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Rumsfeld used torture to “find” Iraq-al Qaeda link

There have been so many articles on aspects of the SASC report last night that I can’t find time to read them, much less, post them all. But here’s one from McClatchy, with a different angle:

Report: Abusive tactics used to seek Iraq-al Qaida link

By Jonathan S. Landay
McClatchy Newspapers

WASHINGTON — The Bush administration applied relentless pressure on interrogators to use harsh methods on detainees in part to find evidence of cooperation between al Qaida and the late Iraqi dictator Saddam Hussein’s regime, according to a former senior U.S. intelligence official and a former Army psychiatrist.

Such information would’ve provided a foundation for one of former President George W. Bush’s main arguments for invading Iraq in 2003. In fact, no evidence has ever been found of operational ties between Osama bin Laden’s terrorist network and Saddam’s regime.

The use of abusive interrogation — widely considered torture — as part of Bush’s quest for a rationale to invade Iraq came to light as the Senate issued a major report tracing the origin of the abuses and President Barack Obama opened the door to prosecuting former U.S. officials for approving them.

Former Vice President Dick Cheney and others who advocated the use of sleep deprivation, isolation and stress positions and waterboarding, which simulates drowning, insist that they were legal.

A former senior U.S. intelligence official familiar with the interrogation issue said that Cheney and former Defense Secretary Donald H. Rumsfeld demanded that the interrogators find evidence of al Qaida-Iraq collaboration.

“There were two reasons why these interrogations were so persistent, and why extreme methods were used,” the former senior intelligence official said on condition of anonymity because of the issue’s sensitivity.

“The main one is that everyone was worried about some kind of follow-up attack (after 9/11). But for most of 2002 and into 2003, Cheney and Rumsfeld, especially, were also demanding proof of the links between al Qaida and Iraq that (former Iraqi exile leader Ahmed) Chalabi and others had told them were there.”

It was during this period that CIA interrogators waterboarded two alleged top al Qaida detainees repeatedly — Abu Zubaydah at least 83 times in August 2002 and Khalid Sheik Muhammed 183 times in March 2003 — according to a newly released Justice Department document.

“There was constant pressure on the intelligence agencies and the interrogators to do whatever it took to get that information out of the detainees, especially the few high-value ones we had, and when people kept coming up empty, they were told by Cheney’s and Rumsfeld’s people to push harder,” he continued.

“Cheney’s and Rumsfeld’s people were told repeatedly, by CIA . . . and by others, that there wasn’t any reliable intelligence that pointed to operational ties between bin Laden and Saddam, and that no such ties were likely because the two were fundamentally enemies, not allies.”

Senior administration officials, however, “blew that off and kept insisting that we’d overlooked something, that the interrogators weren’t pushing hard enough, that there had to be something more we could do to get that information,” he said.

A former U.S. Army psychiatrist, Maj. Charles Burney, told Army investigators in 2006 that interrogators at the Guantanamo Bay, Cuba, detention facility were under “pressure” to produce evidence of ties between al Qaida and Iraq.

“While we were there a large part of the time we were focused on trying to establish a link between al Qaida and Iraq and we were not successful in establishing a link between al Qaida and Iraq,” Burney told staff of the Army Inspector General. “The more frustrated people got in not being able to establish that link . . . there was more and more pressure to resort to measures that might produce more immediate results.”

Excerpts from Burney’s interview appeared in a full, declassified report on a two-year investigation into detainee abuse released on Tuesday by the Senate Armed Services Committee.

Senate Armed Services Committee Chairman Carl Levin, D-Mich., called Burney’s statement “very significant.”

“I think it’s obvious that the administration was scrambling then to try to find a connection, a link (between al Qaida and Iraq),” Levin said in a conference call with reporters. “They made out links where they didn’t exist.”

Levin recalled Cheney’s assertions that a senior Iraqi intelligence officer had met Mohammad Atta, the leader of the 9/11 hijackers, in the Czech Republic capital of Prague just months before the attacks on the World Trade Center and the Pentagon.

The FBI and CIA found that no such meeting occurred.

A senior Guantanamo Bay interrogator, David Becker, told the committee that only “a couple of nebulous links” between al Qaida and Iraq were uncovered during interrogations of unidentified detainees, the report said.

Others in the interrogation operation “agreed there was pressure to produce intelligence, but did not recall pressure to identify links between Iraq and al Qaida,” the report said.

The report, the executive summary of which was released in November, found that Rumsfeld, former Secretary of State Condoleezza Rice, and other former senior Bush administration officials were responsible for the abusive interrogation techniques used at Guantanamo and in Iraq and Afghanistan.

Rumsfeld approved extreme interrogation techniques for Guantanamo in December 2002. He withdrew his authorization the following month amid protests by senior military lawyers that some techniques could amount to torture, violating U.S. and international laws.

Military interrogator, however, continued employing some techniques in Afghanistan and later in Iraq.

Bush and his top lieutenants charged that Saddam was secretly pursuing nuclear, biological and chemical weapons in defiance of a United Nations ban, and had to be overthrown because he might provide them to al Qaida for an attack on the U.S. or its allies.

ON THE WEB

Senate report, part 1

Senate report, part 2

MORE FROM MCCLATCHY

In reversal, Obama opens door to prosecuting top Bush aides

Bush-era interrogations: from waterboarding to forced nudity

Guantanamo: Beyond the Law – a McClatchy investigation

Archive of McClatchy’s Iraq intelligence reporting

April 22nd, 2009

Daily Show on torture memos

The Daily Show With Jon Stewart M – Th 11p / 10c
We Don’t Torture
thedailyshow.com
Daily Show
Full Episodes
Economic Crisis Political Humor

April 21st, 2009

Obama, Blair, and Panetta praise the moral cowards, ignore the true heroes

It turned out to be harder than I expected to find the complete texts of the statements made by President Obama, Director of National Intelligence Dennis Blair, and CIA Director Leon Panetta on Thursday as the Office of Legal Council torture memos were being released. Thanks to Spencer Ackerman, I have located them and post them here.

I must say that, reading these in their entirety, they are as chilling as the memos themselves. While the memos describe the torture program in meticulous, bureaucratic detail — including the temperature of water to be used to chill people, and the length and number of waterboarding episodes permitted per day — the statements from our President and two of his top officials heap praise upon those who were all too willing to sacrifice their morals and decency in pursuit of this horrific program.

To proclaim the torturers as heroes and to thank them for committing horrors is to spit in the face of those who suffered from this program of state-sponsored torture, not just from the CIA, but the thousands who experienced this program’s derivative programs at Guantanamo, Abu Ghraib, Bagram, and elsewhere in Iraq and Afghanistan. These statements also poke a finger in the eyes of all those human rights advocates and simply decent people who for years fought against this and related programs of state-sponsored abuse.

And, perhaps most disturbingly, to absolve and convey hero status to those who shelved their consciences is an insult to the true heroes of this sordid chapter in our history, the many men and women in our military and our government who refused to go along and protested and fought against these acts of state-sponsored horror. For the interrogators who gave up careers spanning decades out of shame over what their profession was being turned into, the JAGs who fought the development of this policy and risked scorn in defending the “worst of the worst,” the prosecutors who denounced the concealing of abuse in the highly politicized trials at Guantanamo, again at the cost of careers, and those officials like Albert Mora who took seriously their obligation to defend the Constitution are real heroes. These are the individuals who deserve the praise of our leaders and our people.

We can continue to debate what type of accountability there should be for the guards, interrogators, doctors and psychologists who implemented these policies. But they are not heroes. They are not people to be thanked. They are not people who did their best in the difficult circumstances after 911. They are at best sad human beings who went along with authority when their nation needed them to refuse, individuals without a moral compass, examples to be held up as an example to our children of what they must do their best not to become. They are no better, perhaps even worse, than the rightly scorned MPs of Abu Ghraib.

Despite the political courage it took to release these documents, the leaders who issued these statements praising the CIA agents of torture are ultimately moral cowards, afraid to tell the public what it needs to hear. They represent, not the change we need, but the stability that makes future state-sanctioned abuses all the more likely.

Obama:

To the Men and Women of CIA:

I want to take this opportunity to thank you for the work you are doing for the country. Your work has informed every President dating back to President Truman and it protects our people. I have come to rely on your service and I believe strongly that it is vital to the security of our country. Given the threats, challenges, and opportunities facing America, the CIA remains as critical today as it has ever been to our Nation’s security. While necessity requires that the country may not know all of your names or the work that you do, all of us enjoy the freedom that you have helped secure.

