"Abu Ghraib" by Fernando Botero.
July 12, 2010
There is increasing evidence that United States physicians, psychologists, nurses, and medics have been complicit in torture and other illegal procedures in Iraq, Afghanistan, and Guantánamo. They violated one of the principal precepts of medical ethics: “First, do no harm.” Government physicians and psychologists who participated in and authorized the torture of detainees have escaped discipline, accountability and even internal investigations. The Pentagon, the C.I.A., state licensing boards, and professional medical societies have not initiated any action to investigate, much less discipline, these individuals. Presumably these health care professionals continue to treat an unknowing public with little or no fear of prosecution or disciplinary action.
Background
On April 16, 2009, President Obama released four top secret memos that allowed the CIA under the Bush administration to torture al-Qaeda and other suspects held at Guantánamo and secret detention centers round the world. According to the memos, ten techniques were approved: attention grasp (grasping the individual with both hands, one hand on each side of the collar opening, in a controlled and quick motion); walling (in which the suspect could be pushed into a wall); a facial hold; a facial slap; cramped confinement; wall standing; sleep deprivation; insects placed in a confinement box (the suspect had a fear of insects); and waterboarding.
In waterboarding, the individual is bound securely to an inclined bench, which is approximately four feet by seven feet. The individual’s feet are generally elevated. A cloth is placed over the forehead and eyes. Water is then applied to the cloth in a controlled manner which produces the perception of suffocation and incipient panic.
Gulf War veteran Joe Tougas, dressed in Guantanamo Bay detention camp garb, volunteered to be waterboarded during a demonstration at UC Berkeley, 11/14/07, to demonstrate the practice is a severe form of inhumane torture. Photo by John Han.
In the now-discredited August 2002 memorandum from then Assistant Attorney General Jay Bybee to then White House Counsel Alberto Gonzalez, narrowly defined physical torture as requiring pain “equivalent in intensity to the pain accompanying serious physical injury, such as organ failure, the permanent impairment of a significant bodily function, or even death.”
And we all remember former Vice President Cheney’s comment that “enhanced interrogation techniques,” (a euphemism for torture) sanctioned by the Bush administration, are not torture and dismissed criticism as “contrived indignation and phony moralizing.”
The “Yamashita standard” is based upon the precedent set by the United States Supreme Court in the case of Japanese General Tomoyuki Yamashita (In re Yamashita, 327 U.S. 1 (1946). Yamashita was prosecuted in 1945, in a still controversial trial, for atrocities committed by troops under his command in the Philippines. He was subsequently was charged with “unlawfully disregarding and failing to discharge his duty as a commander to control the acts of members of his command by permitting them to commit war crimes.”
Would the “Yamashita standard” apply to those in the chain of command right up to then President Bush as commander-in-chief of the armed forces, Donald Rumsfeld, his Secretary of Defense, Alberto Gonzales, his attorney general, and the directors of the Central Intelligence Agency?
It is a moot point now as President Obama has ruled out prosecutions against those who had been involved in torture. It is a “time for reflection, not retribution,” he said.
Defining Medical Torture
Medical torture (also known as a medical interrogation) describes the involvement and sometimes active participation of medical professionals in acts of torture, either to judge what victims can endure, to apply treatments which will enhance torture, or as torturers in their own right. Medical torture may involve the use of their expert medical knowledge to facilitate interrogation or corporal punishment, in the conduct of torturous human experimentation or in providing professional medical sanction and approval for the torture of prisoners. The term also covers torturous scientific (or pseudo-scientific) experimentation upon unwilling human subjects.
Pentagon top health official doctor William Winkenwerder Jr. in 2005 allowed military physicians to participate in torture and share medical records with interrogators so long as a detainee wasn’t officially their patient. Winkenwerder got an award from the AMA that year for outstanding contributions “to the betterment of the public health.” The AMA has refused to condemn Pentagon and CIA torture practices and made no response when in Feb., 2006, the U.N. Commission on Human Rights condemned U.S. doctors for having “systematically” participated in detainee abuse. Bioethicist Steven Miles of the University of Minnesota Medical School said the U.N. condemnation should have been “a call to arms” yet “the AMA said nothing.”
