I. EXPERIMENTS IN TORTURE: Evidence of Human Subject Research and Experimentation in the “Enhanced” Interrogation Program; Physicians For Human Rights pdf (June, 2010)
II. Physicians for Human Rights: CIA Performed Illegal Medical Experiments While Torturing Prisoners
Physicians for Human Rights: CIA Performed Illegal Medical Experiments While Torturing Prisoners (Feb. 15, 2011)
Loaded on Feb. 15, 2011 by Matthew Clarke published in Prison Legal News February, 2011, page 20
Filed under: Medical Misconduct, Government Misconduct, Medical Experiments/Exploitation, Forcible Treatment, Excessive Force, Guard Brutality/Beatings, Terrorism. Location: United States of America.
by Matt Clarke
According to a report released by Physicians for Human Rights (PHR) in June 2010, the Central Intelligence Agency (CIA) performed illegal non-consensual human medical experiments on high-value terrorism detainees in connection with torturing those detainees. Also see article on p. 8.
The PHR report was released following a two-year review of declassified but redacted government records related to the treatment of terrorism detainees subjected to Enhanced Interrogation Techniques (EITs), which included waterboarding (controlled drowning), sleep deprivation, excessive temperatures and infliction of severe pain.
The human-subject medical research was performed by doctors from the CIA’s Office of Medical Services (OMS). OMS physicians were present during the use of EITs, monitored the detainees’ medical condition and documented the EIT practices and outcomes.
Knowledge gained from this medical research was then used to refine future EIT protocol, determine the ability of detainees to endure severe pain, calibrate the level of pain caused by certain EITs, research the effects of sleep deprivation, and determine the advisability and effectiveness of using simultaneous combinations of EITs.
Following the 9/11 attacks, the Department of Justice’s (DOJ) Office of Legal Counsel (OLC) set up a legal framework to permit torture and protect the torturers from legal consequences. To do this, they used a twofold approach. First, they claimed that terrorism detainees were not prisoners of war under the Geneva Conventions because they were not uniformed military personnel of a national government. That was a correct interpretation.
However, the OLC took this valid legal premise a step further and claimed that terrorism detainees were not covered by the Geneva Conventions. This is incorrect. The Geneva Conventions cover all persons involved in warfare, even those labeled by the DOJ as “unlawful combatants.” This was eventually confirmed by the U.S. Supreme Court in Hamdan v. Rumsfeld, 548 U.S. 557 (2006) [PLN, Sept. 2006, p.27].
The second part of the DOJ’s legal framework was the redefinition of “torture” to circumvent statutes criminalizing such acts. To accomplish this, the OLC issued a memorandum redefining torture as an act that causes long-term mental harm or physical pain and suffering equivalent to the pain and suffering caused by organ failure or death. OLC lawyers argued for medical monitoring of the EITs and to use the monitoring information to refine the EITs as a way of showing concern for the detainees’ safety, so as to avoid accusations of torture.
Apparently, no one in the DOJ or OLC ever considered the legality of allowing such medical monitoring to become medical experimentation. There was a disturbing feedback loop established between the military and CIA in refining torture techniques to make them more effective. When the OLC gave its approval to EITs by redefining torture, the CIA was faced with a dilemma – it had no current experience or knowledge of torture.
Therefore it turned to the military, which had two sources of information concerning torture: military personnel who had been captured and tortured by an enemy, and torture performed by the military itself as part of its Survival, Evasion, Resistance and Escape (SERE) program.
SERE was designed to teach military personnel what they could expect to experience should they be captured by an enemy. The SERE program included waterboarding, but it was limited to a single instance of short duration. Further, participation in SERE was voluntary and only with the participant’s consent. Thus, it differed considerably from the torture inflicted by the CIA on terrorism detainees.
Nonetheless, the CIA used information from the SERE manual and SERE personnel to set up EITs. The knowledge flowed both ways. When OMS doctors suggested using saline solution instead of water to avoid a potentially fatal drop in blood salinity caused by repeated waterboarding, the SERE manual was revised to reflect that change. Thus, the medical research results obtained from monitoring torture sessions were used by both the CIA and the military.
