Medical professional forced to torture by DoD & CIA

[David Guyatt]

I'm not quite sure how anyone can be convinced to torture and water board detainees contrary ton their own standards, but that's just me I suppose.

But any medical professional guilty of the worst excesses should now expect to pay the price for their weakness by being banned from practising their profession?

CIA made doctors torture suspected terrorists after 9/11, taskforce finds

Doctors were asked to torture detainees for intelligence gathering, and unethical practices continue, review concludes

• Sarah Boseley, health editor
  
• The Guardian, Monday 4 November 2013
  
• Jump to comments (110)
  

An al-Qaida detainee at Guantanamo Bay in 2002: the DoD has taken steps to address concerns over practices at the prison in recent years. Photograph: Shane T Mccoy/PA

Doctors and psychologists working for the US military violated the ethical codes of their profession under instruction from the defence department and the CIA to become involved in the torture and degrading treatment of suspected terrorists, an investigation has concluded.
The report of the Taskforce on Preserving Medical Professionalism in National Security Detention Centres concludes that after 9/11, health professionals working with the military and intelligence services "designed and participated in cruel, inhumane and degrading treatment and torture of detainees".
Medical professionals were in effect told that their ethical mantra "first do no harm" did not apply, because they were not treating people who were ill.
The report lays blame primarily on the defence department (DoD) and the CIA, which required their healthcare staff to put aside any scruples in the interests of intelligence gathering and security practices that caused severe harm to detainees, from waterboarding to sleep deprivation and force-feeding.
The two-year review by the 19-member taskforce, Ethics Abandoned: Medical Professionalism and Detainee Abuse in the War on Terror, supported by the Institute on Medicine as a Profession (IMAP) and the Open Society Foundations, says that the DoD termed those involved in interrogation "safety officers" rather than doctors. Doctors and nurses were required to participate in the force-feeding of prisoners on hunger strike, against the rules of the World Medical Association and the American Medical Association. Doctors and psychologists working for the DoD were required to breach patient confidentiality and share what they knew of the prisoner's physical and psychological condition with interrogators and were used as interrogators themselves. They also failed to comply with recommendations from the army surgeon general on reporting abuse of detainees.
The CIA's office of medical services played a critical role in advising the justice department that "enhanced interrogation" methods, such as extended sleep deprivation and waterboarding, which are recognised as forms of torture, were medically acceptable. CIA medical personnel were present when waterboarding was taking place, the taskforce says.
Although the DoD has taken steps to address concerns over practices at Guantánamo Bay in recent years, and the CIA has said it no longer has suspects in detention, the taskforce says that these "changed roles for health professionals and anaemic ethical standards" remain.
"The American public has a right to know that the covenant with its physicians to follow professional ethical expectations is firm regardless of where they serve," said Dr Gerald Thomson, professor of medicine emeritus at Columbia University and member of the taskforce.
He added: "It's clear that in the name of national security the military trumped that covenant, and physicians were transformed into agents of the military and performed acts that were contrary to medical ethics and practice. We have a responsibility to make sure this never happens again."The taskforce says that unethical practices by medical personnel, required by the military, continue today. The DoD "continues to follow policies that undermine standards of professional conduct" for interrogation, hunger strikes, and reporting abuse. Protocols have been issued requiring doctors and nurses to participate in the force-feeding of detainees, including forced extensive bodily restraints for up to two hours twice a day.
Doctors are still required to give interrogators access to medical and psychological information about detainees which they can use to exert pressure on them. Detainees are not permitted to receive treatment for the distress caused by their torture.
"Putting on a uniform does not and should not abrogate the fundamental principles of medical professionalism," said IMAP president David Rothman. "'Do no harm' and 'put patient interest first' must apply to all physicians regardless of where they practise."The taskforce wants a full investigation into the involvement of the medical profession in detention centres. It is also calling for publication of the Senate intelligence committee's inquiry into CIA practices and wants rules to ensure doctors and psychiatrists working for the military are allowed to abide by the ethical obligations of their profession; they should be prohibited from taking part in interrogation, sharing information from detainees' medical records with interrogators, or participating in force-feeding, and they should be required to report abuse of detainees.

