Doctors “calibrated” pain for CIA interrogations

[Magda Hassan]

Doctors “calibrated” pain for CIA interrogations

By Ed Hightower
12 June 2010

First, do no harm.

-Hippocratic Oath
According to a recent report, the CIA’s Office of Medical Services (OMS) utilized doctors to carefully monitor the physical effects of torture techniques on prisoners.
The report, issued by the non-profit organization Physicians for Human Rights, relies on declassified government documents to demonstrate that the CIA and other agencies, including the Department of Justice’s Office of Legal Counsel, engaged in human experimentation in violation of international law, domestic law and relevant ethical requirements for health care professionals.
While government experiments on tortured detainees were expanded under the Bush administration, the same secret detention and interrogation have continued under the Obama administration. Obama, whose mantra on questions of torture has been “looking forward, not backward,” has acted to shield officials who crafted the legal framework for abuses.
The presence of medical professionals during “enhanced interrogations” served several purposes: to undermine the traditional meaning of “torture”; to legally protect interrogators who could claim the interrogations were in the presence of medical personnel and therefore “safe”; and to meticulously refine the effectiveness of such illegal techniques as waterboarding, sleep deprivation, “stress” positions and physical beating.
The report, Experiments in Torture: Human Subject Research and Experimentation in the “Enhanced” Interrogation Program, provides ample and specific evidence of the use of physicians. By gathering data on the effects of torture on human subjects, doctors, psychologists and others working for the CIA treated detainees as human guinea pigs.
The report focuses on the ethical violations of medical professionals. However, its findings also reveal a consensus within the US ruling elite that torture is not only acceptable, but imperative.
Already, the government’s application of medical science to torture has resulted in new standards and practices. A striking example is waterboarding. This technique, banned by international law, involves fastening the subject to a table, face up, and slowly pouring water into the subject’s face to induce the sensation of drowning.
The report cites official CIA instructions to OMS (Office of Medical Services) for observation of waterboarding, which specifically directed medical professionals to document the length of each application of water, how the water was applied, if a seal was formed, if the nasopharynx or oropharynx were filled, how much water was spilled, and how the subject appeared afterwards. The subject’s vital signs, including blood-oxygen level, were also recorded.
As a direct result of data taken from subjects of waterboarding, the CIA introduced substantial changes in this practice, which it dubbed “Waterboarding 2.0.” In order to mitigate the risk of subjects choking on their own food during this torture, the CIA feeds a liquid diet to prospective subjects. In place of fresh water a mild saline solution is now used to avoid pneumonia or hyponatremia, a condition marked by low sodium levels, which can result in brain damage, coma and death. OMS professionals supervised the implementation of a new device that can quickly move a subject into upright position in case of drowning. Finally, a tracheotomy kit is present, though hidden, in case the subject chokes.
The report notes that Khalid Sheik Mohammed, a high value detainee, was tortured by waterboarding at least 183 times.
OMS employees observed 25 detainees undergo individual and combined applications of torture techniques for the Office of Legal Counsel. The Justice Department used these observations to argue that various techniques were legal because they did not cause “severe pain.”
The Physicians for Human Rights report cites a 2005 memo from Steven G. Bradbury, principal deputy assistant attorney general to CIA senior deputy general counsel documenting the OMS findings:
“No apparent increase in susceptibility to severe pain has been observed either when techniques are used sequentially or when they are used simultaneously—for example, when an insult slap is simultaneously combined with water dousing or a kneeling stress position, or when wall standing is simultaneously combined with an abdominal slap and water dousing.Nor does experience show that, even apart from changes in susceptibility to pain, combinations of these techniques cause the techniques to operate differently so as to cause severe pain. OMS doctors and psychologists, moreover, confirm that they expect that the techniques, when combined as described in the Background Paper and in the April 22 [redacted] Fax, would not operate in a different manner from the way they do individually, so as to cause severe pain.” [Emphasis added]
Standing behind this type of “science,” CIA and other interrogators can engage in the most savage physical and psychological abuse, and then claim that it is safe, even doctor-approved.