I also wanted to share with you a decision that I made last night. Later today, the Department of Justice will release certain memos issued by the Office of Legal Counsel between 2002 and 2005. I did not make this decision lightly. As you may know, the release is part of an ongoing court case. I have fought for the principle that the United States must carry out covert activities and hold information that is classified for the purposes of national security and will do so again in the future. But the release of these memos is required by our commitment to the rule of law.

Much of the information contained in the memos has been in the public domain, and the previous Administration has acknowledged portions of the program – and some of the practices – associated with them. My judgment on this is a matter of record. I have prohibited the use of these interrogation techniques, and I reject the false choice between our security and our ideals.

In releasing these memos, the men and women of the CIA have assurances from both myself, and from Attorney General Holder, that we will protect all who acted reasonably and relied upon legal advice from the Department of Justice that their actions were lawful. The Attorney General has assured me that these individuals will not be prosecuted and that the Government will stand by them.

The men and women of our intelligence community serve courageously on the front lines of a dangerous world. Their accomplishments are unsung and their names unknown, but because of their sacrifices, every single American is safer. They need to be fully confident that as they defend the Nation, I will defend them. We will protect their identities as vigilantly as they protect our security.

This is a time for reflection, not retribution. We have been through a dark and painful chapter in our history. But at a time of great challenges and disturbing disunity, nothing will be gained by spending our time and energy laying blame for the past. The national greatness that you so courageously and capably uphold is embedded in America’s ability to right its course in concert with our core values, and to move forward with confidence.

It is a core American value that we are a Nation of laws, and the CIA protects and upholds that principle under extraordinarily difficult circumstances every day. My Administration will always act in accordance with the law, and with an unshakeable commitment to our ideals. That is why we have released these memos, and that is why we have taken steps to ensure that the actions described within them never take place again.

Thank you for your service, and God bless the work that you do.

Barack Obama

Blair:

Sincerely,

The Department of Justice released today four previous Office of Legal Counsel opinions which concluded certain harsh interrogation techniques used by CIA officers on suspected al Qa’ida terrorists were legal. The opinions spell out in graphic detail techniques used in questioning high value detainees suspected of involvement in, and plans for, terrorist activity against the United States and its allies.

As the leader of the Intelligence Community, I am trying to put these issues into perspective. We cannot undo the events of the past; we must understand them and use this understanding as we move into the future.

It is important to remember the context of these past events. All of us remember the horror of 9/11. For months afterwards we did not have a clear understanding of the enemy we were dealing with, and our every effort was focused on preventing further attacks that would kill more Americans. It was during these months that the CIA was struggling to obtain critical information from captured al Qa’ida leaders, and requested permission to use harsher interrogation methods. The OLC memos make clear that senior legal officials judged the harsher methods to be legal.

Those methods, read on a bright, sunny, safe day in April 2009, appear graphic and disturbing. As the President has made clear, and as both CIA Director Panetta and I have stated, we will not use those techniques in the future. But we will absolutely defend those who relied on these memos and those guidelines.

As a young Navy officer during the Vietnam years, I experienced public scorn for those of us who served in the Armed Forces during an unpopular war. Challenging and debating the wisdom and policies linked to wars and warfighting is important and legitimate; however disrespect for those who serve honorably within legal guidelines is not. I remember well the pain of those of us who served our country even when the policies we were carrying out were unpopular or could be second-guessed.

We in the Intelligence Community should not be subjected to similar pain. Let the debate focus on the law and our national security. Let us be thankful that we have public servants who seek to do the difficult work of protecting our country under the explicit assurance that their actions are both necessary and legal.

There will almost certainly be more public attention about the actions of intelligence agencies in the past. What we must do is make it absolutely clear to the American people that our ethos is to act legally, in as transparent a manner as we can, and in a way that they would be proud of if we could tell them the full story.

Panetta:

This afternoon, the Department of Justice is releasing a series of opinions that its Office of Legal Counsel provided CIA between 2002 and 2005. They guided CIA’s detention and interrogation program, which ended this past January. Over the life of that initiative, CIA repeatedly sought and repeatedly received written assurances from the Department of Justice that its practices were fully consistent with the laws and legal obligations of the United States. Those operations were also approved by the President and the National Security Council principals, and were briefed to the Congressional leadership.

As this information is revealed, it is important to understand the context in which these operations occurred. In the wake of September 11th, the President turned to CIA—as Presidents have done so often in our history—and entrusted our officers with the most critical of tasks: to disrupt the terrorist network that struck our country and prevent further attacks. CIA responded, as duty requires.

Although this Administration has now put into place new policies that CIA is implementing, the fact remains that CIA’s detention and interrogation effort was authorized and approved by our government. For that reason, as I have continued to make clear, I will strongly oppose any effort to investigate or punish those who followed the guidance of the Department of Justice.

The President and the Attorney General have also made clear that there will be no investigation or prosecution of CIA personnel who operated within the legal system. In addition, the Department will provide legal representation to CIA personnel subject to investigations relating to these operations.

This is not the end of the road on these issues. More requests will come—from the public, from Congress, and the Courts—and more information is sure to be released. We cannot control the debate about the past. But we can and must remain focused on our mission today and in the future. The President and the rest of our citizens are counting on all of us to help disrupt, destroy, and dismantle al Qa’ida—and to learn the plans of our other adversaries. We have an obligation to this nation and to each other to do all we can to protect America.

This is an exceptional organization of talented men and women, dedicated to our national security. It is an extraordinarily capable organization that quietly defends our country while following its laws and upholding its values. For that reason, I am proud to stand beside you as your Director. And for that reason, this President—and future Presidents—will continue to ask us to undertake the hard missions that only we can. This is an opportunity for CIA to begin a new and great chapter in our history of service to the nation.

You need to be fully confident that as you defend the nation, I will defend you.

Leon E. Panetta

April 20th, 2009

Rahm Emanuel says Obama against prosecutions of those who devised torture policy

Since the OLC memos were released, some have taken comfort in the fact that President Obama’s statement only spoke against prosecution of CIA operatives who relied, in good faith, on the memos. This left open the possibility of prosecution of the Bush officials who planned the torture and the lawyers who devised the spurious legal theories.

Valtin now points out:

This morning on “This Week with George Stephanopoulos”, Obama’s chief of staff, Rahm Emanuel, said the White House did not support prosecuting — not only CIA officers who tortured, believing in “good faith” what they were doing was legal — but would also not support the prosecution of “those who devised the [interrogations/torture] policy.”

The video can be watched here. The elevant section begins with about 3:30 remaining.

The President is now officially committed to a policy of legal exceptionalism, that US leaders who design and order war crimes such as torture should be immune. Since the Convention against Torture requires signatory countries to investigate torture, President Obama is now engaged in an obstruction of justice.

Please go to http://www.whitehouse.gov/contact/ and let them know what you think of this Profile in Cowardice.

1 comment April 19th, 2009

Hari: Want the good life, create quality

Johann Hari argues that societies with greater equality have better quality of life. As an added bonus, they are more likely to survive the disruptions resulting from climate change:

From Now on, Equality Needs to Be Our Organizing Principle

By Johann Hari

In the smoking rubble of market fundamentalism, we are all being forced to rethink the principles that order our societies – and one small, shining idea is rising from the wreckage. It is the idea of human equality.

The need for us to return to this, our best and most basic instinct, is spelled out in a new book by Professor Richard Wilkinson and Dr. Kate Pickett called ‘The Spirit Level: Why More Equal Societies Almost Always Do Better.’ It is the culmination of twenty-five years of scientific research. The truths it contains provide us with a compass to rebuild our societies – and a reason to be profoundly optimistic. There is a way we can make our societies dramatically better – and the impulse to do it is hard-wired into each of our brains.

It starts with a stark realization. For millennia, there was one obvious and necessary way to improve human life: raise material living standards. If you are hungry, you will be made a lot happier by food. If you are thirsty, you will be made a lot happier by water. The human impulse for self-improvement was simple: give us more, and give it to us now. But we now know from reams of studies that once your basic needs are met – once you pass the magic number of $25,000 a year – something changes.

We carry on accumulating and accumulating, because it’s what we’ve grown to think will give us happiness, but it works less and less. And after a while, this unhindered chasing of More More More by the very richest begins to make us miserable – and corrodes some of the other basics we need as humans.

One of our most basic psychological needs is for status – to feel that we are a valued member of our tribe. We evolved in small, very egalitarian tribes of hunter-gatherers, and have only lived outside them for a few minutes in evolutionary terms. So when we feel our status is threatened – or there is no way of becoming respected by the rest of the tribe – we begin to malfunction in all sorts of ways.

