Doctors Complicit in Refining CIA Torture Tactics?

Mother Jones reports:

"In the course of trying to prove that its "enhanced" interrogation program was legal, the Bush administration may have broken the law, according to a new report (http://phrtorturepapers.org/]) by Physicians for Human Rights. The watchdog group claims that in an attempt to establish that brutal interrogation tactics did not constitute torture, the administration ended up effectively experimenting on terrorism detainees. This research, PHR alleges, violated an array of regulations and treaties, including international guidelines on human testing put in place after the Holocaust."

Although medical complicity in torture has been condemned in principle, since the Nuremberg Doctor Trials–which were conducted by American jurists–no one has been willing to investigate medical professionals who provide governments with their professional expertise in use of torture–neither have they been held accountable.

According to the Physicians for Human Rights report, which draws on numerous declassified government documents, "medical professionals working for and on behalf of the CIA" frequently monitored detainee interrogations, gathering data on the effectiveness of various interrogation techniques and the pain thresholds of detainees. This information was then used to "enhance" future interrogations, PHR contends.

PHR concluding that these medical professionals engaged in non-consensual human research and experimentation in violation of medical ethics and domestic and international law.

There was no therapeutic purpose or intent to monitor and collect this data. The PHR report argues: "that the collection of medical information was acquired and applied to inform subsequent [interrogation] practices," which amounts to illicit human subject research.

PHR is the first group to argue that the presence of medical personnel to monitor the CIA’s use of torture –e.g., waterboarding, sleep deprivation and other "enhanced" interrogation techniques–rendered these medical professionals complicit in lending support to interrogation practices that were intentionally harmful:

"Medical personnel were ostensibly responsible for ensuring that the legal threshold for “severe physical and mental pain” was not crossed by interrogators, but their presence and complicity in intentionally harmful interrogation practices were not only apparently intended to enable the routine practice of torture, but also to serve as a potential legal defense against criminal liability for torture, the report states."

 

"The data allowed the C.I.A. to judge the emotional and physical impact of the techniques, helping the agency to “calibrate the level of pain experienced by detainees during interrogation, ostensibly to keep it from crossing the administration’s legal threshold of what it claimed constituted torture.”  The report argues that these medical professionals crossed the line, turning the detainees (prisoners) into research subjects without their voluntary consent–thereby violating both international and national standards that set limits on human research and experimentation.

The Nuremberg Code (1947), formulated as part of the judicial verdict that found the Nazi doctors guilty of crimes against humanity is universally accepted. Thirty years later, the American Common Rule was adopted after revelations about the unethical U.S. government-sponsored Tuskegee syphilis experiment were brought to light, applies to 17 government agencies–including the CIA and the Dept. of Defense.  Both the Nuremberg Code and the Common Rule ban human experimentation without voluntary, informed consent.

Underscoring the Of particular note: one goal of the research angle seems to have been to immunize Bush administration officials and CIA interrogators from potential prosecution for torture. PHR cites a series of legal papers that are now popularly known as the "torture memos":

For example, Justice Department lawyers argued that medical monitoring would demonstrate that interrogators didn’t intend to harm detainees; that "lack of intent to cause harm" could then serve as the cornerstone of a legal defense should an interrogator be targeted for prosecution. In 2003, in an internal CIA memo cited in the PHR report, the CIA’s general counsel, Scott Muller, argued that medical monitoring of interrogations and "reviewing evidence gained from past experience where available (including experience gained in the course of U.S. interrogations of detainees)" would allow interrogators to inoculate themselves against claims of torture because it "established" they didn’t intend to cause harm to the detainees.

Failure to prosecute American doctors for violating fundamental ethical standards prohibiting non-consensual experimentation has encouraged doctors to use their professional expertise for evil.

Vera Hassner Sharav

THE NEW YORK TIMES
June 6, 2010
Medical Ethics Lapses Cited in Interrogations
By JAMES RISEN

WASHINGTON — Medical professionals who were involved in the Central Intelligence Agency’s interrogations of terrorism suspects engaged in forms of human research and experimentation in violation of medical ethics and domestic and international law, according to a new report from a human rights organization. http://phrtorturepapers.org/

Doctors, psychologists and other professionals assigned to monitor the C.I.A.’s use of waterboarding, sleep deprivation and other “enhanced” interrogation techniques gathered and collected data on the impact of the interrogations on the detainees in order to refine those techniques and ensure that they stayed within the limits established by the Bush administration’s lawyers, the report found. But, by doing so, the medical professionals turned the detainees into research subjects, according to the report, which is scheduled to be published on Monday by Physicians for Human Rights.

The data collected by medical professionals from the interrogations of detainees allowed the C.I.A. to judge the emotional and physical impact of the techniques, helping the agency to “calibrate the level of pain experienced by detainees during interrogation, ostensibly to keep it from crossing the administration’s legal threshold of what it claimed constituted torture,” the report said. That meant that the medical professionals crossed the line from treating the detainees as patients to treating them as research subjects, the report asserted.

