Torture, National Security & Accountability University of Hawaii William S. Richardson School of Law Honolulu, HI September 30, 2010 Vincent Iacopino MD, PhD Senior Medical Advisor Physicians for Human Rights, Cambridge, MA; Adjunct Professor of Medicine University of Minnesota Medical School Senior Research Fellow Human Rights Center University of California, Berkeley
Purpose: Evidence of US Torture The Bush/Cheney narrative: That the US government authorized and implemented safe, legal and effective enhanced interrogation techniques (EITs) in a good faith effort to obtain actionable intelligence necessary to save lives and it did June 2, 2010 President George W. Bush stated Yeah, we waterboarded Khalid Sheikh Mohammed I'd do it again to save lives But the evidence we will examine tells a different story That US policy makers authorized and implemented a systematic policy of torture aided and abetted by medical personnel which has cost thousands American lives and endangered the security of the United States and people around the world.
US Legal Obligations Prior to 911 Geneva Conventions (Common Article 3) UN Convention Against Torture US Federal Criminal Anti-Torture Statute US Constitution (5 th, 8 th, 14 th Amendments) Traditional US military law and guidelines Uniform Code of Military Justice Army Regulation 190-8 US Army Field Manual 34-52 (1987)
Post 9/11: A New Legal Framework October 2001: War in Afghanistan started January 2002, White House Counsel Alberto Gonzales: Geneva Conventions rendered obsolete in new kind of war. February 2002, President Bush: Geneva Conventions do not apply to al Qaeda and Taliban unlawful combatants. Humane treatment subject to military necessity CIA exempted altogether
Redefining Torture as Enhanced Interrogation Techniques EITs August 2002: Justice Department s Office of Legal Counsel (OLC) redefines torture as Physical Pain Threshold: equivalent to serious physical condition or injury such as death, organ failure, or serious impairment of body functions Mental Pain Threshold prolonged (months and even years) and calculated to disrupt profoundly the senses or the personality Specific Intent: the interrogator must specifically intend to inflict severe physical/mental pain.
Authorized Enhanced Interrogation Techniques Threats of harm to detainee & family Prolonged isolation Hooding Sensory deprivation and overload Forced nudity Prolonged sleep deprivation Painful stress positions Sexual humiliation Use of dogs to instill fear Waterboarding (CIA)
Enhanced Interrogation Techniques Previously Recognized as Torture Each EIT considered to constitute Torture (CAT, SRT) U.S. recognized them as such in its annual country reports on human rights practices Used by the Chinese & North Koreans to extract false confessions during the Korean War and were later included in the Survival, Evasion, Resistance, and Escape (SERE) training of US soldiers to resist torture if captured by an enemy Secretary of Defense, Rumsfeld, approved EITs despite multiple warnings from legal sources and trained interrogation experts on the questionable legality and the unreliability of coerced confessions
Science Used to Justify Torture: The SERE Studies Cited to justify the EITs as safe, legal & effective SERE Studies showed marked increases in Stress hormones levels (= to major surgery, parachuting) Psychological stress (Subjective Units of Stress Scale) Dissociation symptoms (96%) (Clinician-Administered Dissociative Symptom Scale) a symptom of PTSD No assessment of PTSD, Depression, or longterm follow-up SERE subjects: exposed to limited forms of EITs, provided consent, & able to stop their participation at any time
Safe, Legal & Effective EITs Required Systematic Medical Monitoring OLC required health professionals to monitor EITs systematically and subsequently to apply the generalizable knowledge to ensure the safety of these techniques and in so doing engaged in unethical human subject research and experimentation. Human experimentation was used both to justify the safety of EITs and to further refine EIT practices. OLC Attorneys cannot claim safe, legal and effective EITs without the self-incriminating defense of illegal and unethical human subject research (human experimentation).