The prohibition against non-consensual human experimentation arose from the Nazi medical atrocities of World War II, and stems from three sources: the Nuremberg Code, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (National Commission), and the Common Rule. The Nuremberg Code requires the voluntary, informed consent of the human subject of any experiment and mandates that the subject be free to terminate participation in the experiment at any time. This is considered “customary” international law, violations of which are universally condemned. Unfortunately, the U.S. has a history of ignoring the Nuremberg Code when it comes to socially marginalized populations, such as the infamous Tuskegee syphilis experiments involving poor southern black men and numerous experiments on prisoners. [See, e.g., PLN, March 2008, p.1].
The National Commission was created by Congress following public outrage over such non-consensual government experiments. The Commission – a group of leading experts in medicine, law and ethics – issued the Belmont Report in 1979, which recommended requiring informed consent, established additional safeguards for vulnerable populations such as prisoners whose ability to give informed consent was compromised, and called for the establishment of an institutional review board of researchers, ethic experts and lay people within each medical or scientific organization to oversee the design of human research studies.
These protections became codified in codes of professional conduct and federal regulations collectively referred to as the Common Rule. All federally-funded research, including that performed by the CIA and military, are subject to the Common Rule.
Additionally, all four Geneva Conventions list “biological experimentation” as grave breaches, and the War Crimes Act of 1996 criminalizes grave breaches of the Geneva Conventions. However, there is no indication that any U.S. official will be investigated, much less held accountable, for the illegal human medical experiments performed on terrorism detainees by the CIA.
The PHR report calls for a wide-ranging, multi-pronged investigation into the CIA’s human medical experimentation on terrorism detainees and the legal framework that purported to legitimize it; the suspension of federally-funded human medical experimentation; and the adoption of stronger policies prohibiting torture and torture-related human medical experiments.
Not surprisingly CIA officials contested the conclusions in the PHR report, claiming they did not conduct any human medical experiments as part of the agency’s detention program. An impartial investigation might reveal who is right and whether the CIA was complicit in human rights violations related to illicit medical experimentation on terrorism detainees.
The report is available on PLN’s website or at http://phrtorturepapers.org. An article detailing the findings of the PHR report appeared in the January 7, 2011 issue of Science, a leading journal that covers scientific research.
“Science and medicine were used to justify the predetermined conclusion that torture could be ‘safe, legal and effective’ when, in fact, the health professionals who were charged with ensuring detainees’ safety were instead calibrating the harm inflicted upon them,” stated Vince Iacopino, Senior Medical Advisor for Physicians for Human Rights. “Not only does that make for bad science, but it also contradicts every ethical code that these professionals should be operating under.”
Sources: Los Angeles Times; “Experiments in Torture: Evidence of Human Subject Research and Experimentation in the ‘Enhanced’ Interrogation Program,” Physicians for Human Rights (June 2010); www.physiciansforhumanrights.org
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III. June 2010: “Experiments in Torture: Unlawful Experimentation in ‘Enhanced’ Interrogation”
March 27, 2015
Following a two-year review of declassified government documents related to detainee interrogation, Physicians for Human Rights (PHR) issued a report, “Experiments in Torture: Unlawful Experimentation in “Enhanced” Interrogation documenting evidence of illegal and unethical human subject experimentation:
“Both before and after Sept. 11, 2001, experimentation for non-clinical purposes on detainees by US military and intelligence services—either with or without their consent— would not have been permissible under widely accepted and understood interpretations of US and international law and medical ethics. Such experimentation violates accepted US legal interpretations, as well as all governing codes of conduct for any health professionals involved.”
“…several examples within the DoJ [Department of Justice] memos and other government documents reveal the implementation of a program of medical monitoring that involved many core elements of a research regime, namely, the meticulous collection and analysis of data to derive generalizable knowledge … the core elements, goals, roles, and rationales of a research plan are present in declassified documents related to the “enhanced” intelligence program (EIP), despite there being no public evidence of IRB approval or a formalized research plan.” (p. 6)
“The use of health professionals to monitor intentionally harmful interrogation techniques places them in the service of national security objectives which are in conflict with the interests of those who they are monitoring. The result has been a co-opting of health professionals by the national security apparatus and a violation of the highest medical admonition to “do no harm.” Until the questions examined in this paper are answered and, if ethical violations or crimes were committed, those responsible are held accountable, the misuse of medical and scientific expertise for expedient and non-therapeutic goals jeopardizes the ethical integrity of the profession, and the public trust in the healing professions risks being seriously compromised.”