Yet, according to an AMA opinion, “Physicians must oppose and must not participate in torture for any reason. Participation in torture includes, but is not limited to, providing or withholding any services, substances, or knowledge to facilitate the practice of torture. Physicians must not be present when torture is used or threatened.” (AMA Code of Medical Ethics opinion 2.067)
According to the American Pychological Association: ” BE IT RESOLVED that the APA reaffirms its 1986 condemnation of torture and other cruel, inhuman, or degrading treatment or cruel, inhuman, or degrading punishment wherever it occurs.” (American Psychologists Ethical Principles of Psychologists and Code of Conduct (2006)). However, in May, 2006, APA President Steven Sharfstein noted that psychiatrists “wouldn’t get into trouble” if they heeded military orders despite the APA’s advice that members should not directly assist in interrogations, which he added should not be considered “an ethical rule.”
Torture is prohibited under international law and the domestic laws of most countries. Although, Amnesty International estimates that at least 81 world governments currently practice torture, some openly.
Nuremberg “Doctor’s Trial”
The “doctor’s trial.” one of many trials at Nuremberg is somewhat instructive. Twenty-three German physicians who willingly participated in the Nazi program to euthanize persons deemed “unworthy of life” (the mentally ill, mentally retarded, or physically disabled or who conducted pseudoscientific medical experiments utilizing thousands of concentration camp prisoners without their consent. Most died or were permanently crippled as a result. Most of the victims were Jews, Poles, Russians, and also Roma (Gypsies). After almost 140 days of proceedings, including the testimony of 85 witnesses and the submission of almost 1,500 documents, the American judges pronounced their verdict on August 20, 1947. Sixteen of the doctors were found guilty. Seven were sentenced to death. They were executed on June 2, 1948. The tribunal rejected the defense that the accused were only following orders issued by others. Instead, individuals were held responsible for their actions, although for those found guilty, the tribunal indicated that a person’s place in the hierarchy of authority and the nature of those orders could be considered as mitigating circumstances in the determination of sentencing.
But you say, these German doctors’ actions resulted directly or indirectly in thousands of deaths and the crippling of prisoners. Is there a difference in kind or is the difference really one of degree?
Disobeying Unlawful Orders
The Constitution states (Article VI) states:
This Constitution, and the Laws of the United States which shall be made in Pursuance thereof; and all Treaties made, or which shall be made, under the Authority of the United States, shall be the supreme Law of the Land; and the Judges in every State shall be bound thereby, any Thing in the Constitution or Laws of any State to the Contrary notwithstanding.
Article 3 of the Geneva Conventions states in pertinent part:
In the case of armed conflict not of an international character occurring in the territory of one of the High Contracting Parties, each party to the conflict shall be bound to apply, as a minimum, the following provisions:
1. Persons taking no active part in the hostilities, including members of armed forces who have laid down their arms and those placed hors de combat by sickness, wounds, detention, or any other cause, shall in all circumstances be treated humanely, without any adverse distinction founded on race, colour, religion or faith, sex, birth or wealth, or any other similar criteria.
To this end the following acts are and shall remain prohibited at any time and in any place whatsoever with respect to the above-mentioned persons:
(a) Violence to life and person, in particular murder of all kinds, mutilation, cruel treatment and torture;
(b) Taking of hostages;
(c) Outrages upon personal dignity, in particular, humiliating and degrading treatment.”
Article 3 is straightforward and clear. Under Article VI of the Constitution, it forms part of the supreme law of the land.
Thus, a member of the military is personally held responsible for all of his or her actions, in all countries, at all times and places. “I was only following orders” is not a defense.
To disobey an unlawful order seems clear in principal, but not always in practice. A military physician is subject to a potential moral conflict between healing, on the one hand, and obeyance to the military hierarchy and the command structure, on the other. American doctors at prisons in Iraq, Afghanistan, Guantánamo, and elsewhere, are supposed to know their medical responsibility to document injuries and raise questions about possible abuse. Yet, those physicians and other medical personnel are part of a command structure that permitted, encouraged, and sometimes committed torture to a degree that it became the norm in the prison environment and to which they were expected to comply.
The Nazis provided the most extreme example of physicians becoming socialized to atrocity. In addition to cruel medical experiments, many Nazi doctors, as part of military units, were directly involved in killing. To reach that extreme point, they underwent a sequence of socialization: first to the medical profession, a self-protective guild; then to the military, where they became subjected to the chain of command; and finally to camps such as Auschwitz, where adaptation included assuming leadership roles in the death factory. Most of these physicians were ordinary people who had killed no one before joining murderous Nazi institutions. They were corruptible and certainly responsible for what they did, but they became murderers mainly in atrocity-producing settings.
