American Doctors Without Morals

[Guest guest]

THE NEW YORK TIMES

March 1, 2010

Op-Ed Contributors

Doctors Without Morals

By LEONARD S. RUBENSTEIN and STEPHEN N. XENAKIS

AFTER five years of investigation, the Justice Department has released its

findings regarding the government lawyers who authorized waterboarding and

other forms of torture during the interrogation of suspected terrorists at

Guantánamo Bay and elsewhere. The report’s conclusion, that the lawyers

exercised poor judgment but were not guilty of professional misconduct, is

questionable at best. Still, the review reflects a commitment to a

transparent investigation of professional behavior.

In contrast, the government doctors and psychologists who participated in

and authorized the torture of detainees have escaped discipline,

accountability or even internal investigation.

It is hardly news that medical staff at the C.I.A. and the Pentagon played a

critical role in developing and carrying out torture procedures.

Psychologists and at least one doctor designed or recommended coercive

interrogation methods including sleep deprivation, stress positions,

isolation and waterboarding. The military’s Behavioral Science Consultation

Teams evaluated detainees, consulted their medical records to ascertain

vulnerabilities and advised interrogators when to push harder for

intelligence information.

Psychologists designed a program for new arrivals at Guantánamo that kept

them in isolation to “enhance and exploit†their “disorientation and

disorganization.†Medical officials monitored interrogations and ordered

medical interventions so they could continue even when the detainee was in

obvious distress. In one case, an interrogation log obtained by Time

magazine shows, a medical corpsman ordered intravenous fluids to be

administered to a dehydrated detainee even as loud music was played to

deprive him of sleep.

When the C.I.A.’s inspector general challenged these “enhanced

interrogation†methods, the agency’s Office of Medical Services was brought

in to determine, in consultation with the Justice Department, whether the

techniques inflicted severe mental pain or suffering, the legal definition

of torture. Once again, doctors played a critical role, providing

professional opinions that no severe pain or suffering was being inflicted.

According to Justice Department memos released last year, the medical

service opined that sleep deprivation up to 180 hours didn’t qualify as

torture. It determined that confinement in a dark, small space for 18 hours

a day was acceptable. It said detainees could be exposed to cold air or

hosed down with cold water for up to two-thirds of the time it takes for

hypothermia to set in. And it advised that placing a detainee in handcuffs

attached by a chain to a ceiling, then forcing him to stand with his feet

shackled to a bolt in the floor, “does not result in significant pain for

the subject.â€

The service did allow that waterboarding could be dangerous, and that the

experience of feeling unable to breathe is extremely frightening. But it

noted that the C.I.A. had limited its use to 12 applications over two

sessions within 24 hours, and to five days in any 30-day period. As a

result, the lawyers noted the office’s “professional judgment that the use

of the waterboard on a healthy individual subject to these limitations would

be ‘medically acceptable.’â€

The medical basis for these opinions was nonexistent. The Office of Medical

Services cited no studies of individuals who had been subjected to these

techniques. Its sources included a wilderness medical manual, the National

Institute of Mental Health Web site and guidelines from the World Health

Organization.

The only medical source cited by the service was a book by Dr. Horne,

a sleep expert at Loughborough University in Britain; when Dr. Horne learned

that his book had been used as a reference, he said the C.I.A. had distorted

his findings and misrepresented his research, and that its conclusions on

sleep deprivation were nonsense.

Dr. Horne had used healthy volunteers who were subject to no other stresses

and could withdraw at any time, while C.I.A. and Pentagon interrogators used

a broad array of stresses in combination on the detainees. Sleep

deprivation, he said, mixed with pain-inducing positioning, intimidation and

a host of other stresses, would probably exhaust the body’s defense

mechanisms, cause physical collapse and worsen existing illness. And that

doesn’t begin to acknowledge the dire psychological consequences.

The shabbiness of the medical judgments, though, pales in comparison to the

ethical breaches by the doctors and psychologists involved. Health

professionals have a responsibility extending well beyond nonparticipation

in torture; the historic maxim is, after all, “First do no harm.†These

health professionals did the polar opposite.

