Posts filed under 'Medicine'

Physicians for Human Rights on California health provider interrogations bill

Physicians for Human Rights President Leonard Rubenstein has written a letter supporting the California bill that would try and get California licensed health providers out of any direct role aiding national security interrogations. [Available as pdf here.]:

January 11, 2007

Senator Mark Ridley-Thomas
State Capitol, Room 4061
Sacramento, CA 95814

Re: Support for Resolution on Health Professional Involvement in Torture

Dear Senator Ridley-Thomas:

I am writing on behalf of Physicians for Human Rights (PHR), an organization that for 20 years has been engaged in mobilizing the health professions to advance human rights. We strongly support the resolution you have offered. It is a critical step toward restoring the integrity of the health professions in the context of national security policy and renewing public confidence in these professions.

For its entire history, PHR has been engaged in documenting torture throughout the world and ending medical complicity in it. We also led the process of establishing international standards for medical documentation of torture (the Istanbul Protocol), which were endorsed by the UN General Assembly. In 1997 Physicians for Human Rights shared in the Nobel Peace Prize as a member of the Steering Committee of the International Campaign to Ban Landmines.

In recent years, we have been actively engaged in stopping torture by the United States and any medical participation in it. We issued a seminal report on the use of psychological torture, Break Them Down, and a medico-legal analysis of “enhanced” interrogation techniques, Leave No Marks (available on our web site, www.physiciansforhumanrights.org.) PHR has been particularly concerned about the role of health professionals as designers, implementers, and supervisors of systematic torture and cruel, inhuman, and degrading treatment of detainees. This role is in direct contravention of the foundational tenets of medical ethics and domestic and international human rights law and significantly undermines the health professional’s role as healer. We and our advisers have written analyses of the problem for the Journal of the American Medical Association and other scientific and legal journals, provided op-ed articles for major newspapers including the Los Angeles Times, and provided testimony to the U.S. Congress. We have also played an active role in providing guidance and advice to professional associations, including the American Medical Association, the American Psychiatric Association, and the American Psychological Association, in setting out the ethical standards applicable to the health profession in the context of interrogation.

It is this background that leads us to support the resolution you are offering. It states clearly that all health professionals should not participate in torture or cruel, inhuman and degrading treatment. Moreover, it follows the approach the American Medical Association and the American Psychiatric Association took after careful study, which holds that to be true to ethical commitments, physicians should not participate in the interrogation of individual detainees at all – even an interrogation that doesn’t involve torture or cruel treatment. These organizations adopted this stance in recognition that the traditional standard – no participation in torture and cruel treatment – is inadequate. I would like to review the reasons for this stance.

First, it is indisputable that even the most benign interrogation is designed to induce distress and anxiety. Interrogations conducted by the United States in the context of detention of terrorist suspects, significantly exacerbate this distress, and the potential for long-term harm, because they take place in a closed environment where human rights violations, including no due process and indefinite confinement, can easily occur. Engaging in any interrogation support in these circumstances, even where the interrogation is legal, is inconsistent with core ethical value of all the health professions in avoiding harm. This stance is similar to the ethical prohibition on physicians from participation in executions even in states where, as in California, capital punishment is legal.

Second, while it is often claimed that health professionals can play the role of a “safety officer” in interrogations, the investigations we and others have conducted have shown that the opposite is the case: in this role, health professionals in Behavioral Science Consultation Teams become the decision-makers in the calibration of the degree of pain and distress to be inflicted. This is shown in a forthright report issued by the Army Surgeon General in 2005, which on the one hand affirmed that health professionals act to assure that interrogations are safe, but expected them to advise interrogators when it was permissible to increase the distress and pain inflicted on a detainee.

Third, it is often argued that health professionals, particularly behavioral scientists, by sharing information and insights about individual detainees, can help establish rapport with a detainee and otherwise support non-coercive interrogations. But this role provides an invitation – which is embodied in current military rules – to share medical records and results of examinations with interrogators. The AMA and American Psychiatric Association have therefore come to the view that their members may train interrogators generally about human behavior and interrogation but not participate in individual interrogations.

Finally, there is a terrible slippery slope in engaging in interrogations that fall short of torture or cruel treatment. As we know, the interpretations of what amounts to torture and cruel treatment by the Justice Department, CIA and Department of Defense are ever-changing, and health professionals ought not to be in the position of being told that a certain interrogation method is acceptable because the lawyers have said so. They are not in a position, either from the point of view of legal knowledge of authority, to contest such determinations, and the prudent approach is to remove them from the situation where such choices must be made. The record of interrogations by the United States has indeed shown that psychologists and physicians have been reassured that the conduct involved does not involve torture and cruel treatment, when in fact it does. Whether serving as supposed “safety officers,” members of Behavioral Consultative Science Teams (BSCTs), or as advisors and implementers to interrogations, health professionals, especially psychologists and physicians, have had their medical expertise and prestige twisted to legitimate criminal treatment of suspected terrorists. The untenable position in which they have been placed can only be avoided by banning participation altogether.

We are aware that some health professionals and the American Psychological Association wish to continue a role for health professionals in interrogations, and thus urge adherence to the pre-9/11 standard, which only prohibits participation in torture or cruel, inhuman or degrading treatment. But the experience of the past six years shows why that standard is unworkable and ineffective, and why both internationally – through the World Medical Association – and domestically, the majority approach since 9/11 has been to end the participation of members of health professions obligated to “do no harm” in interrogation altogether.

Because your resolution does precisely this approach we support it. It can help provide health professionals serving in national security environments the ethical and legal guidance they so desperately require to operate in US detention facilities in a manner that comports with their professional ethics and values. By passing this resolution, California will also send a strong message to national security agencies that there is no circumstance where a health professional should be allowed to participate in the willful infliction of harm, and that California will hold health professionals who engage in these activities accountable for their violation of their solemn duty to “do no harm”.

Sincerely,

Leonard S. Rubenstein
President

3 comments January 13th, 2008

Action Opportunity for California Residents: Get health professionals out of interrogations!

This is an urgent opportunity for action for residents of California who are concerned about the role of psychologists and other health professionals in torture and abuse of U.S. detainees.

A broad coalition of health, human rights, and legal organizations in California are working to encourage the State of California to:

Notify all state-licensed health professionals of their legal and professional obligations not to participate in torture.

Notify them that participants in torture may be subject to prosecution.

Request that the U.S. Department of Defense and the CIA remove all California-licensed health professionals, including psychologists, from participating in prisoner interrogations.

If you would like to know more about this initiative, or sign a related online petition, go to the following web page, posted by the American Friends Service Committee:

http://www.afsc-pswro.org/crm/licensingpetition.php?

The California State Senate will be holding a hearing on Monday afternoon, Jan. 14th, on a proposed resolution on this matter. Contact the California State Senate Committee on Business, Professions and Economic Development, at 916-651-4104, for more information about that resolution and hearing.

Daily Kos blogger Valtin has more information on this. Go read his post. From it I reproduce the actual bill:

AUTHORS COPY
10/15/07 08:1OAM
58048 RN 07 29989 PAGE 1
LEGISLATIVE COUNSEL’S DIGEST
as introduced, Ridley-Thomas.

General Subject: Health professionals: torture.

