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The latest CIA Inspector General’s May 2004 Counterterrorism Detention and Interrogation Activities Report, released to the public on August 24, 2009, describes previously unknown or unconfirmed interrogation practices performed by the CIA and colluding health professionals. The report highlights the role of the physicians and psychologists who advised and monitored — and thus legitimized — the controversial interrogation methods carried out in support of counterterrorism. The illegal and unethical practices, supervised and implicitly sanctioned by medical professionals, violate US detainee treatment protocol, international human rights standards, the right to health doctrine, and medical ethics.

A team of doctors from Physicians for Human Rights (PHR) highlighted the recent disclosures in a white paper released seven days after the Inspector General’s August report, titled Aiding Torture: Health Professionals’ Ethics and Human Rights Violations Revealed in the May 2004 CIA Inspector General’s Report. The analysis dovetails a related 2007 report written by PHR and Human Rights First, Leave No Marks, which examines the physical and mental effects of the interrogation methods disclosed up to that point, including “forced nudity, isolation, white noise or loud music, continu­ous light or darkness, temperature ma­nipulation, stress positions, sleep deprivation, attention slap, abdominal slap, stress positions and waterboarding.”

The techniques described in the Inspector General’s report amount to torture from both a medical and legal standpoint. These unapproved methods include the following:

• Mock executions and threatening detainees by brandish­ing handguns and power drills;
• Threatening the detainee with harm to family mem­bers, including sexual assault of female family members and murder of detainee’s children; and
• Physical abuse, including the application of pressure to the arteries on the sides of a detainee’s neck, resulting in near loss of consciousness, and tackling or hard take­downs.

Aiding Torture also examines the effects of other interrogation techniques. These include “forced shaving, hooding, restricted diet, prolonged diapering, ‘walling’ and confinement boxes.”

The mandated presence and resulting participation or complicity of health professionals during the interrogation sessions aggravates the case against the “efficacy and safety” of the CIA’s practices. The health professionals and psychologists — Office of Medical Services employees and Department of Defense contractors, respectively — selected, reasoned, and monitored the prisoners’ treatment based on their own initial assessments of mental and physical health. Directly or indirectly, they acted against the sanctified ethics of their profession. As PHR observes, “The required presence of health professionals did not make these methods safer, and in fact only served to sanitize their use and enable the abuse to escalate, thereby placing health professionals in the untenable position of calibrating harm rather than serving as protectors and healers as required by their ethical oath.”

To conclude its analysis, PHR calls for a “full investigation” of war crimes and “reparation” for wrongdoing in the form of financial, psychological, or medical compensation. They call for the incrimination and loss of licensure for health professionals who acted complicity or assertively in the CIA torture procedures. The Inspector General’s report serves as a disturbing and important reminder that interrogation procedures must be reworked and that torture crimes must be redressed. Beyond targeting individual accountability, the US should take a closer look at a system that winds up implicating its own workforce.

For further reading, please see:

Broken Laws, Broken Lives by PHR

International Committee of the Red Cross Report

Military Commissions Act of 2006

A Summary of United Nations Agreements on Human Rights

Enhanced Interrogation Techniques

Newsweek article about the release of the Inspector General’s Report

Mother Jones article on torture psychologists

Future of Freedom Foundation

Salon.com article on the “CIA’s secret history of psychological torture”

Universal Declaration of Human Rights

Interrogations, Forced Feedings, and the Role of Health Professionals: New Perspectives on International Human Rights, Humanitarian Law, and Ethics (2009)
Eds. Ryan Goodman, Mindy Jane Roseman

The American public has been bombarded by news articles, memos, and reports about the horrors of torture committed by the U.S. government in their name. The tragic role of health professionals involved in human rights violations in detention centers has also been well documented. Although international human rights law, humanitarian law, and professional ethics codes prohibit the participation of health professionals in torture, such laws and codes are clearly insufficient in practice. What we need now is to reexamine the institutional and structural pressures that have allowed abuses to occur, and move forward from there.

This process has already begun. In January 2008, the Human Rights Program at Harvard Law School held a workshop for scholars and practitioners from the military and civilian sectors, including World Medical Association president Yoram Blachar, career intelligence officer Steven M. Kleinman, Physicians for Human Rights president Leonard S. Rubenstein, and others. This book compiles the different perspectives of the workshop participants, providing interdisciplinary analysis and suggestions for institutional reform on two specific and important practices: forced feedings and coercive interrogation. The authors examine cultural frameworks and social situations that affect the faculty of health professionals,  provide ethical and policy analysis, and offer practice guidelines. This book is a must-read for anyone concerned with the participation of doctors and psychologists in torture, and the changes that must be made to ensure that they are held accountable and that abuses do not happen again.

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A paper recently published in the journal Mental Health, Religion, and Culture describes an innovative healing approach for monks who have suffered under China’s occupation of Tibet – innovative not in the sense that it tries anything new, but that it actually integrates Tibetan and Western medicine. The paper also demonstrates the challenges and need for expansion of cross-cultural treatment of refugees.

Dr. Michael Grodin of the Boston Center for Refugee Health and Human Rights tailored a treatment for eight Tibetan monks in Boston that includes both Western and Tibetan diagnoses, combining mainstream healthcare with alternative therapies. One patient, Yeshi Togden, was repeatedly imprisoned and tortured in the late 1980s for his participation in peaceful protests against China’s presence in Tibet. Dr. Grodin diagnosed Togden with post-traumatic stress disorder (PTSD), as well as srog-rlung, an imbalance of the life-wind; his treatment included Taoist breathing and musical bowl-playing concurrent with psychotherapy and antidepressants. Read more