The PHR report shows that the DoJ Office of Legal Counsel (OLC) memos hinged on the involvement of health-professionals. The OLC memos state that “a good-faith defense against torture charges could be made if experts claimed that the application of the torture tactics did not cause “severe, long lasting mental pain and suffering.” The PHR report counters by arguing that: “the “enhanced” interrogation techniques are premised on the infliction of mental harm, so the concept of studying them to make them more effective is ethically impermissible, and studying them to make them “safer” is logically untenable — as the techniques are unsafe by design.” (p.6)
“However, while legal memos were drafted to justify the use of “enhanced interrogation techniques,” Physicians for Human Rrights finds that “there is no publicly available evidence that the Department of Justice’s Office of Legal Counsel determined that the alleged experimentation and research performed on detainees was lawful”. In other words, the use of the techniques was sanctioned, but not the performance of human experimentation, or research for developing such techniques.”
“In their attempt to justify the war crime of torture, the CIA appears to have committed another alleged war crime—illegal experimentation on prisoners. Justice Department lawyers appear to never have assessed the lawfulness of the alleged research on detainees in CIA custody, despite how essential it appears to have been to their legal cover for torture.”—Nathaniel A. Raymond, Director of PHR’s Campaign Against Torture and lead report author.
The PHR report notes that although actual observational medical monitoring data are not publicly available in the instances cited,
“data collection was required by OMS [CIA’s Office of Medical Service] monitoring guidelines, and a Justice Department memo draws legal conclusions about the permissibility of the techniques based on apparent scientific analysis of the OMS data referenced in the memos.”
“…several examples within the DOJ memos and other government documents reveal the implementation of a program of medical monitoring that involved many core elements of a research regime, namely, the meticulous collection and analysis of data to derive generalizable knowledge … the core elements, goals, roles, and rationales of a research plan are present in declassified documents related to the “enhanced” intelligence program (EIP), despite there being no public evidence of IRB approval or a formalized research plan.” (p. 6)
“Both before and after Sept. 11, 2001, experimentation for non-clinical purposes on prisoners by US military and intelligence services—either with or without their consent— would not have been permissible under widely accepted and understood interpretations of US and international law and medical ethics. Such experimentation violates accepted US legal interpretations, as well as all governing codes of conduct for any health professionals involved.”
“Also, the “science” on which the authorization of the “enhanced interrogation program” (EIP) was based is flawed by any reasonable standard because it served as a means of justifying a predetermined legal end of aiding in the authorization of torture.
Even the claim of systematic medical monitoring in the name of making “enhanced” interrogation techniques (EITs) “safe, legal, and effective” is contradicted by official monitoring policy, which failed to adequately take into account the mental harm caused by the tactics, among other factors.
In fact, the “enhanced” interrogation techniques are premised on the infliction of mental harm, so the concept of studying them to make them more effective is ethically impermissible, and studying them to make them “safer” is logically untenable — as the techniques are unsafe by design.” (p.6)
In a letter to President Obama, Physicians for Human Rights wrote:
“The use of doctors to monitor intentionally harmful interrogation techniques places them in the service of national security objectives which are in conflict with the best therapeutic interest of those they are monitoring. The result has been a cooptation of health professionals by the national security apparatus and a violation of the highest medical admonition to ‘do no harm.’ The misuse of scientific expertise for expedient and exploratory goals leads to a corrosion of the high standards of the profession.”
PHR indicated that a threefold purpose for conducting this unethical and illegal research:
“First, because the EITs had previously been considered torture, there was little scientific evidence prior to Sept. 11, 2001, about their effects on detainees and questions about their impact and effectiveness were arising as the program proceeded… experiments on detainees [sought] to determine the effects of more prolonged and intense application of the techniques…”
“A second purpose of collecting generalizable medical data was to attempt to calibrate the level of pain caused by the techniques…
“A third purpose…was to create a basis for legal defenses for those engaging in acts that arguably constituted torture. Department of Justice lawyers argued that efforts to refine and improve the application of techniques would provide a potential “good faith” defense for interrogators against charges of torture.”
PHR called for a criminal investigation into the CIA and other government agencies, for illegal human experimentation and research on detainees; also to “issue an executive order immediately suspending any federally-funded human subject research currently occurring in secret;” and called for “a presidential task force to restore the integrity of the US regime of protections for human subjects of research.”
