American health personnel are not immune from cooperating with efforts to misuse psychiatric drugs for social control purposes having no connection with those drugs’ intended uses. The U.S. Immigration and Customs Enforcement agency (ICE) has been systematically administering psychotropic drugs to immigrants in the process of being deported as the Washington Post reported this week. Deportees who in the past had resisted deportation were injected with drugs, often a three drug “cocktail,” in order to keep them pliant during deportation. These drugs included the powerful antipsychotic drug Haldol, as well as the antianxiety drug Ativan, and Cogentin, a drug used to treat the often severe Parkinsons illness like side effects of Haldol.

These drugs were prescribed by psychiatrists and administered by specially selected nurse “medical escorts.” The drugs were administered in extremely high doses, sometimes rendering the deportees unable to speak.  It sometimes took deportees days or even weeks to get the drugs out of their system. Thus Michael Shango was injected with 32.5 milligrams (mg) of Haldol, as well as 8.5 mg of Ativan and some Cogentin over 11 hours. His initial Haldol dose was 10 mg. Compare this with a usual Haldol dose of  2 to 5 mg repeated in 4 to 6 hours for “control of the acutely agitated schizophrenic patient with moderately severe to very severe symptoms” and 2 to 6 mg of Ativan daily for patients whose bodies have already adapted to the medication; lower doses of these drugs are recommended for new patients as people need time to adjust to them.

These drugs, especially Haldol are extremely powerful and are almost never utilized in individuals not diagnosed as actively psychotic. They can be extremely uncomfortable, especially if first administered in high doses and can disorient an individual for days. When Shango was imprisoned upon his return to the Congo, he was so disoriented that he didn’t know where he was fortunately, friends helped him escape. It was weeks before he fully recovered from the drugs.

This use of powerful medications to control detainees is likely illegal. In fact, the Clinton administration had concluded:

“Regarding detainees who are not mentally ill, involuntary medication of such persons for the sole purpose of subduing them during deportation, without a court  order, is not supported by any legal authority and raises ethical issues as well.” [emphasis in original]

Regardless of whether this use of drugs is legal, it violates the professional ethics of most health professions and constitutes a profound threat to the role of healer. Doctors, nurses, and other health professionals rely upon trust between healing professional and patient, trust that the interests of the patient are forefront in the doctors mind. We incorporate recognition of the importance of trust in the crucial importance given to patients’ informed consent in medical decision-making. Except in the most extreme of circumstances, drugs and other medical interventions should be administered only with the consent of, and in the interests of, the person receiving the intervention.

The ethics of most medical professions do allow for involuntary intervention in extreme circumstances to protect the patient or public from imminent harm. Further, in order for a medical treatment to be used involuntarily, the treatment must be, as the Supreme Court stated in considering involuntary drugging of prisoners,  “in the inmate’s medical interest.”  Thus, the American Psychiatric Nurses Association, in a position statement on Mandatory Outpatient Treatment (MOT), endorses mandatory treatment, but insists that it is a last resort:

All patients have the right to make their own decisions and MOT should be used as a last resort. …  If MOT needs to be implemented, measures must be taken to ensure that each patient is treated with respect and dignity, and that full consideration is given to the patient’s rights, civil liberties, and confidentiality issues.

The criterion of “use as a last resort” and treatment “with respect and dignity… and that full consideration is given to the patient’s rights [and] civil liberties” is clearly not met in the ICE use of these powerful drugs.  The psychiatrists and nurse escorts are serving only the interests of the ICE and are oblivious to the interests or the wishes of those receiving drugs, who, because they manifest no medical need, are not in any meaningful sense “patients.” These drugs are being used to control the deportees as they attempt to assert their rights. These drugs thus are in fact often a way of destroying the deportees’ ability to resist disturbing and often questionable deportations. What could be more disrespectful of a person’s dignity than to chemically destroy his or her ability to resist?

The ICE has recently amended thepolicy that allowed involuntary drugging of deportees.  Unfortunately, as Physicians for Human Rights pointed out in a January 28^th 2008 letter to the ICE, the new rules are still inadequate and open to abuse:

The new policy, in fact, largely ratifies ICE’s past practice, allowing court-ordered forced sedation “to effectuate removal” when a detainee’s resistance is deemed “dangerous.” The Amended Policy also requires evidence from a medical doctor that the drug or drugs to be forcibly administered are “medically appropriate.”

