By DENISE GRADY and BENEDICT CAREY
Published: November 4, 2013
A group of experts in medicine, law and
ethics has issued a blistering report that accuses the United States
government of directing doctors, nurses and psychologists, among
others, to ignore their professional codes of ethics and participate in
the abuse of detainees in Afghanistan, Iraq and Guantánamo Bay, Cuba.
The report was published Monday by the Institute
on Medicine as a Profession, an ethics group based at Columbia
University’s College of Physicians and Surgeons, and the Open
Society Foundations, a pro-democracy network founded by the
billionaire George Soros.
The authors were part of a 19-member task
force that based its findings on a two-year review of public
information. The sources included documents released by the government,
news reports, and books and articles from professional journals.
Among the abuses cited in the report are
doctors’ force-feeding of hunger strikers by pushing feeding tubes into
their noses and down their throats. The task force also suggested that
medical personnel ignored their duty to report evidence of beatings or
torture of detainees, and that the Defense Department “improperly
designated licensed health professionals to use their professional
skills to interrogate detainees as military combatants, a status
incompatible with licensing.”
The panel, the Task Force on Preserving
Medical Professionalism in National Security Detention Centers, is not
the first to protest what it said were violations of medical ethics at
detention sites. Other
groups that have described abuses include Physicians for Human
Rights and the International Committee of the Red Cross.
The Central Intelligence Agency and the
Defense Department dismissed the new report as unsubstantiated and
incorrect. Lt. Col. Todd Breasseale, a spokesman for the Defense
Department, said in an email: “Task Force Guantánamo routinely provides
comprehensive and humane medical care to the detainees held at
Guantánamo. They are consummate professionals working under incredibly
stressful conditions.”
Colonel Breasseale defended the force-feeding
of hunger strikers via nasal tubes, which he referred to as “enteral
feeding,” as legal and necessary to prevent them from committing
suicide by starvation.
As of Monday, there were “14 detainees
refusing to eat on a regular basis, and each is approved for enteral
feeding,” he said. “While detainees may be on the enteral feed list,
they do not always require the tube feeding — frequently they will
drink the supplement or eat a meal out of sight of their peers.”
Dean Boyd, a C.I.A. spokesman, said in an
email: “It’s important to underscore that the C.I.A. does not have any
detainees in its custody and President Obama terminated the Rendition,
Detention and Interrogation Program by executive order in 2009. The
task force report contains serious inaccuracies and erroneous
conclusions. The agency is proud of its medical staff, who uphold the
highest standards of their profession in the work they perform.”
According to the new report, the C.I.A.’s
Office of Medical Services drew up guidelines that called for medical
personnel to be present during interrogations to ensure that no
“serious or permanent harm” resulted. For instance, exposure to cold
was to be stopped just before hypothermia was likely to set in, and
loud noise was to be halted just before permanent hearing damage would
occur.
The report claims that C.I.A. medical
personnel were present during waterboarding, and that “the guidelines
advised keeping resuscitation equipment and supplies for an emergency
tracheotomy on hand.”
The military, it says, has adopted some of
the interrogation techniques that the C.I.A. developed, including the
use of doctors and psychologists to help with interrogations.
The report is particularly critical of the
American Psychological Association for allowing psychologists to
participate in interrogations.
The military has long employed psychologists
in its “behavioral science consultation teams,” known as Biscuits, to
assist with interrogations. Little is known about these teams, except
that they study detainees, suggest lines of questioning and help decide
when tactics are too harsh and when it is time to push harder.
“What we’d like to see from the association
is a prohibition saying that psychologists cannot participate in any
individual interrogation of a detainee,” said Steven J. Reisner, the
only psychologist on the task force that produced the report.
Dr. Reisner, who practices in New York, is
president of Psychologists for Social Responsibility, a nonprofit group
that advocates the ethical application of behavioral science. He is
running for president of the American Psychological Association.
“We’d also like to see the association
acknowledge what is already widely known about psychologists’
participation in interrogations, and use those as examples of what
psychologists cannot and should not do,” he said.
The association’s members have been debating
its ethics guidelines regarding interrogation for years. In 2008, in
documents alleging abuse, lawyers for a detainee at Guantánamo Bay
singled out a psychologist as a critical player. At the time, the
guidelines stated that it was “consistent with the A.P.A. ethics code
for psychologists to serve in consultative roles to interrogation and
information-gathering processes for national-security-related purposes”
— as long as the interrogation did not involve any of 19 coercive
procedures, including the use of hoods, waterboarding and physical
assault.
Later that year, the membership voted to
prohibit any consultation in interrogations at Guantánamo or other
so-called black sites run by the C.I.A.
But the association has not gone as far as
the new report urges: It has not prohibited psychologists from
assisting in all interrogations. Psychologists are divided over the
wisdom of such a blanket prohibition, with some arguing that it would
only reduce the level of accountability during interrogations.
Whether a blanket prohibition would alter
military protocols is hard to say. Like most professional groups, the
psychological association has little direct authority over its members.
In a statement released on Monday, the
association said it supported many of the recommendations in the
report, including ethics training for psychologists working with the
military and intelligence services. But, it added, the association has
already issued repeated statements that “have forbidden psychologists
from perpetrating or supporting torture; obligated psychologists to
report torture and abuse; and prohibited specific enhanced
interrogation techniques, such as waterboarding.”
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