A Syrian doctor accused of crimes against humanity went on trial on Wednesday at the Frankfurt Higher Regional court. 

Alaa M. stands accused of gruesome crimes: Of dousing the genitals of teenagers with alcohol and setting them on fire, of kicking prisoners' broken arms and legs, of administering those who protest against mistreatment with injections. These are only three examples from a long list of atrocities drawn up by the attorney general in Frankfurt.

Alaa M. is alleged to have committed his acts of torture in a prison of the military intelligence service as well as in military prisons in Homs and Damascus. In 2015, Alaa M. came to Germany to work as a doctor. The 38-year-old practiced in several hospitals — until he was arrested in June 2020. 

The trial comes on the heels of a landmark decision: Last week, a German court found a Syrian former army colonel guilty of crimes against humanity, handing him a life sentence. That trial was one of the first anywhere in the world to examine state-sponsored torture during the Syrian civil war; the ex-colonel now stands as the highest-ranking Syrian officer to be convicted of crimes against humanity.

'First, do no harm'

Doctors have their patients' trust and are bound by the oath with which the Greek physician Hippocrates laid the foundations for medical ethics some 2,400 years ago: "I will make my prescriptions for the benefit and piety of the sick, according to my best ability and judgment; I will protect them from harm and arbitrary injustice."

Some doctors, though, are not healers and helpers, but willing participants in brutal systems of oppression. Steve Miles, Professor Emeritus of Medicine and Bioethics from the University of Minnesota has done intensive research on the involvement of doctors in torture. Doctors are essential to torture and an integral part of any torture system, Miles explained in an interview with DW.

"They issue false death certificates for medical records. They don't record the fact that torture was a cause of an injury or a death (…) they will design methods of torture that don't leave scars. And they keep the patient alive for the full amount of desired torture. So for these reasons, physicians now are entirely integrated into the system of torture around the world."

Worldwide phenomenon

The human rights organization Amnesty International recorded 140 countries where torture is carried out with the help of doctors.

In Germany, too, doctors have been involved in massive injustice. This applies to Nazi doctors during the Holocaust in the 1930s and 1940. Concentration camp doctor Josef Mengele was notorious, selecting prisoners to live or die as they arrived at the Auschwitz-Birkenau extermination camp. He personally supervised the gas chambers and carried out experiments on prisoners.

More recently, doctors in the former East Germany collaborated with the repressive regime. Lawyer Heidrun Budde recorded several examples of torture specifically in psychiatric institutions. The measures ranged from isolation torture to extremely painful medical interventions conducted with the sole purpose to break people's will.

In 1975, the World Medical Association (WMA) adopted the Tokyo Declaration, an anti-torture manifesto that not only prohibits physicians from direct involvement in torture, it also obligates them to speak out, protest, and protect victims of torture.

According to medical ethics researcher Miles, the doctors are often easily persuaded.

"They're not coerced. And the reason is that the regimes that want to use these doctors are often regimes that have low supplies of physicians, and they don't want to alienate their medical community by coercing them. And so these docs are volunteers. Now in exchange for volunteering for this kind of duty, they are promoted and paid very well. For example, the docs who worked in the Nazi camps were all made SS officers and have received very high pay grades. But it's not simply the incentive. These doctors tend to have a very rigid right or wrong view of patriotism, they have little respect for human rights."

From Abu Ghraib to Guantanamo

Although torture is outlawed worldwide — it is also banned by the Syrian constitution — it does not only happen in authoritarian states that doctors carry out procedures classified as torture by UN conventions. Some methods used by the US in its "war on terror" after 2001 were euphemistically labeled "enhanced interrogation techniques."

They were developed with the help of psychologists and doctors, with one central common feature: not to leave any visible traces. There are records showing medical doctors were often present when prisoners were submitted to so-called "waterboarding" interrogation techniques; in which the prisoner experiences extreme fear of suffocation. And there are documents showing doctors helped to conceal the cause of injuries and even deaths.

Wolfgang Kaleck is founder and secretary general of the European Center for Constitutional and Human Rights (ECCHR), a Berlin-based non-governmental organization that is dedicated also to the fight against torture. Kaleck welcomes the fact that the physician Alaa M. is now being tried in Germany.

However, Kaleck believes that it remains to be seen whether the Federal Prosecutor General really investigates in all directions. He argues that the principle of universal jurisdiction should be applied more broadly, pointing out that the United States, just like Russia and China, does not recognize the International Criminal Court. The human rights lawyer told DW: "The test will be when a high US official responsible for torture after 9/11 is in Germany who is not protected by any immunity. Then the Federal Prosecutor's Office will have to prove that no double standards apply. And that's what we're working toward, of course."

This article was originally written in German. It has been updated following the start of the trial on January 19, 2022.

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