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Bioethics Forum Essay

Modern Day Mengeles

“No power in the world will make us deny our duty, or forget even for a moment our historical task of maintaining the freedom of our people.”

— Joseph Goebbels

“These are patriots and whatever the report says, if it diminishes their contributions to our country, it’s way off base.”

— Former President George W. Bush (in response to the Senate’s CIA report)


The role of psychologists and physicians in the Central Intelligence Agency’s torture program is one of the most concerning and disturbing aspects of the 2014 U.S. Senate Select Committee on Intelligence report on the CIA’s detention and interrogation programTheNew York Times recently published a strong editorial demanding that those health care professionals lose their licenses and be prosecuted. In a comprehensive review and call to action, Physicians for Human Rights detailed each instance of abuse by health care professionals, noting that “the health professionals who participated in the CIA torture program violated core ethical principles common to the healing professions.”

But it’s worse than that. Not only did the medical officers and contractors at the CIA violate the Nuremburg Code and other codes of international medical ethics, but their actions were also eerily similar to the behavior of Nazi doctors.

The CIA’s actions share four main qualities with those of the Nazi doctors: 1) they experimented on their detainees, 2) they perverted medical procedures, turning them into rape and torture, 3) they induced diseases in their detainees, and 4) they provided necessary medical care in order to enable future torture. These parallels, described in detail below, show that, if what the Nazi doctors did qualifies as torture, so too, do the actions of the health care professionals working for the CIA.

Experimentation Resulting in Death

In 2003, the contract psychologists James Mitchell and Bruce Jessen “were deployed to Detention Site Blue to both interrogate and conduct psychological reviews of detainees,” according to the Senate report. These interrogation techniques refer to torture tactics developed by Mitchell and Jessen. The psychologists designed, implemented, and then assessed their interventions, which amounts to a scientific study of torture tactics. They then made recommendations to CIA officers based on these assessments.

One of these recommendations, given by Bruce Jessen to a CIA officer, came just days before the death by torture of detainee Gul Rahman. That officer “ordered that Gul Rahman be shackled to the wall of his cell in a position that required the detainee to rest on the bare concrete floor. Rahman was wearing only a sweatshirt . . . . The next day, the guards found Gul Rahman’s dead body. An internal CIA review and autopsy assessed that Rahman likely died from hypothermia–in part from having been forced to sit on the bare concrete floor without pants.”

Nazi doctors killed their subjects of failed experiments more directly. Robert Jay Lifton’s exhaustive book,Nazi Doctors,details many examples, including a Dr. Schumann’s experiments on a fungal condition that affected the face. Although the condition was treatable by medication, “Schumann seized the occasion to try the efficacy of his x-rays. These caused severe skin eruptions and infections, and in many victims impairment of salivary and tear-duct functions along with paralysis of face and eyes, which in turn caused a number of men to be sent to the gas.”

In both cases, an experiment was conducted to assess a new intervention: in Schumann’s, it was an intervention under the guise of medical treatment, but has been recognized as torture; in the CIA’s case, it was a torture tactic without the pretense of a medical objective. Both ultimately caused death.

Perversion of Medical Procedures

Medical professionals in the Third Reich and contracted by the CIA both utilized torture via medical treatment. Rectal rehydration was once used as a battlefield intervention; the Physicians for Human Rights report notes that “rectal [re]hydration was used in field conditions, particularly during World War II, when severe injuries resulted in marked blood loss, and oral and intravenous administration of fluids were not possible.”

An analogy can be drawn to a penetrative sterilization method widely used at Auschwitz. Dr. Clauberg, an esteemed Nazi doctor there, performed experiments in which he injected a “caustic substance into the cervix [of Jewish women] to obstruct the fallopian tubes” and induce sterilization. Clauberg was using a medical procedure to penetrate women without their consent. Clauberg was committing rape as well as torture.

