Download all the documents in a complete PDF file here

A. Larry James:

A1. Fixing Hell: An Army Psychologist Confronts Abu Ghraib
Date: 2008
Authors: Col. (ret.) Larry C. James (and Gregory A. Freeman) at 35, 36, 49, 32, 50-51, 62, 63, 63-65

B. Survivor testimony:

B1. Affadavit of Omar Ahmed Khadr, submitted in Omar Ahmed Khadr v. The Prime Minister of Canada, et al
Date: 2008
Citations: para 56-57, para 59.

C. Government Records:

C1. Senate Armed Services Report: Inquiry into the Treatment of Detainees in US Custody
Date: November 2008
Pages: 39 (note 277), 128-129, 132-135

C2. Commander’s Inquiry, Allegation of Inhumane Treatment of [redacted]
Date: May 3, 2003
Pages: 1318-1319, 1335-1337, 1365

C3. Draft Memo on BSCT Standard Operating Procedures
Date: November 2002
Citations: para. 4(a), 4(d), 4(e).

C4. Memo on BSCT Standard Operating Procedures
Date: November 2004
Citations: para. 3(a)

C5. Camp Delta Standard Operating Procedures
Date: March 2003
Citations: 4.3, 8.1-8.8

C6. Email discussing Guantanamo [parties redacted]
Date: July 31, 2005

C7. Memo from Jay Bybee for John Rizzo
Date: August 2002
Subject: Interrogation of al Qaeda Operative

D. Law:

D1. Crimes Against Humanity and War Crimes Act
Source: Sections 6(3) and 7(1).

D2. Rome Statute of the International Criminal Court
Source: Article 8.

D3. Criminal Code
Source: Section 269.1(2-3).

E. Web:

E1. Canadian Department of Justice War Crimes Program Website

E2. American Psychological Association Website: About

E3. American Psychological Association Website: Society for Military Psychology Leadership list

F. Secondary Sources:

F1. OLC Memos Confirm Integral Role of Health Professionals in US Torture
Date: Apr. 16, 2009
Author: Physicians for Human Rights

***

Download all the documents in a complete PDF file here.

***

Related: Bond vs. Louisiana Board of Examiners of Psychologists

• Media backgrounder
• Timeline
• Court documents

]]> http://whenhealersharm.org/timeline-of-events/feed/ 0 http://whenhealersharm.org/law-and-ethics/ http://whenhealersharm.org/law-and-ethics/#comments Thu, 23 Jul 2009 20:47:50 +0000 Qa'id Jacobs http://whenhealersharm.org/?p=34 No health professionals involved in post 9-11 torture of prisoners in military and intelligence facilities have been sanctioned for their conduct.

Torture is a Crime

Torture, attempted torture, and conspiracy to commit torture are all crimes under the Federal Torture Statute and the War Crimes Act (along with, e.g., cruel or inhuman treatment, performing biological experiments, rape, sexual assault or abuse, murder, mutilation or maiming, or intentionally causing bodily injury).

Under international law, torture is one of the few crimes considered so egregious that there is universal jurisdiction for it, meaning any state in the world can prosecute a torturer, no matter where the crime was committed. In the words of a landmark U.S. ruling with regard to civil liability for torture, “the torturer has become–like the pirate and slave trader before him–hostis humani generis, an enemy of all mankind.”  Filartiga v. Pena-Irala, 630 F.2d 876, 890 (CA2 1980).

The United Nations Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, a legally binding document signed by President Ronald Reagan in 1988 and ratified in 1994, defines torture as:

any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions.

CAT also prohibits cruel, inhuman or degrading treatment or punishment.

Additionally, Common Article 3 of the Geneva Conventions prohibits torture as well as acts of “violence to life and person, in particular … cruel treatment … outrages upon personal dignity, [and] in particular, humiliating and degrading treatment.” Common Article 3 further provides that those not actively taking part in hostilities, such as persons in detention “shall in all circumstances be treated humanely, without any adverse distinction founded on race, colour, religion or faith, sex, birth or wealth, or any other similar criteria.” The U.S. Supreme Court, in Hamdan v. Rumsfeld, 548 U.S. 557 (2006), determined that Common Article 3 of the Geneva Conventions applied to detainees from the U.S. conflict with Al Qaeda.

