An article in a British journal charges U.S. military medical personnel with ignoring medical ethics and human rights by complying in the mistreatment of American held prisoners in Iraq, Afghanistan, and Guantanamo Bay, Cuba. The article is written by an American medical ethicist who says U.S. military doctors, nurses, and medics failed to live up to accepted standards of detainee care. But U.S. military officials deny knowledge of such medical complicity.

The abuse of detainees at Abu Graib prison in Baghdad has received widespread international news coverage over the past few months, but the role of U.S. medical military staff in the affair has been less widely reported.

Now, University of Minnesota bioethicist Steven Miles accuses U.S. Army medical personnel of adversely affecting the treatment of detainees by collaborating with abusive interrogators and prison guards. Dr. Miles, a physician, makes his charges in the journal Lancet based upon his review of press reports and public U.S. government documents. "That included some participation in some instances of medical professionals essentially being aware of and collaborating with mistreatment as it occurred. They are violations of the Hippocratic Oath. They are also specific violations of a number of international conventions that we are a party to, including the Geneva Conventions," he says.

Dr. Miles says the U.S. armed forces medical services are staffed mainly by humane and skilled people. He points out, however, that some military medical staff in Iraq, Afghanistan, and Guantanamo Bay did not conduct routine medical examinations of prisoners or provide proper care for their injuries. He says they falsified death certificates and medical records when fatal injuries were caused by abuse. He adds that they also provided medical information that was used to design psychologically and physically coercive interrogations. "We somehow blurred the line between medical professionals who were promoting detainees' well being and medical professionals becoming engaged in setting interrogation standards," he says.

The U.S. Defense Department calls Dr. Miles' assertions inaccurate. In a written statement, it says that although its own investigation has not been completed, it has no evidence that American military medical staff collaborated with abusive behavior by army interrogators or guards, failed to render medical aid to injured detainees, or falsified death certificates. It says Dr. Miles' research relies on selected news reports and excerpts of testimony given to the U.S. Congress, not on first-hand investigative work or accounts. The official statement says the lives of dozens, if not hundreds, of Iraqi insurgents and terrorist detainees have been saved by superior care and treatment provided by U.S. military medical staff.

In addition, Dr. Miles notes that since the Abu Graib prison abuses became known, U.S. Defense Secretary Donald Rumsfeld has issued a strict policy for death investigations. But he says lax and permissive military policies set the stage for both the abuses and medical complicity with them. "We need to have medical personnel function essentially as spotters for violations of human rights both to protect the detainees under our control but also so that we can develop a system of accountability so that our own soldiers who become destines also can enjoy similar protections," he says.

The U.S. Defense Department says it is committed to a full and fair review of all matters Dr. Miles raises and to any changes in policies governing the actions of military medical personnel, if needed.

An editorial in The Lancet accompanying Dr. Miles' article calls on U.S. Army health care workers who were involved in or witnessed prisoner mistreatment in Iraq, Afghanistan, and Guantanamo Bay to come forward with information.