Psychologist and investigative reporter, Jeffrey Kaye stated:
“The use of torture has suborned U.S. civil society as a whole in activities that are dark and evil, and the society as a whole must make a tremendous effort if it is to extirpate such evil from its midst.” ( The Public Record, 25 May 2010)
Posted in CIA Torture
IV. INTERROGATION TORTURE TECHNIQUES DEVELOPED BY THE AMERICAN CRIMINAL STATE
Evidence Indicates that the Bush Administration Conducted Experiments and Research on Detainees to Design Torture Techniques and Create Legal Cover
CIA medical personnel accused of conducting torture experiments on detainees
Written by Meredith Wadman
Tuesday, 08 June 2010
Nature.com—Medical personnel on the payroll of the Central Intelligence Agency (CIA) participated in experimentation and research on detainees during interrogations following the US terror attacks of 11 September 2001 according to an independent report released today. The actions documented in the report took place during the administration of President George W. Bush and contravene principles of research ethics set out in the Nuremburg Code, including those explicitly stated by the US government.
The report, Experiments in Torture: Human Subject Research and Evidence of Experimentation in the `Enhanced’ Interrogation Program, was published by the advocacy group Physicians for Human Rights (PHR), based in Cambridge, Massachusetts. It relies on previously classified documents released by US President Barack Obama’s administration between May 2009 and February 2010.
The 30-page document alleges that personnel in the CIA’s Office of Medical Services (OMS) were involved in activities such as adjusting saline levels in water used for the simulated drowning technique called waterboarding, and comparing prisoners’ pain tolerance after various techniques, such as slapping, water dousing and sleep deprivation, were applied serially or in combination.
“The CIA appears to have broken all accepted legal and ethical standards put in place since the Second World War to protect prisoners from being the subjects of experimentation,” says Frank Donaghue, PHR chief executive.
The report notes that there is no publicly available evidence that the spy agency sought or obtained from the Department of Justice a legal justification for the alleged experimentation — in contrast to the careful legal language crafted by the department to justify the use of “enhanced” interrogation techniques such as waterboarding. What’s more, the report alleges, the data systematically collected by CIA medical employees were used as a basis for the department’s legal argument that the “enhanced” techniques did not constitute torture and that the people who implemented them would not be subject to prosecution.
“In an attempt to justify the war crime of torture, the CIA appears to have committed another alleged war crime — illegal experimentation on prisoners,” says Nathaniel Raymond, director of the PHR’s Campaign Against Torture and the report’s lead author.
Neither the White House nor the CIA responded to requests for comment on Sunday; the Department of Justice did not reply to an interview request on Friday.
The report lacks the actual data it alleges were gathered by medical personnel; these were not released by the authorities in documents that are heavily redacted. But, says Raymond: “This report is appropriately sourced, reviewed and written to serve as a basis for further criminal investigation.”
Paul Root Wolpe, director of the Center for Ethics at Emory University in Atlanta, Georgia, reviewed the report and says: “It’s very hard to believe, given everything that I’ve read here, that research was not going on. There’s an enormous amount of circumstantial evidence.”
According to Nancy Berlinger, a research scholar who studies clinical ethics at The Hastings Center in Garrison, New York, the report is distressing in part because it reveals a complete disregard for the Nuremberg Code. The 1947 code was created in response to evidence of Nazi-era experimentation and forms the basis for subsequent US regulations governing research. “To see evidence of experimentation on detainees in US custody feels like a body blow to people who care about research ethics,” says Berlinger.
In one example of what it calls research experimentation, the PHR report quotes CIA guidelines for its health professionals — who included physicians, psychologists and physicians’ assistants — as requiring them to record, for each instance of waterboarding: “how long each application (and the entire procedure) lasted, how much water was used in the process (realizing that much splashes off), how exactly the water was applied, if a seal was achieved, if the naso- or oropharynx was filled, what sort of volume was expelled, how long was the break between applications, and how the subject looked between each treatment.”
On the basis of this data collection, the report continues, CIA medical personnel replaced water in the waterboarding procedure with saline (salt) solution, to reduce the risk of a detainee contracting pneumonia or developing dangerously low levels of sodium in the blood, which can result from swallowing huge quantities of water. They further modified the procedure by putting detainees on a liquid diet before interrogation, to make them less likely to choke on their own vomit, and introducing a specially designed gurney to move the detainee upright quickly in case of choking.