Indeed, other than being chased by a wild animal or worrying that our supplies of food, water and shelter will be cut off, nothing makes humans more anxious than panic about our status. Endless clinical trials show what happens to our bodies when we feel we are going to lose our status and could end up being looked on as inferior. Our bodies lock into a “fight-or flight” response, where our heart and lungs work harder, our blood vessels constrict, and we burn up our energy stores fast. Our systems flood with a hormone called cortisol.

If this lasts only a short period, it can be good for us: it helps us escape that growling lion, or pull ourselves out of the wreckage of a crashed car. But if it goes on for weeks or months, we begin to suffer all sorts of dysfunction – as we’ll see in a moment.

Yet we have built our societies on exaggerating this status panic – and we have been ratcheting it up over the past thirty years. The more unequal a society is, the more intense it becomes. Even if you slip to the bottom in Sweden, it’s not so very different from the top. But when there is a long social ladder and the bottom rung means humiliation and poverty, everyone at every rung feels a sweatier need to cling to their place – and the society starts to go wrong. This isn’t left-wing speculation: it is an empirical fact.

Japan and Sweden are very different societies, but they are consistently at the top of the charts for every indicator of social success. They have low violence, low mental illness, low teenage pregnancy, low drug addiction, low obesity, low prison populations, high life expectancy, and high levels of friendship and trust. They are economically highly equal societies. The US and Portugal are also very different societies, but they are consistently at the bottom of the charts. They are highly unequal societies. If you plot countries on a graph, you see the causal relationships with striking clarity. Increase inequality, and every one of these dysfunctions shoots up with it.

How can this be? When we are locked in stress, we get sicker. High cortisol levels corrode our insides and massively increase the risk of heart-attack. We eat more – and our bodies store fat differently. It hugs them to our middles, rather than storing them lower down, in our hips and thighs. We are far more likely to break down into depression or mental illness, or to snap and attack somebody. James Gilligan – the psychiatrist running the Center for the Study of Violence at Harvard Medical School – explains that acts of violence are “attempts to ward off or eliminate the feeling of shame and humiliation – a feeling that is painful, and can even be intolerable or overwhelming.” He adds that he has “yet to see a serious act of violence that did not represent an attempt to undo this ‘loss of face.’”

And when we are locked in stress, we become more suspicious of the people around us. In highly equal Sweden, 66 percent of people feel they can trust their fellow citizens – and as a result have the highest levels of friendship in the developed world. In highly unequal Portugal, only 10 percent of the population trust the rest: see the bars on the windows.

It can be easier to see how this model of stress and humiliation affects us by looking at our evolutionary cousins. In a recent study, scientists at the University of North Carolina took twenty macaque monkeys, divided them into groups of four, and put them in separate enclosures. In each little group, they formed hierarchies, with some at the top, and some at the bottom. They then made it possible for the monkeys to give themselves a dose of cocaine by pulling a lever. The dominant monkeys took very little cocaine – while the subordinate, humiliated monkeys took huge amounts. They were, in effect, compensating themselves for being at the bottom of the pile with no way out. Now think about the rates of drug addiction in Detroit, or South Central Los Angeles, or the Ninth Ward of New Orleans.

Our elites have adopted an ideology – the extreme inequality of market fundamentalism – that simply doesn’t suit our species. It makes us sick and aggressive and anxious. This doesn’t just affect the poor: the studies show the disastrous effects of inequality run right up the ladder.

It doesn’t have to be this way. By democratically taxing the rich and using the money to lift up the poor, we can make life better for all of us. Of course there must be some income differentials – but nothing like our own grotesque rates. Plato suggested the richest person should be allowed to earn fives times the wage of the poorest person, which seems fair to me. The evidence is in, and it is plain: a more equal society is a happier, safer, and healthier one. (The obvious exception to this rule is Communist societies. They were incredibly miserable: if equality is imposed by crazed tyrants, at the expense of freedom, then it has none of these positive effects.)

Wilkinson and Pickett explain how the US would change over time if we taxed and invested our way to the same levels of economic equality as social democratic Sweden: “The proportion of the population feeling they could trust others might rise by 75 percent – presumably with matching improvements in the quality of community life; rates of mental illness and obesity might similarly be cut by about two-thirds, teenage birth rates could be more than halved, prison populations might be reduced by 75 percent, and people could live longer while working the equivalent of two months less a year.”

It’s a shining vision – and not utopian. It exists now in a free, democratic country. Most Americans intuitively want it: over 80 percent say the income gap is too high. It is only the undemocratic, concentrated power of the wealthy that holds us up.

And there is another, even more sombre reason why we need to democratically equalize our societies. We are now highly likely to face a series of destabilizing and dangerous climate shocks. In his book ‘Collapse: How Societies Choose To Fail or Survive‘, looks at the societies throughout history that have faced similar shocks. The difference between the ones that died out and the ones that survived was relative equality. If the elite stands far above the population and can insulate itself from the effects of the shock – for a while, at least – then the society doesn’t make it through. We need to reorganize ourselves now, while we can.

At the end of the failed age of market fundamentalism, the long-suppressed democratic cry for equality is emerging once again. Its glow should be at the core of how we move beyond this cold, cold depression.

****************

Johann Hari is a writer for the Independent newspaper. To read more of his articles, click here or here.

1 comment April 15th, 2009

Diagnostic abuse of veterans and the dilemmas of health professional ethics

Michael de Yoanna and Mark Benjamin in Salon have just published the first of a three-part series on pressure from the military to not diagnose soldiers with PTSD. They obtained a secret recording of a Denver neuropsychologist confessing to his patient, a sergeant wounded in Iraq, that he is under tremendous pressure to not assign PTSD diagnoses. [Thanks to Salon, you can listen to a portion of this recording here.]

“OK,” McNinch told Sgt. X. “I will tell you something confidentially that I would have to deny if it were ever public. Not only myself, but all the clinicians up here are being pressured to not diagnose PTSD and diagnose anxiety disorder NOS [instead].” McNinch told him that Army medical boards were “kick[ing] back” his diagnoses of PTSD, saying soldiers had not seen enough trauma to have “serious PTSD issues.”

“Unfortunately,” McNinch told Sgt. X, “yours has not been the only case … I and other [doctors] are under a lot of pressure to not diagnose PTSD. It’s not fair. I think it’s a horrible way to treat soldiers, but unfortunately, you know, now the V.A. is jumping on board, saying, ‘Well, these people don’t have PTSD,’ and stuff like that.”

Salon reporters talked with Dr. McNinch, and secretly recorded that conversation, obtaining confirmation of Sgt. X’s experience:

Contacted recently by Salon, McNinch seemed surprised that reporters had obtained the tape, but answered questions about the statements captured by the recording. McNinch told Salon that the pressure to misdiagnose came from the former head of Fort Carson’s Department of Behavioral Health. That colonel, an Army psychiatrist, is now at Fort Lewis in Washington state. “This was pressure that the commander of my Department of Behavioral Health put on me at that time,” he said. Since McNinch is a civilian employed by the Army, the colonel could not order him to give a specific, lesser diagnosis to soldiers. Instead, McNinch said, the colonel would “refuse to concur with me, or argue with me, or berate me” when McNinch diagnosed soldiers with PTSD. “It is just very difficult being a civilian in a military setting.”

McNinch added that he also received pressure not to properly diagnose traumatic brain injury, Sgt. X’s other medical problem. “When I got there I was told I was overdiagnosing brain injuries and now everybody is finding out that, yes, there are brain injuries,” he recalled. McNinch said he argued, “‘What are we going to do about treatment?’ And they said, ‘Oh, we are just counting people. We don’t plan on treating them.’” McNinch replied, “‘You are bringing a generation of brain-damaged individuals back here. You have got to get a game plan together for this public health crisis.’”

When McNinch learned he would be quoted in a Salon article, he cut off further questions. He also said he would deny the interview took place. Salon, however, had recorded the conversation.

Salon got the tape from another medical worker and a Congressional aid, not from the soldier, whom they dub Sgt. X, to protect his identity. The  soldier, surprised that the media got his recording, is afraid that retribution against him will negatively impact his disability claim.

The Army conducted one of those “investigations” so well-known to those familiar with the military and promptly cleared itself. Unfortunately, the Senate Armed Services Committee declined to investigate, though, one might suspect, it was an aid on that committee who gave Salon the tape. Perhaps there is an attempt to create enough public outrage to push the Committee to do the right thing.

This article provides new confirmation of previous reports, several of which are by Mark Benjamin, that the military is seeking to reduce the number of PTSD diagnoses assigned to soldiers. In some cases they have been accused of assigning personality disorder diagnoses, presumed to have existed prior to enlistment, to soldiers more likely suffering from the traumatic effects of war. A personality diagnoses makes the soldier ineligible for veterans benefits, thus avoiding the government assuming the potential high costs of treatment.