This measure would request all relevant California agencies to notify
California-licensed health professionals about their professional obligations under international law relating to torture and the treatment of detainees, as specified, and to also notify those professionals that those who participate in torture, among other forms of treatment, may be subject to prosecution. In addition, the measure would request the United States Department of Defense and the Central Intelligence Agency to remove all California-licensed health professionals from participating in prisoner and detainee interrogations

Fiscal committee: yes.

WHEREAS, Health professionals licensed in California, including, but not limited to, physicians, osteopaths, psychologists, psychiatric workers, and nurses, have and continue to serve nobly and honorably in the armed services of the United States; and

WHEREAS, United States Army regulations and the War Crimes Act and, relative to the treatment of prisoners of war, Common Article III of the Geneva Conventions and the Convention against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment (CAT) require that all military personnel report and not engage in acts of abuse or torture; and

WHEREAS, CAT defines the term “torture” as “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity”; and

WHEREAS, In 2002, the United States Department of Justice reinterpreted national and international law related to the treatment of prisoners of war in a manner that purported to justify long-prohibited interrogation methods and treatment of detainees; and

WHEREAS, Physicians and other medical personnel and psychologists serving in noncombat roles are bound by international law and professional ethics to care for enemy prisoners and to report any evidence of coercion, or abuse of detainees; and

WHEREAS, The World Medical Association (WMA) issued guidelines stating that physicians shall not use nor allow to be used their medical knowledge or skills, or health information specific to individuals, to facilitate or otherwise aid any interrogation, legal or illegal; and

WHEREAS, The guidelines issued by the WMA also state that physicians shall not participate in or facilitate torture or other forms of cruel, inhuman, or degrading procedures of prisoners or detainees in any situations; and

WHEREAS, The American Medical Association’s (AMA) ethical policy prohibits physicians from conducting or directly participating in an interrogation and from monitoring interrogations with the intention of intervening; and

WHEREAS, AMA policy also states that “(t)orture refers to the deliberate, systematic or wanton administration of cruel, inhumane > and degrading treatments or punishments during imprisonment or detainment. Physicians must oppose and must not participate in torture for any reason … Physicians should help provide support for victims of torture and, whenever possible, strive to change the situation in which torture is practiced or the potential for torture is great”; and

WHEREAS, In May 2006, the American Psychiatric Association stated that psychiatrists should not “participate directly in the interrogation of persons held in custody by military or civilian investigative or law enforcement authorities, whether in the United States or elsewhere,” and that “psychiatrists should not participate in, or otherwise assist or facilitate, the commission of torture of any person. Psychiatrists who become aware that torture has occurred, is occurring, or has been planned must report it promptly to a person or persons in a position to take corrective action”; and

WHEREAS, In August 2006, the American Psychological Association stated ___ that “psychologists shall not knowingly participate in any procedure in which torture ___ or other forms of cruel, inhuman, or degrading treatment or cruel, inhuman, or degrading punishment is used or threatened” and that “should torture or other cruel, inhuman, or degrading treatment or cruel, inhuman, or degrading punishment evolve during a procedure where a psychologist is present, the psychologist shall attempt to intervene to stop such behavior, and failing that exit the procedure”; and

WHEREAS, In June 2005, the House of Delegates of the American Nurses Association issued a resolution stating all of the following: “prisoners and detainees have the right to health care and humane treatment”; “registered nurses shall not voluntarily participate in any deliberate infliction of physical or mental suffering”; “registered nurses who have knowledge of ill- treatment of any individuals including detainees and prisoners must take appropriate action to safeguard the rights of that individual”; “the American Nurses Association shall condemn interrogation procedures that are harmful to mental and physical health”; “the American Nurses Association shall advocate for nondiscriminatory access to health care for wounded military and paramilitary personnel and prisoners of war”; and “the American Nurses Association shall counsel and support nurses who speak out about acts of torture and abuse”; and

WHEREAS, In March 2005, the California Medical Association stated that it “condemns any participation in, cooperation with, or failure to report by physicians and other health professionals the mental or physical abuse, sexual degradation, or torture of prisoners or detainees”; and

WHEREAS, In November 2004, the American Public Health Association stated that it “condemns any participation in, cooperation with, or failure to report by health professionals the mental or physical abuse, sexual degradation, or torture of prisoners or detainees:’ that it “urges health professionals to report abuse or torture of prisoners and detainees;’ and that it “supports the rights of health workers to be protected from retribution for refusing to participate or cooperate in abuse or torture in military settings”; and

WHEREAS, The United States military medical system in Guantanamo Bay, Afghanistan, Iraq, and other United States operated foreign military prisons failed to protect detainees’ rights to medical treatment, failed to prevent disclosure of confidential medical information to interrogators and others, failed to promptly report injuries or deaths caused by beatings, failed to report acts of psychological and sexual degradation, and sometimes collaborated with abusive interrogators and guards; and

WHEREAS, Current United States Department of Defense guidelines authorize the participation of certain military health personnel, especially psychologists, in the interrogation of detainees as members of “Behavioral Science Consulting Teams” in violation of professional ethics. These guidelines also permit the use of confidential clinical information from medical records to aid in interrogations and

WHEREAS, Evidence in the public record indicates that military psychologists participated in the design and implementation of psychologically abusive interrogation methods used at Guantanamo Bay, in Iraq, and elsewhere, including sleep deprivation, long-term isolation, sexual and cultural humiliation, forced nudity, induced hypothermia and other temperature extremes, stress positions, sensory bombardment, manipulation of phobias, force-feeding hunger strikers, and more; and

WHEREAS, Published reports indicate that the so-called “enhanced interrogation methods” of the Central Intelligence Agency reportedly include similar abusive methods and that agency psychologists may have assisted in their development; and

WHEREAS, Medical and psychological studies and clinical experience show that these abuses can cause severe or serious mental pain and suffering in their victims, and therefore may violate the “torture” and “cruel and inhuman treatment” provisions of CAT and the United States War Crimes Act, as amended by the Military Commissions Act of 2006; and

WHEREAS, The United States Department of Defense has failed to oversee the ethical conduct of California-licensed health professionals related to torture; now, therefore, be it

Resolved by the Senate and the Assembly of the State of California, jointly, That the Legislature hereby requests all relevant California agencies, including, but not limited to, the Board of Behavioral Sciences, the Dental Board of California, the Medical Board of California, the Osteopathic Medical Board of California, the California State Board of Pharmacy, the Physician Assistant Committee of the Medical Board of California, the California Board of Pediatric Medicine, the Board of vocational Nursing and Psychiatric Technicians, the Board of Psychology, and the Board of Registered Nursing, to notify California-licensed health professionals via newsletter, email, and Web site about their professional obligations under international law, specifically Common Article HI of the Geneva Conventions, the Convention against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment, and the amended War Crimes Act, which prohibit the torture of and the cruel, inhuman, and degrading treatment or punishment of detainees in United States custody; and be it further __

Resolved, That the Legislature hereby requests all relevant California agencies ___ to notify health professionals licensed in California that those who participate in torture and other forms of cruel, inhuman, or degrading treatment or punishment may one day be subject to prosecution; and be it further

Resolved. That the Legislature hereby requests the United States Department of Defense and the Central Intelligence Agency to remove all California-licensed health professionals, including, but not limited to, physicians and psychologists, from participating in any way in prisoner and detainee interrogations, in view of their respective ethical obligations, the record of abusive interrogation practices, and the Legislature’s interest in protecting California health professionals from the risk of criminal liability; and be it further

Resolved, That the Secretary of the Senate transmit copies of this resolution to the United States Department of Defense, the Central Intelligence Agency, and all relevant California agencies, including, but not limited to, the Board of Behavioral Sciences, the Dental Board of California. the Medical Board of California, the Osteopathic Medical Board of California, the California State Board of Pharmacy, the Physician Assistant Committee of the Medical Board of California, the California Board of Pediatric Medicine, the Board of Vocational Nursing and Psychiatric Technicians, the Board of Psychology, and the Board of Registered Nursing.