Illegal and Unethical Human Subject Research Used to Justify Torture Instances of apparent illegal and unethical human subject research in a recent PHR report, Experiments in Torture: Medical personnel required to monitor all waterboarding practices & collect detailed medical information that was used to design, develop and deploy subsequent waterboarding procedures. Information on the effects of simultaneous versus sequential application of the interrogation techniques on detainees was collected and used to establish the policy for using tactics in combination. Information collected by health professionals on the effects of sleep deprivation on detainees was used to establish enhanced interrogation sleep deprivation policy
CIA Office of Medical Service (OMS) Guidelines: Evidence of Torture Complicity The CIA s Office of Medical Service (OMS) developed guidelines for medical personnel to monitor all enhanced interrogations, ostensibly to ensure that the newly established pain thresholds for torture were not exceeded. The CIA s Draft OMS Guidelines on Medical and Psychological Support to Detainee Interrogations actually contain no guidelines for any form of psychological assessment, including psychological stress or dissociation that was measured in the SERE studies. Current OMS Policy: Unknown
DoD Behavioral Science Consultant Team (BSCT) SOP: Evidence of Torture Complicity BSCT Standard Operating Procedures (SOP)(2002-2005). No clinical duty to the detainee (to circumvent medical ethics) Able to obtain medical records from DoD Medical Personnel Provided assessments of psychological and social vulnerabilities and recommendations. No role in the documentation of physical &/or psychological harm Declassified interrogation logs provide evidence of intent to break down detainees, i.e. ego down, futility, fear up euphemisms for debility, dependency, dread elements of torture Maj John Leso MD: to shock, dislocate expectations, foster dependence, and support exploitation to the fullest extent possible evidence of specific intent Current BSCT SOP: Continues to allow for BSCT activities
Further Evidence of Specific Intent Interrogator / BSCT logs: Intent to cause debility, dependency and dread euphemistically referred to as ego down, futility and fear up Case of Mohammadou Slahi: Oct 17 2003 e-mail exchange between LTC Diane Zierhoffer, a ITF-GTMO BSCT Psychologist, stated that : Slahi told me he is "hearing voices' now... He is worried as he knows this is not normal... By the way... is this something that happens to people who have little external stimulus such as daylight, human interaction etc???? Seems a little creepy. LTC Zierhoffer responded: sensory deprivation can cause hallucinations, usually visual rather than auditory, but you never know...in the dark you create things out of what little you have...
Release of Abu Ghraib Photos In May, 2004, the people of the world instantly recognized safe, legal and effective EITs as torture from just a handful of photographs without the aid of any legal memoranda, guidelines or standard operating procedures.
Abu Ghraib
Abu Ghraib
Abu Ghraib
Abu Ghraib
Broken Laws, Broken Lives: Medical Evidence of Torture by U.S. Personnel and It s Impact After years of disclosures by government investigations, media accounts, and reports from human rights organizations, there is no longer any doubt as to whether the current administration has committed war crimes. The only question that remains to be answered is whether those who ordered the use of torture will be held to account. Major General Antonio Taguba, (Ret.)
Methods 11 former detainees referred by NGOs and law firms (Imam, pensioner, teacher, businessmen, health professional, kidnapped for bounty, work in Afg without passport, former soldier served time for speaking against Saddam) PHR clinicians conducted 2-day medical evaluations, including diagnostic tests and psychological instruments Assessment using international Istanbul Protocol standards to assess consistency between individual allegations of abuse and physical and psychological evidence Medical records available for one GTMO detainee
Broken Laws, Broken Lives Findings 11 in-depth medical and psychological evaluations 7 Iraqis: Abu Ghraib, Baghdad International Airport, Camp Bucca, and unknown American-controlled camps 4 others: held in Kandahar, Bagram, and unknown prison facilities in Afghanistan and later on taken to Guantanamo Bay Arrested between late 2001 and early 2003 Length of detention varied from 7 months to 4 years Age ranged from 29 to 47
Findings Patterns of Torture and Ill Treatment All were subjected to various combinations of beatings and assaults, sexual humiliation, isolation, sleep deprivation, sensory deprivation, and others harmful forms of abuse None had any explanation for their arrest and detention None were charged of any crime None have received an apology or compensation from the United States.