The question of what to do with mental health clinicians, like psychologist Dr. Douglas McNinch is complicated. If he, or other clinicians, modified diagnoses to please the powers that be, this is unethical.  Dr. McNinch apparently knows full well that his actions are wrong, yet lacks the moral courage to refuse to play along, or to speak out. His actions arouse little sympathy.

On the other hand, our healthcare system is based upon diagnostic deception. Clinicians often give less or more severe diagnoses in order to get coverage for their patients’ conditions. In many cases this deception is in the patient’s interests, but, other times it is not. Sometimes, rather, the deception is more in furtherance of the clinician’s financial interests. It seems problematic to punish a clinician for giving in to pressure from a dishonorable system. Yet, it also seems problematic that a clinician should get away unscathed for these transgressions.

At present health professional ethics, including that of psychologists, are based upon a model of the individual moral actor doing the right thing. These ethical principles essentially requires every professional to be willing to become a whistleblower. Yet, there is little tradition in the health professions of whistleblowing. We have no whistleblower heroes about whose actions we are taught in our training programs. We participate in no discussion of the  extreme stresses that most whistleblowers experience. And our professional associations have not developed any support mechanism beyond “ethical consultation” for those contemplating risking professional suicide through refusing to play their role in an unethical system.

We know that the health professions failed miserably to respond to a state-sponsored system of torture, a system that was designed by psychologists and required extensive involvement from health professionals, including monitoring of the extent of damage being caused as detainees were tortured, and brutal forced feeding of hunger strikers. As we know, the professional associations failed miserably to respond to this challenge. The American Medical and Psychiatric Associations banned their members participating in interrogations, but remained silent about the monitoring of torture conducted by physicians and the participation of physicians in force feedings that violate professional ethics. The American Psychological Association closed its eyes to the abusive roles that psychologists played in the Bush administration’s torture program, thus providing cover for that program until almost the end of that administration. Professions that failed to adequately confront the moral challenges posed by state-sponsored torture unfortunately cannot be counted upon to deal adequately with other potential state-sanctioned abuses. These professions, and their organized expressions in professional associations, need major reforms to confront the moral challenges of our times.

In any case, the most important result of the current revelations of diagnostic abuse would be to fix an unjust system that is apparently deliberately assigning the wrong diagnoses to returning soldiers, most likely in order to save money. Unjust and unethical systems generate unjust and unethical behavior in those who practice in them. While ethics codes are important, no amount of ethics teaching alone will prevent ethical lapses in powerful unethical systems. At a minimum, health professional associations should be pressured to provide support and training on the responsibilities and the challenges of becoming a whistleblower.

Soldiers who return from war shouldn’t have to face a system out to screw them. Nor should they have to fear retribution for exposing these abuses. It is now up to the administration, the Congress, the health professions, and the public to take action to see that our returning soldiers stop needing lawyers to get the appropriate treatment for the wounds they suffer in our name.

April 9th, 2009

Are rigid guidelines the enemy of quality care?

As a health researcher, I am a strong advocate of increasing the research-base guiding our clinical efforts. Among other things, I help develop systems to assess the outcomes of psychosocial interventions in order to use the resultant knowledge to improve the quality of treatments that are delivered to our clients. Yet, as a clinician, I am a skeptic regarding the quality of our current knowledge and its ability to appropriately guide our practice. Do we really know enough? And what about the large element of clinical expertise that cannot, with our current tools anyway, be quantified.

This is a tension I have lived with and explored throughout my professional career. I even co-edited a book — Reconciling Empirical Knowledge and Clinical Experience: The Art and Science of Psychotherapy — on the interface between research and clinical practice.

I have just been sent this new Wall Street Journal op-ed by Jerome Groopman and Pamela Hartbrand that makes the case that rigid guidelines can be wrong, and even dangerous. Groopman and Hartbrand argue that these guidelines, based as they are on what is believed to be best practices, can, in the current state of our knowledge, easily turn out to be suboptimal or even harmful. As one of the examples they give illustrates:

One key quality measure in the ICU became the level of blood sugar in critically ill patients. Expert panels reviewed data on whether ICU patients should have insulin therapy adjusted to tightly control their blood sugar, keeping it within the normal range, or whether a more flexible approach, allowing some elevation of sugar, was permissible. Expert consensus endorsed tight control, and this approach was embedded in guidelines from the American Diabetes Association. The Joint Commission on Accreditation of Healthcare Organizations, which generates report cards on hospitals, and governmental and private insurers that pay for care, adopted as a suggested quality metric this tight control of blood sugar.

A colleague who works in an ICU in a medical center in our state told us how his care of the critically ill is closely monitored. If his patients have blood sugars that rise above the metric, he must attend what he calls “re-education sessions” where he is pointedly lectured on the need to adhere to the rule. If he does not strictly comply, his hospital will be downgraded on its quality rating and risks financial loss. His status on the faculty is also at risk should he be seen as delivering low-quality care.

But this coercive approach was turned on its head last month when the New England Journal of Medicine published a randomized study, by the Australian and New Zealand Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group, of more than 6,000 critically ill patients in the ICU. Half of the patients received insulin to tightly maintain their sugar in the normal range, and the other half were on a more flexible protocol, allowing higher sugar levels. More patients died in the tightly regulated group than those cared for with the flexible protocol.

This example illustrates both the difficulty with rigid guidelines and the need to be able to use judgment and flexibility in treating patients.

I concur with their concerns. We are far from knowing with any degree of certainty the correctness of most of our clinical guidlines. Yet I also believe that clinical care independent of research is increasingly problematic. While Groopman and Hartbrand are right about the need for clinical flexibility, the ignore the opposite problem whereby the treatment a patient receives depends in an arbitrary manner of which doctor or hospital they go to, or where they live. Thus, enormous geographic variability has been found for certain surgical procedures with no evidence that the variability is based upon anything but custom.

Thus, I believe that health care systems need to measure their outcomes and use the resultant data to improve care. Yet, they also need to avoid the rigid guideline problem.

One way of reconciling these conflicting impulses is to implement outcomes monitoring in a quality improvement framework.That is, the goal is to identify practices and health providers who have superior outcomes and find how to tap their knowledge and expertise and communicate it to those whose outcomes are inferior. A successful quality improvement framework is based upon the assumption that the vast majority of healthcare workers want to deliver quality care. Thus, they will be open data-driven quality improvement efforts, as long as these are conducted in a collaboarative and respectful manner, fully valuing the expertise of healthcare workers while providing them with the information and tools to improve their efforts.

One important aspect of such a quality improvement perspective is that healthcare workers, doctors and others, should be part of team that selects outcome measures and quality improvement implementation procedures. Especially in “fuizzy” areas like mental health, the ability to control the outcomes that are measured is a powerful influence on the nature of treatment that is delivered.

To take one example with which I am intimately familiar, if substance abuse treatment outcomes included measures of such lifetsyle factors as having housing and jobs, as well as improved mental health, then these life domains are likely to be included in treatment planning. However, if substance abuse outcomes only include measurements of substance use, then large aspects of substance abusing clients’ lives will ultimately be given short shrift when planning and conducting treatment.

By the way, similar issues arise in a number of other areas than healthcare. Thus, much of the current efforts to measure “outcomes” in education could similarly benefit from a quality improvement perspective. If teachers and parents, not to mention students, were more integrated into the vast apparatus now assessing educational outcomes through standardized testing, there would likely be less grousing among teachers, with its acompanying drop in morale and loss of experienced teachers to early retirement.

Here is the complete Groopman and Hartbrand article:

Why ‘Quality’ Care Is Dangerous
The growing number of rigid protocols meant to guide doctors have perverse consequences

By Jerome Groopman and Pamela Hartbrand

The Obama administration is working with Congress to mandate that all Medicare payments be tied to “quality metrics.” But an analysis of this drive for better health care reveals a fundamental flaw in how quality is defined and metrics applied. In too many cases, the quality measures have been hastily adopted, only to be proven wrong and even potentially dangerous to patients.

Health-policy planners define quality as clinical practice that conforms to consensus guidelines written by experts. The guidelines present specific metrics for physicians to meet, thus “quality metrics.” Since 2003, the federal government has piloted Medicare projects at more than 260 hospitals to reward physicians and institutions that meet quality metrics. The program is called “pay-for-performance.” Many private insurers are following suit with similar incentive programs.

In Massachusetts, there are not only carrots but also sticks; physicians who fail to comply with quality guidelines from certain state-based insurers are publicly discredited and their patients required to pay up to three times as much out of pocket to see them. Unfortunately, many states are considering the Massachusetts model for their local insurance.

