Medical Ethics Lapses Cited in Interrogations

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The New York Times | [ View Original Source (opens in new window) ]

By James Risen.  WASHINGTON — Medical professionals who were involved in the Central Intelligence Agency’s interrogations of terrorism suspects engaged in forms of human research and experimentation in violation of medical ethics and domestic and international law, according to a new report from a human rights organization.

Doctors, psychologists and other professionals assigned to monitor the C.I.A.’s use of waterboarding, sleep deprivation and other “enhanced” interrogation techniques gathered and collected data on the impact of the interrogations on the detainees in order to refine those techniques and ensure that they stayed within the limits established by the Bush administration’s lawyers, the report found. But, by doing so, the medical professionals turned the detainees into research subjects, according to the report, which is scheduled to be published on Monday by Physicians for Human Rights.

The data collected by medical professionals from the interrogations of detainees allowed the C.I.A. to judge the emotional and physical impact of the techniques, helping the agency to “calibrate the level of pain experienced by detainees during interrogation, ostensibly to keep it from crossing the administration’s legal threshold of what it claimed constituted torture,” the report said. That meant that the medical professionals crossed the line from treating the detainees as patients to treating them as research subjects, the report asserted.

The fact that psychologists, doctors and other health professionals were involved in the interrogations conducted by the C.I.A. and the Defense Department has been previously reported. A confidential report about the issue by the International Committee of the Red Cross, based on interviews with several high-value detainees held by the C.I.A., was leaked to the news media last year.

Physicians for Human Rights has based its conclusions on an analysis of a wide range of publicly released government documents and reports about the agency’s interrogation program and has not offered any new information about the role of medical professionals in the interrogations. The group, which is based in Cambridge, Mass., also does not identify by name any of the medical professionals involved in the interrogations.

In a statement, the C.I.A. denied the group’s charges. “The report is just wrong,” said Paul Gimigliano, an agency spokesman. “The C.I.A. 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.”

The report is the first analysis of the C.I.A.’s interrogation program to argue that one of the unintended consequences of the Bush administration’s efforts to provide legal cover for officials involved in the program was to place medical professionals in legal and ethical jeopardy. There are both international and national limits on human research and experimentation, including those based on the post-World War II Nuremberg Code and the so-called American Common Rule, both of which ban human experimentation without informed consent.

Medical personnel were ostensibly responsible for ensuring that the legal threshold for “severe physical and mental pain” was not crossed by interrogators, but their presence and complicity in intentionally harmful interrogation practices were not only apparently intended to enable the routine practice of torture, but also to serve as a potential legal defense against criminal liability for torture, the report states.

Several academic experts noted, however, that there has been no investigation by the government of the medical professionals involved in the C.I.A. interrogations.

“There are countries that, over the years, have condemned medical complicity in torture in principle, but which haven’t really been willing to investigate medical professionals or hold them accountable,” said Dr. Steven H. Miles of the Center for Bioethics at the University of Minnesota and an expert on the role of medical professionals in torture. “That group of countries includes the United States.”

The report found that the C.I.A.’s practice of waterboarding of high-value detainees offered perhaps the most direct evidence that medical professionals were helping to refine interrogation techniques. The report cites agency guidelines for health professionals involved in interrogations requiring that they document each time a detainee was waterboarded, how long each waterboarding session lasted, how much water was applied, exactly how the water was applied and expelled, whether the detainees’ breathing passages were filled, and how each detainee looked between treatments.

That information led the C.I.A. to make detailed changes in how interrogators conducted waterboarding sessions, the report concluded. Eventually, the agency replaced regular water with saline solution to reduce the detainees’ risk of contracting pneumonia or hyponatremia, a condition of low sodium levels in the blood caused by free water intoxication that can lead to brain edema and herniation, coma and death. The human rights group cited a 2005 memo from the Justice Department’s Office of Legal Counsel, declassified by the Obama administration, saying that the C.I.A. made the switch to saline solution “based on the advice of medical personnel.”

Separately, the Red Cross report made public last year quoted Khalid Shaikh Mohammed, the chief planner of the Sept. 11, 2001, attacks, as saying that when he was waterboarded his pulse and oxygen levels were monitored and that a medical attendant stopped the procedure several times.

The C.I.A. had adopted the use of waterboarding from a military survival training program, but the agency modified the technique as its medical professionals gleaned more information and experience. In addition to the switch to saline solution, the agency’s medical personnel introduced a special gurney so that the detainee could be moved upright quickly in case of choking. The agency also used a blood oximeter to measure vital signs, and detainees were placed on liquid diets on the advice of medical personnel so they would be less likely to choke on their own vomit, the report said.

“There was no therapeutic purpose or intent to monitor and collect this data,” said Jonathan D. Moreno, a professor of medical ethics at the University of Pennsylvania. “You can’t use people as laboratories.”

 

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