The American Psychological Association is working to weaken this bill to meaninglessness. It is up to concerned health providers in California to organize to see that doesn’t happen.

3 comments January 10th, 2008

Bush admin bureacrats foster hhospital infections

Revere at Effect Measure on the bureaucrats at the federal Office for Human Research Protections working to shut down a simple checklist that reduced a type of hospital-induced infections by 2/3. Another Bush administration nightmare of incompetence:

Who will protect us from our protectors?

I guess there are a lot of things in the newspapers that leave you shaking your head, but a recent Op Ed by surgeon Atul Gawande left both Mrs. R. and me shaking our heads simultaneously, accompanied by jaws headed south and and eyes bulging. Quite a visual, I admit. But consider the source. I’ll let Gawande describe it:

“In Bethesda, Md., in a squat building off a suburban parkway, sits a small federal agency called the Office for Human Research Protections. Its aim is to protect people. But lately you have to wonder. Consider this recent case.A year ago, researchers at Johns Hopkins University published the results of a program that instituted in nearly every intensive care unit in Michigan a simple five-step checklist designed to prevent certain hospital infections. It reminds doctors to make sure, for example, that before putting large intravenous lines into patients, they actually wash their hands and don a sterile gown and gloves.

The results were stunning. Within three months, the rate of bloodstream infections from these I.V. lines fell by two-thirds. The average I.C.U. cut its infection rate from 4 percent to zero. Over 18 months, the program saved more than 1,500 lives and nearly $200 million.

Yet this past month, the Office for Human Research Protections shut the program down. The agency issued notice to the researchers and the Michigan Health and Hospital Association that, by introducing a checklist and tracking the results without written, informed consent from each patient and health-care provider, they had violated scientific ethics regulations. Johns Hopkins had to halt not only the program in Michigan but also its plans to extend it to hospitals in New Jersey and Rhode Island.” (New York Times; hat tip GH)

Two thoughts about this occur to me. Well, maybe three. Thought number one. These guys are the counterpart to “Corporate Legal.” Interpret everything in the most conservative possible manner. In this case, that the checklist is an alteration in the usual standard of medical care and collecting information on it is research, research that might put doctors at risk by showing they weren’t doing the right thing. the second thought is that they saw themselves as protecting doctors against predatory trial lawyers. The third is probably closest to the truth: another example of colossally incompetent bozos at the wheel of a Bush federal agency, driving it off the road and killing by-standers.

I’m not a lawyer basher or a federal agency basher. We need lawyers. They preserve our legal rights and represent us in an extremely complicated system. We need federal agencies, too. Research subjects need to be protected. But we also need to be protected from lawyers and agencies with no common sense or worse, no intention of using their abilities and authority for the public good.

Concerning the main point, damage done specifically by a complex and chaotic medical care system is increasing as pressure on everyone in it increases. Much of this damage is avoidable, caused by inappropriate human actions if not error. Human error is hard to prevent completely, but you can minimize it by training and by routinizing critical tasks. Checklists are an important tool for accomplishing this. Evaluating a checklist’s efficacy should be encouraged, not punished. If they had just put up a checklist without evaluating it, presumably this wouldn’t have been a problem.

So I’ve got a checklist item to pin to the wall of everyone who works at the Office for Human Research Protections:

Step One: Remove head from up your ass.

Feel free to evaluate it at your leisure. Which I hope you’ll have a lot of when the nightmare of this administration is finally over (385 days, 23 hours, 21 minutes and 43 seconds at the instant of finishing writing this post).

1 comment January 1st, 2008

NYT explains why CIA torture tapes created

The New York Times today provides further explanation of the reasons the CIA torture tapes were created and the debate regarding their destruction. In the article are little tidbits, including that psychologists viewed the tapes:

“You couldn’t have more than one or two analysts in the room,” said A. B. Krongard, the C.I.A.’s No. 3 official at the time the interrogations were taped. “You want people with spectacular language skills to watch the tapes. You want your top Al Qaeda experts to watch the tapes. You want psychologists to watch the tapes. You want interrogators in training to watch the tapes.”

Also, doctors were viewing them:

The tapes might visually identify as many as five or six people present for each interrogation — interrogators themselves, whom the agency now prefers to call “debriefers”; doctors or doctor’s assistants who monitored the prisoner’s medical state; and security officers, the official said.

Here is the whole article:

Tapes by C.I.A. Lived and Died to Save Image

by Scott Shane & Mark Mazzetti

If Abu Zubaydah, a senior operative of Al Qaeda, died in American hands, Central Intelligence Agency officers pursuing the terrorist group knew that much of the world would believe they had killed him.

So in the spring of 2002, even as the intelligence officers flew in a surgeon from Johns Hopkins Hospital to treat Abu Zubaydah, who had been shot three times during his capture in Pakistan, they set up video cameras to record his every moment: asleep in his cell, having his bandages changed, being interrogated.

In fact, current and former intelligence officials say, the agency’s every action in the prolonged drama of the interrogation videotapes was prompted in part by worry about how its conduct might be perceived — by Congress, by prosecutors, by the American public and by Muslims worldwide.

That worry drove the decision to begin taping interrogations — and to stop taping just months later, after the treatment of prisoners began to include waterboarding. And it fueled the nearly three-year campaign by the agency’s clandestine service for permission to destroy the tapes, culminating in a November 2005 destruction order from the service’s director, Jose A. Rodriguez Jr.

Now, the disclosure of the tapes and their destruction in 2005 have become just the public spectacle the agency had sought to avoid. To the already fierce controversy over whether the Bush administration authorized torture has been added the specter of a cover-up.

The Justice Department, the C.I.A.’s inspector general and Congress are investigating whether any official lied about the tapes or broke the law by destroying them. Still in dispute is whether any White House official encouraged their destruction and whether the C.I.A. deliberately hid them from the national Sept. 11 commission.

But interviews with two dozen current and former officials, most of whom would speak about the classified program only on the condition of anonymity, revealed new details about why the tapes were made and then eliminated. Their accounts show how political and legal considerations competed with intelligence concerns in the handling of the tapes.

The discussion about the tapes took place in Congressional briefings and secret deliberations among top White House lawyers, including a meeting in May 2004 just days after photographs of abuse at Abu Ghraib prison in Iraq had reminded the administration of the power of such images. The debate stretched over the tenure of two C.I.A. chiefs and became entangled in a feud between the agency’s top lawyers and its inspector general. The tapes documented a program so closely guarded that President Bush himself had agreed with the advice of intelligence officials that he not be told the locations of the secret C.I.A. prisons. Had there been no political or security considerations, videotaping every interrogation and preserving the tapes would make sense, according to several intelligence officials.

“You couldn’t have more than one or two analysts in the room,” said A. B. Krongard, the C.I.A.’s No. 3 official at the time the interrogations were taped. “You want people with spectacular language skills to watch the tapes. You want your top Al Qaeda experts to watch the tapes. You want psychologists to watch the tapes. You want interrogators in training to watch the tapes.”