Torture is Unethical

It is a gross contravention of medical ethics, as well as an offence under applicable international instruments, for health personnel, particularly physicians, to engage, actively or passively, in acts which constitute participation in, complicity in, incitement to or attempts to commit torture or other cruel, inhuman or degrading treatment or punishment.

United Nations Principles of Medical Ethics relevant to the Role of Health Personnel, particularly Physicians, in the Protection of Prisoners and Detainees against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (1982)

The doctor shall not countenance, condone or participate in the practice of torture or other forms of cruel, inhuman or degrading procedures, whatever the offence of which the victim of such procedures is suspected, accused or guilty, and whatever the victim’s beliefs or motives, and in all situations, including armed conflict and civil strife.

World Medical Association (WMA) Declaration of Tokyo (1975)

Physicians must oppose and must not participate in torture for any reason. Participation in torture includes, but is not limited to, providing or withholding any services, substances, or knowledge to facilitate the practice of torture. Physicians must not be present when torture is used or threatened.

Physicians may treat prisoners or detainees if doing so is in their best interest, but physicians should not treat individuals to verify their health so that torture can begin or continue. Physicians who treat torture victims should not be persecuted. Physicians should help provide support for victims of torture and, whenever possible, strive to change situations in which torture is practiced or the potential for torture is great.

AMA Code of Medical Ethics Opinion 2.067

Nurses abstain from using their nursing knowledge and skills in any manner, which violates the rights of detainees and prisoners.

International Council of Nurses (ICN)
Position Statement on Nurses’ Role in the Care of Detainees and Prisoners (1975, 1998, and 2006)

Whereas torture is an abhorrent practice in every way contrary to the APA’s stated mission of advancing psychology as a science, as a profession, and as a means of promoting human welfare. …

Be it resolved that psychologists may not work in settings where persons are held outside of, or in violation of, either International Law (e.g., the UN Convention Against Torture and the Geneva Conventions) or the US Constitution (where appropriate), unless they are working directly for the persons being detained or for an independent third party working to protect human rights.

American Psychological Association (APA) Petition Resolution (passed by referendum in 2008)

Links

International Law

• United Nations Convention against Torture
• Geneva Conventions
  • The First Convention – wounded and sick members of the armed forces in the field
  • The Second Convention – wounded, sick, and shipwrecked members of the armed forces at sea as well as shipwreck victims
  • The Third Convention – prisoners of the war
  • The Fourth Convention – civilians in times of war
• International Covenant on Civil and Political Rights

U.S. Criminal Law

• Torture Statute
• War Crimes Act

U.S. Civil Law

• Torture Victim Protection Act
• Alien Tort Statute

State Licensing Laws and Regulations

• NY
  • Physicians
  • Psychologists
    • Psychologists–Laws
      
    • Psychologists–Rules
      
    • Psychologists–Regulations

More coming soon. For full list of psychology licensing laws and licensing boards in the United States, see Ken Pope’s excellent index.

Professional Ethics Standards

• UN Principles of Medical Ethics
• WMA Declaration of Tokyo
• ICN Nurses’ Role in the Care of Detainees and Prisoners
• AMA Principles of Medical Ethics
  • AMA Opinion 2.067 (Torture)
  • AMA Opinion 2.068 (Physician Participation in Interrogation)
• Am. Psychiatric Association Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry
• ANA Code of Nursing Ethics
• Am. Psychological Association (APA) Policies and Actions Related to Detainee Welfare and Professional Ethics in the Context of Interrogation and National Security

See Ken Pope’s Index of Domestic Codes and Practice

A1. Declaration by Mohammed al Qahtani’s attorney, Gitanjali Gutierrez (German  War Crimes Complaint against Rumsfeld, et al.)
Date: November 2006