Matthew Alexander (a pseudonym), a former US Air Force interrogator in Iraq and author of the book How To Break a Terrorist, says: “It’s shocking. This was a feedback cycle. It was a process of doing something, measuring it and then reinserting that into the process. Which the report says is the definition of experimentation.”
In another instance, the report cites a 2005 memo from Steven Bradbury, principal deputy assistant attorney general, to a senior CIA lawyer, John Rizzo, in which observations by CIA medical personnel of some 25 detainees were cited to conclude that enhanced interrogation techniques used in combination, rather than individually, were not likely to make detainees more susceptible to pain.
Describing combination techniques, “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,” Bradbury concluded: “As we understand the experience involving the combination of various techniques, the OMS medical and psychological personnel have not observed any such increase in [pain] susceptibility.”
The Common Rule, which governs US research on human subjects by 17 federal agencies, including the CIA, lays out requirements for rigorous pre-approval of studies by an Institutional Review Board. Rules include the need for the subjects’ voluntary informed consent, lack of coercion and the right of subjects to withdraw from the research at any time.
The PHR has indicated that, along with other organizations, it will file a complaint later this week with the US government’s Office for Human Research Protections (OHRP) and call for the OHRP to investigate the CIA’s medical office. The OHRP’s mandate includes the power to review all federal agencies that engage in federally funded research, whether that research is classified or unclassified.
The group also called on President Obama to ask the attorney general to investigate whether crimes had been committed under the War Crimes Act. In 2006, Congress amended the research provisions of that law to make them more lenient, and made the new language retroactive to 1997. The amended law, for instance, does not require that any biological experiment on a prisoner be carried out in the interests of the subject. The PHR also called on Congress to restore the law to its original wording.
Meredith reported her first Nature story – on gene therapy – in December 1995, fresh from a stint covering Capitol Hill and White House politics as Washington correspondent for The Oakland Tribune. She has a BSc in human biology from Stanford University, studied medicine as a Rhodes Scholar at Oxford, and went to journalism school at Columbia University in New York. Meredith has also contributed to the Washington Post, The New York Times and The Wall Street Journal.
The following is the media release from Physicians for Human Rights
Evidence Indicates that the Bush Administration Conducted Experiments and Research on Detainees to Design Torture Techniques and Create Legal Cover
Illegal Activity Would Violate Nuremberg Code and Could Open Door to Prosecution
Media Contact: Benjamin Greenberg, firstname.lastname@example.org, Tel: 617-301-4237, Cell: 617-510-3417
(Cambridge, MA) In the most comprehensive investigation to date of health professionals’ involvement in the CIA’s “enhanced” interrogation program (EIP), Physicians For Human Rights has uncovered evidence that indicates the Bush administration apparently conducted illegal and unethical human experimentation and research on detainees in CIA custody. The apparent experimentation and research appear to have been performed to provide legal cover for torture, as well as to help justify and shape future procedures and policies governing the use of the “enhanced” interrogation techniques. The PHR report, Experiments in Torture: Human Subject Research and Evidence of Experimentation in the ‘Enhanced’ Interrogation Program, is the first to provide evidence that CIA medical personnel engaged in the crime of illegal experimentation after 9/11, in addition to the previously disclosed crime of torture.
This evidence indicating apparent research and experimentation on detainees opens the door to potential additional legal liability for the CIA and Bush-era officials. There is no publicly available evidence that the Department of Justice’s Office of Legal Counsel determined that the alleged experimentation and research performed on detainees was lawful, as it did with the “enhanced” techniques themselves.
“The CIA appears to have broken all accepted legal and ethical standards put in place since the Second World War to protect prisoners from being the subjects of experimentation,” said Frank Donaghue, PHR’s Chief Executive Officer. “Not only are these alleged acts gross violations of human rights law, they are a grave affront to America’s core values.”
Physicians for Human Rights demands that President Obama direct the Attorney General to investigate these allegations, and if a crime is found to have been committed, prosecute those responsible. Additionally, Congress must immediately amend the War Crimes Act (WCA) to remove changes made to the WCA in 2006 by the Bush Administration that allow a more permissive definition of the crime of illegal experimentation on detainees in US custody. The more lenient 2006 language of the WCA was made retroactive to all acts committed by US personnel since 1997.
