August 6, 2010

A new study in the Journal of the American Medical Association reveals that physicians with the CIA's Office of Medical Services (OMS) played an even greater role in facilitating the torture of detainees than was previously recognized.

As described in the (subscription required) study, "In 2003, partially in response to a CIA Inspector General investigation that questioned the use of enhanced interrogation methods and criticized the agency’s failure to consult with OMS about the risks to detainees of waterboarding, OMS physicians assumed another role, providing opinions to the agency and lawyers whether the techniques used would be expected to cause severe pain or suffering and thus constitute torture."

This advisory function came in addition to the physicians' previous involvement in the torture of detainees through performing medical evaluations before and after interrogation, monitoring waterboarding sessions, and collecting information on the effectiveness and risks of various techniques.

The study, titled "Roles of CIA Physicians in Enhanced Interrogation and Torture of Detainees," was authored by Leonard S. Rubinstein, the president of Physicians for Human Rights, and Brig. Gen. (ret.) Stephen N. Xenakis, a former Army psychiatrist who is now with the Center for Public Health and Human Rights. It is based on a previously secret document from 2004, laying out OMS guidelines for detainee interrogation, which was released by the Obama administration.

In an article for Harper's, human rights lawyer Scott Horton notes that the JAMA study makes it apparent that the OMS physicians did not merely offer a medical opinion as to what constituted torture but "gave their bosses exactly what was expected of them: a green light to torture."

The study emphasizes that even though OMS approved the use of enhanced interrogation methods subject to "medical limitations," those limitations took no account of actual pain and suffering and were merely calculated to minimize the chances of doing permanent physical damage.

They "included durational limits for exposure to a specified temperature, either up to the time hypothermia would be expected to develop or on evidence of hypothermia; body weight loss of 10% or evidence of significant malnutrition as a result of dietary restrictions; and exposure to noise just under the decibel levels associated with permanent hearing loss. Stress positions were permitted for up to 48 hours provided the detainee’s hands were no higher than the head, weight was borne by lower extremities, and preexisting injuries were not aggravated. ... The OMS guidelines also advised that emergency resuscitation equipment be available when waterboarding was used."

Although the guidelines specify that "the detainee's physical condition must be such that these interventions will not have lasting effect," they ignore professional literature on the potential health risks of the techniques, citing instead such sources as "'Wilderness Medicine' 4th Ed., Ch 6 -- Accidental Hypothermia."

"The duplicity in this affair is amazingly circular.," Horton writes. "The Justice Department’s torture lawyers relied on the CIA’s torture doctors for the conclusion that specific techniques did not produce 'severe pain' that ran afoul of the criminal law prohibition on torture; the CIA doctors relied on the Justice Department lawyers for the same conclusion. It looks like a compact, and an alert prosecutor would no doubt call it a joint criminal enterprise. ... It’s hard to see at this point whose behavior was the more ethically odious, though evidence suggests that both engaged in professional misconduct so egregious as to warrant formal disciplinary proceedings."

"The torture doctors expect to have their identities protected, and thus to escape the natural consequences of their gross professional misconduct," Horton concludes. "This helps us understand why senior figures in the intelligence community are today ferociously pressuring the Justice Department to criminalize anyone who attempts to discover the identities of those involved. They assert that those identified would be terrorist targets. In fact, those who are unmasked face likely professional ethics proceedings, as well as the long-term risk of criminal prosecution, particularly if they ever venture beyond the borders of the United States."