Given such advantages, why was the taping stopped by the end of 2002, less than a year after it started?

“By that time,” Mr. Krongard said, “paranoia was setting in.”

The Decision to Tape

By several accounts, the decision to begin taping Abu Zubaydah and another detainee suspected of being a Qaeda operative, Abd al-Rahim al-Nashiri, was made in the field, with several goals in mind.

First, there was Abu Zubaydah’s precarious condition. “There was concern that we needed to have this all documented in case he should expire from his injuries,” recalled one former intelligence official.

Just as important was the fact that for many years the C.I.A. had rarely conducted even standard interrogations, let alone ones involving physical pressure, so officials wanted to track closely the use of legally fraught interrogation methods. And there was interest in capturing all the information to be gleaned from a rare resource — direct testimony from those who had attacked the United States.

But just months later, the taping was stopped. Some field officers had never liked the idea. “If you’re a case officer, the last thing you want is someone in Washington second-guessing everything you did,” said one former agency veteran.

More significant, interrogations of Abu Zubaydah had gotten rougher, with each new tactic approved by cable from headquarters. American officials have said that Abu Zubaydah was the first Qaeda prisoner to be waterboarded, a procedure during which water is poured over the prisoner’s mouth and nose to create a feeling of drowning. Officials said they felt they could not risk a public leak of a videotape showing Americans giving such harsh treatment to bound prisoners.

Heightening the worries about the tapes was word of the first deaths of prisoners in American custody. In November 2002, an Afghan man froze to death overnight while chained in a cell at a C.I.A. site in Afghanistan, north of Kabul, the capital. Two more prisoners died in December 2002 in American military custody at Bagram Air Base in Afghanistan.

By late 2002, interrogators were recycling videotapes, preserving only two days of tapes before recording over them, one C.I.A. officer said. Finally, senior agency officials decided that written summaries of prisoners’ answers would suffice.

Still, that decision left hundreds of hours of videotape of the two Qaeda figures locked in an overseas safe.

Clandestine service officers who had overseen the interrogations began pushing hard to destroy the tapes. But George J. Tenet, then the director of central intelligence, was wary, in part because the agency’s top lawyer, Scott W. Muller, advised against it, current and former officials said.

Yet agency officials decided to float the idea of eliminating the tapes on Capitol Hill, hoping for political cover. In February 2003, Mr. Muller told members of the House and Senate oversight committees about the C.I.A’s interest in destroying the tapes for security reasons.

But both Porter J. Goss, then a Republican congressman from Florida and the chairman of the House Intelligence Committee, and Representative Jane Harman of California, the ranking Democrat, thought destroying the tapes would be legally and politically risky. C.I.A. officials did not press the matter.

The Detention Program

Scrutiny of the C.I.A.’s secret detention program kept building. Later in 2003, the agency’s inspector general, John L. Helgerson, began investigating the program, and some insiders believed the inquiry might end with criminal charges for abusive interrogations.

Mr. Helgerson — now conducting the videotapes review with the Justice Department — had already rankled covert officers with an investigation into the 2001 shooting down of a missionary plane by Peruvian military officers advised by the C.I.A. The investigation set off widespread concern within the clandestine branch that a day of reckoning could be coming for officers involved in the agency’s secret prison program. The Peru investigation often pitted Mr. Helgerson against Mr. Muller, who vigorously defended members of the clandestine branch and even lobbied the Justice Department to head off criminal charges in the matter, according to former intelligence officials

“Muller wanted to show the clandestine branch that he was looking out for them,” said John Radsan, who served as an assistant general counsel for the C.I.A. from 2002 to 2004. “And his aggressiveness on Peru was meant to prove to the operations people that they were protected on a lot of other programs, too.”

Mr. Helgerson completed his investigation of interrogations in April 2004, according to one person briefed on the still-secret report, which concluded that some of the C.I.A.’s techniques appeared to constitute cruel, inhuman and degrading treatment under the international Convention Against Torture. Current and former officials said the report did not explicitly state that the methods were torture.

A month later, as the administration reeled from the Abu Ghraib disclosures, Mr. Muller, the agency general counsel, met to discuss the report with three senior lawyers at the White House: Alberto R. Gonzales, the White House counsel; David S. Addington, legal adviser for Vice President Dick Cheney; and John B. Bellinger III, the top lawyer at the National Security Council.

The interrogation tapes were discussed at the meeting, and one Bush administration official said that, according to notes of the discussion, Mr. Bellinger advised the C.I.A. against destroying the tapes. The positions Mr. Gonzales and Mr. Addington took are unknown. One person familiar with the discussion said that in light of concerns raised in the inspector general’s report that agency officers could be legally liable for harsh interrogations, there was a view at the time among some administration lawyers that the tapes should be preserved.

Looking for Guidance

After Mr. Tenet and Mr. Muller left the C.I.A. in mid-2004, Mr. Rodriguez and other officials from the clandestine branch decided again to take up the tapes with the new chief at Langley, Mr. Goss, the former congressman.

Mr. Rodriguez had taken over the clandestine directorate in late 2004, and colleagues say Mr. Goss repeatedly emphasized to Mr. Rodriguez that he was expected to run operations without clearing every decision with superiors.

During a meeting in Mr. Goss’s office with Mr. Rodriguez, John A. Rizzo, who by then had replaced Mr. Muller as the agency’s top lawyer, told the new C.I.A. director that the clandestine branch wanted a firm decision about what to do with the tapes.

According to two people close to Mr. Goss, he advised against destroying the tapes, as he had in Congress, and told Mr. Rizzo and Mr. Rodriguez that he thought the tapes should be preserved at the overseas location. Apparently he did not explicitly prohibit the tapes’ destruction.

Yet in November 2005, Congress already was moving to outlaw “cruel, inhuman and degrading” treatment of prisoners, and The Washington Post reported that some C.I.A. prisoners were being held in Eastern Europe. As the agency scrambled to move the prisoners to new locations, Mr. Rodriguez and his aides decided to use their own authority to destroy the tapes, officials said.

One official who has spoken with Mr. Rodriguez said Mr. Rodriguez and his aides were concerned about protection of the C.I.A. officers on the tapes, from Al Qaeda, as the C.I.A. has stated, and from political pressure.

The tapes might visually identify as many as five or six people present for each interrogation — interrogators themselves, whom the agency now prefers to call “debriefers”; doctors or doctor’s assistants who monitored the prisoner’s medical state; and security officers, the official said. Some traveled regularly in and out of areas where Al Qaeda and other Islamist extremists are active, he said.

Apart from concerns about physical safety in the event of a leak, the official said, there was concern for the careers of officers shown on the tapes. “We didn’t want them to become political scapegoats,” he said.

According to several current and former officials, lawyers in the agency’s clandestine branch gave Mr. Rodriguez written guidance that he had the authority to destroy the tapes and that such a move would not be illegal.

One day in November 2005, Mr. Rodriguez sent a cable ordering the destruction of the recordings. Soon afterward, he notified both Mr. Goss and Mr. Rizzo, taking full responsibility for the decision.

Former intelligence officials said that Mr. Goss was unhappy about the news, in part because it was further evidence that as the C.I.A. director he was so weakened that his subordinates would directly reject his advice. Yet it appears that Mr. Rodriguez was never reprimanded. Nor is there evidence that Mr. Goss promptly notified Congress that the tapes were gone.