A2. CCR Report: Torture and Cruel, Inhuman and Degrading Treatment of Prisoners at Guantanamo Bay
Date: July 2006

B.  Government Records

B1. Senate Armed Services Committee Report: Inquiry into the Treatment of Detainees in U.S. Custody
Date: November 20, 2008
Pages: 39, 40, 45-47, 50-52, 61-62, 66-70, 88, 94-97

The bipartisan Senate Armed Services Committee (SASC) approved its now public report in November 2008, during the Bush administration.  SASC concluded, among other things, that

[t]he abuse of detainees in U.S. custody cannot simply be attributed to the actions of ‘a few bad apples’ acting on their own. The fact is that senior officials in the United States government solicited information on how to use aggressive techniques, redefined the law to create the appearance of their legality, and authorized their use against detainees. Those efforts damaged our ability to collect accurate intelligence that could save lives, strengthened the hand of our enemies, and compromised our moral authority.

B2. Senate Armed Services Committee Hearing: Testimony of Diane Beaver
Date: June 17, 2008
Pages: 67-68 (morning)

B3. U.S. Army Inspector General: Army Regulation 15-6: Final Report  (“Schmidt-Furlow Report”)
Date: June 9, 2005
Pages: 13-21

B4. Secret Orcon, Interrogation Log, Detainee 063
Date: November 23, 2002—January 11, 2003
Pages: 1-3, 11-13, 18-20, 30-31, 58-60, 66-67

This interrogation log chronicles the abusive treatment of Mohammed al Qahtani (noted as Detainee 063) and was published by TIME magazine on June 12, 2005.  The 83-page document notes the presence of Dr. Leso as MAJ L (BSCT)  on November 23, 2002 and November 27, 2002.  The presence of a member of the three-person BSCT team is noted in the entries for 2 December, 2002; 11 December, 2002; 25 December, 2002; and 29 December, 2002.  In a press release issued on the same day, the Department of Defense acknowledges the authenticity of the leaked log.

B5. DoD News Release 592-05: Guantanamo Provides Valuable Intelligence Information
Date: June 12, 2005

B6. Email between DoD CITF Personnel: FW: Counter Resistance Strategy Meeting Minutes
Date: October 2, 2002

B7. DoD JTF GTMO-BSCT: BSCT Standard Operating Procedures
Date: November 11, 2002

Footnote 277 on p39 of the 2008 SASC report notes that it is not publicly known whether this draft SOP was actually approved.

B8. Memo from Lt. Col. Jerald Phifer to JTF 170 Commander MG Michael Dunlavey
Date: October 11, 2002
Subject: Request for Approval of Counter-Resistance Strategies

B9. Memo from MG Michael Dunlavey to USSOUTHCOM Commander GEN James Hill
Date: October 11, 2002
Subject: Counter-Resistance Strategies

B10. Memo from GEN James Hill to Chairman, Joint Chiefs of Staff GEN Richard Myers
Date: October 25, 2002
Subject: Counter-Resistance Techniques

B11. Action Memo from William J. Haynes III to Sec. of Def. Donald Rumsfeld
Date: November 27, 2002 (approved by Rumsfeld on December 2, 2002)
Subject: Counter-Resistance Techniques

B12. FBI email about abusive interrogation techniques

B13. Letter from T. J. Harrington, Deputy Assistant Director, Counterterrorism to Major General Donald J. Ryder, DOA Criminal Investigation Command
Date: July 14, 2004
Subject: Suspected Mistreatment of detainees

C.  Unofficial Accounts by Government Agents

C1. Fixing Hell: An Army Psychologist Confronts Abu Ghraib
Date: 2008
Authors: Col. (ret.) Larry C. James (and Gregory A. Freeman)
Pages: 4-23, 27-30, 38, 269-271