The same “combined techniques” memo reveals a similar attitude toward sleep deprivation. The OLC’s Bradbury writes:
“You have informed us that to date, more than a dozen detainees have been subjected to sleep deprivation of more than 48 hours, and three detainees have been subjected to sleep deprivation of more than 96 hours; the longest period of time for which any detainee has been deprived of sleep by the CIA is 180 hours. Under the CIA’s guidelines, sleep deprivation could be resumed after a period of eight hours of uninterrupted sleep, but only if OMS personnel specifically determined that there are no medical or psychological contraindications based on the detainee’s condition at that time. As discussed below, however, in this memorandum we will evaluate only one application of up to 180 hours of sleep deprivation.”
Sleep deprivation is intended to disorient and otherwise psychologically weaken subjects for interrogation purposes. Ill effects include hallucinations, other mental health issues, even problems with metabolism. According to earlier military studies conducted on consenting soldiers under the SERE (Survival, Evasion, Resistance and Escape)—a program that trains soldiers to resist torture—torture techniques caused levels of stress hormones as high as those associated with major surgery, combat or other PTSD-causing trauma and high enough to suppress immune responses. Even with consenting subjects, who had the ability to terminate the technique, 96 percent had dissociative experiences. The degree of suffering is no doubt far more severe for detainees held, often for years, without any access to counsel or the outside world at all.
From the above excerpt and many others in the Physicians for Human Rights report, it is clear that those at the highest echelons of state power consider the use of medical science as a legitimate means to develop and defend the torture of human beings. The application of exacting technical skill toward such ends is another expression of the degeneration of American politics, the ruthlessness of its representatives, as well as the reactionary character of the ruling class as a whole. Having practitioners of the healing arts present at torture sessions turns medicine into its opposite: the science of harming.
The author also recommends:
US continues to detain, torture prisoners at secret Afghan base
http://www.wsws.org/articles/2010/jun201...-j12.shtml

[Jan Klimkowski]

Medical students are trained to develop a clinical distance from their patients. This clinical distance, or lack of emotional attachment, is regarded as essential to enable them to treat their patients with professional objectivity.

This is worth comparing with the following:

Psychopathy (pronounced /saɪˈkɒpəθi/[1][2]) is a personality disorder characterized by an abnormal lack of empathy combined with strongly amoral conduct, masked by an ability to appear outwardly normal. Neither psychopathy, nor the similar concept of sociopathy, are nowadays defined in international diagnostic manuals, which instead describe a category of antisocial/dissocial personality disorder.

This is not to say that student doctors are necessarily trained to develop the psychological lack of empathy of psychopaths.

However, it is presumably this clinical distance which, in part, enables spook doctors to behave entire dispasionately towards individuals being tortured, and to see their role as being merely to measure vital signs, degrees of pain, etc.

Either that. Or these "doctors" were born without a functioning moral conscience......

[Magda Hassan]

I keep thinking of Dan Mitrione when I read this article. "The precise pain, in the precise place, in the precise amount, for the desired effect."

[Peter Presland]

I keep thinking of Dan Mitrione when I read this article. "The precise pain, in the precise place, in the precise amount, for the desired effect."

Echoes of another calibration tool too - that of 'terrorist violence' - the precise collective pain, in the precise place, in the precisely amount, for the desired affect...... of producing the required levels of fear, outrage and projection of hatred against designated racial, religious, or other groupings .... and all for purposes now blindingly obvious to anyone not wearing a blindfold.

[Magda Hassan]

More on How Physicians Became Torture Doctors for CIA


Posted by Kevin Gosztola on @ 9:05 am
Article printed from speakeasy: http://blogs.alternet.org/movingtrainmedia
URL to article: http://blogs.alternet.org/movingtrainmed...s-for-cia/




A good amount of documentation on the involvement of psychologists in the torture and abuse of detainees or “terror suspects.” And, a new study provides even more revelations on the involvement of physicians making it increasingly clear that medical professionals put limits on ethical standards they were expected to follow in order to help the CIA interrogate detainees.

The study, titled “Roles of CIA Physicians in Enhanced Interrogation and Torture of Detainees,” authored by Leonard S. Rubinstein, the president of Physicians for Human Rights, and Brigadier General (ret.) Stephen N. Xenakis, a former Army psychiatrists (who is now with the Center for Public Health and Human Rights), utilizes a previously secret document from 2004 and lays out the “guidelines for detainee interrogation” that physicians, psychologists, and other health care professionals developed and followed so they could serve the CIA.

Guidelines indicate the doctors, who were working for the CIA’s Office of Medical Services, conducted medical evaluations [experimentations] on detainees “before and during interrogations” and waterboarding “required the presence of a physician.”

Physicians documented the effects of “enhanced interrogation techniques” [torture] like waterboarding and decided waterboarding “created risks of drowning, hypothermia, aspiration pneumonia, or laryngospasm.” They ignored “clinical experience/research” and assured lawyers “there was no ‘medical reason’ to believe that waterboarding [would] lead to physical pain.”

It was established that “cramped confinement could result in deep vein thrombosis” and death could result from “lengthy exposure to cold water.” And, the physicians, psychologists, and other health care professionals working for the CIA developed “limitations” so that techniques like waterboarding, cramped confinement, sensory deprivation, stress positions, etc could be used on detainees.