Nevertheless, no agency — not the Pentagon, the C.I.A., state licensing

boards or professional medical societies — has initiated any action to

investigate, much less discipline, these individuals. They have ignored the

gross and appalling violations by medical personnel. This is an

unconscionable disservice to the thousands of ethical doctors and

psychologists in the country’s service. It is not too late to begin

investigations. They should start now.

Leonard S. stein is a visiting scholar at the s Hopkins Bloomberg

School of Public Health. N. Xenakis is a psychiatrist and a retired

Army brigadier general.

Copyright 2010 The New York Times Company

FAIR USE NOTICE: This may contain copyrighted (© ) material the use of which

has not always been specifically authorized by the copyright owner. Such

material is made available for educational purposes, to advance

understanding of human rights, democracy, scientific, moral, ethical, and

social justice issues, etc. It is believed that this constitutes a 'fair

use' of any such copyrighted material as provided for in Title 17 U.S.C.

section 107 of the US Copyright Law. This material is distributed without

profit.

[Guest guest]

THE NEW YORK TIMES

March 1, 2010

Op-Ed Contributors

Doctors Without Morals

By LEONARD S. RUBENSTEIN and STEPHEN N. XENAKIS

AFTER five years of investigation, the Justice Department has released its

findings regarding the government lawyers who authorized waterboarding and

other forms of torture during the interrogation of suspected terrorists at

Guantánamo Bay and elsewhere. The report’s conclusion, that the lawyers

exercised poor judgment but were not guilty of professional misconduct, is

questionable at best. Still, the review reflects a commitment to a

transparent investigation of professional behavior.

In contrast, the government doctors and psychologists who participated in

and authorized the torture of detainees have escaped discipline,

accountability or even internal investigation.

It is hardly news that medical staff at the C.I.A. and the Pentagon played a

critical role in developing and carrying out torture procedures.

Psychologists and at least one doctor designed or recommended coercive

interrogation methods including sleep deprivation, stress positions,

isolation and waterboarding. The military’s Behavioral Science Consultation

Teams evaluated detainees, consulted their medical records to ascertain

vulnerabilities and advised interrogators when to push harder for

intelligence information.

Psychologists designed a program for new arrivals at Guantánamo that kept

them in isolation to “enhance and exploit†their “disorientation and

disorganization.†Medical officials monitored interrogations and ordered

medical interventions so they could continue even when the detainee was in

obvious distress. In one case, an interrogation log obtained by Time

magazine shows, a medical corpsman ordered intravenous fluids to be

administered to a dehydrated detainee even as loud music was played to

deprive him of sleep.

When the C.I.A.’s inspector general challenged these “enhanced

interrogation†methods, the agency’s Office of Medical Services was brought

in to determine, in consultation with the Justice Department, whether the

techniques inflicted severe mental pain or suffering, the legal definition

of torture. Once again, doctors played a critical role, providing

professional opinions that no severe pain or suffering was being inflicted.

According to Justice Department memos released last year, the medical

service opined that sleep deprivation up to 180 hours didn’t qualify as

torture. It determined that confinement in a dark, small space for 18 hours

a day was acceptable. It said detainees could be exposed to cold air or

hosed down with cold water for up to two-thirds of the time it takes for

hypothermia to set in. And it advised that placing a detainee in handcuffs

attached by a chain to a ceiling, then forcing him to stand with his feet

shackled to a bolt in the floor, “does not result in significant pain for

the subject.â€

The service did allow that waterboarding could be dangerous, and that the

experience of feeling unable to breathe is extremely frightening. But it

noted that the C.I.A. had limited its use to 12 applications over two

sessions within 24 hours, and to five days in any 30-day period. As a

result, the lawyers noted the office’s “professional judgment that the use

of the waterboard on a healthy individual subject to these limitations would

be ‘medically acceptable.’â€

The medical basis for these opinions was nonexistent. The Office of Medical

Services cited no studies of individuals who had been subjected to these

techniques. Its sources included a wilderness medical manual, the National

Institute of Mental Health Web site and guidelines from the World Health

Organization.