[Magda Hassan]

This is just crap. They have spines made of jelly and no morals at all. That is it. No one made any doctor do any thing that they did not want to go along with. Of course they should not only be struck off for ever but criminally charged with everything possible. If these doctors had stood their professional ground and told the DoD there would be no co-operation and in fact report what was happening in the US gulags, for that is what they are nothing less, it never would have gone this far. They are lower than pond scum.

[Magda Hassan]

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Blue Ribbon Task Force Says Army Field Manual on Interrogation Allows Torture, Abuse

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A report by a multidisciplinary task force, made up largely of medical professionals, ethicists and legal experts, has called on President Obama to issue an executive order outlawing torture and other abusive techniques currently in use in the military's Army Field Manual on interrogations. The Task Force, which wrote the report for The Institute on Medicine as a Profession (IMAP) and the Open Society Foundations (OSF), has also called on the Department of Defense to rewrite the Army Field Manual in accordance with such an executive order.
The recommendation for action on the Army Field Manual (AFM) was the second finding and recommendation in the report (PDF):

The president has issued an executive order prohibiting the use of torture and other forms of cruel, inhuman, or degrading treatment, and has repudiated Justice Department legal memoranda authorizing its use. However, the Army Field Manual on Human Intelligence Collector Operations, which binds both military and CIA interrogators, permits methods of interrogation that are recognized under international law as forms of torture or cruel, inhuman, or degrading treatment. Such methods include sleep deprivation, isolation, and exploitation of fear.

Besides recommending that the Department of Defense (DoD) revise the AFM itself, the Task Force report calls for the United States to "accede to the Optional Protocol to the Convention Against Torture, which requires the creation of an independent domestic monitoring body for the purpose of preventing torture against individuals in custody."
The recommendation to issue a new executive order on current forms of torture and abuse, and to rewrite the Army Field Manual is one of eight findings and numerous recommendations in the report. The first recommendation was for President Obama to "order a comprehensive investigation of U.S. practices in connection with the detention of suspected terrorists following 9/11 and report the results to Congress and the American people."
The report continued, "The investigation should include inquiry into the circumstances, roles, and conduct of health professionals in designing, participating in, and enabling torture or cruel, inhuman, or degrading treatment of detainees in interrogation and confinement settings and why there were few if any known reports by health professionals." In the body of the report, the Task Force indicated the investigation should include an examination of the "highly questionable" and "unexplained" use of the drug mefloquine on all the Guantanamo detainees, something I will examine in more depth in a future article.
Entitled Ethics Abandoned: Medical Professionalism and Detainee Abuse in the "War on Terror", the IMAP/OSF report was written by the Task Force on Preserving Medical Professionalism in National Security Detention Centers. The TF roster included a former president of the American Psychiatric Association; the President of IMAP; the Chair of the Department of Health Law, Bioethics & Human Rights at the Boston University School of Public Health; a member of the International Committee of the Red Cross; a former Army general; and, controversially, the former Chief Surgeon and head of the Naval Hospital at Guantanamo, among other distinguished members.
Transforming Physicians into "Agents of the Military"
The bulk of the report concerns the ways in which the CIA and the Department of Defense, with the connivance of the Department of Justice, changed the rules and procedures surrounding the use of health care professionals in interrogations and national security detention centers such that doctors and psychologists were enlisted in the design, participation and enabling of torture and cruel, inhumane and degrading treatment of detainees.
The task force moreover found that health care professionals caused grave harm to those who otherwise should have been in their care, or to those whom they were otherwise under an ethical and professional obligation not to harm. Task Force member Dr. Gerald Thomson, Professor of Medicine Emeritus at Columbia University, said in a press release, "It's clear that in the name of national security the military trumped that covenant, and physicians were transformed into agents of the military and performed acts that were contrary to medical ethics and practice. We have a responsibility to make sure this never happens again."
According to the Task Force, DoD and the CIA accomplished the subornation of doctors and psychologists to torture by three mechanisms: the government's labeling of prisoners as "'unlawful combatants' who did not qualify as prisoners of war under the Geneva Conventions," along with the Department of Justice approval of "interrogation methods recognized domestically and internationally as constituting torture or cruel, inhuman, or degrading treatment"; "undermining health professionals' allegiances to established principles of professional ethics and conduct through reinterpretation of those principles; and pervasive secrecy. (See Kevin Gosztola's story at The Dissenter.)
This is the second report in a little over six months to document the activity of medical professionals in the torture and abuse of detainees. Published last April, The Constitution Project's report on detainee abuse also noted that the Army Field Manual allowed for abuse and called for DoD "to eliminate [the AFM's] Appendix M, which permits the use of abusive tactics…. Language prohibiting the use of stress positions and abnormal sleep manipulation that was removed [from the AFM] in 2006 should be restored." (For the full report, see PDF.)
The AFM's Covert Actualization of Torture
I have followed the story of the new Army Field Manual since it was released in September 2006. In aJanuary 2009 article at AlterNet I noted that rather than an alternative to torture, the Army Field Manual eliminated some of the worst of the CIA's "enhanced interrogation techniques," like waterboarding, only to take the standard operating procedure of Camp Delta at Guantanamo Bay and expand it all over the world.
In its Appendix M, meant only for detainees who did not qualify for the Geneva Conventions' Prisoner of War protections, under a deceptive omnibus "technique" called "Separation," the new AFM allowed for ongoing isolation and sleep deprivation of prisoners, for dietary and environmental manipulations, so long as they were not "extreme", and for forms of sensory deprivation (under the description "field expedient separation").

