First Do No Harm: Balaam and the Ethics of Responsibility
June 26th is United Nations Day of Support for Victims of Torture. Below is a sample d'var torah connecting Parshat Balak with the 2010 Physicians for Human Rights report on illegal human experimentation at Guantanamo, along with actions you can take to ensure an end to U.S.-sponsored torture. It was originally published in June, 2010.
First do no harm: Balaam and the ethics of responsibility
Rabbi Rachel Kahn-Troster
In this week's parsha, Balak, Balak, the Moabite king, is facing an unprecedented national security situation. After years of wandering in the desert, the Israelites have begun their final march towards the Promised Land. They have become a large and mighty nation, and with God guiding their actions, they have begun to conquer the nations surrounding Canaan. Perceiving that this new enemy might require a new kind of response, Balak sends messengers to a local prophet, Balaam, to entice him to rain down curses on the Israelites. The king is certain of the efficacy of this enhanced response: "For I know that he whom you bless is blessed indeed and he whom you curse is cursed." (Numbers 22:6)
But Balaam's ability to prophesize is a gift to him from God, and God reminds him that he cannot use it to harm God's people. In response to Balaam's rejection, Balak sends greater offers of rewards. Balaam is swayed-the situation at hand, with its tangible benefits, overtakes his sense of higher responsibility. He journeys towards the king, ready to curse the Israelites. God continually reminds him that he can only say the words God puts into his mouth. Even the puzzling incident with the donkey, who tries to prevent Balaam from reaching Balak and reminds him of the limits of human abilities when compared to God, does not dissuade Balaam from fulfilling the terms of his contract with Balak. Four times, at four different locations, Balaam tries to curse the Israelites but blesses them instead. Balak is enraged, but God will not let Balaam betray his ethical responsibilities and the terms of his prophetic profession. He cannot harm the Israelites, no matter how hard he tries.
"First, do no harm." In medicine, this is the ethical principle that the treatment should not be worse than the illness or injury. It also expresses a hope that a doctor, in doing everything within his or her power to heal, is acting in the best interest of the patient and the common good, and not out of less noble motivations.
Judaism has also long regarded the ability to practice medicine as a gift from God. A medieval commentator, weighing in on whether doctors can treat their parents (given that injuring a parent is potentially a capital offense), remarks that doctors are exempt under Jewish law from the fines for causing bodily harm in their work on a patient. When a doctor starts treating, the "injury" that results might heal the patient or ultimately make matters worse. But, says the commentator, doctors are compelled to do their work by God: God has blessed them with the gift of healing and so the doctor is not personally responsible for harm that befalls the patient.
Whether they view God as guiding their hands, or whether guided by the idea that the treatment should not cause more harm than the illness, doctors have long operated on the basis of higher ethical principles, putting their patients ahead of political concerns. The results of ignoring these ethics can be devastating, and the 20th century is full of examples of the atrocities, illegal experiments, and unethical research undertaken by physicians. As Jews, we cannot forget the horrific experiments conducted by Nazi doctors in the name of "science." The scholar Robert Lifton has noted the ways in which German doctors were slowly drawn away from their ethical responsibilities into the evils of the Nazis, coming to place their loyalty to the state above their moral calling. And in response, the world created laws, such as the Nuremberg Code, the Geneva Convention, and American laws governing research and experimentation that require the active consent of the subject.
That is why it was so shocking to learn, earlier this month, about a disturbing new report from Physicians for Human Rights. Experiments in Torture: Human Subject Research and Evidence in the 'Enhanced' Interrogation Program is an investigation of the role of medical personnel at Guantanamo. The report, based on publicly available information, concludes that health professionals, in their role as monitors of the CIA Enhanced Interrogation Program (EIP), conducted human experimentation and research on prisoners in U.S. custody. The results of this research were critical components for the fabrication of a legal framework construed to protect interrogators from prosecution for committing acts of torture and also served to refine the illegal torture practices used by the U.S. government.
In the report, PHR focuses on three areas where medical personnel conducted illegal experimentation and research:
- Research and medical experimentation on detainees was used to measure the effects of waterboarding and adjust the procedure according to the results. After medical monitoring and advice, the CIA experimentally added saline, in an attempt to prevent putting detainees in a coma or killing them through over-ingestion of large amounts of plain water.
Health professionals monitored sleep deprivation on more than a dozen detainees in 48-, 96- and 180-hour increments. This research was apparently used to monitor and assess the effects of varying levels of sleep deprivation to support legal definitions of torture and to plan future sleep deprivation techniques.
Health professionals appear to have analyzed data, based on their observations of 25 detainees who were subjected to individual and combined applications of "enhanced" interrogation techniques, to determine whether one type of application over another would increase the subject's "susceptibility to severe pain." Since the Torture Memos defined torture as the pain equivalent to death or major organ failure, research was necessary in order to define that threshold.
These accusations are devastating. God's blessing to guide the hands of doctors has been used instead to do harm. In the name of national security, core values have been sacrificed and those charged with easing suffering have instead perpetuated it. PHR notes that this concern is not just in the past: As recently as February, 2010, President Obama's then director of national intelligence, Admiral Dennis Blair, disclosed that the US had established an elite interrogation unit that will conduct "scientific research" to improve the questioning of suspected terrorists.
How easily we move away from blessing instead of cursing! In a recent editorial about the PHR report, Rabbi David Saperstein of the Religious Action Center wrote:
Nazi medical experimentation in the concentration camps was an unparalleled horror, significantly different from the research conducted on prisoners in U.S. custody. Nevertheless, the Holocaust has provided vitally needed moral lessons to the world. Among the most crucial is the need to stop abusive activity and violations of international law when they first begin.
In related remarks, Rabbi Saperstein referred to the Nuremberg Code and other laws that prevent human experimentation as "fences around the Torah," the checks and balances that prevent us from engaging in egregious behavior that deny the image of God found in every person. We can always invent rationalizations for circumventing our values, for doing harm. Indeed, Rabbi Saperstein writes, "as a democracy committed to human rights we may not, dare not, in good conscience avail ourselves of barbaric practices, no matter how tempting the results may seem." We must not fall into the temptations that befell Balaam. We must bless instead of curse.
That is why we must take action to ensure the United States never again commits acts of torture or asks its doctors to violate their ethical principles. The contents of President Obama's January 22, 2009 Executive Orders on detention, interrogation, and rendition must be enshrined into legislation, and there must be accountability for torture at all levels of government through an official Commission of Inquiry.