D.  Secondary Sources

D1. Torture Team
Date: 2008
Author: Philippe Sands
Pages: 125, 127-128, 233

D2. Washington Post: Detainee Tortured, Says U.S. Official
Date: January 14, 2009
Reporter: Bob Woodward

D3. ProPublica: Tortured Profession: Psychologists Warned of Abusive Interrogations, Then Helped Craft Them
Date: May 5, 2009 (updated May 7, 2009)
Reporter: Sheri Fink

D4. New England Journal of Medicine: Doctors and Interrogators at Guantánamo Bay
Date: July 7, 2005 (Volume 353 at 6-8)
Authors: M. Gregg Bloche and Jonathan H. Marks

D5. New York Times: Red Cross Finds Detainee Abuse in Guantanamo
Date: November 30, 2004
Reporter: Neil Lewis

The New York Times reported that  a 2004 International Committee of the Red Cross (ICRC) document referenced another ICRC report from January 2003, in which the organization “raised questions of whether ‘psychological torture’ was taking place.”  The date of the January 2003 report suggest that its conclusions would likely relate at least in part to the period of Dr. Leso’s tenure at Guantanamo, from June 2002 through January 2003.  Neither of the reports has been made public.

D6. Associated Press: Red Cross complains to U.S. on Guantanamo
Date: Nov. 30, 2004

According to the Associated Press, the ICRC would not confirm or deny the information regarding the Nov. 2004 New York Times article.  However, a Pentagon spokesperson reportedly confirmed that the ICRC had previously informed the U.S. government of its concerns that indefinite detention was torture.  U.S. official reportedly rejected the ICRC’s criticism.

D7. American Journal of Bioethics: Medical Ethics and the Interrogation of Guantanamo 063
Date: April 2007 (Volume 7, Number 3 at 1-7)
Author: Steven H. Miles

D8. Time: Inside the Interrogation of Detainee 063
Date: June 12, 2005
Reporters: Adam Zagorin, Michael Duffy,

D9. New Yorker: The Experiment
Date: July 11, 2005
Reporter: Jane Mayer

E.  Biographical Information

E1. Johns Hopkins University: Alumni Notes

E2. State University of New York (SUNY): Doctoral Program NOTES and NEWS

E3. NY State Education Department, Office of the Professions: License Information  for “Leso, John”

E4. DailyKos: Army Psychologist Pleads ‘Fifth’ in Case of Prisoner 900
Date: August 14, 2008
Blogger: “Meteor Blades”

On the discredited theory that “breaking” prisoners would yield valuable intelligence, psychologists designed torture methods that mirrored the torture used by the Chinese and North Koreans to elicit false confessions from American prisoners of war.  Psychologists took techniques like suffocation by water, confinement in a coffin-like box, severe isolation, and prolonged sleep deprivation, used by the U.S. military on its own soldiers as preparation for torture by enemy forces, and reverse-engineered them into offensive interrogation techniques to be used against our own prisoners.

Health professionals have advised interrogators on methods of abuse that would exploit prisoners’ vulnerabilities.

In their roles as members of the Behavioral Science Consultation Teams (BSCTs), psychologists and psychiatrists observed abusive interrogations and advised interrogators on how to exploit their phobias and other psychological and physical vulnerabilities, sometimes using information culled from the prisoners’ own medical records.

Health professionals have used medical procedures to harm prisoners.

Numerous prisoners have reported receiving forced and medically unnecessary “treatment” or procedures for interrogation or punishment.  Examples include forced enemas, unwarranted surgery and unknown psychotropic drugs.  A Guantánamo prison guard reported that a medic charged with giving physical therapy purposefully caused a prisoner severe pain for his own enjoyment, and that a Navy doctor, under the guise of conducting “cavity searches” for security purposes, forcefully penetrated his patients’ rectums with intent to hurt and degrade them.  Even today, under President Obama’s watch, Guantánamo physicians, nurses and prison guards continue to forcibly feed hunger strikers through the use of a 6-point restraint chair and the brutal forceful insertion and removal of thick nasogastric tubes.