The investigations over the tapes frustrate some C.I.A. veterans, who say they believe that the agency is being unfairly blamed for policies of coercive interrogation approved at the top of the Bush administration and by some Congressional leaders. Intelligence officers are divided over the use of such methods as waterboarding. Some say the methods helped get information that prevented terrorist attacks. Others, like John C. Gannon, a former C.I.A. deputy director, say it was a tragic mistake for the administration to approve such methods.

Mr. Gannon said he thought the tapes became such an issue because they would have settled the legal debate over the harsh methods.

“To a spectator it would look like torture,” he said. “And torture is wrong.”

1 comment December 30th, 2007

Law & Order SVU on doctors and US torture

Crooks & Liars has the clip from October’s episode of Law & Order SVU on a US doctor’s torture in Iraq. I wish I could embed, but go watch it here.  It is extremely moving.

Add comment November 19th, 2007

AMA ducks torture issue

We in the American Psychological Association are fond of pointing to the, in many ways superior policy statement on participation in interrogations of the American Medical Association. Bioethicist Steven Miles sends this note reminding us that the APA has avoided giving teeth to their policy:

The AMA continues to give the scandal of medical complicity in torture the silent treatment. The below resolution proposed came to the AMA house of Delegates this weeks. The AMA’s Committee on Constitution & Bylaws recommended that it not be adopted:

“Guidelines concerning physicians as members of Behavioral Science Consultant Teams, as well as their duties towards detained individuals, are already addressed by Department of Defense polices and federal law.”

The resolution did not even get a floor vote.

Steve Miles

*********************************************
AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES

Resolution: 2

(I-07)

Introduced by: Michigan Delegation

Subject: Physicians’ Duty to Report Torture

Referred to: Reference Committee on Amendments to Constitution and Bylaws

(Jane C.K. Fitch, MD, Chair)

Whereas, The Geneva Convention prohibits the torture of prisoners and requires the reporting of torture; and

Whereas, Adherence to the Geneva Convention is required by armed service regulations; and

Whereas, The codes of ethics of the World Health Organization and the AMA prohibit any physician involvement in torture; and

Whereas, The Michigan State Medical Society Committee on Bioethics believes that the vast majority of physicians serving in the US military serve with an extremely high degree of ethics and professionalism, such that any deviation from these standards of ethics, among a few medical personnel, would constitute a serious and deplorable breach of these high standards and unfairly tarnish the reputation of other military physicians; and

Whereas, Previous, known military inquiries into detainee abuse in Iraq, Afghanistan and Guantanamo Bay have implicated some medical personnel but have not looked specifically at the role of medical personnel in these practices; and

Whereas, Those charged with teaching ethics to future physicians are handicapped in discussing the ethical standards expected of military physicians when they are unable to learn specific examples of both ethically exemplary and ethically questionable behavior under difficult wartime conditions; therefore be it

RESOLVED, That our American Medical Association ask the US Congress to conduct an investigation sufficient to assure that the US military is currently or has recently investigated the medical issues related to alleged detainee abuses, and the involvement or noninvolvement of medical personnel in such activities, especially that:

a. physicians are not being used as members of the Behavioral Science Consultation Teams (BSCTs) advising detainee interrogation procedures and

b. all detained individuals are treated according to the same standards of care expected for US military personnel in the theater (Directive to Take Action); and be it further

RESOLVED, That our AMA ask the US Congress to investigate that bodies currently involved in training military physicians are addressing the ethical codes and principles pertinent to the prevention of abuse of detainees, including where appropriate real examples drawn from recent events in Iraq, Afghanistan and Guantanamo Bay. (Directive to Take Action)

Fiscal Note: Estimated cost of $9,823 to communicate with Congress through letters, meetings and other mechanisms.

Received: 09/26/07

1 comment November 13th, 2007

Avian flu and public health’s Maginot Line

I haven’t mentioned avian influenza for a long time. But that doesn’t mean that the threat is gone. As Revere points out at Effect Measure, the threat is the same it always was. As in all things human, it’s a matter of probabilities ad possibilities, never certainties. Revere today points out that the appropriate public health response our government should be taking would be good for all of us:

Public health’s Maginot Line

Influenza A/H5N1 (bird flu) bubbles away this year much as in past years and public health professionals continue to wait with bated breath for the other shoe to drop. It could happen this year, next year or not at all. That’s the way the world is. Betting on “not at all” isn’t considered prudent by most people in public health, despite the fact that it’s possible. So given the uncertainty, what is the best strategy?

It is a bit disconcerting to see that the overwhelming preponderance of resources to pandemic preparedness resources are going into influenza-specific counter-measures, particularly vaccines and antivirals. If a pandemic doesn’t materialize not all of it is wasted. The boost that the threat of a pandemic has given to vaccine technology is real and significant and will pay off in the long run for diseases other than influenza for which vaccination is a reasonable preventive. So that’s good. Antivirals are more narrowly specific to influenza. Both are narrowly conceived, however, and are framed in terms of an uncertain event. But they are not the only reasonable response, nor even the ones where, if we were gaming out the possibilities, the likelihood of biggest pay-off would come. What are we suggesting?

In our view the biggest benefit comes with investment in public services which strengthen the community’s response to health threats of all kinds. Investment in routine public health — vital data and surveillance, substance abuse, elder care, maternal and child health, infectious disease control, human resources, social service support for the ill in the community and all the rest of it — is the place where we would put most of the money. If national planners are reluctant to give up the “magic bullet” approach of vaccines and antivirals then we are talking about additional investment. Given that every dollar invested in infrastructure is almost certain to pay off in multiple dollars of saved expense, we can afford this. And if a pandemic does come, it will pay off handsomely there, too. Vaccines and antivirals still depend upon the public health system. They don’t work at a distance.

We’ve been saying this for three years. It is not a change in attitude occasioned by a new threat assessment. On the contrary, our threat assessment has not changed at all. Only the virus changes. Whether the viral changes we are seeing is bringing us closer to a pandemic, farther away from one or are neutral in that regard we don’t know. So we have to respond in the most rational way.

The strategy of vaccines and antivirals appears to us a public health Maginot Line. Effective if the enemy comes that way. But if it goe

Add comment November 9th, 2007

Democracy Now!: More Health Care Professionals Involved In Design, Structuring of Torture Than in Providing Care for Survivors

Sometimes, with all I’m involved in, I never get around to posting something I’m intending to post. So, belatedly, here is a September 28 Democracy Now! interview with Doug Johnson of the Center for Victims of Torture and bioethicist Steven Miles. The chilling title makes clear the central importance of fighting health provider, including psychologist, collaboration with the torturers wherever it occurs, including in US detention centers and “black sites”:

More Health Care Professionals Involved In Design, Structuring of Torture Than in Providing Care for Survivors
Friday, September 28th, 2007

“In today’s world there are more health care professionals involved in the design and structuring of torture than there are involved in providing care for survivors,” said Douglas Johnson, executive director of the Center for Victims of Torture in Minneapolis. We also speak with professor Steven Miles, author of “Oath Betrayed: Torture, Medical Complicity, and the War on Terror.” [includes rush transcript]


As we broadcast from Twin Cities Public Television in St. Paul, Minnesota, we turn now to the issue of torture. Minneapolis is the home of the Center for Victims of Torture of Torture - an organization that works to heal the wounds of torture on individuals, their families and their communities and to stop torture worldwide.