Did any medical personnel refuse to engage in torture and, if so, were they disciplined?
Conclusion
Those who sanctioned torture either don’t know the law, or advocated flaunting the law. Human torture is not only morally unacceptable – it is also a crime. Waterboarding, for example, is explicitly prohibited by the Convention Against Torture and the Geneva Conventions. Using torture places us in the same company as history’s infamous torturers. Waterboarding, for example, dates back to the Dark Ages. By using torture, we lost any ideological advantage we might have had — the promotion of democracy, freedom and human rights. We became the thugs our enemies say we are.
Where does that leave us as a society if we do not punish those who carry out unlawful orders? We expect our physicians and psychologists to maintain a high standard of ethics, a high duty to their patients, and often to put the interests of their patients ahead of their own interests. Failure to meet these standards is an unconscionable disservice to the thousands of ethical physicians and psychologists in and out of the military.
The Hunger Site
July 30, 2010 at 4:19 pm
First do no harm. that is the oath. their licenses should be revoked and they should never be permitted to practice medicine anywhere in the world!!
July 25, 2010 at 7:50 am
If this includes non consensual experimentation, then we as a society are also experimentees. We have known about the torture for years, we have seen vile images and yet it seems to periodically fall out of the news. Maybe they’re testing us to see how indifferent we have become toward human rights abuses.
For someone interested in the history of this type of experimentation, I suggest they look at Sargant’s work in the 1950s on Pavlovian techniques for “breaking” people, Ewen Cameron’s “depatterning” in the MK Ultra projects, and Tavistock Institute founders’ work on PTSD and soldier’s breaking points. That should get someone thinking of how psychology/psychiatry is not only used in creating the tactics but what the end goals might be.
There are some of us here in the US who are not guilty of any crimes yet have been harassed, abused, socially engineered and, in some cases, tortured with directed energy weapons. I can’t speak for the others since there might be pretend targets out there, but this harassment in its more overt phase resembles much of what I cited above. The fact that many harassees are easily led into larger conspiracy theories or radical views that don’t help resolve our problem directly is not likely to be a coincidence. In addition, the constant state of trauma and the development of PTSD in some is likely to cause certain types of physical changes to the brain that would make them more susceptible to suggestion, have a weakened memory and weakened “long term planning” skills, as well as affect the regulation of emotions.
To bring it back to Guantanamo, if interrogation wasn’t really the goal, then what was?
I’ll suggest that especially within academia there are those who know more about these programs than they let on. There might be systems of coercion and blackmail to make sure it stays that way. Then again there’s always greed and hypocrisy.
As for the politicians? Look at what happened to Clinton after they had the radiation experiment hearings. Those reports were only the tip of the iceberg.
Nobody likes dysfunction, but until people inside the system of non consensual experimentation break out, that’s what we’ll continue having.
July 15, 2010 at 1:54 pm
More corrections to my above comments… my apologies for not having all my facts straight.
When I wrote Sally’s law I meant “Laura’s Law” which was partially inspired by a New York law called “Kendra’s Law”.
Today in the Examiner Melissa Griffin (in a commentary) and Alioto-Pier (in a letter) defend Laura’s law saying that it will not involve coercive medicating.
That may be true– but I believe it is a slippery slope; it will involve coerced, involuntary commitment.
Detained persons would not only likely be marked with a scarlet letter, but they would be vulnerable to questionable forms of persuasion that might lead them to unnecessary treatments or use of drugs just to be free.
How are people to be deemed a danger to themselves or others? That is the most critical question. What are the appropriate thresholds for enforcing conformity? What will keep such a law from becoming a “catch-all” solution that encourages fear and sloppiness?
No one wants to see people suffer, injure themselves or others.
But we should be extremely wary of any psychiatric certitudes. I would refer people to reading Peter R. Breggin on the matter for a strongly reasoned alternative view to current psychiatric dogma.
Breggin is abhorred by the Pharmaceutical industry and Psychiatric interests– at one time they tried hard to paint him as freak and Scientologist. He is their enemy no. 1.
I believe rather than enforcing “good” we should all take a more reasoned interest in our communities, and use common sense protecting and nurturing our weakest neighbors.