Health professionals have calibrated pain and monitored interrogations that risked leaving prisoners in need of treatment.

I was stripped naked and remained naked through the month of July[,]…kept for several days in a standing position with my arms above my head and fixed with handcuffs and a chain to a metal ring in the ceiling. …  My lower leg was examined on a daily basis by a doctor using a tape measure for signs of swelling.  I do not remember…how many days I was kept standing….

Walid Bin Attash (ICRC Report, 2007)
(Attash had a prosthetic leg at the time)

I would be strapped to a special bed….A cloth would be placed over my face.  Cold water…was then poured onto the cloth by one of the guards so that I could not breathe.…[A]s I struggled in the panic of not being able to breathe.….a doctor was always present, standing out of sight behind the head of bed, but I saw him when [sic] came to fix a clip to my finger which was connected to a machine.  I think it was to measure my pulse and oxygen content in my blood.  So they could take me to the breaking point.

Khalid Shaik Mohammed, as told to the (ICRC Report, 2007)

As we understand it, when the waterboard is used, the subject’s body responds as if the subject were drowning, even though the subject may be well aware that he is in fact not drowning. You have informed us that this procedure does not inflict actual physical harm. Thus, although the subject may experience the fear or panic associated with the feeling of drowning, the waterboard does not inflict physical pain.

…  as we discussed above, you have informed us that in determining which procedures to use and how you use them, you have selected techniques that will not harm Zubaydah’s wound. You have also indicated that numerous steps will be taken to ensure that none of these procedures in any way interferes with the proper healing of Zubaydah’s wound.  You have also indicated that, should it appear at any time that Zuhaydah is experiencing severe pain or suffering, the medical personnel on hand will stop the use of any technique.

Jay Bybee, OLC Memo to CIA Acting General Counsel John Rizzo (2002)

We recognize the theoretical possibility that the use of one or more techniques would make a detainee more susceptible to severe pain or that the techniques, in combination, would operate differently from the way they would individually and thus cause severe pain.  But as we understand the experience involving the combination of various techniques, the OMS medical and psychological personnel have not observed any such increase in susceptibility. Other than the waterboard, the specific techniques under consideration in this memorandum–including sleep deprivation–have been applied to more than 25 detainees. … 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 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 … would not operate in a different manner from the way they do individually so as to cause severe pain.

Steven Bradbury, OLC Memo to CIA Senior Deputy General Counsel John Rizzo (2005)

Health professionals have checked prisoners to certify that they were capable of surviving additional abuse.

Health personnel conducted medical exams for non-therapeutic purposes, including the vetting of prisoners for interrogations designed to be harmful to the prisoners’ physical and mental health.  Medics intervened in abusive interrogations to lower blood pressure, administer fluids and medication and to allow rest so that abusive treatment could proceed.

Health professionals have shared confidential patient information that was used to harm patients.

Physicians failed to maintain the privacy and confidentiality of their patients’ information by turning over medical records to interrogators or BSCT personnel for exploitative purposes.

Health professionals have covered up evidence of torture and abuse.

Medical personnel left out signs of torture from medical reports, altered medical reports written by others to destroy evidence of torture, failed to properly examine prisoners upon arrival into prisons and then after interrogations to guard against abuse, and facilitated the concealment of injuries suggesting abuse by not filing existing pre- and post-interrogation exams with the prisoners’ medical records.  Medical examiners have falsified, delayed or improperly withheld autopsies and death certificates, failed to report injuries that were clearly caused by abuse, and released death certificates that do not comply with the Geneva Conventions and accepted medical practice.

Health professionals have turned a blind eye to cruel treatment.

Medical personnel routinely permitted their clinical findings to be used to inflict torture, walked away from abuse occurring in their presence and systematically failed to report incidents of abuse.