How did we get here? Initially, the quality improvement initiatives focused on patient safety and public-health measures. The hospital was seen as a large factory where systems needed to be standardized to prevent avoidable errors. A shocking degree of sloppiness existed with respect to hand washing, for example, and this largely has been remedied with implementation of standardized protocols. Similarly, the risk of infection when inserting an intravenous catheter has fallen sharply since doctors and nurses now abide by guidelines. Buoyed by these successes, governmental and private insurance regulators now have overreached. They’ve turned clinical guidelines for complex diseases into iron-clad rules, to deleterious effect.

One key quality measure in the ICU became the level of blood sugar in critically ill patients. Expert panels reviewed data on whether ICU patients should have insulin therapy adjusted to tightly control their blood sugar, keeping it within the normal range, or whether a more flexible approach, allowing some elevation of sugar, was permissible. Expert consensus endorsed tight control, and this approach was embedded in guidelines from the American Diabetes Association. The Joint Commission on Accreditation of Healthcare Organizations, which generates report cards on hospitals, and governmental and private insurers that pay for care, adopted as a suggested quality metric this tight control of blood sugar.

A colleague who works in an ICU in a medical center in our state told us how his care of the critically ill is closely monitored. If his patients have blood sugars that rise above the metric, he must attend what he calls “re-education sessions” where he is pointedly lectured on the need to adhere to the rule. If he does not strictly comply, his hospital will be downgraded on its quality rating and risks financial loss. His status on the faculty is also at risk should he be seen as delivering low-quality care.

But this coercive approach was turned on its head last month when the New England Journal of Medicine published a randomized study, by the Australian and New Zealand Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group, of more than 6,000 critically ill patients in the ICU. Half of the patients received insulin to tightly maintain their sugar in the normal range, and the other half were on a more flexible protocol, allowing higher sugar levels. More patients died in the tightly regulated group than those cared for with the flexible protocol.

Similarly, maintaining normal blood sugar in ambulatory diabetics with vascular problems has been a key quality metric in assessing physician performance. Yet largely due to two extensive studies published in the June 2008 issue of the New England Journal of Medicine, this is now in serious doubt. Indeed, in one study of more than 10,000 ambulatory diabetics with cardiovascular diseases conducted by a group of Canadian and American researchers (the “ACCORD” study) so many diabetics died in the group where sugar was tightly regulated that the researchers discontinued the trial 17 months before its scheduled end.

And just last month, another clinical trial contradicted the expert consensus guidelines that patients with kidney failure on dialysis should be given statin drugs to prevent heart attack and stroke.

These and other recent examples show why rigid and punitive rules to broadly standardize care for all patients often break down. Human beings are not uniform in their biology. A disease with many effects on multiple organs, like diabetes, acts differently in different people. Medicine is an imperfect science, and its study is also imperfect. Information evolves and changes. Rather than rigidity, flexibility is appropriate in applying evidence from clinical trials. To that end, a good doctor exercises sound clinical judgment by consulting expert guidelines and assessing ongoing research, but then decides what is quality care for the individual patient. And what is best sometimes deviates from the norms.

Yet too often quality metrics coerce doctors into rigid and ill-advised procedures. Orwell could have written about how the word “quality” became zealously defined by regulators, and then redefined with each change in consensus guidelines. And Kafka could detail the recent experience of a pediatrician featured in Vital Signs, the member publication of the Massachusetts Medical Society. Out of the blue, according to the article, Dr. Ann T. Nutt received a letter in February from the Massachusetts Group Insurance Commission on Clinical Performance Improvement informing her that she was no longer ranked as Tier 1 but had fallen to Tier 3. (Massachusetts and some private insurers use a three-tier ranking system to incentivize high-quality care.) She contacted the regulators and insisted that she be given details to explain her fall in rating.

After much effort, she discovered that in 127 opportunities to comply with quality metrics, she had met the standards 115 times. But the regulators refused to provide the names of patients who allegedly had received low quality care, so she had no way to assess their judgment for herself. The pediatrician fought back and ultimately learned which guidelines she had failed to follow. Despite her cogent rebuttal, the regulator denied the appeal and the doctor is still ranked as Tier 3. She continues to battle the state.

Doubts about the relevance of quality metrics to clinical reality are even emerging from the federal pilot programs launched in 2003. An analysis of Medicare pay-for-performance for hip and knee replacement by orthopedic surgeons at 260 hospitals in 38 states published in the most recent March/April issue of Health Affairs showed that conforming to or deviating from expert quality metrics had no relationship to the actual complications or clinical outcomes of the patients. Similarly, a study led by UCLA researchers of over 5,000 patients at 91 hospitals published in 2007 in the Journal of the American Medical Association found that the application of most federal quality process measures did not change mortality from heart failure.

State pay-for-performance programs also provide disturbing data on the unintended consequences of coercive regulation. Another report in the most recent Health Affairs evaluating some 35,000 physicians caring for 6.2 million patients in California revealed that doctors dropped noncompliant patients, or refused to treat people with complicated illnesses involving many organs, since their outcomes would make their statistics look bad. And research by the Brigham and Women’s Hospital published last month in the Journal of the American College of Cardiology indicates that report cards may be pushing Massachusetts cardiologists to deny lifesaving procedures on very sick heart patients out of fear of receiving a low grade if the outcome is poor.

Dr. David Sackett, a pioneer of “evidence-based medicine,” where results from clinical trials rather than anecdotes are used to guide physician practice, famously said, “Half of what you’ll learn in medical school will be shown to be either dead wrong or out of date within five years of your graduation; the trouble is that nobody can tell you which half — so the most important thing to learn is how to learn on your own.” Science depends upon such a sentiment, and honors the doubter and iconoclast who overturns false paradigms.

Before a surgeon begins an operation, he must stop and call a “time-out” to verify that he has all the correct information and instruments to safely proceed. We need a national time-out in the rush to mandate what policy makers term quality care to prevent doing more harm than good.

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Dr. Groopman, a staff writer for the New Yorker, and Dr. Hartzband are on the staff of Beth Israel Deaconess Medical Center in Boston and on the faculty of Harvard Medical School.

April 8th, 2009

Obama’s exemplary legal appointees

I have not shied from criticizing several of Obama’s appointments. Partially to balance that critical tone,  here is an article by Scott Horton on some of his exemplary legal picks. I am disapointed in a number of Obama’s picks and policies.  But some, like those discussed here, fill me with hope:

The Woman Who Could Nail Bush: Are the Worst of the Torture Memos Still to Come?

By Scott Horton

Until recently, the Justice Department’s Office of Legal Counsel, often considered the “brains” of the department, has been known mostly to legal experts. But for the past eight years, it was the epicenter of allegations of political manipulation and, worse, the source of infamous memoranda on torture. In tapping Eric Holder as attorney general, President Obama has promised to restore standards of professionalism to the department. For Republicans, this is tantamount to a declaration of partisan war.

On March 19, the nomination of Indiana University law professor Dawn Johnsen to head the OLC was endorsed by the Judiciary Committee with every Republican voting against her and Sen. Arlen Spector (R-PA) abstaining. The nomination was to have been brought to the Senate floor for a vote on Monday and then again on Wednesday, but it has been held back. Republican leaders, it appears, are playing with the notion of making Johnsen the target of their first filibuster.

The highly credentialed Johnsen is an improbable target, and OLC was long viewed as an obscure post. But Johnsen served as a lawyer for the American Civil Liberties Union and the National Abortion & Reproductive Rights Action League. Antiabortion groups have targeted Johnsen over the last three weeks with a massive telephone, email, and letter-writing campaign, demanding that senators oppose her nomination. Johnsen is labeled a “radical, pro-abortion activist,” although her views on the abortion issue line up very closely with the mainstream. While the noise surrounding the Johnsen nomination appears on the surface to be about the abortion issue—over which her position at OLC would have very little influence—discussions with Republican stalwarts reveal that their main concerns lie elsewhere.

The real reason for their vehement opposition is that Johnsen is committed to overturning the Bush administration’s policies on torture and warrantless surveillance, which would clip the wings of the imperial presidency. Even more menacingly (from their perspective), she is committed to shining a light on some of the darkest skeletons of the Bush years. Already, publication of OLC memoranda authorizing torture, approving warrantless surveillance, and pronouncing the First and Fourth Amendments a dead letter in connection with domestic military operations has rocked the public. More memos, potentially even more disturbing, I have learned, are about to be made public soon. Yet these are difficult issues on which to attack Johnsen, other than through vague suggestions that she is “weak on national security.” Hence the steady stream of accusations linked to her largely irrelevant views about abortion rights.