I believe there are humane alternatives for many of the solutions like Kendra’s or Laura’s law which are hardly explored. Why aren’t they? Maybe they are less profitable, and require us to be more loving, less judgmental, and more available.
Another fact check: perhaps it is the SFWeekly, not the Bay Guardian that has a Noise section. So my apology to either if I am wrong.
I seldom read either beyond the editorials and investigative pieces.
July 15, 2010 at 7:54 am
update: a new iteration of lights at Mid-Market: lasers.
Sprucing up Mid-Market is a good idea, but must it be so garish, gimmicky, and low-brow?
http://tinyurl.com/27qtzc4
I recall the hateful posters, advertising the Yerba Buena Center that said “NOISE!” with heavily painted recumbent figures to look disfigured… to grab attention… not so unlike the powder-burned victims of white phosphorus. I am always hoping that San Francisco’s artists can evolve to more natural colors– and humanity endorsing themes– as opposed to the mechanical and robotic– “thing” oriented themes. Mona Caron for example is refreshing and headed the right way. Amy Franceschini too with her love of life forms.
Noise is unwanted sound– it is not synonymous with music, and only is delightful to those who enjoy torture or pain.
There is a place for it. I love punk music– as a rebellion and as a celebration of individuality. It is sad, however, that so much that is original is grasped, exploited and reduced to formulas which are seldom creative, if yet lucrative.
If San Francisco (including its surface-blighted Mid-Market) is to rise above the formula, the mundane, and pedestrian– it needs an artistic awakening that is more eternal than gimmmicks, cultural basts and shocks. It must also be cognizant of San Francisco’s past ambition to be lustrous– a luster in tune with its natural dreamlike light.
I know this city has the talent– but does it have the vision to encourage it?
The other day I was elated to see a squad of painters whitewashing the Stockton Street tunnel. I still wish the city could scrap the underground dig and put people movers (moving sidewalks– as novel as cable cars?) through it between Chinatown and Union Square.
Small is still beautiful. Human trumps things. I don’t want to see years of Chinatown economic lassitude while developers get rich off of monstrous projects.
What if a moving sidewalk was put on Market between 2nd street and 9th? Vision involves thinking outside of the box and exploring all ideas.
They don’t involve just slapping on acrylic or erecting plexiglass. Flowers and lovely trees have always improved the city. When I pass the flower stalls on Market and elsewhere, I always ask the sellers why they don’t have a competition of art students to paint their huts to complement their flowers. Then again, they know their business best, maybe too much paint is ersatz.
Another thought about Noise: the Bay Guardian (it has a place), has an eponymous section. There is nothing classy about it– the paper, like “progressives” who are incapable of slipping the surly bonds of the power of the status quo, gets more respect than it is due.
I believe San Franciscan culture is a reflection of its media. If only the media could be less crude, and less often foul.
I think capitalism is the root cause: putting things before people, and idolizing money and power.
I have gone far afield of the topic above– but I see a distinct link between the Brave New World we are creating and the accelerating evils perpetrated at home and abroad.
If there must be a garish in-your-face and on-the-floor district, perhaps SOMA s appropriate.
For the rest of San Francisco I wish a more sublime and humanity up-lifting future.
July 13, 2010 at 11:31 pm
Correction: a “Love” fest. Meanings matter.
July 13, 2010 at 8:26 pm
I detest that word”Homeland”– I detest the insidious concepts and the tangible police state that has grown up around the awkward word. In this country! The country of my birth and the country I love for so many many reasons.
When I hear the word “homeland”, and it is harped almost everywhere (e.g. NPR, which with some others I now call National Propaganda Radio), I picture in my mind’s eye a macabre mob of syrupy-sweet fascists and brownshirts mouthing it, a mob lusting for blood and destruction.
Who are these people in my imagination?
I first picture a small team of screw-faced agents-provocateurs, pretending to be real people in the Chronicle’s Comments sections. In a nightmare that follows, I picture not provocateurs, but real folks– benighted by an evil spell that makes them heartless and incapable of reason.
Amplified by the Chronicle, and promoted by Angela Alioto-Pier (and I believe Psychiatric and Phamaceutical interests), there is a push in San Francisco to implement Sally’s Law: the forced psychiatric treatment of people deemed mentally ill– with no clear answer as to how they will be so deemed.
Maybe they’ll get me first. I can talk strangely, and am hardly conventional. To be that, I sometimes muse that one must eschew the protest down the street, and get naked at a Love Fest. Boom Boom Boom.
