Directive 2005/36/EC and torture in Bahraini hospitals

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 by Gerry Liston, Legal Officer at GLAN - Global Legal Action Network

What role could Directive 2005/36/EC on the recognition of professional qualifications have in addressing the systematic use of torture in Bahrain?

The Royal College of Surgeons in Ireland (‘RCSI’) is Ireland’s largest medical school. In addition to its Irish campus, it operates a number of “constituent colleges” overseas, including one in Manama, the capital of Bahrain, which is called the RCSI-Bahrain. The programme of education delivered to students of the RCSI-Bahrain is the same the programme delivered to students in Dublin; graduates of the RCSI-Bahrain are also awarded the same degrees as their Irish counterparts.

Throughout the period of political unrest which commenced in Bahrain in 2011, patients of the training hospitals associated with the RCSI-Bahrain were subjected to extreme abuse for their involvement in protests. Physicians for Human Rights reported, for example, that ‘egregious abuses against patients including torture, beating, verbal abuse, humiliation and threats of rape and killing’ occurred in the Salmaniya Medical Complex – Bahrain’s largest hospital.[i]

Medics were also targeted extensively by the Bahraini authorities.[ii] Many were tortured, prosecuted and imprisoned for their involvement in peaceful protests, for treating injured protesters and for speaking to the media.[iii] A report of the Bahrain Independent Commission of Inquiry, a body established by the Bahraini government to investigate and report on the 2011 unrest, confirmed that both patients and medics were abused in hospitals associated with the RCSI-Bahrain.[iv]

The link between the RCSI and torture in Bahraini hospitals has been the subject of long-running controversy in Ireland. Much focus has also been placed on the role of the Irish Medical Council which, because of the fact that Irish degrees are awarded by the RCSI-Bahrain, must periodically accredit that institution. In spite of the overwhelming evidence of the extreme human rights abuses in its training hospitals, the Medical Council granted the RCSI-Bahrain full, unconditional approval in 2014.

The issue has now re-arisen as the RCSI-Bahrain falls due for accreditation in 2020. Furthermore, torture remains rife in Bahrain and the Global Legal Action Network has obtained and furnished to the Medical Council evidence that protesters continue to be abused in the RCSI-Bahrain’s training hospitals.

Where does Directive 2005/36/EC come into the equation? According to Irish law, for a programme of medical education to receive accreditation, it must comply with Article 24 of this Directive which states, for example, that participants in programmes of basic medical education must acquire ‘suitable clinical experience in hospitals under appropriate supervision.’ It must surely be the case that this condition cannot be satisfied in an environment in which patients and doctors are subject to extreme and systematic abuse.

This is not just a matter of interpreting Article 24 in light of its ordinary meaning and purpose. Such an interpretation is also demanded by the requirement that EU law be interpreted in a manner consistent with customary international law. Were Article 24 of the Directive interpreted in such a way that a clinical setting in which systematic torture is rampant could satisfy its conditions, this would arguably amount to implied recognition that that situation is lawful. This would therefore breach the duty on States not to recognise as lawful a situation created by a serious breach of a peremptory norm of international law as codified in Article 41(2) of the International Law Commission’s Draft Articles on State Responsibility for Internationally Wrongful Acts.

Technically, no breach of EU law is committed by Ireland if the Irish Medical Council deems, for the purpose of its accreditation of the RCSI-Bahrain, that the latter complies with Article 24 of Directive 2005/36/EC. This is because that Directive does not require Member States to conduct periodic accreditation of educational institutions within its jurisdiction.

However, a “host” Member State would fall foul of the Directive – Recital (10) of which makes clear that recognition of qualifications obtained outside the territory of the EU must respect the minimum training requirements such as those contained in Article 24 – were it to recognise an RCSI-Bahrain-awarded qualification. Furthermore, were the Irish Medical Council, as the competent authority for the purpose of the Directive, to issue evidence to the competent authority of a host State suggesting that RCSI-Bahrain qualifications satisfy the requirements of Article 24, this would give rise to a breach of the Directive by Ireland.

Directive 2005/36/EC therefore provides a perhaps unlikely mechanism by which to address the issue of torture in Bahrain’s hospitals. It is clearly regrettable that it is the innocent graduates of the RCSI-Bahrain, or at least those graduates who seek to practice in Europe, who must suffer the consequences of it being invoked. At the same time, who could argue against an interpretation that Article 24 cannot be satisfied by training in a clinical setting in which the rights of both patients and doctors are violated in such an egregious way?

[i]                 Physicians for Human Rights (‘PHR’), ‘Do No Harm: A Call for Bahrain to End Systematic Attacks on Doctors and Patients’ (2011), available at https://s3.amazonaws.com/PHR_Reports/bahrain-do-no-harm-2011.pdf, p. 21.

[ii]                See, for example, Human Rights Watch, ‘Bahrain: Medics Describe Torture in Detention’ (October 2015) available at https://www.hrw.org/news/2011/10/21/bahrain-medics-describe-torture-detention

[iii]                Human Rights Watch, ‘No Justice in Bahrain – Unfair Trials in Military and Civilian Courts’ (2012), p. 20. Available at https://www.hrw.org/report/2012/02/28/no-justice-bahrain/unfair-trials-military-and-civilian-courts. See also, Human Rights First, ‘Stories from Bahrain’s Crackdown: Dr. Fatima Haji, Internal Medicine and Rheumatology Specialist’ (2014) available at http://www.humanrightsfirst.org/blog/stories-bahrain’s-crackdown-dr-fatima-haji-internal-medicine-and-rheumatology-specialist

[iv]                Bahrain Independent Commission of Inquiry, ‘Report of the Bahrain Independent Commission of Inquiry’ (2011), paras. 828 to 847 and Cases No. 25 (p. 453) and 43 (p. 467) available at http://www.bici.org.bh/BICIreportEN.pdf.

Pictures credits: Department of Education by Rosa G..

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