“In their attempt to justify the war crime of torture, the CIA appears to have committed another alleged war crime – illegal experimentation on prisoners,” said Nathaniel A. Raymond, Director of PHR’s Campaign Against Torture and lead report author. “Justice Department lawyers appear to never have assessed the lawfulness of the alleged research on detainees in CIA custody, despite how essential it appears to have been to their legal cover for torture.”
PHR’s report, Experiments in Torture, is relevant to present-day national security interrogations, as well as Bush-era detainee treatment policies. As recently as February, 2010, President Obama’s then director of national intelligence, Admiral Dennis Blair, disclosed that the US had established an elite interrogation unit that will conduct “scientific research” to improve the questioning of suspected terrorists. Admiral Blair declined to provide important details about this effort.
“If health professionals participated in unethical human subject research and experimentation they should be held to account,” stated Scott A. Allen, MD, a medical advisor to Physicians for Human Rights and lead medical author of the report. “Any health professional who violates their ethical codes by employing their professional expertise to calibrate and study the infliction of harm disgraces the health profession and makes a mockery of the practice of medicine.”
Several prominent individuals and organizations in addition to PHR will file a complaint this week with the US Department of Health and Human Services’ Office for Human Research Protections (OHRP) and call for an OHRP investigation of the CIA’s Office of Medical Services.
The PHR report indicates that there is evidence that health professionals engaged in research on detainees that violates the Geneva Conventions, The Common Rule, the Nuremberg Code and other international and domestic prohibitions against illegal human subject research and experimentation. Declassified government documents indicate that:
Research and medical experimentation on detainees was used to measure the effects of large- volume waterboarding and adjust the procedure according to the results. After medical monitoring and advice, the CIA experimentally added saline, in an attempt to prevent putting detainees in a coma or killing them through over-ingestion of large amounts of plain water. The report observes: “‘Waterboarding 2.0’ was the product of the CIA’s developing and field-testing an intentionally harmful practice, using systematic medical monitoring and the application of subsequent generalizable knowledge.”
Health professionals monitored sleep deprivation on more than a dozen detainees in 48-, 96- and 180-hour increments. This research was apparently used to monitor and assess the effects of varying levels of sleep deprivation to support legal definitions of torture and to plan future sleep deprivation techniques.
Health professionals appear to have analyzed data, based on their observations of 25 detainees who were subjected to individual and combined applications of “enhanced” interrogation techniques, to determine whether one type of application over another would increase the subject’s “susceptibility to severe pain.” The alleged research appears to have been undertaken only to assess the legality of the “enhanced” interrogation tactics and to guide future application of the techniques. Experiments in Torture: Human Subject Research and Experimentation in the ‘Enhanced’ Interrogation Program is the most in-depth expert review to date of the legal and medical ethics issues concerning health professionals’ involvement in researching, designing and supervising the CIA’s “enhanced” interrogation program. The Experiments in Torture report is the result of six months of investigation and the review of thousands of pages of government documents. It has been peer-reviewed by outside experts in the medical, biomedical and research ethics fields, legal experts, health professionals and experts in the treatment of torture survivors.
The lead author for this report was Nathaniel Raymond, Director of the Campaign Against Torture, Physicians for Human Rights (PHR) and the lead medical author was Scott Allen, MD, Co-Director of the Center for Prisoner Health and Human Rights at Brown University and Medical Advisor to PHR. They were joined in its writing by Vincent Iacopino, MD, PhD, PHR Senior Medical Advisor; Allen Keller, MD, Associate Professor of Medicine, NYU School of Medicine, Director, Bellevue/NYU Program for Survivors of Torture; Stephen Soldz, PhD, President-elect of Psychologists for Social Responsibility and Director of the Center for Research, Evaluation and Program Development at the Boston Graduate School of Psychoanalysis; Steven Reisner, PhD, PHR Advisor on Ethics and Psychology; and John Bradshaw, JD, PHR Chief Policy Officer and Director of PHR’s Washington Office.
Physicians for Human Rights (PHR) mobilizes the health professions to advance the health and dignity of all people by protecting human rights. As a founding member of the International Campaign to Ban Landmines, PHR shared the 1997 Nobel Peace Prize.
The report was extensively peer reviewed by leading experts in related medical, legal, ethical and governmental fields addressed in the document.