BOOM BOOM BOOM.
July 13, 2010 at 12:27 pm
Twenty-three German physicians who willingly participated in the Nazi program to euthanize persons deemed “unworthy of life” (the mentally ill, mentally retarded, or physically disabled) conducted pseudo-scientific medical experiments utilizing thousands of concentration camp prisoners without their consent.
Words is often a lingering victimizer. Below are several examples:
1. “Die Euthanasie” was a Nazism for murder. It ought not continue, it does. Several Nazisms continue in contemporary usage. We are creatures of habit, even in the terms we employ.
2. Reducing any group to a “the” has serious consequences. It was widely employed under Nazism, industrially efficiently employed under Nazism. Several such diminutions are prominent in the US, three are listed above.
3. “Disabled” is a political term. The first group disabled in most societies is women, skin tone is the second most common pretense for disabling, religion comes third, and then a series of descriptors, among them conditions called today “dis-abilities,” blindness, deafness, other physical attributes.
Societies, broadly defined and narrowly defined, often define themselves by whom they enable and disable.
Harold A. Maio, retired Mental Health Editor (via email)
Ft Myers, FL
July 12, 2010 at 6:10 pm
I grew up believing we were the “good guys”.
The reality is we are a barbaric species. Read the book about the ape families called The Demonic Male. That is an eye-opener.
I still want to believe Humans have choices… though it seems clearer than ever to me that our choices can be limited by the framework of the society we live in.
Donald Rumsfeld was unimpressed that prisoners were made to stand all day. He bragged that he did it regularly.
Of course it is easy so long as he had the choice to sit whenever he chose (prisoners have no choice, which is torture).
[Rumsfeld lives, by the way, at Mount Misery– the plantation once owned by the brute who tried to break Frederick Douglass.]
Where do we draw a line? Have we become so inured to having no choices, that even medical professionals have no common sense– indeed, have developed a diabolical sense?
I cannot bear to visit stores that make their employees constantly stand– so to serve us better– and to discourage “laziness” or “inattentiveness”.
What choices do those employees have? Are they being tortured?
I’d say yes. The practice is barbaric and against all common sense– how cruel it is to see people blithely shop in such environments.
Stone mentions sleep deprivation as one form of torture that is condoned ny our good representatives.
How are people’s sleep deprived? Noise and lights. Low frequency percussive noise can be a weapon– and it is not uncommon for us to tolerate it regularly in our busy cities. Below a certain threshold it will scramble your guts. Some frequencies attack almost like Chinese water torture it is hardly perceptible as sound– but as a feeling.
To me it is weird that people must always be accompanied by sound. We even encourage loud abrasive electronic gizmos for children. They need it because they have no patience– or they have no patience because they have it? I don’t know. ADD is up, I’ve heard, as are pill sales.
People may say we have a choice about noise– we can move. But where? We must work where there is work. We must live somewhere.
I am glad the Mid-Market plans for expanded lighting was turned down by the voters– although I expect a reiteration of it by stubborn developers. To a degree we can block out light, but we cannot block sound.
We have paper instead of plastic, but we have no common sense about the stress and damage caused by sound.
I often think I will invent some headphones designed to annoy worse than the cheap ones we oftrn encounter on crowded buses. The speakers will be opposite the ear and blast outwards.
I suspect no one would have the guts to tell anyone to turn them off. Cool!
I expect to make a million bucks and move to some desert or some iceberg– where the military is probably planning a helicopter base… sigh. There is no escape.
When I came to the city I heard a clever comedian, I wish I could recall his name– an elderly man with “old folk” jokes– like: “How do you know when your old? When you bend over to tie your shoes and look for something else to do while you’re down there.”
Another funny joke of his was:
“You think when you go to the old folks’ home you will finally escape all the noise your boneheaded neighbors plagued you with at your old apartment.
You get there and settle in when without warning but day in day out you hear: Woo! Woo! Wooo! Woo! Woo! Wooooo!”
We accept so much in this world. Maybe that’s what keeps us praying.
July 12, 2010 at 5:01 pm
And even ABC says that our San Francisco Rep, House Speaker Nancy Pelosi, knew about the torture in 2002, but lied, claiming she didn’t, in 2009, http://blogs.abcnews.com/thenote/2009/05/intelligence-re.html.