In 2005, health care professionals used a nasogastric tube and intravenous feeding to provide nutrients to detainees on hunger strikes. “CIA records indicate that Majid Khan cooperated with the feedings and was permitted to infuse the fluids and nutrients himself. After approximately three weeks, the CIA developed a more aggressive treatment regimen ‘without unnecessary conversation.’ Majid Khan was then subjected to involuntary rectal feeding and rectal hydration,” stated the Senate report. There is no indication that this change was based on Khan’s actions. This was obviously not a necessary medical procedure, but rather a demeaning, painful way of penetrating Majid Khan without his consent. Those officers were committing rape and torture.

Induction of Disease

One of the more famous practices of Nazi doctors was to induce diseases and disorders in subjects in order to study treatments or preventive measures or simply to document the natural course of the disease. For example, Dutch Jews were infected with typhus in order to test vaccines.

The Senate report recounts evidence that CIA torturers had induced psychosis in one of their detainees as a result of torture. In 2005, “a CIA psychologist stated that bin al-Sibh ‘has remained in social isolation’ for as long as two and a half years and the isolation was having a ‘clear and escalating effect on his psychological functioning.’” At the recommendation of the psychologist, bin al-Shibh (a detainee) “was transferred to U.S. military custody at Guantanamo Bay, Cuba. After his arrival, bin al-Shibh was placed on anti-psychotic medications.”

At least the Nazis performed these experiments with the ultimate goal of healing future patients. By contrast, the physicians and psychologists working for the CIA experimented with torture to learn how to more effectively harm subjects.

Medical Treatment to Enable Torture

Finally, the Nazis and the CIA used medical intervention as a temporary measure to heal a patient before harming or killing them through experimentation or torture. Josef Mengele, the most infamous Nazi doctor, had a special interest in twin studies. When one twin with syphilis died of diphtheria, Mengele “was attentive to and provided special care and medications for the surviving twin, who also developed diphtheria and whom he was said to like very much—until she recovered, at which time he had her killed so that her syphilis could be confirmed at post-mortem examination,” according toNazi Doctors. Mengele provided medical care so that he could continue his experiments on his subject, not so that he could improve her health.

There are many examples of this type of medical care within the CIA torture report. Medical care was provided not for the needs of the detainees, but rather for those of the CIA. In one instance, “after one of Abu Zubaydah’s eyes began to deteriorate, CIA officers requested a test of Abu Zubaydah’s other eye, stating that the request was ‘driven by our intelligence needs’” rather than “‘humanitarian concern for AZ.’ The cable relayed, ‘We have a lot riding upon his ability to see read, and write.’”

Medical care was also administered to allow torture to continue. Another detainee, Abu Ja’far al-Iraqi, “was provided medication for swelling in his legs to allow for continued standing sleep deprivation.”

Other aspects of the psychologists’ involvement at the CIA share qualities with the Nazis. Both groups were relatively inexperienced. Mitchell and Jessen, both alumni of the Air Force SERE school, had no prior experience in waterboarding, for which they became administrators and experts. Nazi doctor Horst D. was recruited to the Party largely because of “his military experience and medical inexperience,” statesNazi Doctors. There were other parallels. According to Physicians for Human Rights, the psychologists managed to obtain exclusive rights to certain torture techniques, including waterboarding, which they evaluated and administered. This exclusive status was reserved for Nazi medical personnel as well: they were the only ones allowed to handle the killing gas and determine who was worthy of it.

Perhaps the most telling part of the torture summary is this notation by one medical officer:  “Things are slowly evolving form [sic] [Office of Medical Services] being viewed as the institutional conscience and the limiting factor to the ones who are dedicated to maximizing the benefit in a safe manner and keeping everyone’s butt out of trouble.”

Fifty-one percent of Americans currently believe that the CIA torture tactics were justified. How, then, does that make us different from the German citizens of the Third Reich? Support of torture, even and especially under the guise of patriotism, must not override our ethical obligation to stand up against egregious human rights violations.

Mengele fled to Argentina and was never caught and brought to justice for his war crimes. We cannot let the same happen with the CIA psychologists and medical personnel who enabled, designed, and thus encouraged the use of torture.

Alessandra Hirsch, MS, is the project manager at PharmedOut and the granddaughter of a holocaust survivor. She will be attending medical school in the fall.

Posted by Susan Gilbert at 01/12/2015 11:32:29 AM |

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