V. CIA Health Professionals’ Role in Systematic Torture, Including ‘Human Subjects Research’
16 Dec 2014 Kevin Gosztola Kevin Gosztola
Cover page for Physicians for Human Rights’ analysis of CIA torture report summary
An organization of United States health professionals has put out a comprehensive analysis of the role US health professionals played in the CIA torture program. The analysis, stemming from the US Senate intelligence committee’s executive summary of its torture report, raises alarming questions about whether these professionals engaged in “human subjects research” that constituted a crime against humanity.
Physicians for Human Rights (PHR) highlights eight “categories of abuse” and a range of activities health professionals committed in violation of treaties, laws and ethical codes. It outlines the obligations health professionals have, which were not followed, and concludes “CIA relied upon health professionals at every step to commit and conceal the brutal and systematic torture of national security detainees.”
“PHR finds that health professionals played not only a central but an essential role in the CIA torture program—to an extent not previously understood,” according to PHR’s report [PDF].
In response to the revelations, PHR calls on President Barack Obama for a “federal commission to investigate, document and hold accountable all health professionals who participated in the CIA torture program.” The federal commission should specifically focus on how health professionals designed, directed, monitored and attempted to provide “legal justifications.”
The “unethical and illegal acts perpetrated by CIA health professionals,” which PHR outlines, include:
1) Designing, directing, and profiting from the torture program: Psychologists conceptualized and designed the CIA torture techniques, then helped implement the program, receiving a sole source, multi-million dollar CIA contract for these services.
2) Intentionally inflicting harm on detainees: Health professionals intentionally inflicted and/or threatened to inflict severe harm and suffering on detainees in CIA custody.
3) Enabling [Justice Department] lawyers to create a fiction of “safe, legal, and effective” interrogation practices: Health professionals participated in the DoJ’s Office of Legal Counsel’s spurious legal rationale that the techniques would not be considered torture so long as health professionals certified they were not.
4) Engaging in potential human subjects research to provide legal cover for torture: Health professionals collected and analyzed data from application of techniques in an effort to legitimize torture. [Office of Medical Services] officials expressed concern that these documentation practices could constitute illegal human subjects research. Senior CIA officials who were asked to evaluate the efficacy of the tactics expressed similar concerns.
5) Monitoring detainee torture and calibrating levels of pain: Health professionals monitored, documented, and calibrated the intentional infliction of harm on detainee.
6) Evaluating and treating detainees for purposes of torture: Health professionals evaluated and treated detainees before, during, and after torture in order to enable the torture to occur.
7) Conditioning medical care on cooperation with interrogators: Health professionals provided medical care that was contingent upon whether or not detainees were deemed to have cooperated with interrogators.
8) Failing to document physical and/or psychological evidence of torture: Health professionals did not document the torture inflicted on detainees, which served to conceal the tactics’ harmful effects.
PHR acknowledges that the prohibition against human experimentation in response to Nazi atrocities during World War II. “Unethical human subjects research also arose in the United States with the now infamous Tuskegee experiment, whereby black men were monitored as they died of diagnosed, but untreated, syphilis.” Following the experiment, which ended in 1972, safeguards were enacted to require that subjects of studies give “informed consent.”
The torture report summary contains a number of details that suggest human experimentation may have been ongoing. Part of deciding what “tactics” to use on detainees stemmed from analyzing “previously collected” data on detainees who were tortured. The data was used to “reauthorize” the use of certain torture techniques.
“Data collection from detainees by OMS is consistent with definitions of human subjects research under US federal codes,” PHR states. “If further investigation establishes that human subjects research without consent was performed systematically on detainees then such activities are violations of the Nuremberg Code and could constitute a crime against humanity.”
An OMS officer at one point expressed concern that studying results of CIA interrogations may constitute “human experimentation.”
The CIA inspector general replied, “OIG did not have in mind doing additional, guinea pig research on human beings. What we are recommending is that the Agency undertake a careful review of its experience to date in using the various techniques and that it draw conclusions about their safety, effectiveness, etc., that can guide CIA officers as we move ahead.”
In regards to the “intentional infliction of harm,” one of the most grotesque acts described in the summary is rectal force-feeding.
Former CIA director Michael Hayden has barbarically defended this as a “medical procedure.” However, the case of Majid Khan shows this “medical procedure” was really torture.
