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The CIA Torture Report and the Medical Profession

The long-awaited CIA Inspector General Report of 2004 has been released. For now, it is available on the homepage of the American Civil Liberties Union, though it will probably migrate to the rest of the ACLU torture file, which has impressively improved its indexing and is now suitable for real scholarship. Scholars beware: the documents are pdf photocopies and thus are not text searchable.

The report is greatly redacted, and one may expect that the redactions are worse than the released material, as has been the case with other investigations. It is notably deficient in not describing the interrogation of prisoners by our proxy interrogating allies, such as Uzbekistan. Overall, it contains little that could not have been inferred.

There were three circles of hell.

1. Ordinary POWs were picked up in sweeps and at the whim of forward base commanders abused for immediate tactical intelligence in Iraq and Afghanistan.

Administrative supervision: local base commanders

Number of prisoners: probably 50,000+

Number abused: unknown

Deaths by guard violence: at least 50

Medical role: principally silence and random acts of sadism. The Armed Forces Institute of Pathology delayed death reporting.

2. High value detainees were held by the Army.

Administrative supervision: White House lawyers supervised by Vice President Cheney and following directives personally written by Secretary of Defense Rumsfeld

Number of prisoners: several thousand

Number abused: unknown

Deaths by interrogational violence: 20 to 50.

Medical role: Some got pre/post interrogation physicals by the Air Force. Defense intelligence ran behavioral science consultation teams at joint interrogation and detention centers. Interrogational medical and psychology experts devised interrogation plans to break the prisoners down under ambiguous guidelines that were loosely enforced. The SERE (Survival, Evasion, Resistance and Escape) program supplied support in teaching techniques to “tiger teams” consisting of an interrogator, intelligence officer, and translator, all of whom had minimal experience in interrogation. The Armed Forces Institute of Pathology delayed death reporting.

3. CIA prisoners (note: although the CIA calls these high value detainees, they are more properly called ghost prisoners since the fact of their imprisonment was highly classified) wereheld at Abu Ghraib, Qaim, Guantanamo site 7, Salt Pit in Afghanistan, etc., and ghost prisoners were held under CIA control in rendition sites in Europe, Asia, Africa.

Administrative supervision: White House lawyers as supervised by Vice President Cheney and following directives overseen by Secretary of State Rice and CIA Director George Tenet.

Number of detainees: 100 to 300.

Abuse rates: high

Deaths: unknown.

Medical role: CIA medical operations set up an as yet incompletely defined system of medical and psychology experts to devise interrogation plans to break the prisoners down under ambiguous guidelines that were loosely enforced. This system appears to have been roughly similar to the Department of Defense system. The general contours of this system of medical/psychological design and monitoring of abusive interrogations is outlined in the recently released CIA Inspector General report. There was considerable improvisation in abuse, none of which was novel compared to the discredited forms of harsh interrogation that had been the subject of previous CIA research. The SERE program supplied educational resources.

The size of the medical personnel participating in the Defense Department’s and CIA’s interrogation system is not clear. However, it was large enough at both command and operational levels to fully operate the program without encumbering dissent.

The Institute of Medicine and the American Medical Association tacitly supported the devolution of the medical ethics of torture to these new lower U.S. standards. Both organizations repeatedly declined to support:

            a. an independent investigation of the role of U.S. personnel in organizing and implementing these abuses;

            b. calling for the accountability of identified participants, by means of licensing boards or censure by medical associations;

            c. implementation of the U.S. War Crimes Act’s sanctions against medical personnel.

Steven H. Miles, M.D., is a professor of medicine at the Center for Bioethics, University of Minnesota. He is the author of Oath Betrayed: America’s Torture Doctors (University of California Press, 2009).

Published on: August 26, 2009
Published in: Bioethics

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