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Allegations about CIA interrogations raise medical-ethics questions

Did medical professionals conduct illegal human research and experimentation on detainees in U.S. custody? The Minneapolis-based Center for Victims of Torture wants a federal probe.

Demonstrator Maboud Ebrahimzadeh is held down during a simulation of waterboarding outside the Justice Department in Washington, D.C., in 2007.
REUTERS/Kevin Lamarque
Demonstrator Maboud Ebrahimzadeh is held down during a simulation of waterboarding outside the Justice Department in Washington, D.C., in 2007.

Chilling new allegations came out this month in connection with the CIA’s interrogations of suspected terrorists: the group Physicians for Human Rights reported evidence that medical professionals conducted illegal human research and experimentation on detainees in U.S. custody.

Now, the Minneapolis-based Center for Victims of Torture has joined human rights groups in filing a formal complaint against the CIA. The groups are calling for a federal investigation.

“Essentially there has been no investigation ordered by a president, there has been no public accounting of what happened, how it happened and why it happened,” said Douglas Johnson, the Center’s executive director. “There’s been no public tracing through of the decisions — where they went wrong, why they went wrong and what we learned from this situation in order to make sure it doesn’t happen again.”

The new physicians’ report indicates that medical experts working for the CIA “performed research on how to psychologically break prisoners and on how to use physically harmful forms of torture including waterboarding,” Dr. Steven Miles, a Center board member, said in a statement.

Miles, author of the book “Oath Betrayed: America’s Torture Doctors,” was one of the first U.S. physicians to object publicly to the role that doctors, psychologists and medics played in the CIA interrogations. He also is a professor at the University of Minnesota’s Center for Bioethics.

Dr. Steven Miles
Dr. Steven Miles

In response to this latest development, Miles said: “These health professionals violated laws and medical ethics pertaining to the use of prisoners as research subjects dating back to Nuremburg and ratified by every U.S. administration since then.”

The CIA denied the allegations in an e-mail to MinnPost.

“The report’s just wrong,” said George Little of the CIA’s Office of Public Affairs. “The CIA did not, as part of its past detention program, conduct human subject research on any detainee or group of detainees. The entire detention effort has been the subject of multiple, comprehensive reviews within our government, including by the Department of Justice.”

Medical monitoring vs. illegal research
In the months following the 9/11 attacks, Bush administration lawyers at the Justice Department helped redefine interrogation practices such as waterboarding, sleep deprivation, enforced nudity, temperature extremes and prolonged isolation. They established legal thresholds for such “enhanced interrogation.” And they enlisted medical monitors to ensure that detainees were not pushed over the newly defined thresholds of illegal torture.

That much had been widely reported. And it was a subject of intense controversy even before the International Committee of the Red Cross reported [PDF] in 2007 that the medical experts had participated in ill-treatment of 14 detainees by working to “serve the interrogation process, not their patients.”

What is new is the evidence presented in the 30-page report by the physicians group based in Cambridge, Mass. The report outlines three reasons for concluding that illegal and unethical human research had been conducted in order to fine-tune the interrogation treatments in a fashion that would shield the interrogators from charges they had illegally tortured the detainees:

• The CIA’s medical personnel were required to monitor all waterboarding practices and collect detailed information. The information was used to design, develop and deploy subsequent waterboarding procedures. For example, it led the CIA to use saline solution rather than plain water. The change enabled the CIA to subject each detainee to repeated episodes (up to 183 times) of the near-drowning treatment by reducing chances they would succumb to pneumonia and hyponatremia, a condition of low sodium levels in the blood;

• Information on the effects of subjecting a detainee to several different techniques simultaneously — repeated slapping combined with water dousing and forced prolonged kneeling — was collected to justify using such tactics in combination. These data were gathered through an assessment of the presumed “susceptibility” of the subjects to severe pain;

• Information collected by health professionals on the effects of sleep deprivation on detainees was used to establish the policy for that aspect of the “enhanced” interrogation program.

I asked Johnson at the Center for Victims of Torture where he defines the line between “monitoring” and conducting “human research.” Here is his reply:

“Generally in situations of torture the existence of medical professionals is to keep someone alive so that the interrogation could continue. That’s certainly what we’ve seen in many, many places of the world — Chile, Argentina, China and so forth. … What this report says, based on research done by Physicians for Human Rights, is that the health care people went beyond that and did research in the sense they were collecting data on individuals and their reactions in order to alter the interrogation methods. It was engaging in the accumulation of data about the impact on the interrogation techniques and then the use of that data to design and redesign the forms of torture that were in play.”

Details missing
The evidence cited in the report was gleaned from government documents in the public record that had been heavily redacted. Also, the physicians’ group could not gain access to many additional relevant documents that remain classified.

Thus, the group concluded: “While this report provides evidence that data from human research were compiled, apparently analyzed, and used to affect subsequent interrogations and to set policy, a comprehensive federal investigation is required to answer the questions this evidence raises.”

Because so much is blacked out from the public documents, it isn’t clear which and how many health professionals were involved in the alleged research. Nor is it clear where they are now.

The complaint against the CIA was filed with the Office for Human Research Protections of the U.S. Department of Health and Human Services. By federal regulation, [PDF] that agency is responsible for investigating such complaints. Where it finds wrongdoing, the agency can suspend federal research funds and refer a case to other agencies including local medical licensing boards and the U.S. Department of Justice.

Beyond the Center for Victims of Torture, other original cosigners include Amnesty International USA, Human Rights Watch, National Religious Campaign Against Torture, Psychologists for social Responsibility and four other groups.

“I’ve learned by the struggles that have occurred in other places that you have to keep pushing from multiple directions in order to get some level of accountability on these issues,” said Johnson at the Center for Victims of Torture, which handles torture cases from many countries around the world.

“For whatever reason the [Obama] administration has decided not to get a full accounting of what happened and not to address culpability,” he said. “As a consequence you have to look at the wide array of institutions that exist in our country as others have in theirs and see if something and someone will finally take the responsibility.”

The official hush about what happened during the CIA’s interrogations is something you might have expected to see at one time or another in “Argentina or some other country emerging from a dictatorship where the institutions are fragile,” Johnson said.

“I don’t believe they are fragile in our country,” Johnson said. “I believe they are robust and capable of deciding the difference between fact and fiction and determining culpability under the law. We should use those institutions and trust those institutions to arrive at the truth.”

Sharon Schmickle writes about national and foreign affairs and science. She can be reached at sschmickle [at] minnpost [dot] com.