Today, we are joined by the center’s executive director Douglas Johnson. Doctor Steven Miles is also with us. He is a professor of medicine at the University of Minnesota Medical School and a faculty member of its Center for Bioethics. He is the author of the book “Oath Betrayed: Torture, Medical Complicity, and the War on Terror.”

But before we turn to our guests, we play an excerpt from Wednesday’s Democratic debate at Dartmouth College. It aired on MSNBC and was moderated by Tim Russert.

  • Excerpt of Democratic debate on issue of torture.
  • Dr. Steven Miles, author of “Oath Betrayed: Torture, Medical Complicity, and the War on Terror.” He is a professor of medicine at the University of Minnesota Medical School and a faculty member of its Center for Bioethics. He is also a practicing physician.
  • Douglas Johnson, executive director of the Center for Victims of Torture and the past president of the National Consortium of Torture Treatment Programs.

AMY GOODMAN: We turn now to the issue of torture. Minneapolis is the home of the Center for Victims of Torture, an organization that works to heal the wounds of torture on individuals, their families, their communities, and to stop torture worldwide.We’re joined by the center’s executive director, Douglas Johnson. Doctor Steven Miles is also with us. He’s a professor of medicine at the University of Minnesota Medical School and a faculty member of its Center for Bioethics. He is the author of the book Oath Betrayed: Torture, Medical Complicity, and the War on Terror.

But before we go to our guests, I want to play an excerpt from Wednesday’s Democratic debate at Dartmouth College. It aired on MSNBC and was moderated by Tim Russert.

    TIM RUSSERT: I want to move to another subject, and this involves a comment that a guest on Meet the Press made, and I want to read it as follows: “Imagine the following scenario. We get lucky. We get the number three guy in al-Qaeda. We know there’s a big bomb going off in America in three days, and we know this guy knows where it is. Don’t we have the right and responsibility to beat it out of him? You could set up a law where the president could make a finding or could guarantee a pardon.” President Obama, would you do that as president?

    SEN. BARACK OBAMA: America cannot sanction torture. It’s a very straightforward principle and one that we should abide by. Now, I will do whatever it takes to keep America safe. And there are going to be all sorts of hypotheticals in emergency situations, and I will make that judgment at that time. But what we cannot do is have the President of United States state as a matter of policy that there is a loophole or an exception where we would sanction torture. I think that diminishes us, and it sends the wrong message to the world.

    TIM RUSSERT: Senator Biden, would you allow this presidential exception?

    SEN. JOSEPH BIDEN: No, I would not. And I met up here in New Hampshire with seventeen four- — three- and four-star generals, who after my making a speech at Drake Law School pointing out I would not under any circumstances sanction torture, I thought they were about to read me the Riot Act. Seventeen of our four-star and three-star generals said, “Biden, will you make a commitment you will never use torture?” It does not work, and it’s part of the reason why we got the faulty information on Iraq in the first place, because it was engaged in by one person who gave whatever answer they thought there were going to give in order to stop being tortured. It doesn’t work. It should be no part of our policy ever. Ever.

    TIM RUSSERT: Senator Clinton, this is the number three man in al-Qaeda. We know there’s a bomb about to go off, and we have three days. And we know this guy knows where it is. Should there be a presidential exception to allow torture in that kind of situation?

    SEN. HILLARY CLINTON: You know, Tim, I agree with what Joe and Barack have said. As a matter of policy, it cannot be American policy, period. I met with those same three- and four-star retired generals, and their principal point, in addition to the values that are so important for our country to exhibit, is that there is very little evidence that it works. Now, there are a lot of other things that we need to be doing that I wish we were: better intelligence; making our, you know, our country better respected around the world; working to have more allies. But these hypotheticals are very dangerous, because they open a great big hole in what should be an attitude that our country and our president takes toward the appropriate treatment of everyone, and I think it’s dangerous to go down this path.

    TIM RUSSERT: The guest who laid out this scenario for me with that proposed solution was William Jefferson Clinton last year. So he disagrees with you.

    SEN. HILLARY CLINTON: Well, he’s not standing here right now.

    TIM RUSSERT: So there is a disagreement?

    SEN. HILLARY CLINTON: Well, I’ll talk to him later.

AMY GOODMAN: That was an excerpt from Wednesday’s Democratic presidential debate at Dartmouth College. We are joined now in St. Paul, Minnesota by Douglas Johnson of the Center for Victims of Torture and Dr. Steven Miles, author of the book Oath Betrayed: Torture, Medical Complicity, and the War on Terror.

Dr. Miles, let’s begin with you. Your response?

DR. STEVEN MILES: What Joe Biden said was that he would not ever order torture. What Ms. Clinton said was that we would never have a policy for torture, but she did not rule out the possibility of an executive order for torture in a specific circumstance. And Barack Obama was very hard to read on this matter. So the only clear statement came from Joe Biden, and I think that further clarification on this needs to be addressed.

It’s not just that there’s no evidence, but the National Intelligence University, in a huge analysis of this last year, in two thousand — well, actually, earlier this year, that there is no evidence that torture works, and furthermore that it leads subjects to provide misinformation and to become recalcitrant to cooperation with providing information that we need.

AMY GOODMAN: How did you get involved with this issue?

DR. STEVEN MILES: Well, when I saw the pictures of Abu Ghraib, I was stunned. And the question was: where was the prison medical staff? Why didn’t they blow the whistle on it? And I figured that what they’d done is that they had attempted to blow the whistle on it and that their reports had been suppressed. And what I found was that the Armed Forces Institute of Pathology was suppressing information about deaths from torture and that the medical staff, including psychiatrists and psychologists, were actually integrated into the system of devising course of interrogations.

AMY GOODMAN: And so, you wrote this book Oath Betrayed. When we were doing the Burma segment, you made an interesting comment.

DR. STEVEN MILES: Well, you take the speaker that you had. He was talking about the use of dogs, close confinement in crowded cells, meal deprivation. All of these are techniques which are currently approved against the use of prisoners that we’re holding, which, by the way, I’d point out, as in Burma, 85% in Iraq are innocent or ignorant of insurgency activity. And it is very difficult for us to say to Burma, “Don’t do these techniques,” when we have set as a matter of national policy that in national emergency, given national sovereignty, that we can embark on torture.

AMY GOODMAN: The ticking time bomb theory that Tim Russert posed?

DR. STEVEN MILES: I’ve looked at every instance of a ticking time bomb that’s been proposed in the war on terror. All of them are not what the government has said they are. In fact, basically there is never a circumstance where you know that a particular prisoner has a particular information and will yield with a particular amount of pressure. In fact, gathering intelligence is a matter of pulling information gradually from a number of sources, who you recruit through rapport building.

One of the fascinating things about the ticking time bomb scenario is that it has elicited bad information, which has sent our troops on dangerous and fatal missions, as they go and chase down wild goose chases to get bad — chasing down bad information. And furthermore, the sole source for the information that bioweapons were being developed jointly by Saddam Hussein and al-Qaeda came from a guy that we kidnapped in Sweden, took to Egypt and tortured, and that made it to the UN and was part of the authorization to go to war.

AMY GOODMAN: We have been doing extensive coverage of the debate in the American Psychological Association. They, this year, ultimately did not pass a moratorium on psychologist involvement in coercive interrogations. Can you talk more about what is going on there and the contrast with the American Medical Association and American Psychiatric Association?