The only medical source cited by the service was a book by Dr. Horne,

a sleep expert at Loughborough University in Britain; when Dr. Horne learned

that his book had been used as a reference, he said the C.I.A. had distorted

his findings and misrepresented his research, and that its conclusions on

sleep deprivation were nonsense.

Dr. Horne had used healthy volunteers who were subject to no other stresses

and could withdraw at any time, while C.I.A. and Pentagon interrogators used

a broad array of stresses in combination on the detainees. Sleep

deprivation, he said, mixed with pain-inducing positioning, intimidation and

a host of other stresses, would probably exhaust the body’s defense

mechanisms, cause physical collapse and worsen existing illness. And that

doesn’t begin to acknowledge the dire psychological consequences.

The shabbiness of the medical judgments, though, pales in comparison to the

ethical breaches by the doctors and psychologists involved. Health

professionals have a responsibility extending well beyond nonparticipation

in torture; the historic maxim is, after all, “First do no harm.†These

health professionals did the polar opposite.

Nevertheless, no agency — not the Pentagon, the C.I.A., state licensing

boards or professional medical societies — has initiated any action to

investigate, much less discipline, these individuals. They have ignored the

gross and appalling violations by medical personnel. This is an

unconscionable disservice to the thousands of ethical doctors and

psychologists in the country’s service. It is not too late to begin

investigations. They should start now.

Leonard S. stein is a visiting scholar at the s Hopkins Bloomberg

School of Public Health. N. Xenakis is a psychiatrist and a retired

Army brigadier general.

Copyright 2010 The New York Times Company

FAIR USE NOTICE: This may contain copyrighted (© ) material the use of which

has not always been specifically authorized by the copyright owner. Such

material is made available for educational purposes, to advance

understanding of human rights, democracy, scientific, moral, ethical, and

social justice issues, etc. It is believed that this constitutes a 'fair

use' of any such copyrighted material as provided for in Title 17 U.S.C.

section 107 of the US Copyright Law. This material is distributed without

profit.

[Guest guest]

THE NEW YORK TIMES

March 1, 2010

Op-Ed Contributors

Doctors Without Morals

By LEONARD S. RUBENSTEIN and STEPHEN N. XENAKIS

AFTER five years of investigation, the Justice Department has released its

findings regarding the government lawyers who authorized waterboarding and

other forms of torture during the interrogation of suspected terrorists at

Guantánamo Bay and elsewhere. The report’s conclusion, that the lawyers

exercised poor judgment but were not guilty of professional misconduct, is

questionable at best. Still, the review reflects a commitment to a

transparent investigation of professional behavior.

In contrast, the government doctors and psychologists who participated in

and authorized the torture of detainees have escaped discipline,

accountability or even internal investigation.

It is hardly news that medical staff at the C.I.A. and the Pentagon played a

critical role in developing and carrying out torture procedures.

Psychologists and at least one doctor designed or recommended coercive

interrogation methods including sleep deprivation, stress positions,

isolation and waterboarding. The military’s Behavioral Science Consultation

Teams evaluated detainees, consulted their medical records to ascertain

vulnerabilities and advised interrogators when to push harder for

intelligence information.

Psychologists designed a program for new arrivals at Guantánamo that kept

them in isolation to “enhance and exploit†their “disorientation and

disorganization.†Medical officials monitored interrogations and ordered

medical interventions so they could continue even when the detainee was in

obvious distress. In one case, an interrogation log obtained by Time

magazine shows, a medical corpsman ordered intravenous fluids to be

administered to a dehydrated detainee even as loud music was played to

deprive him of sleep.

When the C.I.A.’s inspector general challenged these “enhanced

interrogation†methods, the agency’s Office of Medical Services was brought

in to determine, in consultation with the Justice Department, whether the

techniques inflicted severe mental pain or suffering, the legal definition

of torture. Once again, doctors played a critical role, providing

professional opinions that no severe pain or suffering was being inflicted.