Selected Sources

• Steven Miles: Oath Betrayed: America’s Torture Doctors (2009)
• CCR Report on Current Conditions of Confinement at Guantánamo (February 2009)
• ICRC Report on the Treatment of Fourteen “High Value Detainees” in CIA Custody (February 2007)
• Torture memoranda of the Office of Legal Counsel, Department of Justice (2002, 2005)
• Senate Armed Services Committee Inquiry into the Treatment of Detainees in U.S. Custody (November 2008)
• JTF-Guantánamo BSCT: Standard Operation Procedures (2002-2005)
• DoD: Interrogation Log, Detainee 063, SECRET ORCON (November 2002-January 2003)
• Testimony of Spc. Brandon Neeley (February 2009)
• NY Times: China Inspired Interrogations at Guantánamo (July 2, 2008)
• NY Times: In Adopting Harsh Tactics, No Look at Past Use (April 21, 2009)
• NY Times: Harold E. Fischer Jr., an American Flier Tortured in a Chinese Prison, Dies at 83 (May 8, 2009)
  

[T]he ‘healing hand’ can also be the ‘hurting hand.’

Albert Jonsen and Leonard Sagan
in THE BREAKING OF BODIES AND MINDS (Stover & Nightingale, 1985)

Why “health professionals” and not “doctors”?

Medical doctors, including psychiatrists and medical examiners, are health professionals, but so are psychologists and nurses. All of these professions have been implicated in the torture and abuse of prisoners in CIA secret prisons and in military detention centers, such as those in Guantánamo, Afghanistan, and Iraq. The term “health professionals” refers to anyone who is trained or licensed in a healing profession.

Do we know for a fact that health professionals participated in torture and cruel, inhuman or degrading treatment of prisoners?

Yes. For years, prisoners have alleged abuse by health professionals that amounts to torture and cruel, inhuman or degrading treatment (CIDT), and official documents, now being disclosed in steadily increasing numbers, confirm their accounts. For example, we know that the International Committee of the Red Cross – the legal body charged with ensuring compliance with the Geneva Conventions – reported to high-level U.S. administration officials on credible allegations of medically assisted torture in CIA detention. Most recently, declassified Justice Department memos and a bipartisan report issued by the Senate Armed Services Committee confirmed that psychologists and doctors were essential to rationalizing and carrying out the government’s torture policy. As New York State Assemblymember Richard Gottfried said, these papers

documented that [health professionals] … were involved ‘whenever’ these techniques were used. The Justice Department and the CIA made it clear that the program was – for legal and practical reasons – entirely dependent on the participation of health care professionals….The documents shatter any illusion that the physicians were somehow protecting the prisoners.

In the case of force-feeding, policymakers openly acknowledge and defend the involvement of health professionals in forcibly feeding hunger striking prisoners, but question instead the charge that the practice is illegal and unethical. The force-feeding program at Guantánamo conflicts with the World Medical Association’s Malta Declaration on Hunger Strikers, updated in 2006 specifically to address U.S. policy at the Naval Base prison.

How were health professionals involved in torture and cruel, inhuman and degrading treatment?

Among other things, health professionals:

• crafted abusive tactics and falsely legitimized their use;
• advised interrogators on methods of abuse that would exploit prisoners’ vulnerabilities;
• used medical procedures to harm prisoners;
• gauged pain and monitored interrogations that risked leaving prisoners in need of treatment;
• checked prisoners to certify that they were capable of surviving additional abuse;
• conditioned medical or mental health treatment on cooperation with interrogation;
• shared confidential patient information that was used to harm patients;
• covered up evidence of torture and abuse; and
• turned a blind eye to cruel treatment.

Click here for more information.

Did the abuse – and health professional involvement in it – end with the Bush Administration?