Will the Republicans attempt to filibuster the Johnsen nomination? The threat is sufficiently serious to have provoked the editors of the New York Times to editorialize in support of Johnsen on Thursday. Calling the operation of OLC in the Bush era “lawless,” the editors wrote, “Ms. Johnsen is superbly qualified and has fought for just the sort of change the office needs.”

The controversy surrounding Johnsen provides a flashpoint for President Obama’s nominees for administration legal posts. Unsurprisingly, they look an awful lot like Barack Obama—strong legal credentials, an academic bent, and liberal attitudes balanced by a strong commitment to political pragmatism.

Obama’s top picks start with a couple of well-known Washington names. Eric Holder, the nation’s first black attorney general, was a career Justice Department attorney who spent his formative years as a prosecutor in the department’s Public Integrity Section (much-criticized for abuse under Bush). He spent time as a U.S. attorney, a judge, and ran the Justice Department for a while as deputy attorney general in the Clinton years. Obama’s White House counsel, Greg Craig, is a Washington fixture at the powerhouse Williams & Connolly law firm. The former foreign-policy aide to Sen. Edward Kennedy and State Department official has handled high-profile cases from Clinton’s impeachment defense to representing the father of Elian Gonzales. In the way of Washington, he is also has ties to powerful Republicans, including Karl Rove and Alabama Sen. Richard Shelby, whom he successfully represented in a sensitive FBI investigation into the leaking of classified data.

But delving deeper into the list, the names are less known for pragmatic politics and inside-the-Beltway experience than for pure intellectual firepower. Nearly a quarter of all Obama nominees have a Harvard degree. No fewer than 11 Harvard Law School faculty members drew appointments in the Obama team, including the dean, Elena Kagan, who was also deputy domestic-policy adviser to President Clinton. He also tapped Yale’s law-school dean, Harold Koh, widely thought to be a possible Supreme Court appointment, to serve as the principal lawyer at the State Department. Obama has mined the University of Chicago, the University of Michigan, and Georgetown. All these schools are being forced to scramble as professors announce the cancellation of classes and prepare to depart for Washington.

A scan of the names involved makes clear that Obama is not looking for any particular ideological line—the candidates tapped range from centrist conservatives to traditional liberals. But he clearly is seeking individuals highly regarded by their peers who are on top of the issues for which they will have responsibility.

The trio of appointments Obama announced for the OLC underscores this point. In addition to Johnsen, Obama chose Harvard law professor David Barron and Georgetown law professor Marty Lederman as her two deputies. The three nominees have similar histories. Each served in the OLC in prior administrations before departing for academia. And over the last eight years, each spent a good deal of time and energy studying and criticizing the conduct of the OLC in the Bush years. Barron and Lederman co-authored a highly regarded two-part historical study of presidential powers, which demolished the underpinnings of the most significant OLC memoranda authored by John Yoo, including the famous torture memorandum. The three may well have been the Bush OLC’s most vocal critics, highlighting its departure from traditions and practices of earlier administrations. All three were also sharply critical of the Bush team’s devotion to secrecy in the formation of legal policy. It is therefore unsurprising that the Obama team has moved very quickly to publish the previously secret opinions that their Bush predecessors issued and to overturn those decisions. It would be hard to identify three lawyers more knowledgeable about the subject than Johnsen, Barron, and Lederman.

In the coming two weeks, their push for transparency will result in the publication of more Bush-era OLC memos, including the specific approvals granted for waterboarding, extended isolation, and other torture techniques—memos that the Bush administration has sought to keep secret. Former CIA Director Michael Hayden and Obama adviser John Brennan are said to have “gone to the mat” to keep the opinions secret, but Obama sided with his designated OLC team and upheld the decision to declassify and publish them.

Harvard law professor Laurence Tribe, one of the nation’s leading constitutional scholars and Supreme Court advocates, and Obama’s former teacher, is often mentioned as an adviser in the background, a gray eminence, counseling Obama on appointments and policy choices. He is widely believed to covet an appointment to the Supreme Court, though, at 67 years old, he might be passed over for a younger person. While Tribe is a regular target of the right and closely connected to an array of liberal causes, those familiar with his role in the recent appointments process say that he has steadily advised Obama to avoid ideological confrontations and stressed pragmatism as an important quality for appointees.

Another legal academic said to figure in Obama’s inner circle is Harvard law professor Cass Sunstein, who until recently was a colleague of Obama’s at the University of Chicago Law School. Sunstein has been appointed to head the White House Office of Information and Regulatory Affairs, while his wife Samantha Power, a Pulitzer Prize-winning author, serves as chief on the National Security Council as head of international organizations. Sunstein is associated with the notion of judicial minimalism, arguing that decisions should be taken on the narrowest possible case-specific grounds so as to preserve a broader range of options in future cases. The executive orders that Obama issued in his first two days in office were widely seen as following Sunstein’s minimalist approach in confronting a range of national-security issues on which Obama has pledged changes.

Unlike Obama, a professor of law, George W. Bush was noted for a sharp disdain for lawyers. He liked to make disparaging jokes about attorneys in pinstripes and tasseled loafers. “I don’t care what the international lawyers say, we are going to kick some ass,” he barked as the war on terror got under way, according to former counterterrorism chief Richard Clarke. Through the Bush administration, appointment to high-level legal positions was usually a reward for faithful service—as personified by Alberto Gonzales, who as counsel to the president and attorney general arguably held the two most powerful legal posts. Gonzales’ entire career, as a partner at the prestigious Houston firm of Vinson & Elkins, in Texas state government, and finally in Washington, was marked by service to a single client: George W. Bush.

The Bush administration’s overriding concern was for political loyalty. It demanded individuals who would unquestioningly implement the White House’s directives. The notion of independent professional judgment was derided as counterproductive at best and a cloak for liberal activism at worst. To that end, selecting the best and the brightest was not advisable. Where prior administrations looked for the top graduates from the nation’s elite law schools, the Bush team scoured schools not found in a list of the top-100 law schools (and sometimes not even ABA-accredited), but with strong ties to the religious right and the Republican Party. Justice Department officials openly asked job candidates whether they had worked for the Bush-Cheney campaign and contributed money and quickly rejected those whose offense was support for John McCain in the 2000 Republican primaries. Membership in the movement’s conservative legal organization, the Federalist Society, was also a plus if not essential—in recently disclosed emails, former Bush-era U.S. attorney and Civil Rights Division Director Bradley Schlozman (whose case is now under review for the possible filing of criminal charges) called them “ideological comrades.” The result was a Justice Department filled with political hacks in appointed positions and a historically unprecedented level of politicization in its decision-making process.

The Obama nominees, presenting the sharpest possible contrast, have drawn sputtering fire from Republicans in Congress and have come under broad attack from religious-right leaders who previously had strong influence in Justice Department picks. Dawn Johnsen is an interesting test case. If the Republicans opt for a filibuster or move to line up a unanimous GOP vote in opposition, it will be a shot across the bow of the Obama Justice Department.

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Scott Horton is a law professor and writer on legal and national-security affairs for Harper’s magazine and the American Lawyer, among other publications.

April 2nd, 2009

Torture of Abu Zubaida, designed by psychologists, yielded nothing

The first of the CIA’s “enhanced interrogations,” that of Abu Zubaida,  described as “torture” in recently leaked portions of the International Committee of the Red Cross’s report on CIA interrogation tactics, led to nothing other than tens of thousands of investigatory hours wasted chasing fairy stories he told to get the pain to stop, the Washington Post reports today.  All reliable information obtained from him was obtained prior to the torture.

Since 2006, Senate intelligence committee members have pressed the CIA, in classified briefings, to provide examples of specific leads that were obtained from Abu Zubaida through the use of waterboarding and other methods, according to officials familiar with the requests.

The agency provided none, the officials said.

However, when the torture began, Zubaida did talk, he told, not the banal truth, but what his interrogators and their bosses wanted to hear:

Abu Zubaida’s revelations triggered a series of alerts and sent hundreds of CIA and FBI investigators scurrying in pursuit of phantoms. The interrogations led directly to the arrest of Jose Padilla, the man Abu Zubaida identified as heading an effort to explode a radiological “dirty bomb” in an American city. Padilla was held in a naval brig for 3 1/2 years on the allegation but was never charged in any such plot. Every other lead ultimately dissolved into smoke and shadow, according to high-ranking former U.S. officials with access to classified reports.

“We spent millions of dollars chasing false alarms,” one former intelligence official said.