Other forms of Physical and Psychological Abuse Electric shocks Sodomy- instrumentation Suspension Cigarette burns Loud music and lights Threats of death Threats to family Use of dogs Cultural/religious disrespect Temperature extremes Screwdriver stabbed in face
Other Forms of Psychological Abuse Mock rape of a family member Urinate on detainee Wipe floor with detainee like a human sponge Pull out genital hair Menstrual blood wiped on detainee Spit in food Body writing with degrading phrases Forced to wear a dog leash and howl like a dog Forced to watch anal intercourse simulated by other detainees Drink urine on multiple occasions
Findings Health Consequences of Torture and Cruel Treatment Physical evidence : Scarring and Healed Lesions, i.e. screwdriver stabbed in face, cigarette burns, Musculoskeletal injuries: brachial plexus 1/11 Bone scan findings and/or scars among 6/11 Rectal tear scars among 2 of 3 alleging sodomy Ongoing chronic symptoms: i.e. headaches, persistent pain in their limbs, joints, muscles and ligaments, as well as functional impairments
Findings Health Consequences of Torture and Cruel Treatment Psychological evidence : Major Depressive Disorder (6/11) PTSD (9/11) Suicidal Ideation (7/11) Somatization (1/11) Sexual Dysfunction, Alcohol Dependence
Findings Complicity of Medical Personnel Direct abuse in torture Presence during interrogations (3/11) Treating torture-related injuries to enable continued interrogation/abuse Denial of medical care & pain medication Failure to report injuries caused by abuse Forced medication and injections Failing to diagnose and treat psychological conditions related to torture and ill treatment
Conclusion The authorization and application of abusive interrogation and detention techniques by U.S. officials constitute a systematic policy of torture and ill treatment Applied and condoned over extended periods of time in 3 theaters of operation Authorized and unauthorized abuses have resulted in severe and lasting physical and psychological pain and disabilities
DoD Medical Personnel in Guantanamo Bay Neglected and/or Concealed Medical Evidence of Torture Review of 9 GTMO cases (medical records, related files, independent forensic evaluations) by Vincent Iacopino, MD, PhD & Stephen N. Xenakis, MD, Brigadier General (Ret), U.S. Army Physical and psychological evidence of the detainees torture allegations of torture in all cases. DoD GTMO clinical medical personnel failed to inquire and/or document causes of the physical injuries and psychological symptoms they observed. Psychological symptoms were commonly attributed to personality disorders and routine stressors of confinement. All continue to experience severe, long-term & debilitating psych symptoms
Consequences of U.S. Torture Undermines US security False Confession of Ibn al-shaykh al-libi Libyan paramilitary trainer for Al-Qaeda Renditioned to Egypt Jan 2002 and tortured Confessed to knowledge of WMD in Iraq Instrumental in the U.S. decision to invade Iraq > 4,000 US casualties, hundreds of thousands of Iraqi casualties, devastating effects on US economy
Consequences of U.S. Torture Jeopardized the effective legal prosecutions of suspected terrorists Placed U.S. soldiers at greater risk of harm Undermined the capacity for the U.S. to hold other countries accountable for human rights abuses Fueled US resentment and aided recruitment of terrorists Dishonored American men and women in uniform Forced servicemen and women to commit crimes Moral Contradiction: becoming that which we claim to oppose In the absence of accountability sets a dangerous precedent should there be future terrorist attacks
The Good News Executive Order (1/22/09) Ensuring Lawful Interrogations Army Field Manual 2 22.3 (2006) uniform standard for all US interrogations, including CIA Geneva Convention (Common Article 3) protection against: torture, cruel treatment, humiliating and degrading treatment All CIA detention facilities to be closed ICRC access to all detainees Special Interagency Task Force on Interrogation and Transfer Policies Non-military study of Army Field Manual 2 22.3 interrogation practices To study practices of transferring individuals to other countries to ensure compliance with US domestic & international obligations, i.e. non-refoulment
More Good News: Statement of 16 retired admirals and generals (1/22/09): It is vital to the safety of our men and women in uniform that the United States never sanction the use of interrogation methods that we would find unacceptable if inflicted by an enemy against captured Americans. OSI/IMAP Task Force: 21 medical and legal experts working with U.S. agencies on reforming medical policies Legal Cases Against BSCT Psychologists: John Leso, Larry James, and James Mitchell
The Challenge of Learning From Past Mistakes BBC World Service opinion poll on torture (27,000 people in 25 different countries, June, 2008) A majority of the world s citizens opposed torture: 59% unwilling to compromise protection against torture 29% think governments should be allowed to use some degree of torture in order to combat terrorism A majority of Americans (58%) opposed torture: 36% of Americans favor torture in certain cases, one of the highest rates among the 25 countries polled.
What Needs to Happen End Rendition of detainees to countries that practice torture Note: Recent 9 th Circuit COA decision dismissing the illegal rendition case of 5 detainees tortured in other countries Revise Army Field Manual 2 22.3 (2006) Appendix M Isolation, sleep & sensory deprivation inconsistent with Common Article 3 and CAT End DoD policy (2005) provides for non-clinical role of medical personnel and continued use of BSCT personnel Reestablish the meaning of the rule of law through effective accountability and prevention Public education on/constituency for human rights as conditions for global health, peace and security