the Resolution allows to ?provide consultation. . .pertaining to
information gathering methods which are humane,? but the text that the footnote refers too
broadly prohibits from being present at ?any national security interrogations.? The
implication of these two pieces of text together is that are not to be present at all
during interrogations but can provide guidance on information-gathering policies at an abstract
level. The Committee on Legal Issues questions this distinction and recommends that the
Resolution be revised to more explicitly allow for the inclusion of in the practice
of humane information-gathering approaches.

We recognize that this Resolution was written during a time when the APA felt compelled to

assert its strong opposition against torture in the wake of the IR. However, the practice of
interrogations and information-gathering approaches has been informed by a wealth of

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 science. can provide guidance on best practices to promote the
humane treatment of detainees during efforts to gather information from these individuals, and it
is inconsistent with the APA mission to promote public welfare to remove from
contributing their expertise in this way. In fact, the APA has multiple sources of guidance for
working in this ?eld, including but not limited to, our Ethics code, research
concerning false confessions, and other guidelines concerning best practices.

Level 2 Concerns:

None

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Board Response to NBI on Detainee Treatment

The Board recommends adoption of a substitute motion in response to Council New Business
Item entitled ?Resolution to Amend Council?s 2009, 2013, and 2015 Resolutions to Clarijj/
that May Provide Treatment to Detainees or Military Personnel in National
Security Settings,?

The substitute motion includes the following changes:

1)

2)

The following is clari?ed in the text recommended for revision:

Military providing mental health treatment to detainees in national security settings
are able to do so ethically, in full adherence to our profession?s Ethical Principles of
and Code of Conduct (Amended effective June 1, 2010 and January 1, 2017) (the
?Ethics Code?) and are able to obtain any information or ask any questions necessary to act
competently and ethically.

Rationale: In accordance with the highest ethical ideals of the profession, including Bene?cence
and Non-Male?cence, Justice, and Respect for People's Rights and Dignity, 
respect the dignity and worth of all people, practice within the boundaries of their competence,
bene?t those with whom they work, and take care to do no harm. Similarly, the AMA Principles
of Medical Ethics require that physician shall be dedicated to providing competent medical
care, with compassion and respect for human dignity and rights.?

Furthermore, the language about military not being restricted in their
communication with the detainees is included in response to reports that military at
the Guantanamo Bay detention facility did not ask about, or document, histories of torture, abuse,
or resultant PTSD in contrast to information obtained from independently-examined
detainees. They also need to have access to the detainee?s full medical record available to the
federal government.

The following clause is included:

BE IT RESOLVED that APA strongly encourages the Department of Defense to make
independent working for the detainees or for a human rights organization
available as health care providers to detainees at sites identi?ed in the 2015 resolution as
operating outside of, or in violation of, the US. Constitution or international law.

Rationale: This clause is derived from the 2009 Council petition resolution and was
included in an earlier NBI that Council considered in a ?mega-issue? discussion in
August of 2016, which had been drafted with input from diverse groups. The intent of
this provision is to take into account the concern that detainees who had been abused or
tortured are unlikely to build a therapeutic alliance with health care professionals who
work for the military at settings that do not offer human rights protections under the
Constitution or international law. Military who provided mental health
care to detainees (which has been on a voluntary basis) at such settings received
specialized training to do so. While there are important security clearance issues to
consider at military detention facilities, it can be argued that arranging for independent

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3)

forensic who are competent multiculturally and linguistically (when
feasible) are trained and experienced in working with torture victims and others in a
detention setting would be bene?cial. Such an action would also enable more military
to provide care to other military personnel in keeping with their principal
training and mission.

The following clause is included:

APA recommits to its anti-torture policy dating back to 1985 (which has explicitly been
incorporated into the Ethics Code as Standard 3.04 as part of the implementation of
the 2015 Council policy) and to continue to take strong action to oppose torture or cruel,
inhuman, or degrading treatment or punishment of detainees held in US. custody and to
safeguard their welfare.

Rationale: On the hoped-for future, there will be no threat or risk of national security
detainees being abused in US. custody (as there is no evidence that they are now). Were
this to be the case, the Board recognizes that the above-stated caveats to NBI 35B would
be rendered moot. This is because our current APA policy dating back to 2009 only
prohibits military from treating detainees ?in settings where persons are
held outside of, or in violation of, either International Law the UN Convention
Against Torture and the Geneva Conventions [as deemed by UN. authorities as clari?ed
by the 2015 Council resolution] or the US Constitution (where appropriate)?

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