According to Justice Department memos released last year, the medical

service opined that sleep deprivation up to 180 hours didn’t qualify as

torture. It determined that confinement in a dark, small space for 18 hours

a day was acceptable. It said detainees could be exposed to cold air or

hosed down with cold water for up to two-thirds of the time it takes for

hypothermia to set in. And it advised that placing a detainee in handcuffs

attached by a chain to a ceiling, then forcing him to stand with his feet

shackled to a bolt in the floor, “does not result in significant pain for

the subject.â€

The service did allow that waterboarding could be dangerous, and that the

experience of feeling unable to breathe is extremely frightening. But it

noted that the C.I.A. had limited its use to 12 applications over two

sessions within 24 hours, and to five days in any 30-day period. As a

result, the lawyers noted the office’s “professional judgment that the use

of the waterboard on a healthy individual subject to these limitations would

be ‘medically acceptable.’â€

The medical basis for these opinions was nonexistent. The Office of Medical

Services cited no studies of individuals who had been subjected to these

techniques. Its sources included a wilderness medical manual, the National

Institute of Mental Health Web site and guidelines from the World Health

Organization.

The only medical source cited by the service was a book by Dr. Horne,

a sleep expert at Loughborough University in Britain; when Dr. Horne learned

that his book had been used as a reference, he said the C.I.A. had distorted

his findings and misrepresented his research, and that its conclusions on

sleep deprivation were nonsense.

Dr. Horne had used healthy volunteers who were subject to no other stresses

and could withdraw at any time, while C.I.A. and Pentagon interrogators used

a broad array of stresses in combination on the detainees. Sleep

deprivation, he said, mixed with pain-inducing positioning, intimidation and

a host of other stresses, would probably exhaust the body’s defense

mechanisms, cause physical collapse and worsen existing illness. And that

doesn’t begin to acknowledge the dire psychological consequences.

The shabbiness of the medical judgments, though, pales in comparison to the

ethical breaches by the doctors and psychologists involved. Health

professionals have a responsibility extending well beyond nonparticipation

in torture; the historic maxim is, after all, “First do no harm.†These

health professionals did the polar opposite.

Nevertheless, no agency — not the Pentagon, the C.I.A., state licensing

boards or professional medical societies — has initiated any action to

investigate, much less discipline, these individuals. They have ignored the

gross and appalling violations by medical personnel. This is an

unconscionable disservice to the thousands of ethical doctors and

psychologists in the country’s service. It is not too late to begin

investigations. They should start now.

Leonard S. stein is a visiting scholar at the s Hopkins Bloomberg

School of Public Health. N. Xenakis is a psychiatrist and a retired

Army brigadier general.

Copyright 2010 The New York Times Company

FAIR USE NOTICE: This may contain copyrighted (© ) material the use of which

has not always been specifically authorized by the copyright owner. Such

material is made available for educational purposes, to advance

understanding of human rights, democracy, scientific, moral, ethical, and

social justice issues, etc. It is believed that this constitutes a 'fair

use' of any such copyrighted material as provided for in Title 17 U.S.C.

section 107 of the US Copyright Law. This material is distributed without

profit.

[Guest guest]

THE NEW YORK TIMES

March 1, 2010

Op-Ed Contributors

Doctors Without Morals

By LEONARD S. RUBENSTEIN and STEPHEN N. XENAKIS

AFTER five years of investigation, the Justice Department has released its

findings regarding the government lawyers who authorized waterboarding and

other forms of torture during the interrogation of suspected terrorists at

Guantánamo Bay and elsewhere. The report’s conclusion, that the lawyers

exercised poor judgment but were not guilty of professional misconduct, is

questionable at best. Still, the review reflects a commitment to a

transparent investigation of professional behavior.

In contrast, the government doctors and psychologists who participated in

and authorized the torture of detainees have escaped discipline,

accountability or even internal investigation.

It is hardly news that medical staff at the C.I.A. and the Pentagon played a

critical role in developing and carrying out torture procedures.

Psychologists and at least one doctor designed or recommended coercive

interrogation methods including sleep deprivation, stress positions,

isolation and waterboarding. The military’s Behavioral Science Consultation

Teams evaluated detainees, consulted their medical records to ascertain

vulnerabilities and advised interrogators when to push harder for

intelligence information.