While we welcome this recognition of medical concerns, the Amended Policy offers no criteria for the vague standard of “appropriateness,” providing far too little guidance and presenting far too great a risk that ICE’s sole interest in removal will subvert the physician’s obligation to the patient’s health.

The use of drugs by ICE is, unfortunately, part of a pattern by the Bush administration of the misuse of the health professions for non-therapeutic purposes. I and others have written extensively about the role of psychologists in aiding national security interrogations, interrogations that often cross the line into torture. Recently the Washington Post and CQ reported on likely involuntary drugging of detainees (see my commentary: Involuntary Drugging of US Detainees: A Crisis for the Health Professions). It is beginning to look as if there is a pattern of inappropriate use of psychopharmacological agents for overcoming resistances of various types.

So far Congress and the health professions have failed to systematically confront the abuses of these professions by the current administration. The failures, until recently, of Congress to stop or actively expose administration abuses are well known.  While at times making strong statements against certain abuses, none of the health professions has taken active steps to investigate abuses or to expose or discipline members participating in abuses. All too often, good sounding words have been a substitute for action. Bioethicist Steven Miles, author of Oath Betrayed: Torture, Medical Complicity, and the War on Terror, said in response to these latest revelations:

Governments do not inject people with antipsychotics, medical personnel do.

In 35 years of practice, I have never had to give such high doses of antipsychotics to any person with any mental illness as is described in this story.

Again, we have an utter breakdown of the accountability of health professionals.  As with the behavior of nurses and doctors in the war on terror prisons and the use of drugs for the CIA-State Department’s rendition flights, we have a failure of understanding of professional ethics and complete passivity of the AMA and the American Nurses Association.

It is time for both Congress and the health professions themselves to investigate. Recently Senators Levin, Biden and Hagel wrote the Defense Department Inspector General requesting an investigation of the reports of involuntary detainee drugging. This new report of involuntary drugging may be investigated as well. We need a mechanism, however, for a detailed examination of the perversions of the health professions by the current administration. I have previously called for a Truth and Reconciliation process to deal with the shameful cowardice of the health professions in actively and/or passively aiding the administrations’ detention and interrogation abuses. Perhaps this process needs to be expanded to confront the broad range of health profession failures to actively oppose their professions’ perversion by the forces of the state.

Enjoy! And go buy the book. I cried as I read each chapter.

BTW, Amy and David will be in Boston on Friday:

WHEN: Doors open at 6:00pm, event begins at 7:00pm
WHERE: The Jamaica Plain Forum, First Church in Jamaica Plain, Unitarian Universalist, 6 Eliot St., Jamaica Plain, MA 02130
DESCRIPTION: A talk and booksigning with journalists Amy Goodman and David Goodman.
TICKETS: Advanced Tickets and Books in advance:
$5 in advance or at the door (cash or check only, please)
To be sold at Rhythm and Muse Bookstore
470 Center St.
Jamaica Plain, MA 02130

David and Amy have asked me to say a few words, though I’ll get there a bit late as I have to teach that night. So, if you’re in th Boston area, please join us.

As anyone reading this blog regularly knows, al-Qahtani’s interrogation is notable because a psychologist, Maj. John Leso, is documented as being present at the interrogation. Also notable is that in the two years since this became public knowledge the American Psychological Association has failed to take action against Maj. Leso, an APA member, despite at least four ethics complaints being filed against him dating back to the summer of 2006. Evidently the APA is against torture, except when it is documented to have occurred.

Here is a BBC account of reasons for the dropping of charges:

Why has the US dropped 9/11 charges?

By Adam Brookes
BBC News,

The American government has given no reason why charges against the man it has alleged was the “20th hijacker” in the 11 September 2001 attacks on the US have been dropped.

Mohammad al-Qahtani has been held at Guantanamo Bay since 2002, following his detention in Afghanistan.

In February, he was charged with conspiracy, terrorism, and murder in violation of the laws of war, among other offences.

The US alleges he attempted to come to the United States in order to take part in the 9/11 attacks, but was stopped at the airport on his arrival.

An immigration officer suspected he intended to stay in the US illegally, and refused him entry.

The charges were dropped “without prejudice” - which means they could be brought again at a later date.

Five other men were charged alongside Mr Qahtani.

They include Khaled Sheikh Mohammed - the man accused of organising the 9/11 attacks.

Their trials before military commissions - the special military courts in Guantanamo Bay - are slated to go ahead.

