Physicians for Human Rights Working on Torture Report Critique

One of the more disturbing appendices to the 2004 CIA inspector general’s report on torture comes from the Office of Medical Services. On September 4, 2003, the office in the CIA responsible for “assessing and monitoring the health of all Agency detainees subject to ‘enhanced’ interrogation techniques” issued its set of guidelines for what was acceptable treatment. For instance, there’s a long discussion of what constitutes an “uncomfortably cool environment” — an embraced technique — based on “core body temperature” and “increased metabolic rate.” After all, these are medical professionals. But instead of pledging to do no harm, OMS instructs that if the temperature falls too low and the detainee is endangered, the detainees “should be monitored and the actual temperatures documented.” If there’s any instruction that the doctors should help the detainee, it’s redacted.

Medical professionals, in other words, were acting as “calibrators of harm,” says Nathaniel Raymond, director of Physicians for Human Rights’ anti-torture project. That’s a violation of the law and professional ethics.

On waterboarding, the CIA’s Office of Medical Services enters especially dangerous territory. The guidelines are clear that “a rigid guide to medically approved use of the waterboard in essentially healthy individuals is not possible, as safety will depend on how the water is applied and the specific response each time it is used.” Indeed, the program lacks “hard data to quantify” the “cumulative risk” of an “aggressive program” of waterboarding. The guidelines come very close to advocating experimentation on detainees, a dubious ethical and legal practice:

In order to best inform future medical judgments and recommendations, it is important that every application of the waterboard be thoroughly documented: how long each application (and the entire procedure) lasted, how much water was used in the process (realizing that much splashes off), how exactly the water was applied, if a seal was achieved, if the naso- or oropharynx was filled, what sort of volume was expelled, how long was the break between applications, and how the subject looked between each treatment.

Raymond says Physicians for Human Rights will come out in the next few days with a thorough study of the implications of such medical involvement in the CIA’s interrogation programs. Pointing to the behavioral science program that was used to inform interrogations at Guantanamo, he says, “there’s been a massive reverse-engineering and re-tasking across the military and intelligence universe” when it comes to medicine and psychology. “What kind of tasking memos and legal protection for these doctors existed to allow them to perform in this role? It’s a huge question.”