The President of the National Lawyers Guild Marjorie Cohn has stated that portions of the AFM protocol, especially the use of isolation and prolonged sleep deprivation, constitutes cruel, inhuman or degrading treatment or punishment and is illegal under the Common Article 3 of the Geneva Conventions, the U.N. Convention Against Torture and the International Covenant on Civil and Political Rights. Hina Shamsi, an attorney with the ACLU's National Security Project, has stated that portions of the AFM are "deeply problematic" and "would likely violate the War Crimes Act and Geneva," and at the very least "leave the door open for legal liability." Physicians for Human Rights and the Constitution Project have publicly called for the removal of problematic and abusive techniques from the AFM.
Yet, the interrogation manual is still praised by politicians, including then-presidential candidate Barack Obama, who in December 2007 said he would "have the Army Field Manual govern interrogation techniques for all United States Government personnel and contractors."

The authors of the 2006 Army Field Manual presented their work as reform, and at first that's what many believed. Even today, Appendix M is represented as a single "technique." Some misunderstand the idea of "separation" and think it has something to do with isolating prisoners for safety or security reasons. But the Manual itself (PDF) calls such separation for security reasons "segregation," and specifically says the "Separation" discussed in Appendix M is not the same as security segregation but is meant for interrogation purposes, its techniques to be applied with others in the Army Field Manual, including Fear Up and Ego Down techniques, i.e., with use of fear and humiliation.
Yet all of this was presented with prettified words of adherence to Geneva, and forbidding of torture and abusive techniques like waterboarding and hooding, or use of dogs, types of torture and abuse allowed by the CIA and DoD during the Bush years.
The Torture Memo That Obama Never Rescinded
Obama was a man of his word, and he eliminated the CIA "enhanced interrogation" program, and withdrew the torture memos that had justified it. Or at least that was the impression. In fact, as I revealed in anarticle at The Dissenter on May 1 this year, Obama never rescinded all the Yoo/Bybee/Bradbury Office of Legal Council memos on interrogation, but had passed them on to his Attorney General for final disposition. Bradbury's April 16, 2006 memo on the Army Field Manual and Appendix M was never rescinded, according to a spokesperson for the Department of Defense. (DoJ has refused substantive comment on the issue.)
Bradbury's memo was deeply dishonest. It made assertions about the legality of techniques that were never documented (though they were presented in a verbal report to Congress). He approved the constitutionality of the bulk of the AFM (everything except Appendix M) in one sentence, hiding the fact that the manual had changed in substantive ways from earlier versions, besides the addition of Appendix M. This included an expansion of the "Fear Up" technique to include the exploitation of "new" phobias in prisoners, the elimination of the prohibition against stress positions and sleep deprivation, and a widening of the latitude in using drugs on prisoners.
The truth about how the Army Field Manual has been used to hide abuse of prisoners has been largely hidden from the public. Although both the IMAP/OSF and Constitution Project reports have gotten a lot of press coverage, very little of the coverage has noted the calls for a revision of the Army Field Manual, or the fact the AFM even has techniques that amount to torture and cruel, inhuman or degrading treatment.
To the calls for an executive order and rewriting the field manual must be added the revocation of the Bradbury Army Field Manual/Appendix M memo.
Obama, the Army Field Manual, and Torture
