The Breaking of Bodies and Minds: Torture, Psychiatric Abuse, and the Health Professions

this volume refreshing. It cannot, however, replace the infectious diseases-oriented texts for complete coverage of each specific disease. In too many countries today, health professionals directly or indirectly inflict needless suffering through their complicity in acts of torture. They participate in crimes such as the falsification of medical reports on prisoners tortured or killed in custody, examination and treatment of patients with the goal of preparing them for further torture, and the administration of drugs and treatments whose sole purpose is to cause physical or psychological pain. Psychiatrists label political or social misfits as mentally ill and arrange for their indefinite confinement in psychiatric hospitals. The Breaking of Bodies and Minds is a grim look into this situation, with horrifying examples, yet, at the same time, it provides concrete suggestions as to how health professionals can help to combat these abuses. The book is organized into two major sections, with chapters contributed by twenty different writers. The first section, on torture, includes chapters on such topics as medical ethics, testimony and case histories of torture victims-for example, Joelito Filartiga-and reports on the physical and psychological effects of torture on victims and their families. The last chapter of the section discusses medical action against torture and outlines principles (both existing and proposed) which define the physi-cian's primary responsibility to his or her patient, even in situations of emergency or personal danger. The second section explores the issue of psychiatric abuse, particularly in the Soviet Union. Chapters in this section discuss the development of psychiatric abuse for political purposes in the Soviet Union, beginning in early nineteenth century Czarist Russia, the methods used to diagnose dissidents; case studies; the current state of Soviet psychiatry; and the response of the World Psychiatric Association and the American Psychiatric Association to reports of abuse in the Soviet Union. The final chapter is a general discussion of the prevention of torture and psychiatric abuse. The authors propose a twelve-point approach, including international publicity and condemnation of acts of torture and abuse as they are uncovered, legal action on the part of victims or their families, compensation, care and rehabilitation for victims, government safeguards against incommunicado detention, and other actions. Also included are appendices describing codes of ethics and declarations on abuse, selected organizations concerned with torture and psychiatric abuse, and a bibliography. On the whole, the book is well written. The authors make their points without …