Ann Intern Med. 1995 Apr 15;122(8):607-13. doi: 10.7326/0003-4819-122-8-199504150-00009.
The prevention of torture and the treatment of survivors are issues that concern an increasing number of physicians in their daily work. Every day, thousands of men, women, and children are subjected to violence and are forced to flee their homelands. There are more than 18 million refugees in the world and hundreds of thousands of persons seeking asylum, many of them in the United States. Physicians are often the first to interview these victims of abuse. Torture has serious and long-lasting health consequences. Thus, physicians can play a key role in documenting and preventing many forms of abuse and in treating survivors. In some areas, physicians may become the targets of arrest because of their work as clinicians or as influential members of their communities. They may also face disturbing ethical dilemmas as they witness torture or its results. As members of the medical profession, physicians have an obligation to their peers around the world. This report reviews the current state of physicians' involvement in the prevention of international torture and in the treatment of its victims. We propose ways in which physicians can become involved by caring for survivors of torture and by providing expert testimony on behalf of victims who seek asylum. We discuss how the medical profession complements the efforts of individual physicians by providing an infrastructure to support and guide their work. Medical organizations can adopt and disseminate ethical principles that specifically address human rights and their violation. They can coordinate letter-writing networks for human rights, organize or sponsor fact-finding missions, and develop continuing medical education courses on topics such as the identification and treatment of victims of torture. We conclude that physicians can make a difference, both as clinicians and as advocates for the health of the public and the protection of the human rights. The American College of Physicians will continue to advocate for the rights of persons and communities to live in dignity and peace, free of the fear of unjust imprisonment or torture.
预防酷刑以及治疗幸存者是越来越多医生在日常工作中所关注的问题。每天，成千上万的男女老少遭受暴力并被迫逃离家园。世界上有超过1800万难民以及数十万寻求庇护者，其中许多人在美国。医生常常是首批询问这些受虐受害者情况的人。酷刑会造成严重且持久的健康后果。因此，医生在记录和预防多种形式的虐待行为以及治疗幸存者方面可发挥关键作用。在一些地区，医生可能因其临床工作或作为社区中有影响力的成员而成为被逮捕的对象。他们在目睹酷刑或其后果时，也可能面临令人困扰的伦理困境。作为医疗行业的成员，医生对世界各地的同行负有义务。本报告审视了医生参与预防国际酷刑及治疗酷刑受害者的现状。我们提出医生可通过照料酷刑幸存者以及代表寻求庇护的受害者提供专家证词来参与其中的方式。我们讨论了医疗行业如何通过提供支持和指导其工作的基础设施来补充个体医生的努力。医疗组织可以采用并传播专门涉及人权及其侵犯问题的伦理原则。它们可以协调人权方面的写信网络，组织或赞助实况调查团，并开发关于诸如酷刑受害者的识别与治疗等主题的继续医学教育课程。我们得出结论，医生作为临床医生以及公众健康和人权保护的倡导者都能有所作为。美国医师协会将继续倡导个人和社区有尊严、和平地生活的权利，使其免受不公正监禁或酷刑恐惧的困扰。