No. Even today, under President Obama’s watch, Guantánamo physicians, nurses and prison guards continue to forcibly feed hunger strikers through the use of a 6-point restraint chair and the brutal forceful insertion and removal of thick nasogastric tubes. For many of the men in GTMO, solitary confinement, sensory deprivation, environmental manipulation and sleep deprivation are daily realities that have led to severe mental and physical suffering. Camp officials have refused to acknowledge clear suicide attempts. Instead, they classify them as “manipulative self-injurious behavior,” downplaying injuries and, in some cases, mental illness. Unless forced by court order, President Obama has denied prisoners access to independent medical experts and often even to their own medical records. Instead, the men are left to the exclusive care of medical personnel whom they distrust and who have a record of grossly mistreating and mismanaging the mentally ill.  The Immediate Reaction Force (IRF), a team of military guards comparable to a riot squad, continues to beat men in response to allegations of disciplinary infractions and during unnecessarily brutal “cell extractions,” with no sign that health professionals are objecting to or reporting such abuse.  Click here for CCR’s Report on Current Conditions of Confinement at Guantánamo (January 2009).

It seems like many people were responsible. Why focus on health professionals, especially if they weren’t the ones at the very top?

Because holding these health professionals accountable is important to

• survivors of medically assisted torture.  The relationship between patients and health professionals is based on trust,  and torture survivors can feel particularly violated when those professionals participate in their abuse.  Some develop fear and mistrust of all health care personnel that leads them to avoid seeking the mental and physical treatment vital to their recovery.
• health professionals, most of whom take seriously their commitment to do no harm.  Torture by health professionals, particularly when not adequately addressed by the professional associations, ultimately corrupts the profession itself.
• the rest of us – as patients and members of civil society, we have a right to treatment by health professionals who we can trust, and a right to a government that upholds the law.

Elected officials relied heavily on both legal and health professionals to design and execute their torture program.  As CCR continues its campaign for the prosecution of the “torture lawyers,” it now adds health professionals to its call for accountability. Some health professionals did in fact hold positions of great responsibility.  Others worked lower down the chain of command, but the principles established for the Nuremberg Trials set the precedent that following orders is not a valid defense.   Additionally, widespread complicity does not absolve any one group or individual of responsibility.  On the contrary, when so many people are responsible, the importance of examining everyone’s role is paramount.  As sociologist Martha Huggins points out:

Systemic torture is fostered and perpetuated by actors and organizations inside and outside the local torture environment. The direct perpetrators of Abu Gharib [sic] torture— some guards and some interrogators, government and private—could not have serially tortured without a range of facilitators who provided organizational, technical, legal, and financial support for their violence.  In the immediate torture environment, facilitators included translators, medical doctors, nurses, medics, guards, and dog handlers, among many others. … Asking why someone would torture another therefore only explores a small part of the problem. Understanding that direct perpetrators’ violent actions can only occur within a system that includes facilitators and their organizations, makes it clear that facilitators are even more essential to the long-term stability and protection of a torture system than its more visible direct perpetrators.  [emphasis added]

Health professionals contributed to systematic torture by lending a stamp of legitimacy and scientific credibility to otherwise vile conduct. Their oath to do no harm affords them a particular respect and status in our society. Because of this, the public is often less inclined to believe that terrible things could happen at a prison staffed with health personnel. The Bush administration seemed keenly aware of this. Although government lawyers provided the legal cover, they used doctors and psychologists to pull off the abusive detention and interrogation program, using medical personnel to attempt to create a golden shield from liability. For example, according to the lawyers’ contrived logic in one memorandum, the crime of torture required specific intent to cause a prisoner severe pain or suffering. Under this theory, as long as medical officers were there, interrogators and policymakers could point to them as proof that causing severe pain or suffering was not their specific intent. The lawyers also explicitly relied on psychologists’ assessments that techniques such as suffocation by water (waterboarding), stress positions, and sleep deprivation did not cause “prolonged” mental harm.

Finally, when health professionals working in closed institutions become part of a system of abuse, those institutions lose their front line of defense against torture. Incorporating them into the machinery of harm is an effective and pernicious way to stop them from identifying and reporting torture. Resistance on the part of health professional societies – often influential civil society groups – can prove instrumental in countering that effect and undermining a torture regime.

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