…Khan accepted nasogastric and IV feeding and was allowed to infuse fluids and nutrients himself. Nevertheless, after three weeks, the CIA opted to rectally force-feed him with Ensure and his own pureed lunch to eliminate “unnecessary conversation.” The summary noted that according to CIA records, Khan was “very hostile” to rectal feeding…
Khan is the detainee who had hummus, pasta with sauce, nuts and raisins ‘pureed’ and rectally infused.” And, as PHR points out, this could cause “rectal trauma” and “additional harmful health consequences both physically and emotionally.”
“Rectal exams” conducted with “excessive force” on detainees also were torture. PHR notes, “One of the detainees, Mustafa al-Hawsawi, was later diagnosed with “chronic hemorrhoids, an anal fissure, and symptomatic rectal prolapse.”
“Rather than reject such brutal practices, medical officers appear to have modified them to increase pain: ‘we used the largest Ewal [sic] tube we had,’ stated one officer in a February 2004 email.”
It was a medical officer who found that subjecting Khalid Sheikh Mohammed to “rectal rehydration” helped clear his head and was “effective” in getting him to talk. These professionals identified with interrogation objectives more than patient care. Their notes would help medical officers “perfect” the torture.
The summary shows, as PHR also highlights, “medical officers often documented torture techniques that they monitored in meticulous detail demonstrating the medical staff’s profound disconnect from core principles of medical ethics prohibiting the participation of health professionals in torture.”
On August 4, 2002, Abu Zubaydah was waterboarded for the first time. PHR suggests that subsequently Zubaydah had his diet changed to help facilitate watarboarding.
During the first waterboarding session, which lasted two-and-a-half hours, Zubaydah “coughed, vomited, and had ‘involuntary spasms of the torso and extremities,’” according to the summary.
The attitude of one medical officer was one of feigned indifference. “So it begins,” the OMS officer wrote in an email. “Abu Zubaydah seems very resistant to the water board. Longest time with the cloth over his face so far has been 17 seconds. This is sure to increase shortly. NO useful information so far.… He did vomit a couple of times during the water board with some beans and rice. It’s been 10 hours since he ate so this is surprising and disturbing. We plan to only feed Ensure for a while now.”
The intentional infliction of harm as well as the calibration of “levels of pain” may seem like the most brutal acts CIA health professionals committed. Yet, what is possibly more sinister is how the health professionals engaged in a conspiracy to make certain the brutality remained within limits that could be construed as “legal.”
It has long been known that lawyers for the Justice Department’s Office of Legal Counsel (OLC), like John Yoo, authored memos indicating that health professionals ensured “severe and long lasting” mental and physical pain and suffering did not occur in violation of US laws, which prohibit torture.
For inflicted physical and mental pain to be torture, the “physicians and psychologists would need to confirm that the interrogator (in some cases, the physicians and psychologists themselves) specifically intended to cause physical and mental pain.” Victims could experience severe physical and psychological trauma and if personnel could claim that was not the intent they were able to argue they did not torture.
Both CIA contract psychologists, James Mitchell and Bruce Jessen, are condemned by PHR for their role in developing torture. Mitchell and Jessen were key to implementing methods that would “break the detainees’ will and create a condition of debility, dependency and dread.”
One cable Mitchell and Jessen sent on the “aggressive phase” of Zubaydah’s interrogation indicated:
Our goal was to reach the stage where we have broken any will or ability of subject to resist or deny providing us information (intelligence) to which he had access. We additionally sought to bring subject to the point that we confidently assess that he does not/not possess [sic] undisclosed threat information, or intelligence that could prevent a terrorist event.
As PHR states, “Prolonged deprivation of food, sound, light, and sleep (for up to 180 hours); exposure in freezing temperatures (resulting in death in one case); diapering; being forced to soil one’s self; repeated beatings; and multiple near drowning experiences by waterboarding to the point of unconsciousness are intentional acts that cannot be conducted without inflicting severe physical and mental pain.”
Altogether, PHR’s analysis shows health professionals “violated their professional ethics, undermined the critical bond of trust between patients and doctors, and broke the law.” Health professionals are supposed to “do no harm” and “protect the lives and health of patients under their care from harm and brutality.” Personnel acting as health professionals flagrantly and criminally disregarded these ethics.
Records on any human experimentation or human subjects research that took place should not be concealed and covered up. That information, if senators have it readily available, should be made public immediately.