E/CN.4/2006/120 page 22 and mental health”, (b) to use their knowledge and skills to assist in the interrogation of detainees “in any manner that may adversely affect physical or mental health”, or (c) to certify the fitness of detainees for any “treatment or punishment that may adversely affect their physical or mental health”. The United Nations Principles also state that there may be no derogation from these principles on any ground, including public emergency. 74. The World Medical Association adopted similar ethical standards in the Declaration of Tokyo (1975), which was subsequently adopted by the American Medical Association.111 The Declaration prohibits doctors from participating in, or being present during, any form of torture or other form of cruel, inhuman or degrading treatment and from providing any knowledge to facilitate such acts. The doctor’s fundamental role is to alleviate distress and no other motive shall prevail against this purpose.112 The International Council of Nurses also condemns interrogation procedures harmful to mental and physical health, as well as inhumane treatment of detainees:113 “Nurses have a fundamental responsibility to promote health, to prevent illness, to restore health and to alleviate suffering.”114 These internationally agreed ethical norms are implied in, and form an essential part of, the right to health. Compliance by health professionals with such ethical standards is essential to realizing the right to health. 75. The Special Rapporteur has received reports, many confirmed by investigations of the United States military,115 that health professionals in Guantánamo Bay have systematically violated widely accepted ethical standards set out in the United Nations Principles of Medical Ethics and the Declaration of Tokyo, in addition to well-established rules on medical confidentiality. Alleged violations include: (a) breaching confidentiality by sharing medical records or otherwise disclosing health information for purposes of interrogation;116 (b) participating in, providing advice for or being present during interrogations;117 and (c) being present during or engaging in non-consensual treatment, including drugging and force-feeding.118 In sum, reports indicate that some health professionals have been complicit in abusive treatment of detainees detrimental to their health. Such unethical conduct violates the detainees’ right to health, as well as the duties of health professionals arising from the right to health. 76. A report of the International Committee of the Red Cross indicates that the “apparent integration of access to medical care within the system of coercion meant that inmates were not cooperating with the doctors. Inmates learn from their interrogators that they have knowledge of their medical histories and the result is that prisoners no longer trust the doctors”.119 The Special Rapporteur is concerned that the information detainees disclose to health professionals has been used to punish and coerce, and therefore detainees have learned that they cannot trust health professionals. As a result, detainees may not seek health care or, if they do, may not disclose to health professionals all information necessary to receive adequate and appropriate health care. In the context of the hunger strikes, a trusting relationship between the detainee and the health professional is essential for the health professional to provide health information and advice to the hunger striker consistent with ethical principles. 77. The United States Department of Defense has promulgated Medical Program Principles that parallel the United Nations Principles of Medical Ethics, yet differ significantly in several