Though the Post doesn’t say this, similar claims were reported in July 2007 by Vanity Fair reporter Katherine Eban in her account of the role psychologists James Mitchell and Bruce Jessen played in designing, conducting, and training for the CIA’s torture program.  Eban added the detail that the pre-torture information was obtained primarily by FBI [rather than CIA] agents.

While other accounts have disputed the Bush administration’s claims that Zubaida was an important al Qaeda figure, the Post story reports that he wan’t even an al Qaeda member until after 911:

Abu Zubaida was not even an official member of al-Qaeda, according to a portrait of the man that emerges from court documents and interviews with current and former intelligence, law enforcement and military sources. Rather, he was a “fixer” for radical Muslim ideologues, and he ended up working directly with al-Qaeda only after Sept. 11 — and that was because the United States stood ready to invade Afghanistan.

Further:

“He was the above-ground support,” said one former Justice Department official closely involved in the early investigation of Abu Zubaida. “He was the guy keeping the safe house, and that’s not someone who gets to know the details of the plans. To make him the mastermind of anything is ridiculous.”

The Post also reports that the idea of torturing Zubaida came, not from the CIA operatives, but from the very top:

As weeks passed after the capture without significant new confessions, the Bush White House and some at the CIA became convinced that tougher measures had to be tried.

The pressure from upper levels of the government was “tremendous,” driven in part by the routine of daily meetings in which policymakers would press for updates, one official remembered.

“They couldn’t stand the idea that there wasn’t anything new,” the official said. “They’d say, ‘You aren’t working hard enough.’ There was both a disbelief in what he was saying and also a desire for retribution — a feeling that ‘He’s going to talk, and if he doesn’t talk, we’ll do whatever.’ ”

The application of techniques such as waterboarding — a form of simulated drowning that U.S. officials had previously deemed a crime — prompted a sudden torrent of names and facts. Abu Zubaida began unspooling the details of various al-Qaeda plots, including plans to unleash weapons of mass destruction.

Looking beyond the Post article, Eban, together with Jane Mayer and Mark Benjamin, reminds us that it was psychologists who developed these techniques that proved eminently able to elicit prolific, albeit false, information. as Eban expressed it:

I…  discovered that psychologists weren’t merely complicit in America’s aggressive new interrogation regime. Psychologists, working in secrecy, had actually designed the tactics and trained interrogators in them while on contract to the C.I.A.

It appears that these psychologists based their torture program on the “learned helplessness” theories of former American Psychological Association President Martin Seligman. Seligman lectured to a 2002 CIA-organized meeting at which Mitchell and Jessen were present. [See Valtin on this conference] While Seligman claims to be ignorant of any connection between the meeting and CIA torture policy, afterwards Mitchell and Jessen were citing Seligman’s ideas as inspiration for their work. Mayer has pointed out that Seligman must have known Mitchell and Jessen as he has recently admitted that they were in the audience for this talk.

We might also add, as the Defense Department Inspector General and the Senate Armed Services Committee reported, that it was largely psychologists that designed the abusive interrogation techniques for the military that were implemented at Guantanamo, Abu Ghraib, and elsewhere in Iraq and Afghanistan.

After the Zubaida fiasco, the CIA turned to help from the American Psychological Association [APA]. As I recently reported, they organized in July 2003 a joint APA-CIA-Rand conference on the Science of Deception, to which CIA torture psychologists Mitchell and Jessen were invited. At this conference they discussed, among other things:

  • What pharmacological agents are known to affect apparent truth-telling behavior?….
  • What are sensory overloads on the maintenance of deceptive behaviors? How might we overload the system or overwhelm the senses and see how it affects deceptive behaviors?
  • The APA leadership has never come clean regarding their participation in this conference and why the CIA’s top torrture consultants were invited. They have never revealed what these torture planners told the conference or what information they were provided by the assembled psychologists. Rather, the APA, when asked about these torture psychologists, simply repeats, as if a mantra, that they are not APA members and are not subject to APA ethics sanctions, as if that clears the APA. Until the APA makes all records of the conference publicly and speaks in depth of what went on there, we can only continue to suspect that they have much to hide.

    Furthermore, when the APA in 2005 formed an “ethics” task force to discuss the participation of psychologists in Bush administration interrogations, one of the majority of participants from the military-intelligence establishment was Scott Shumate, who Eban places at the torture of Zubaida. While Eban claims that Shumate was disturbed by the treatment meeted out there, he nonethless remained at his CIA post for another year while the torture of Zubaida and others continued. Any disgust that Shumate may have felt did not prevent his bragging of his involvement with “several” captured, and presumably tortured, terrorists,  in a bio for consulting:

    He has been with several of the key apprehended terrorists as well as numerous other terrorists ….

    Thanks to the new Post article, we have further evidence that the CIA’s torture program designed by supposedly “scientific” psychologists, was worse than ineffective. Also ineffective were the policies of the APA that supposedly prevented psychologists from participating in torture. It is time that both are investigated.

    Here is the Post article:

    Detainee’s Harsh Treatment Foiled No Plots
    Waterboarding, Rough Interrogation of Abu Zubaida Produced False Leads, Officials Say

    By Peter Finn and Joby Warrick

    When CIA officials subjected their first high-value captive, Abu Zubaida, to waterboarding and other harsh interrogation methods, they were convinced that they had in their custody an al-Qaeda leader who knew details of operations yet to be unleashed, and they were facing increasing pressure from the White House to get those secrets out of him.

    The methods succeeded in breaking him, and the stories he told of al-Qaeda terrorism plots sent CIA officers around the globe chasing leads.

    In the end, though, not a single significant plot was foiled as a result of Abu Zubaida’s tortured confessions, according to former senior government officials who closely followed the interrogations. Nearly all of the leads attained through the harsh measures quickly evaporated, while most of the useful information from Abu Zubaida — chiefly names of al-Qaeda members and associates — was obtained before waterboarding was introduced, they said.

    Moreover, within weeks of his capture, U.S. officials had gained evidence that made clear they had misjudged Abu Zubaida. President George W. Bush had publicly described him as “al-Qaeda’s chief of operations,” and other top officials called him a “trusted associate” of al-Qaeda leader Osama bin Laden and a major figure in the planning of the Sept. 11, 2001, terrorist attacks. None of that was accurate, the new evidence showed.

    Abu Zubaida was not even an official member of al-Qaeda, according to a portrait of the man that emerges from court documents and interviews with current and former intelligence, law enforcement and military sources. Rather, he was a “fixer” for radical Muslim ideologues, and he ended up working directly with al-Qaeda only after Sept. 11 — and that was because the United States stood ready to invade Afghanistan.

    Abu Zubaida’s case presents the Obama administration with one of its most difficult decisions as it reviews the files of the 241 detainees still held in the U.S. military prison at Guantanamo Bay, Cuba. Abu Zubaida — a nom de guerre for the man born Zayn al-Abidin Muhammed Hussein — was never charged in a military commission in Guantanamo Bay, but some U.S. officials are pushing to have him charged now with conspiracy.

    The Palestinian, 38 and now in captivity for more than seven years, had alleged links with Ahmed Ressam, an al-Qaeda member dubbed the “Millennium Bomber” for his plot to bomb Los Angeles International Airport on New Year’s Eve 1999. Jordanian officials tied him to terrorist plots to attack a hotel and Christian holy sites in their country. And he was involved in discussions, after the Taliban government fell in Afghanistan, to strike back at the United States, including with attacks on American soil, according to law enforcement and military sources.

    Others in the U.S. government, including CIA officials, fear the consequences of taking a man into court who was waterboarded on largely false assumptions, because of the prospect of interrogation methods being revealed in detail and because of the chance of an acquittal that might set a legal precedent. Instead, they would prefer to send him to Jordan.

    Some U.S. officials remain steadfast in their conclusion that Abu Zubaida possessed, and gave up, plenty of useful information about al-Qaeda.

    “It’s simply wrong to suggest that Abu Zubaida wasn’t intimately involved with al-Qaeda,” said a U.S. counterterrorism official, speaking on the condition of anonymity because much about Abu Zubaida remains classified. “He was one of the terrorist organization’s key facilitators, offered new insights into how the organization operated, provided critical information on senior al-Qaeda figures . . . and identified hundreds of al-Qaeda members. How anyone can minimize that information — some of the best we had at the time on al-Qaeda — is beyond me.”

    Until the attacks on New York and Washington, Abu Zubaida was a committed jihadist who regarded the United States as an enemy principally because of its support of Israel. He helped move people in and out of military training camps in Afghanistan, including some men who were or became members of al-Qaeda, according to interviews with multiple sources, who spoke on the condition of anonymity. He was widely known as a kind of travel agent for those seeking such training.