The fact that psychologists, doctors and other health professionals were involved in the interrogations conducted by the C.I.A. and the Defense Department has been previously reported. A confidential report about the issue by the International Committee of the Red Cross, based on interviews with several high-value detainees held by the C.I.A., was leaked to the news media last year.

Physicians for Human Rights has based its conclusions on an analysis of a wide range of publicly released government documents and reports about the agency’s interrogation program and has not offered any new information about the role of medical professionals in the interrogations. The group, which is based in Cambridge, Mass., also does not identify by name any of the medical professionals involved in the interrogations.

In a statement, the C.I.A. denied the group’s charges. “The report is just wrong,” said Paul Gimigliano, an agency spokesman. “The C.I.A. did not, as part of its past detention program, conduct human subject research on any detainee or group of detainees. The entire detention effort has been the subject of multiple, comprehensive reviews within our government, including by the Department of Justice.”

The report is the first analysis of the C.I.A.’s interrogation program to argue that one of the unintended consequences of the Bush administration’s efforts to provide legal cover for officials involved in the program was to place medical professionals in legal and ethical jeopardy. There are both international and national limits on human research and experimentation, including those based on the post-World War II Nuremberg Code and the so-called American Common Rule, both of which ban human experimentation without informed consent.

Medical personnel were ostensibly responsible for ensuring that the legal threshold for “severe physical and mental pain” was not crossed by interrogators, but their presence and complicity in intentionally harmful interrogation practices were not only apparently intended to enable the routine practice of torture, but also to serve as a potential legal defense against criminal liability for torture, the report states.

Several academic experts noted, however, that there has been no investigation by the government of the medical professionals involved in the C.I.A. interrogations.

“There are countries that, over the years, have condemned medical complicity in torture in principle, but which haven’t really been willing to investigate medical professionals or hold them accountable,” said Dr. Steven H. Miles of the Center for Bioethics at the University of Minnesota and an expert on the role of medical professionals in torture. “That group of countries includes the United States.”

The report found that the C.I.A.’s practice of waterboarding of high-value detainees offered perhaps the most direct evidence that medical professionals were helping to refine interrogation techniques. The report cites agency guidelines for health professionals involved in interrogations requiring that they document each time a detainee was waterboarded, how long each waterboarding session lasted, how much water was applied, exactly how the water was applied and expelled, whether the detainees’ breathing passages were filled, and how each detainee looked between treatments.

That information led the C.I.A. to make detailed changes in how interrogators conducted waterboarding sessions, the report concluded. Eventually, the agency replaced regular water with saline solution to reduce the detainees’ risk of contracting pneumonia or hyponatremia, a condition of low sodium levels in the blood caused by free water intoxication that can lead to brain edema and herniation, coma and death. The human rights group cited a 2005 memo from the Justice Department’s Office of Legal Counsel, declassified by the Obama administration, saying that the C.I.A. made the switch to saline solution “based on the advice of medical personnel.”

Separately, the Red Cross report made public last year quoted Khalid Shaikh Mohammed, the chief planner of the Sept. 11, 2001, attacks, as saying that when he was waterboarded his pulse and oxygen levels were monitored and that a medical attendant stopped the procedure several times.

The C.I.A. had adopted the use of waterboarding from a military survival training program, but the agency modified the technique as its medical professionals gleaned more information and experience. In addition to the switch to saline solution, the agency’s medical personnel introduced a special gurney so that the detainee could be moved upright quickly in case of choking. The agency also used a blood oximeter to measure vital signs, and detainees were placed on liquid diets on the advice of medical personnel so they would be less likely to choke on their own vomit, the report said.