Torture claims

As well as his military lawyer, Mr Qahtani is represented by a civilian lawyer from the Center for Constitutional Rights - a New York-based legal rights organisation.

The CCR said in a statement it believed the charges against him had been dropped because Mr Qahtani had been tortured.

“The government’s claims against our client were based on unreliable evidence obtained through torture at Guantanamo,” it said.

“Using torture to string together a web of so-called evidence is illegal, immoral and cannot be the basis for a fair trial.”

Published reports in 2006 described Mr Qahtani’s interrogation.

The reports - based on leaks from the Pentagon - said he had been subjected to stress positions, sleep deprivation, extreme temperatures, humiliation and other highly coercive practices.

Some lawyers believe military officers did not want to face a discussion of these interrogation techniques in court, nor to have their case collapse publicly because the evidence obtained using such techniques might be ruled inadmissible.

Controversial commissions

However, proceedings against the five other suspects, including Khaled Sheikh Mohammed, appear to be going ahead.

It has been frequently reported, and is widely believed by civilian and military lawyers, that similar interrogation techniques were used in these cases, too.

So how are they able to go ahead, if the case against Mr Qahtani is dropped?

Lawyers suggest that in those cases there may be other evidence - obtained independently, and not tainted with the threat of inadmissibility.

One lawyer who is not directly involved with the Guantanamo detainees called the failure of the case against Mr Qahtani a “huge setback” for the US government and the entire legal process at Guantanamo Bay.

“Yet again, we don’t know what is really happening in this system,” he said. “Transparency is zero.”

The military commissions process remains extremely controversial.

A case before the Supreme Court - Boumediene vs Bush - challenges its very legality under the constitution. The Court is expected to rule in the next two months.

Issues White Paper On Torture Liability

Contacts:

Marjorie Cohn, NLG President, marjorie@tjsl.edu; 858-204-3565

Jeanne Mirer, NLG International Committee, mirerfam@earthlink.net; 313-515-2046

New York. The National Lawyers Guild (NLG) calls on Congress to appoint a Special Prosecutor, independent of the Department of Justice, to investigate and prosecute high Bush officials and lawyers including John Yoo for their role in the torture of prisoners in U.S. custody.

The NLG has issued a White Paper explaining why the memos, which purported to give objective legal advice, subject all those involved to prosecution under international and U.S. domestic law. This includes people who ordered the torture, approved it or gave advice to justify it.

Guild President Marjorie Cohn testified on May 6 before the Subcommittee on the Constitution, Civil Rights and Civil Liberties of the House Judiciary Committee, that some lawyers in the Department of Justice were “part of a common plan to violate U.S. and international laws outlawing torture.”

The 14-page White Paper details the ways in which the lawyers, including Yoo, Jay Bybee, David Addington, and William Haynes, counseled the White House on how to get away with war crimes. The lawyers said that the Department of Justice would not enforce federal laws against torture, maiming, assault and stalking. “Just because the statute says,” John Yoo explained in a recent Esquire interview, “that doesn’t mean you have to do it.”

Professor Cohn told the congressmen it was “reasonably foreseeable” the lawyers’ advice “would result in great physical and mental harm or death to many detainees”; more than 100 have died, many from torture. Torture, like genocide, slavery and wars of aggression, is absolutely prohibited at all times. No country can ever pass a law that would allow them.

Professor Philippe Sands, a British international litigator and author of the new book, “Torture Team,” also testified at the congressional hearing. He said that after his extensive interviews with many Bush officials, including John Yoo, “it became clear to me that the Administration has spun a narrative that is false, claiming that the impetus for the new interrogation techniques came from the bottom-up. That is not true; the abuse was a result of pressure and actions driven from the highest levels of government.”

It was recently revealed that Dick Cheney, Condoleezza Rice, Donald Rumsfeld, Colin Powell, George Tenet, and John Ashcroft met in the White House and personally oversaw and approved the torture by authorizing specific torture techniques including waterboarding. President Bush admitted he knew and approved of their actions.

“They are all liable under the War Crimes Act and the Torture Statute,” Professor Cohn testified. “Under the doctrine of command responsibility, commanders, all the way up the chain of command to the commander-in-chief, are liable for war crimes if they knew or should have known their subordinates would commit them, and they did nothing to stop or prevent it. The Bush officials ordered the torture after seeking legal cover from their lawyers.”

The National Lawyers Guild calls on Congress to appoint a Special Prosecutor, independent of the Department of Justice, to investigate and prosecute the high officials of the Bush administration and the lawyers who advised them, for their roles in misusing the rule of law and legal analysis to justify torture and other crimes.

