Some doctors "played a significant role" in a system of illegal detentions and torture during the 12 years of military rule in Uruguay, an article in the Journal of the American Medical Association says.

The author, Dr. Maxwell G. Bloche, said he interviewed more than 40 doctors, former prisoners, military officers and politicians during a visit to Uruguay last December. He was investigating charges by former prisoners and human rights groups that military doctors had supported the torture of prisoners in several ways, such as making reports that covered up abuses, failing to help injured prisoners and assisting brutal interrogators.

Bloche, who is associated with Yale Law School and Columbia University, said many doctors were employed in clandestine prisons where suspected leftist activists or sympathizers were held. International organizations and private human rights groups have estimated that as many as 40,000 people were detained by the military and security forces during the period of military rule that ended last year.

"That torture was routine" in clandestine detention centers "appears established beyond serious dispute," Bloche wrote. He said doctors in the clandestine jails examined prisoners and provided information to their jailers without the prisoners' knowledge or permission.

Interrogators sometimes used this information to tailor the torture to fit the prisoner's physical condition, he wrote, and in other cases, military officers "sometimes requested medical examinations during . . . torture 'to see if things had to stop' or could continue."

The military doctors he interviewed, Bloche said, tended to justify their role in these jails by saying that they "conceived of themselves as producers of a technical work product, without personal responsibility for the uses to which that product might be put."

Bloche also described the case of Dr. Eduardo Saiz, who signed an autopsy report attributing the death of a prisoner to "cardio-respiratory failure." A second autopsy, performed at the family's request, showed strong evidence that the prisoner had been severely beaten and possibly drowned during a torture known as el submarino, in which a prisoner's head is held under filthy water.

Uruguay's civilian government has dismissed Dr. Saiz and has begun proceedings that could deprive him of his license to practice.

Bloche concluded that many doctors in Uruguay "systematically served the bureaucracy of state terror" in a way that is "not clearly condemned in existing medical ethical codes." He said there is a need to "refine our conception of the physician's ethical obligations when his employer makes nonclinical use of his medical work product."