Limitations included: “exposure to specified temperature either up to time of hypothermia would develop or on evidence of hypothermia,” dietary restrictions up to “body weight loss of 10% or evidence of significant malnutrition,” “exposure to noise just under decibel levels associated with hearing loss,” up to 48 hours of exposure to stress positions “provided hands were no higher than the head” of a detainee, and no more than eight consecutive hours or eighteen hours per day of “confinement in a box.”

Much of this took place after 2003, after a CIA Inspector General investigation of “enhanced interrogation techniques” [torture], OMS physicians were asked to provide “opinions to the agency and lawyers on whether techniques used would be expected to cause severe pain or suffering and thus constitute torture.” Slowly, OMS physicians’ work for the CIA transformed into work, which violated “ethical standards,” prohibiting physicians from using “medical skills to facilitate torture or be present when torture is taking place.”

The physicians consulted directly with Department of Justice lawyers and were asked to provide legal cover by supporting “legal decisions” that “interrogators who applied enhanced interrogation techniques neither inflicted sever mental or physical pain or anguish and thus did not commit torture.” For techniques like sleep deprivation, they claimed the use thereof “could not lead to profound disruption in the detainees’ senses or personality (the legal definition of psychological torture).”

As suggested in the opening paragraph, it has been evident that physicians and psychologists have been involved in torture for some time, especially since Wikileaks leaked the Guantanamo Standard Operating Procedures Manual in November 2007.

The manual indicated that, “incoming prisoners were to be held in near-isolation for the first [four] weeks to foster dependence on interrogators and `enhance and exploit the disorientation and disorganization felt by a newly arrived detainee in the interrogation process.’” It outlines how isolation was to be used on detainees, a technique Physicians for Human Rights said can lead to symptoms of “`bewilderment, anxiety, frustration, dejection, boredom, obsessive thoughts or ruminations, depression, and, in some cases, hallucination’” and, if prolonged, could result in “increased stress, abnormal neuroendocrine function, changes in blood pressure and inflammatory stress responses.”

Then, it was known those involved understood how they could be prosecuted for violating international law. As an April 16, 2003, memo from Defense Secretary Donald Rumsfeld explained

“Caution: the use of isolation as an interrogation technique requires detailed implementation instructions, including specific guidelines regarding the length of isolation, medical and psychological review, and approvals for extension of the length of by the appropriate level in the chain of command. This technique is not know to have been generally used for interrogation purposes for longer than 30 days. Those nations that believe that detainees are subject to POW protections may view use of this technique as inconsistent with the requirements of Geneva III, Article 13 which provides that POWs must be protected against acts of intimidation; Article 14 which provides that POWs are entitled to respect for their person; Article 34 which prohibits coercion and Article 126 which ensures access and basic standards of treatment. Although the provisions of Geneva are not applicable to the interrogation of unlawful combatants, consideration should be given to these views prior to application of this technique.”

The report is yet another indication of the need for more investigation, accountability, and reform from the Obama Administration. Yet, as demonstrated by a comprehensive report (”Establishing the New Normal“) from the ACLU, the Obama Administration has avoided its obligation to accountability for torture and chosen to follow the dangerous mantra of “looking forward, not back,” a false choice because, as the ACLU states in the report:

“a strong democracy rests not on the goodwill of its leaders but on the impartial enforcement of laws. Sanctioning impunity for government officials who authorized torture sends a problematic message to the world, invites abuses by future administrations, and further undermines the rule of law that is the basis of any democracy.”

[Jan Klimkowski]

Then, it was known those involved understood how they could be prosecuted for violating international law. As an April 16, 2003, memo from Defense Secretary Donald Rumsfeld explained

“Caution: the use of isolation as an interrogation technique requires detailed implementation instructions, including specific guidelines regarding the length of isolation, medical and psychological review, and approvals for extension of the length of by the appropriate level in the chain of command. This technique is not know to have been generally used for interrogation purposes for longer than 30 days. Those nations that believe that detainees are subject to POW protections may view use of this technique as inconsistent with the requirements of Geneva III, Article 13 which provides that POWs must be protected against acts of intimidation; Article 14 which provides that POWs are entitled to respect for their person; Article 34 which prohibits coercion and Article 126 which ensures access and basic standards of treatment. Although the provisions of Geneva are not applicable to the interrogation of unlawful combatants, consideration should be given to these views prior to application of this technique.”

The report is yet another indication of the need for more investigation, accountability, and reform from the Obama Administration.

My bold highlighting.

In other words, the treatment of these prisoners was clearly in breach of the Geneva Convention on several counts. Therefore, the Bush regime and its lackey lawyers and shrinks unilaterally decided that Geneva did not apply.