The White Paper can be read at www.nlg.org/news/statements/White Paper - Yoo hearing.doc

The trick requires a toothpick and transparent tape. A sleight-of-hand maneuver causes the toothpick to disappear then reappear. At least, so it seems. In reality, the toothpick hides behind the performer’s thumb, held in place by the tape.

“The whole thing lasted 45 seconds,” Piculas said.

He said the students liked the trick. He showed them how to do it so they could perform it at home.

One student in the Rushe Middle class apparently took the trick the wrong way, Piculas said. He said he was told the student became so traumatized that the student’s father complained.

Glad to hear that Florida school districts are protecting our students from the evils of magic.

The World at 350
A Last Chance for Civilization

By Bill McKibben

Even for Americans, constitutionally convinced that there will always be a second act, and a third, and a do-over after that, and, if necessary, a little public repentance and forgiveness and a Brand New Start — even for us, the world looks a little Terminal right now.

It’s not just the economy. We’ve gone through swoons before. It’s that gas at $4 a gallon means we’re running out, at least of the cheap stuff that built our sprawling society. It’s that when we try to turn corn into gas, it sends the price of a loaf of bread shooting upwards and starts food riots on three continents. It’s that everything is so inextricably tied together. It’s that, all of a sudden, those grim Club of Rome types who, way back in the 1970s, went on and on about the “limits to growth” suddenly seem… how best to put it, right.

All of a sudden it isn’t morning in America, it’s dusk on planet Earth.

There’s a number — a new number — that makes this point most powerfully. It may now be the most important number on Earth: 350. As in parts per million (ppm) of carbon dioxide in the atmosphere.

A few weeks ago, our foremost climatologist, NASA’s Jim Hansen, submitted a paper to Science magazine with several co-authors. The abstract attached to it argued — and I have never read stronger language in a scientific paper — “if humanity wishes to preserve a planet similar to that on which civilization developed and to which life on earth is adapted, paleoclimate evidence and ongoing climate change suggest that CO2 will need to be reduced from its current 385 ppm to at most 350 ppm.” Hansen cites six irreversible tipping points — massive sea level rise and huge changes in rainfall patterns, among them — that we’ll pass if we don’t get back down to 350 soon; and the first of them, judging by last summer’s insane melt of Arctic ice, may already be behind us.

So it’s a tough diagnosis. It’s like the doctor telling you that your cholesterol is way too high and, if you don’t bring it down right away, you’re going to have a stroke. So you take the pill, you swear off the cheese, and, if you’re lucky, you get back into the safety zone before the coronary. It’s like watching the tachometer edge into the red zone and knowing that you need to take your foot off the gas before you hear that clunk up front.

In this case, though, it’s worse than that because we’re not taking the pill and we are stomping on the gas — hard. Instead of slowing down, we’re pouring on the coal, quite literally. Two weeks ago came the news that atmospheric carbon dioxide had jumped 2.4 parts per million last year — two decades ago, it was going up barely half that fast.

And suddenly, the news arrives that the amount of methane, another potent greenhouse gas, accumulating in the atmosphere, has unexpectedly begun to soar as well. Apparently, we’ve managed to warm the far north enough to start melting huge patches of permafrost and massive quantities of methane trapped beneath it have begun to bubble forth.

And don’t forget: China is building more power plants; India is pioneering the $2,500 car, and Americans are converting to TVs the size of windshields which suck juice ever faster.

Here’s the thing. Hansen didn’t just say that, if we didn’t act, there was trouble coming; or, if we didn’t yet know what was best for us, we’d certainly be better off below 350 ppm of carbon dioxide in the atmosphere. His phrase was: “…if we wish to preserve a planet similar to that on which civilization developed.” A planet with billions of people living near those oh-so-floodable coastlines. A planet with ever more vulnerable forests. (A beetle, encouraged by warmer temperatures, has already managed to kill 10 times more trees than in any previous infestation across the northern reaches of Canada this year. This means far more carbon heading for the atmosphere and apparently dooms Canada’s efforts to comply with the Kyoto Protocol, already in doubt because of its decision to start producing oil for the U.S. from Alberta’s tar sands.)

We’re the ones who kicked the warming off; now, the planet is starting to take over the job. Melt all that Arctic ice, for instance, and suddenly the nice white shield that reflected 80% of incoming solar radiation back into space has turned to blue water that absorbs 80% of the sun’s heat. Such feedbacks are beyond history, though not in the sense that Francis Fukuyama had in mind.