A lot has been made in recent years about how the New York Times is reticent to use the word "torture" to describe what is under any common sense or legal definition torture. That is certainly a disgraceful adaptation to the U.S. government's policies on interrogation, which include Bush and Cheney's outright advocacy of torture to the Obama administration's refusal to investigate or hold accountable those who tortured.
Even more egregious has been the characterization by the Times of the Army Field Manual as "nonabusive." Charlie Savage characterized the Army Field Manual as "nonabusive" in a widely-distributedarticle, "Election to Decide Future Interrogation Methods in Terrorism Cases" (Sept. 27, 2012). Savage's contention that Obama has stuck to a "strict no-torture policy" is belied by the evidence. Such misinformation, whether intentional or not, does real harm, the more so as it comes from an authoritative source.
As difficult as it is for many people to accept, we know from all that is described above that the Obama administration is itself involved in torture, from its approval of extraordinary rendition to the documented operation of detention centers, ostensibly under the administration of allied forces, where torture takes place. (See this 2011 report in The Nation by Jeremy Scahill about CIA torture sites in Somalia.) Other accusations of torture by agencies such as the Federal Bureau of Investigation exist as well.
Yet it is the covert actualization of torture in the Army Field Manual that is the most pervasive application of torture at this date, as the AFM is the primary standard for interrogations used by both DoD and the CIA.
The IMAP/OSF report notes that the U.S. torture program was predicated on the production of "debility, dependency and dread" in those who are interrogated (see pgs. xiv and 18). The origin of this "DDD"-style torture was the research done under the CIA's MKULTRA and associated programs, which included DoD behavioral research on SERE-style training to withstand torture even as early as the 1950s. (For more on this aspect of the story, see "Beware Misdirection on Torture (the DDD' Story)" and "Top U.S. Behavioral Scientists Studied Survival Schools to Create Torture Program Over 50 Years Ago.")
The Army Field Manual utilizes precisely this program: isolation and sleep deprivation to produce both debility and dependency, use of "Fear Up" and sensory deprivation to cause "dread." Sometimes drugs are used to enhance these effects. The IMAP/OSF report notes the research I did with Jason Leopold, which culminated in the FOIA release of the DoD's Inspector General report on drugging, which admitted to both involuntary drugging of prisoners, and the fact that at least one prisoner (Jose Padilla) was made to think he had been given hallucinogenic drugs, in order to cause fear and disorientation.
The reason serious problems with the Army Field Manual issue do not command more interest among the American people is political. The issue usually goes unreported. The significance of the fact the nation's primary interrogation manual utilizes torture and abuse is not recognized, though this is primarily because the press does not push it. Even the human rights organizations who have publicly taken the AFM to task, or publicly called for change, do not put the issue on the front burner. Indeed, even IMAP left their recommendation to rewrite the Army Field Manual out of its press release.
But the fact remains that more and more sections of the Establishment are able to see through the propaganda and ignorance surrounding the nation's interrogation protocols. While the IMAP/OSF and Constitution Project reports represent important steps forward in the battle to end torture, it will take a political battle with major elements within the Democratic Party who still support the Army Field Manual and other aspects of the militarist program that is the "war on terror" to make the changes in interrogation policy something concrete and not only aspirational.
http://dissenter.firedoglake.com/2013/11...ure-abuse/