Physicians for Human Rights report

CIA doctors, psychologists participated in torture of prisoners

By Tom Eley
4 September 2009

A new report by the medical ethics group Physicians for Human Rights (PHR) charges that medical professionals attached to the Central Intelligence Agency (CIA) assisted in the torture of terror detainees.

CIA doctors also provided a pseudo-medical rationale for torture and used prisoners as human research subjects to determine the effects and efficacy of various methods of torture, the report states. These acts constitute war crimes according to the Geneva Conventions and are clear violations of medical ethics.

PHR called for an independent investigation of medical personnel in the CIA interrogation program. It is seeking to determine how many doctors participated in torture, and on what scientific and medical basis they conducted their work.

The study, “Aiding Torture,” analyzes the role of doctors, psychologists, and nurses in known instances of torture at prisons where terror suspects were held, including Abu Ghraib in Iraq, Guantánamo Bay in Cuba, and Bagram in Afghanistan. It is based on the 2004 CIA Inspector General’s report on torture, which the Obama administration released two weeks ago, in heavily redacted form and in compliance with a court order.

In a press release accompanying the report, PHR asserted that “the extent to which American physicians and psychologists violated human rights and betrayed the ethical standards of their professions by designing, implementing, and legitimizing a worldwide torture program is greater than previously known.”

“The CIA relied on medical expertise to rationalize and carry out abusive and unlawful interrogations,” the group said. Furthermore, medical personnel experimented on inmates through the “aggregate collection of data on detainees’ reaction to interrogation methods.”

“They were experimenting and keeping records of the results,” said Steven Reisner, co-author of the report. “That in itself is a war crime under the Geneva Conventions. Doctors are certainly guilty of war crimes for permitting torture to go forward and overseeing it while they had the authority to stop it.”

“The required presence of health professionals did not make interrogation methods safer, but sanitized their use, escalated abuse, and placed doctors and psychologists in the untenable position of calibrating harm rather than serving as protectors and healers,” Reisner added. “The fact that psychologists went beyond monitoring, and actually designed and implemented these abuses—while simultaneously serving as ‘safety monitors’—reveals the ethical bankruptcy of the entire program.”

It is all but certain that sections of the CIA Inspector General’s report—completely redacted by the Obama administration—deal with instances in which detainees were killed as a result of abuse they suffered in their interrogations. This raises the possibility that medical personnel not only collaborated in CIA torture, but in murder.

The new report substantiates a lengthy section of an International Committee of the Red Cross (ICRC) report, leaked earlier this year, on the role of medical personnel in torture. The ICRC concluded that doctors were present during waterboarding sessions to observe the results of the near-drowning technique on the oxygen levels in prisoners’ blood.

Likewise, the PHR report asserts that “medical professionals were directed to meticulously monitor the waterboarding of detainees to try to improve the technique’s effectiveness, essentially using the detainees as human subjects, a practice that approaches unlawful experimentation.”

PHR singles out the role of psychologists in waterboarding, who reportedly gathered data on the amount of water used and the length of time prisoners were exposed. “That is experimentation and as such is a war crime,” Reisner said.

“Medical doctors and psychologists colluded with the CIA to keep observational records about waterboarding,” said PHR Medical Advisor and lead report author Scott Allen, MD. Citing one example, Allen pointed to instances of interrogators placing “a cloth over a detainee’s face to block breathing and induce feelings of fear, helplessness, and a loss of control. A doctor would stand by to monitor and calibrate this physically and psychologically harmful act, which amounts to torture.”

Allen’s reference to doctors observing the fear and helplessness in tortured prisoners is significant. “Learned helplessness” was a central aim of the CIA torture methods.

Medical personnel were involved in the interrogation process from the moment detainees arrived in the prison. The report notes “the role of health professionals in participating in initial psychological and physical assessments of detainees in an intake process closely linked to the process of interrogation [whereby] all interrogations were monitored in real-time by health professionals.”

Medical or scientific experimentation on prisoners of war violates the laws of war and and basic precepts of human rights. It is also a major breach of long-established medical ethics, including the Hippocratic oath, which stipulate that medical personnel must provide care to the sick and wounded and do no harm.

“That health professionals who swear to oaths of healing so abused the sacred trust society places in us by instigating, legitimizing and participating in torture, is an abomination,” states co-author Allen Keller, MD, director of the Bellevue/New York University Program for Survivors of Torture. “Health professionals who aided torture must be held accountable by professional associations, by state licensing boards, and by society. Accountability is essential to maintain trust in our professions and to end torture, which scars bodies and minds, leaving survivors to endure debilitating injuries, humiliating memories and haunting nightmares.”

The experimentation and study of the physical and psychological effects of torture on inmates simultaneously at a number of different CIA prisons could only have occurred if it were organized and ordered by high-ranking Bush administration officials. Taken together with other evidence of torture during the Bush administration, the PHR report leaves no doubt that this was the case.

Bush administration Office of the Legal Counsel (OLC) memos released through court order earlier this year connect the dots. These memos provide detailed descriptions of the physical and psychological impact of various forms of torture on inmates, including waterboarding, exposure to cold water, beatings, extreme isolation, and forced nudity.

The memos noted CIA guidelines that require the presence of doctors and psychologists for some of these methods. But it is clear that the central role of medical personnel at the interrogations was to analyze the “success” of various forms of torture in breaking the resistance of prisoners to interrogators.

“Not only were health professionals involved in designing and monitoring the CIA interrogation program, they also played an indirect but essential role in the legal justifications for the program prepared by the Office of Legal Counsel (OLC),” the report notes. “The OLC was asked by the CIA whether certain techniques constituted torture under [US law] by causing ‘severe physical or mental pain or suffering.’ Since the OLC lawyers had no direct experience of the techniques, they necessarily relied instead on the judgment of health professionals. Yet, in a striking example of bootstrapping, they turned for advice about the pain caused by the techniques to the very health professionals who were implementing them.”

It continues, “In essence, the lawyers were asked if the techniques constituted torture and they replied to the CIA that they only did so if the CIA Office of Medical Services (OMS) informed them that the techniques reached the defined standard of pain. The OMS health professionals obligingly passed on through CIA channels their opinion that the pain was not in fact severe.”

The report notes one OLC memo which concluded that waterboarding is not torture because “however frightening the experience may be, OMS personnel have informed us that the waterboard technique is not physically painful.”

The role of US medical personnel in torturing prisoners and experimenting on their bodies recalls the infamous practices of Nazi doctors on concentration camp inmates in WWII. A number of these doctors were tried and convicted at the Nuremberg war crimes trials in the war’s aftermath.

The Nuremberg Code emerged from the trial of Nazi doctors, who claimed that their experiments were not fundamentally different than those carried out before the war. The first of the 10 principles in the code states that in cases of experimentation on human subjects, the consent of the individual is absolutely necessary. The Nuremberg Code of ethics provided the basis for the US Code of Federal Regulations, Title 45 Volume 46, which regulates all federally funded experiments.