CIA medical doctors helped significantly in the torture
M. Gregg Bloche reports in the NY Times:
President-elect Donald J. Trump on Tuesday expressed reservations about the use of torture. But he did not disavow the practice, or his promise to bring it back. And if he does, C.I.A. doctors may be America’s last defense against a return to savagery. But they’ll need to break sharply with what they did the last time around.
Buried in a trove of documents released last summer is the revelation that C.I.A. physicians played a central role in designing the agency’s post-Sept. 11 torture program. The documents, declassified in response to an American Civil Liberties Union lawsuit, show in chilling detail how C.I.A. medicine lost its moral moorings. It’s long been known that doctors attended torture as monitors. What’s new is their role as its engineers.
The documents include previously redacted language from a directive by the C.I.A.’s Office of Medical Services telling physicians at clandestine interrogation sites to flout medical ethics by lying to detainees and collaborating in abuse. This language also reveals that doctors helped to design a waterboarding method more brutal than what even lawyers for the George W. Bush administration allowed.
The directive counsels that clinical care “not undermine the anxiety and dislocation that the various interrogation techniques are designed to foster.” It instructs physicians not to “appear overly attentive” and to confound patients’ expectations via deceit. Recommended tactics include doing clinical exams while pretending to be guards, changing medication schedules to disrupt detainees’ sense of time and hiding drugs in food.
It also outlines protocols for prolonged shackling in painful positions that would permit development of skin lesions and edema (swelling because of leakage of fluid from blood vessels) up to the knees. Sleep-deprivation protocols call for a balance between breaking detainees’ resistance and preserving their capacity to provide information.
If forced wakefulness “is intended to be one element in the process of demonstrating helplessness in an unpleasant environment,” the directive counsels, two-hour “naps” between days of sleeplessness are “sufficient.”
Previously redacted language also discloses the origin of the degrading practice of “rectal hydration,” first reported by the Senate Select Committee on Intelligence in 2014: The medical service advised that “individuals refusing adequate liquids” be given fluids forcibly, through a “rectal tube.”
Other language shows that C.I.A. physicians collaborated in waterboarding more terrifying and dangerous than what government lawyers permitted. The Justice Department allowed interrogators to simulate drowning for up to 40 seconds by using a wet cloth to block air flow through the nose and mouth. But according to the directive, the medical service determined that a good air seal “was not easily achieved by the wet cloth.” So it instead went along with pouring “up to several liters of water” onto captives’ faces.
“The resulting occlusion,” the directive said, “was primarily from water filling the nasopharynx, breathholding, and much less frequently the oropharynx being filled — rather than the ‘sealing’ effect of the saturated cloth.” The drowning experience, in other words, wasn’t simulated; it was real.
That C.I.A. interrogators actually employed this method is consistent with videotapes of waterboarding sessions. A 2004 review of these since-destroyed videos found that instead of using the wet-cloth technique, interrogators “continuously applied large volumes of water.” The review, by the C.I.A.’s inspector general, noted that this “differed” from what the Justice Department had authorized. The agency’s method, a psychologist-interrogator told the inspector general, was “more poignant and convincing.”
The medical service instructed physicians to manage waterboarding’s dangers by combining the practice with sleep deprivation and shackling of detainees in stressful positions; this, the service advised, could “prolong the period of moderate use of the waterboard by reducing the intensity of its early use.”
The service conceded in the recently released text that the abuse its doctors helped to plan put detainees at deadly risk. Inhalation of water, spasm of the larynx, hypothermia and lung and limb infections are among the hazards physicians were told to watch for.
The role of physicians included assessing the comparative efficacy of abusive methods. The medical service judged extended sleep deprivation “most effective” because of its “demonstrably cumulative” contribution toward “demonstrating helplessness in an unpleasant environment.” But it concluded that confinement in tiny boxes worked poorly since this offered “a respite from interrogation,” and it expressed skepticism about the effectiveness of waterboarding.
Some of the agency’s doctors challenged the torture program’s efficacy and questioned why the psychologists who created it served in conflicting roles as both its managers and evaluators. There were objections, as well, to the ethics of putting behavioral science to such brutal use. But the program’s advocates prevailed, and the medical service instructed its physicians accordingly. There have been no public indications that any refused to go along.
Unlike the contractor-psychologists who created the torture program and have faced public excoriation, the C.I.A. physicians who helped design it remain anonymous. . .
And the Obama administration established that torturing prisoners carries no penalty. Those who torture people at the government’s orders received decorations and promotions but no punishment or accountability
The belated discovery that physicians were directly involved in torturing prisoners and in devising ways to make the torture worse is exactly why there should have been a serious investigation rather than a cover-up, and the findings should have been shared with the public.