“There was no therapeutic purpose or intent to monitor and collect this data,” said Jonathan D. Moreno, a professor of medical ethics at the University of Pennsylvania. “You can’t use people as laboratories.”
~~~~~~~~~~~~~~~

MOTHER JONES
Did the Bush Administration Experiment on Detainees?
Not only were terrorism suspects tortured, they were also used as human guinea pigs, a new report alleges.
By Nick Baumann |
Sun Jun. 6, 2010 9:00 PM PDT

In the course of trying to prove that its "enhanced" interrogation program was legal, the Bush administration may have broken the law, according to a new report (PDF [1]) by Physicians for Human Rights [2]. The watchdog group claims that in an attempt to establish that brutal interrogation tactics did not constitute torture, the administration ended up effectively experimenting on terrorism detainees. This research, PHR alleges, violated an array of regulations and treaties, including international guidelines on human testing put in place after the Holocaust.

According to the report, which draws on numerous declassified government documents, "medical professionals working for and on behalf of the CIA" frequently monitored detainee interrogations, gathering data on the effectiveness of various interrogation techniques and the pain threshholds of detainees. This information was then used to "enhance" future interrogations, PHR contends.

By monitoring post-9/11 interrogations and keeping records on the effectiveness of various techniques, medical professionals could also provide Bush administration lawyers with the information they needed to set guidelines for the use of so-called "enhanced" interrogation tactics. For instance, attorneys in the Justice Department’s Office of Legal Counsel (OLC) who were devising the legal rationale for the interrogation program could use the research to determine how many times a detainee could be waterboarded. Or, based on the observations of the medical personnel monitoring the interrogation sessions, they could assess whether it was legally justifiable to administer techniques like stress positions or water dousing in combination or whether these methods needed to be applied separately.

Physicians for Human Rights makes the case that since human subject research is defined as the "systematic collection of data and/or identifiable personal information for the purpose of drawing generalizable inferences," what the Bush administration was doing amounted to human experimentation:

    Human experimentation without the consent of the subject is a violation of international human rights law to which the United States is subject; federal statutes; the Common Rule, which comprises the federal regulations for research on human subjects and applies to 17 federal agencies, including the Central Intelligence Agency and the Department of Defense; and universally accepted health professional ethics, including the Nuremberg Code… Human experimentation on detainees also can constitute a war crime and a crime against humanity in certain circumstances.

Ironically, one goal of the "experimentation" seems to have been to immunize Bush administration officials and CIA interrogators from potential prosecution for torture. In the series of legal papers that are now popularly known as the "torture memos," Justice Department lawyers argued that medical monitoring would demonstrate that interrogators didn’t intend to harm detainees; that "lack of intent to cause harm" could then serve as the cornerstone of a legal defense should an interrogator be targeted for prosecution. In 2003, in an internal CIA memo cited in the PHR report, the CIA’s general counsel, Scott Muller, argued that medical monitoring of interrogations and "reviewing evidence gained from past experience where available (including experience gained in the course of U.S. interrogations of detainees)" would allow interrogators to inoculate themselves against claims of torture because it "established" they didn’t intend to cause harm to the detainees.

The Bush administration believed that the medical teams could boost their legal defense in another way, too. In the memos, the OLC lawyers formulated a legal threshold for the level of pain that constituted torture. In a memo drafted on March 14, 2003, John Yoo, a primary author of the torture memos, defined that boundary as treatment leading to "long-term" mental harm or pain and suffering equal to or greater than that caused by organ failure or death. So one purpose of the medical monitoring project was to insure that the techniques interrogators were using did not breach that bright line.

One document cited in the PHR report highlights this practice especially well. On May 10, 2005, then-OLC head Steven Bradbury wrote to then-CIA acting general counsel John Rizzo about the legality of using multiple interrogation techniques simultaneously, as opposed to one by one. Referring directly to data gathered by the CIA’s Office of Medical Services, Bradbury decided that both methods were okay:

    But as we understand the experience involving the combination of various techniques, the OMS medical and psychological personnel have not observed any such increase in susceptibility. Other than the waterboard, the specific techniques under consideration in this memorandum— including sleep deprivation—have been applied to more than 25 detainees.… No apparent increase in susceptibility to severe pain has been observed either when techniques are used sequentially or when they are used simultaneously—for example, when an insult slap is simultaneously combined with water dousing or a kneeling stress position, or when wall standing is simultaneously combined with an abdominal slap and water dousing. Nor does experience show that, even apart from changes in susceptibility to pain, combinations of these techniques cause the techniques to operate differently so as to cause severe pain. OMS doctors and psychologists, moreover, confirm that they expect that the techniques, when combined… would not operate in a different manner from the way they do individually, so as to cause severe pain.

It’s possible, of course, that the data about detainees’ "susceptibility to pain" was collected as part of standard medical monitoring of interrogations. But PHR says that doesn’t matter: it’s clear that " the collection of medical information was acquired and applied to inform subsequent [interrogation] practices," which amounts to illicit human subject research.

PHR claims that in addition to the data on simultaneous and sequential application of interrogation techniques, the experimentation program focused on two other areas of research: the safety and effectiveness of waterboarding and the effects of sleep deprivation. In each case, PHR points to declassified documents in which Bush administration officials acknowledge how medical information gathered during interrogations is being aggregated and used to inform future questioning.

There is some evidence to suggest that someone in the Bush administration may have realized they could be vulnerable to charges of illegal experimentation. The Military Commissions Act, passed by Congress in 2006, amended the 1996 War Crimes Act, a law that imposes criminal penalties for "grave breaches" of the Geneva Conventions. Specifically, the language on illegal "biological experiments" was weakened. The new law no longer requires that an experiment be carried out in the interest of the subject in order to be legal. (Research on how to make torture more effective is clearly not in the interest of the person who is going to be tortured.) In addition, it allows experiments that do not "endanger" the subject—rather than simply prohibiting all experiments that "are not justified by the medical, dental, or hospital treatment of the prisoner concerned and carried out in his interest," as the previous version did.

The PHR report doesn’t produce a smoking gun—there’s no memo saying "we’re going to experiment on detainees." The organization acknowledges as much, noting that none of the actual medical monitoring data from interrogations has ever been made public. PHR says that only a "comprehensive federal investigation" can answer the questions raised by its report. But don’t hold your breath for one. To date, the "enhanced interrogation" program itself has yet to be fully probed.

UPDATE: Here’s a video [3] of faith leaders responding to the PHR report and calling for an investigation.
Source URL: http://motherjones.com/politics/2010/06/bush-administration-experimented-detainees-phr-report

Links:
[1] http://phrtorturepapers.org/?dl_id=9
[2] http://phrtorturepapers.org/?page_id=63
[3] http://nrcat.org/act