Psychologists designed a program for new arrivals at Guantánamo that kept

them in isolation to “enhance and exploit†their “disorientation and

disorganization.†Medical officials monitored interrogations and ordered

medical interventions so they could continue even when the detainee was in

obvious distress. In one case, an interrogation log obtained by Time

magazine shows, a medical corpsman ordered intravenous fluids to be

administered to a dehydrated detainee even as loud music was played to

deprive him of sleep.

When the C.I.A.’s inspector general challenged these “enhanced

interrogation†methods, the agency’s Office of Medical Services was brought

in to determine, in consultation with the Justice Department, whether the

techniques inflicted severe mental pain or suffering, the legal definition

of torture. Once again, doctors played a critical role, providing

professional opinions that no severe pain or suffering was being inflicted.

According to Justice Department memos released last year, the medical

service opined that sleep deprivation up to 180 hours didn’t qualify as

torture. It determined that confinement in a dark, small space for 18 hours

a day was acceptable. It said detainees could be exposed to cold air or

hosed down with cold water for up to two-thirds of the time it takes for

hypothermia to set in. And it advised that placing a detainee in handcuffs

attached by a chain to a ceiling, then forcing him to stand with his feet

shackled to a bolt in the floor, “does not result in significant pain for

the subject.â€

The service did allow that waterboarding could be dangerous, and that the

experience of feeling unable to breathe is extremely frightening. But it

noted that the C.I.A. had limited its use to 12 applications over two

sessions within 24 hours, and to five days in any 30-day period. As a

result, the lawyers noted the office’s “professional judgment that the use

of the waterboard on a healthy individual subject to these limitations would

be ‘medically acceptable.’â€

The medical basis for these opinions was nonexistent. The Office of Medical

Services cited no studies of individuals who had been subjected to these

techniques. Its sources included a wilderness medical manual, the National

Institute of Mental Health Web site and guidelines from the World Health

Organization.

The only medical source cited by the service was a book by Dr. Horne,

a sleep expert at Loughborough University in Britain; when Dr. Horne learned

that his book had been used as a reference, he said the C.I.A. had distorted

his findings and misrepresented his research, and that its conclusions on

sleep deprivation were nonsense.

Dr. Horne had used healthy volunteers who were subject to no other stresses

and could withdraw at any time, while C.I.A. and Pentagon interrogators used

a broad array of stresses in combination on the detainees. Sleep

deprivation, he said, mixed with pain-inducing positioning, intimidation and

a host of other stresses, would probably exhaust the body’s defense

mechanisms, cause physical collapse and worsen existing illness. And that

doesn’t begin to acknowledge the dire psychological consequences.

The shabbiness of the medical judgments, though, pales in comparison to the

ethical breaches by the doctors and psychologists involved. Health

professionals have a responsibility extending well beyond nonparticipation

in torture; the historic maxim is, after all, “First do no harm.†These

health professionals did the polar opposite.

Nevertheless, no agency — not the Pentagon, the C.I.A., state licensing

boards or professional medical societies — has initiated any action to

investigate, much less discipline, these individuals. They have ignored the

gross and appalling violations by medical personnel. This is an

unconscionable disservice to the thousands of ethical doctors and

psychologists in the country’s service. It is not too late to begin

investigations. They should start now.

Leonard S. stein is a visiting scholar at the s Hopkins Bloomberg

School of Public Health. N. Xenakis is a psychiatrist and a retired

Army brigadier general.

Copyright 2010 The New York Times Company

FAIR USE NOTICE: This may contain copyrighted (© ) material the use of which

has not always been specifically authorized by the copyright owner. Such

material is made available for educational purposes, to advance

understanding of human rights, democracy, scientific, moral, ethical, and

social justice issues, etc. It is believed that this constitutes a 'fair

use' of any such copyrighted material as provided for in Title 17 U.S.C.

section 107 of the US Copyright Law. This material is distributed without

profit.