    That role, it turned out, would play a part in deciding his fate once in U.S. hands: Because his name often turned up in intelligence traffic linked to al-Qaeda transactions, some U.S. intelligence leaders were convinced that Abu Zubaida was a major figure in the terrorist organization, according to officials engaged in the discussions at the time.

    But Abu Zubaida had strained and limited relations with bin Laden and only vague knowledge before the Sept. 11 attacks that something was brewing, the officials said.

    His account was echoed in another U.S. interrogation going on at the same time, one never previously described publicly.

    Noor al-Deen, a Syrian, was a teenager when he was captured along with Abu Zubaida at a Pakistani safe house. Perhaps because of his youth and agitated state, he readily answered U.S. questions, officials said, and the questioning went on for months, first in Pakistan and later in a detention facility in Morocco. His description of Abu Zubaida was consistent: The older man was a well-known functionary with links to al-Qaeda, but he knew little detailed information about the group’s operations.

    The counterterrorism official rejected that characterization, saying, “Based on what he shared during his interrogations, he was certainly aware of many of al-Qaeda’s activities and operatives.”

    One connection Abu Zubaida had with al-Qaeda was a long relationship with Khalid Sheik Mohammed, the self-proclaimed mastermind behind the Sept. 11 attacks, officials said. Mohammed had approached Abu Zubaida in the 1990s about finding financiers to support a suicide mission, involving a small plane, targeting the World Trade Center. Abu Zubaida declined but told him to try bin Laden, according to a law enforcement source.

    Abu Zubaida quickly told U.S. interrogators of Mohammed and of others he knew to be in al-Qaeda, and he revealed the plans of the low-level operatives who fled Afghanistan with him. Some were intent on returning to target American forces with bombs; others wanted to strike on American soil again, according to military documents and law enforcement sources.

    Such intelligence was significant but not blockbuster material. Frustrated, the Bush administration ratcheted up the pressure — for the first time approving the use of increasingly harsh interrogations, including waterboarding.

    Such treatment at the hands of the CIA has raised questions among human rights groups about whether Abu Zubaida is capable of standing trial and how the taint of torture would affect any prosecution.

    The International Committee of the Red Cross said in a confidential report that the treatment of Abu Zubaida and other, subsequent high-value detainees while in CIA custody constituted torture. And Abu Zubaida refused to cooperate with FBI “clean teams” who attempted to re-interview high-value detainees to build cases uncontaminated by allegations of torture, according to military sources.

    “The government doesn’t retreat from who KSM is, and neither does KSM,” said Joseph Margulies, a professor of law at Northwestern University and one of Abu Zubaida’s attorneys, using an abbreviation for Mohammed. “With Zubaida, it’s different. The government seems finally to understand he is not at all the person they thought he was. But he was tortured. And that’s just a profoundly embarrassing position for the government to be in.”

    His lawyers want the U.S. government to arrange for Abu Zubaida’s transfer to a country besides Jordan — possibly Saudi Arabia, where he has relatives.

    The Justice Department declined repeated requests for comment.

    Even before President Obama suspended military commissions at the military base in Cuba, prosecutors had expunged Abu Zubaida’s name from the charge sheets of a number of detainees who were captured with him and stood accused of conspiracy and material support for terrorism.

    When they were first charged in 2005, these detainees were accused of conspiring with Abu Zubaida, and the charge sheets contained numerous references to Abu Zubaida’s alleged terrorist activities. When the charges were refiled last year, his name had vanished from the documents.

    Abu Zubaida was born in 1971 in Saudi Arabia to a Palestinian father and a Jordanian mother, according to court papers. In 1991, he moved to Afghanistan and joined mujaheddin fighting Afghan communists, part of the civil war that raged after the 1989 withdrawal of the Soviet Union. He was seriously wounded by shrapnel from a mortar blast in 1992, sustaining head injuries that left him with severe memory problems, which still linger.

    In 1994, he became the Pakistan-based coordinator for the Khalden training camp, outside the Afghan city of Khowst. He directed recruits to the camp and raised money for it, according to testimony he gave at a March 2007 hearing in Guantanamo Bay.

    The Khalden camp, which provided basic training in small arms, had been in existence since the war against the Soviets. According to the 9/11 Commission’s report, Khalden and another camp called Derunta “were not al Qaeda facilities,” but “Abu Zubaydah had an agreement with Bin Laden to conduct reciprocal recruiting efforts whereby promising trainees at the camps could be invited to join al Qaeda.”

    Abu Zubaida disputes this, saying he admitted to such a connection with bin Laden only as the result of torture.

    When the Sept. 11 attacks occurred, Abu Zubaida was in Kabul, the Afghan capital. In anticipation of an American attack, he allied himself with al-Qaeda, he said at a 2007 hearing, but he soon fled into hiding in Pakistan.

    On the night of March 28, 2002, Pakistani and American intelligence officers raided the Faisalabad safe house where Abu Zubaida had been staying. A firefight ensued, and Abu Zubaida was captured after jumping from the building’s second floor. He had been shot three times.

    Cowering on the ground floor and also shot was Noor al-Deen, Abu Zubaida’s 19-year-old colleague; one source said that he worshiped the older man as a hero. Deen was wide-eyed with fear and appeared to believe that he was about to be executed, remembered John Kiriakou, a former CIA officer who participated in the raid.

    “He was frightened — mostly over what we were going to do with him,” Kiriakou said. “He had come to the conclusion that his life was over.”

    Deen was eventually transferred to Syria, but attempts to firmly establish his current whereabouts were unsuccessful.

    His interrogations corroborated what CIA officials were hearing from Abu Zubaida, but there were other clues at the time that pointed to a less-than-central role for the Palestinian. As a veritable travel agent for jihadists, Abu Zubaida operated in a public world of Internet transactions and ticket agents.

    “He was the above-ground support,” said one former Justice Department official closely involved in the early investigation of Abu Zubaida. “He was the guy keeping the safe house, and that’s not someone who gets to know the details of the plans. To make him the mastermind of anything is ridiculous.”

    As weeks passed after the capture without significant new confessions, the Bush White House and some at the CIA became convinced that tougher measures had to be tried.

    The pressure from upper levels of the government was “tremendous,” driven in part by the routine of daily meetings in which policymakers would press for updates, one official remembered.

    “They couldn’t stand the idea that there wasn’t anything new,” the official said. “They’d say, ‘You aren’t working hard enough.’ There was both a disbelief in what he was saying and also a desire for retribution — a feeling that ‘He’s going to talk, and if he doesn’t talk, we’ll do whatever.’ ”

    The application of techniques such as waterboarding — a form of simulated drowning that U.S. officials had previously deemed a crime — prompted a sudden torrent of names and facts. Abu Zubaida began unspooling the details of various al-Qaeda plots, including plans to unleash weapons of mass destruction.

    Abu Zubaida’s revelations triggered a series of alerts and sent hundreds of CIA and FBI investigators scurrying in pursuit of phantoms. The interrogations led directly to the arrest of Jose Padilla, the man Abu Zubaida identified as heading an effort to explode a radiological “dirty bomb” in an American city. Padilla was held in a naval brig for 3 1/2 years on the allegation but was never charged in any such plot. Every other lead ultimately dissolved into smoke and shadow, according to high-ranking former U.S. officials with access to classified reports.

    “We spent millions of dollars chasing false alarms,” one former intelligence official said.

    Despite the poor results, Bush White House officials and CIA leaders continued to insist that the harsh measures applied against Abu Zubaida and others produced useful intelligence that disrupted terrorist plots and saved American lives.

    Two weeks ago, Bush’s vice president, Richard B. Cheney, renewed that assertion in an interview with CNN, saying that “the enhanced interrogation program” stopped “a great many” terrorist attacks on the level of Sept. 11.

    “I’ve seen a report that was written, based upon the intelligence that we collected then, that itemizes the specific attacks that were stopped by virtue of what we learned through those programs,” Cheney asserted, adding that the report is “still classified,” and, “I can’t give you the details of it without violating classification.”

    Since 2006, Senate intelligence committee members have pressed the CIA, in classified briefings, to provide examples of specific leads that were obtained from Abu Zubaida through the use of waterboarding and other methods, according to officials familiar with the requests.

    The agency provided none, the officials said.

    Staff researcher Julie Tate contributed to this report.

    1 comment March 29th, 2009

    Rethink Afghanistan, Parts 1 & 2

    Brave New Films is creating a series of short films in its Rethink Afghanistan project. Here is

    Part 1: Afghanistan + More Troops = Catastrophe

    Part 2: Pakistan: “The Most Dangerous Country”

    March 27th, 2009

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