DR. STEVEN MILES: Essentially, what the American Psychological Association has said is that psychologists may work with interrogators to break persons down. And it turns out that that was the specific agenda all the way from the beginning, including when military people were stacked on their interrogation policy committee.

The directive from then-President Koocher, as expressed in his emails, said as follows: the goal of such psychologists’ works will ultimately be the protection of others, innocents, by contributing to the incarceration, debilitation or even death of the potential perpetrator, who will often remain unaware of the psychologists’ involvement.

And then, a month later he said to that same American Psychological Association policy committee, “I have zero interest in entangling the American Psychological Association with nebulous, toothless, contradictory and obfuscatory treaties that comprise ‘international law.’ Rather, I prefer to see the American Psychological Association take principled stand on policy issues where psychology has some scientific basis for doing so.” Well, the irony of this is that the scientific evidence weighs against course of interrogation, and the psychologists should have put the brake on the CIA, but in fact they worked with the CIA to develop these techniques, which then spread through the Army, and it resulted in enormous damage.

AMY GOODMAN: How did you get that email of the former president of the APA, Gerald Koocher?

DR. STEVEN MILES: What happened was that there was a task force that was set up to do this. Nine out of the twelve members were related to the military; three weren’t. One, Jean Maria Arrigo, has made the email correspondence to that committee available. And this is being — currently being posted up on various websites.

AMY GOODMAN: We’ve interviewed Jean Maria Arrigo on Democracy Now!

Doug Johnson, your thoughts on this issue? You are the head of the Center for Torture Victims here in Minneapolis. It’s very unusual to have such a center. There are only a few in the United States, is that right?

DOUGLAS JOHNSON: Well, unfortunately, there are over thirty now.

AMY GOODMAN: Oh, over thirty.

DOUGLAS JOHNSON: And we all work as closely together as possible to learn from each other. And I think the experience for all of us is that we care for people who the rest of the community would consider innocent victims of torture, but all of those survivors would tell you that they would have said anything, anything at all that was wanted of them, eventually, to get the torture to stop. And so, they’ll confess, they’ll give the information that’s fed to them, because the person who most needs a confession is the torturer. Without that confession, the torturer has no justification for what they’ve done. And the only way that torture states manage the dissidence and the moral — morale and the minds of their torturers is that a confession emerges. And that’s one of the key reasons why truth doesn’t emerge from torture. Anything could emerge. Sometimes it’s a danger.

But one of the big problems of the focus on the ticking time bomb is it’s really an enormous distraction. The focus on just what’s happening in the interrogation center and the tactics of interrogation have obscured, for most of us, and especially our policymakers, what the strategic results of torture are. And one of those key strategic results is this: I spent some time with Alberto Mora, who had been the Navy legal counsel who fought against the torture policy, someone you should have on your show, when we were visiting members of the Senate Intelligence Committee, and he emphasized that the reason we have the Geneva Accords, of course, emerging from the way Allied troops were dealt with by the Nazis and the Japanese prison camps, was the notion that if a soldier knows that they will be treated humanely, when they are trapped and they have no place to go, they have at least the opportunity of surrendering, but if they know they will be treated cruelly, if they will be tortured, if they will be otherwise treated without dignity, then the total incentive for them is to fight to the last man.

And under those circumstances, and under the circumstances we now have in Iraq, when we are overpowering a group with firepower, we have given them the total incentive to fight to the last man. And that endangers American troops right now. Americans die from this policy, because we have falsely thought that the creation of fear keeps us safe, rather than endangers us.

AMY GOODMAN: How do you treat victims of torture at the center?

DOUGLAS JOHNSON: Well, we have a multidisciplinary team.

AMY GOODMAN: How many victims are there now?

DOUGLAS JOHNSON: Well, we believe there are about 30,000 just in Minnesota, at least a half a million in the United States. They’ve come from so many countries. We’ve provided care for people from almost eighty countries.

AMY GOODMAN: And how many are in your center now?

DOUGLAS JOHNSON: We only have the capacity for about 300 a year, which means we have a hundred years of work sitting in the state right now. So one of our key roles is to be the learning center, to learn the impact of torture and what we do about it, and try and engage the broader mainstream healthcare program to do what ought to be done in the healthcare system. That’s an enormous struggle.

So, in addition to our care, we have major programs with as many resources as we could put together to train mainstream survivors. We also have a contract to provide the technical assistance to the other centers in the US, and we work with seventeen centers in parts of the world where torture is used to try and reinforce them and really broaden the capacity in the world to work with people.

AMY GOODMAN: I think when a lot of people think torture, they think other countries. In our headlines, we read the story of what’s happening in Chicago and the exposes around one of the top police for years, Jon Burge, and his torture victims. What is your response to that?

DOUGLAS JOHNSON: Well, our friends at the Kovler Center in Chicago have been engaged in this case, and one advantage of the treatment centers is also to be able to begin to develop forensic evidence in these kinds of cases. So our colleagues in the human rights community have been really the impetus behind this investigation.

Torture occurs everywhere, and including the United States. What has distinguished us, for the most part, is that in the US, when it does occur, we have active investigations and intervention. And that this occurred over a decade in Chicago really indicates a very high level of corruption, which, I would have to say, in the world, where we see torture occurring, there is a very high correlation always with corruption.

AMY GOODMAN: Professor McCoy, who wrote the book A Question of Torture, said psychological torture is worse than physical. Is that true?

DOUGLAS JOHNSON: That was a surprise to me when I arrived at the center nineteen years ago, because, again, I had the imagination that it’s the physical. But our clients tell us that the physical, they don’t always remember. I think it’s sort of like a woman who gives birth. Why would she give birth again? There’s something about the actual pain of the event that fades. And what they tell us is that the subject of their nightmares are the psychological forms of torture, the mock executions, observing other people being tortured. But what we have seen is that the processes of psychological torture have become much, much more utilized and more highly sophisticated over the years.

AMY GOODMAN: Professor Miles?

DR. STEVEN MILES: There was a terrific study that was done of Bosnian survivors, came out last year, and what it found was that in terms of causing post-traumatic stress disorder, that physical torture, emotional torture and sexual torture, or the intensity or duration of torture were not associated with a greater or lesser likelihood of PTSD. And so, that emotional torture, such as, say, being forced to witness the rape of a loved one or a mock execution, is just as likely to cause long-term disability as physical torture.

AMY GOODMAN: What about the ones that the US military, CIA, etc., have engaged in, like isolation, sleep deprivation, sensory deprivation?

DR. STEVEN MILES: The means that we have used basically resemble those used by all other countries, with the single exception that we have not used mutilation — that is, cutting off hands or ears, which have been done in some countries. But in terms of the range of physical abuses, from electrical, thermal, hypothermic, beating and various forms of emotional trauma, they look exactly like other countries.

AMY GOODMAN: What do you think of the APA debate, what’s been going on, why the APA hasn’t passed a moratorium?

DR. STEVEN MILES: Well, I can’t really speculate on why. There is a fair amount of speculation, but I think it’s just that. Certainly, when the psychiatrists said that we will not participate in this, they got blown off of these interrogation panels. The APA current position is essentially dovetailed to continue substantial involvement with the Central Intelligence Agency. And furthermore, they very specifically stated that physicians — or psychologists could work in secret prisons with an option of leaving if they wanted, but not with an obligation to call attention to the abuses within secret prisons. And so, the APA policy is fundamentally designed to work with a secret prison system, which is the worst form of danger to prisoners.