And we have, at best, a few years to short-circuit them — to reverse course. Here’s the Indian scientist and economist Rajendra Pachauri, who accepted the Nobel Prize on behalf of the Intergovernmental Panel on Climate Change last year (and, by the way, got his job when the Bush administration, at the behest of Exxon Mobil, forced out his predecessor): “If there’s no action before 2012, that’s too late. What we do in the next two to three years will determine our future. This is the defining moment.”

In the next two or three years, the nations of the world are supposed to be negotiating a successor treaty to the Kyoto Accord. When December 2009 rolls around, heads of state are supposed to converge on Copenhagen to sign a treaty — a treaty that would go into effect at the last plausible moment to heed the most basic and crucial of limits on atmospheric CO2.

If we did everything right, says Hansen, we could see carbon emissions start to fall fairly rapidly and the oceans begin to pull some of that CO2 out of the atmosphere. Before the century was out we might even be on track back to 350. We might stop just short of some of those tipping points, like the Road Runner screeching to a halt at the very edge of the cliff.

More likely, though, we’re the Coyote — because “doing everything right” means that political systems around the world would have to take enormous and painful steps right away. It means no more new coal-fired power plants anywhere, and plans to quickly close the ones already in operation. (Coal-fired power plants operating the way they’re supposed to are, in global warming terms, as dangerous as nuclear plants melting down.) It means making car factories turn out efficient hybrids next year, just the way we made them turn out tanks in six months at the start of World War II. It means making trains an absolute priority and planes a taboo.

It means making every decision wisely because we have so little time and so little money, at least relative to the task at hand. And hardest of all, it means the rich countries of the world sharing resources and technology freely with the poorest ones, so that they can develop dignified lives without burning their cheap coal.

That’s possible — we launched a Marshall Plan once, and we could do it again, this time in relation to carbon. But in a month when the President has, once more, urged us to drill in the Arctic National Wildlife Refuge, that seems unlikely. In a month when the alluring phrase “gas tax holiday” has danced into our vocabulary, it’s hard to see (though it was encouraging to see that Clinton’s gambit didn’t sway many voters). And if it’s hard to imagine sacrifice here, imagine China, where people produce a quarter as much carbon apiece as we do.

Still, as long as it’s not impossible, we’ve got a duty to try. In fact, it’s about the most obvious duty humans have ever faced.

A few of us have just launched a new campaign, 350.org. Its only goal is to spread this number around the world in the next 18 months, via art and music and ruckuses of all kinds, in the hope that it will push those post-Kyoto negotiations in the direction of reality.

After all, those talks are our last chance; you just can’t do this one light bulb at a time. And if this 350.org campaign is a Hail Mary pass, well, sometimes those passes get caught.

We do have one thing going for us: This new tool, the Web which, at least, allows you to imagine something like a grassroots global effort. If the Internet was built for anything, it was built for sharing this number, for making people understand that “350″ stands for a kind of safety, a kind of possibility, a kind of future.

Hansen’s words were well-chosen: “a planet similar to that on which civilization developed.” People will doubtless survive on a non-350 planet, but those who do will be so preoccupied, coping with the endless unintended consequences of an overheated planet, that civilization may not.

Civilization is what grows up in the margins of leisure and security provided by a workable relationship with the natural world. That margin won’t exist, at least not for long, this side of 350. That’s the limit we face.

Bill McKibben is a scholar-in-residence at Middlebury College and co-founder of 350.org. His most recent book is The Bill McKibben Reader.

Copyright 2008 Bill McKibben

War. We don’t really know what this means. Children hopped up on drugs fighting the country’s wars, people getting killed for others’ small gain. No, we don’t know of this but we do know that war occurs yet even though our country is in one at this very moment we don’t stray far from our regular lives. Others die as we relax in front of the television and others sacrifice their lives…but for what. They always say “we’re protecting our country;” the irony of this statement is from what. The battles being fought aren’t on our soil so we don’t really know what war is like. We can see it, hear about it, even get involved with stopping it but we will never know what war is like. Our war was a pointless war. We wanted oil and so we attacked innocent Iraq when our oil buddies in Saudi Arabia had most of the terrorists behind the 911 bombings, but who cares. So while people fight and get killed every day, we can’t only do anything but hope that this war we never knew ends.