AMY GOODMAN: Doug Johnson.

DOUGLAS JOHNSON: I think it’s important to understand — and this is an example of it — that currently in today’s world there are more healthcare professionals involved in the design and structuring of torture than there are those who are involved in providing care for survivors.

AMY GOODMAN: Say that again.

DOUGLAS JOHNSON: There are more healthcare people involved in the design and the instrumentation of torture than there are involved in providing healing for the survivors.

AMY GOODMAN: In this country.

DR. STEVEN MILES: No, around the world.

DOUGLAS JOHNSON: In the world.

AMY GOODMAN: Around the world.

DOUGLAS JOHNSON: In the world. And it is, in many times, because healthcare people get engaged and confused by the same ticking time bomb theories that fuel 24 and other fantasy programs, which have unfortunately seem to be the basis of learning for many of our policymakers. It’s fantasy-driven, and it causes people to do stupid things.

AMY GOODMAN: Dr. Miles?

DR. STEVEN MILES: About 130 countries torture, but of the survivors, somewhere between 20% and 50% report seeing a health professional directly involved in supervising the torture. And that doesn’t count the ones who never see the physician who falsely certifies the cause of death as natural causes. So it’s actually around 40% of survivors actually see the health practitioner involved in the torture. And, you know, as Doug said, about 1% of the torture victims in Minnesota are actually getting treatment.

AMY GOODMAN: And finally, Doug Johnson, your view of the whole controversy within the American Psychological Association? And have you taken a stance on this, your center?

DOUGLAS JOHNSON: Well, we see ourselves as a technical and professional organization, and we try and feed people the information that comes from our work. I have to say, though, that in my view there’s a strong parallel here with what happened in Uruguay at the height of the repression in Uruguay. And here, you had really a struggle between two groups of psychologists. The dominant group in Uruguay were psychoanalytic; the emerging group were behavioralists, and they were second-class citizens in the psychological world. Therefore, they allied themselves with the military in designing systems of torture, of designing the whole structure of what was called Libertad prison, so that it became an ongoing instrument of torment and disruption and psychological dissonance within the minds of the prisoners, a situation that was so bad that it was the very first report from the ICRC that was released to the public, the second only being what we know about in Guantanamo. And so, it’s hard for us not to see those parallels, that there may be a bigger struggle in the way psychology is going, and some are aligning the wrong way.

AMY GOODMAN: Well, I want to thank you both very much for joining us, Steven Miles, author of the book Oath Betrayed: Torture, Medical Complicity, and the War on Terror; and Doug Johnson, head of the center for torture victims here in St. Paul, Minneapolis. The specific name is the Center for Victims of Torture. Thank you so much.

Add comment October 14th, 2007

Blumner: Psychologists, torture and the rules

St. Petersburg Times columnist Robyn Blumner writes of the American Psychological Association’s soft spot for abusive interrogations, withe the loopholes in the 2007 APA Resolution and its total disdain for international law in deeming it ethical for psychologists to participate in interrogations in prisons that grossly defy that law:

Psychologists, torture and the rules

In Ariel Dorfman’s riveting play Death and the Maiden, a former political prisoner believes that the man who has given her husband a lift after his car breaks down was in fact her torturer 15 years earlier. But because she was blindfolded during her abusive interrogations, the audience is never as certain as she is. The victim claims to recognize her tormentor by the sound of his voice and the one thing she knows that this Good Samaritan has in common with her abuser: He is a doctor.

Doctors take a Hippocratic oath to do no deliberate harm, so it is particularly chilling when a doctor is an agent of suffering, even if he’s doing so in the service of perceived national interests.

When I initially saw this play performed years ago, I was smugly comforted by the notion that torture was a perversion indulged in by other nations, not ours. No longer, of course. The latest revelations about Justice Department memos justifying, excusing and approving highly abusive prisoner interrogations only confirm what we already knew about our Torture Nation, irrespective of President Bush’s farcical denials.

It is no longer purely academic to ask whether American medical or psychological practitioners may participate in such information eduction or whether their professions courageously stand in the way.

To its credit, the American Medical Association flatly bars medical professionals from being a part of prisoner interrogations. “Physicians must neither conduct nor directly participate in an interrogation, because a role as physician-interrogator undermines the physician’s role as healer,” states AMA policy. Another part of the policy bars doctors from monitoring interrogations as well. There is no daylight here. It is per se an unethical act.

Psychologists, however, have been far less categorical. While the American Psychological Association has had a longstanding policy that, in general terms, bars participation in torture or cruel, inhuman or degrading questioning. It wasn’t until August that the APA adopted a resolution that outlined specific interrogation techniques that were off-limits for its members.

Cruel and inhuman techniques such as waterboarding, hooding, forced nakedness, stress positions, exposure to extreme cold or heat and a variety of others that the CIA has reportedly used on detainees, were strictly prohibited under the new rules. But the organization rejected an airtight resolution that would have barred its members from participating in interrogations with any prisoner whose human rights were not adequately protected.

It also equivocated on the use of isolation or sleep deprivation, which were condemned only to the extent they caused significant suffering or lasting harm.

This cagey language left the door open for its members to continue to participate in harmful and coercive questioning.

Psychologists have been reportedly key to executing abusive interrogations within the military and the CIA. A piece by Katherine Eban of Vanity Fair, “Rorschach and Awe,” describes the way two psychologists came to mastermind the CIA’s interrogation methods. And America’s bargain with the devil.

Eban reports how James Elmer Mitchell and Bruce Jessen reverse-engineered a military training program known as SERE (Survival, Evasion, Resistance, Escape). This program was designed to help our own soldiers withstand imprisonment by an enemy that refused to abide by the Geneva Conventions, but Mitchell, who received his Ph.D. in psychology from USF, and Jessen redesigned it for use on our prisoners.

The idea behind the Mitchell-Jessen approach is to break down the detainee through isolation and other severe treatment so he has no idea whether it is day or night and can predict nothing about the future. This makes him wholly dependent upon his interrogators.

The original SERE program was based on Communist interrogation techniques. But, as Eban points out, the Communists weren’t as much interested in getting actionable intelligence from their U.S. prisoners as having our soldiers confess falsely to things that could be used for propaganda.

Jack Bauer is a fictional character. In the real world, experts say that using brutality isn’t likely to get you any better intelligence than using tried and true rapport-building techniques - methods that don’t violate civilized norms or generate rage in Muslims worldwide.

A report, “Educing Information,” sponsored by the Intelligence Science Board and put together by the nation’s top interrogation experts, says things like: “(C)oercion or pressure can actually increase a source’s resistance and determination not to comply,” among other findings suggesting abusive interrogations are counterproductive to keeping us safe.

The APA is desperately trying to distance itself from Mitchell and Jessen. It states bluntly that their methods have been “discredited by responsible psychologists everywhere, including within the military.”

But the association refuses to go the distance by telling its members that when a prisoner has been stripped of every inalienable right and the protections of the Geneva Conventions, psychologists have no business lending their expertise to the interrogations to come.

Add comment October 14th, 2007

Sicko: Michael Moore on Oprah

Michael Moore was on Oprah yesterday. They, along with a healthcare economist and an insurance industry publicist, had the deepest discussion of the healthcare that crisis that I’ve ever seen in the corporate media. You can watch it here:

Parts 2-6 after the break.




Add comment September 28th, 2007

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