"Experiments in Torture": Text of Physicians for Human Rights Report

 Physicians for Human Rights have released a 27-page report:

Executive Summary

Following the Sept. 11, 2001, attacks, the Bush administration initiated new human intelligence collection programs. To that end, it detained and questioned an unknown number of people suspected of having links to terrorist organizations. As part of these programs, the Bush administration redefined acts, such as waterboarding, forced nudity, sleep deprivation, temperature extremes, stress positions and prolonged isolation, that had previously been recognized as illegal, to be “safe, legal and effective” “enhanced” interrogationtechniques (EITs).

War on Terror Analysis: Was Bush Detention Programme “Human Experimentation”? (Leopold)

Bush administration lawyers at the Department of Justice’s (DoJ’s) Office of Legal Counsel (OLC) accomplished this redefinition by establishing legal thresholds for torture, which required medical monitoring of every application of “enhanced” interrogation. 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.



Investigation and analysis of US government documents by Physicians for Human Rights (PHR) provides evidence indicating that the Bush administration, in the period after Sept. 11, conducted human research and experimentation on prisoners in US custody as part of this monitoring role. Health professionals working for and on behalf of the CIA monitored the interrogations of detainees, collected and analyzed the results of those interrogations, and sought to derive generalizable inferences to be applied to subsequent interrogations. Such acts may be seen as the conduct of research and experimentation by health professionals on prisoners, which could violate accepted standards of medical ethics, as well as domestic and international law. These practices could, in some cases, constitute war crimes and crimes against humanity. The knowledge obtained through this process appears to have been motivated by a need to justify and to shape future interrogation policy and procedure, as well as to justify and to shape the legal environment in which the interrogation program operated.

PHR analyzes three instances of apparent illegal and unethical human subject research for this report:

1. Medical personnel were required to monitor all waterboarding practices and collect detailed medical information that was used to design, develop, and deploy subsequent waterboarding procedures;

2. 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. These data were gathered through an assessment of the presumed “susceptibility” of the subjects to severe pain;

3. Information collected by health professionals on the effects of sleep deprivation on detainees was used to establish the “enhanced” interrogation program’s (EIP) sleep deprivation policy.

The human subject research apparently served several purposes. It increased information on the physical and psychological impact of the CIA’s application of the “enhanced” interrogation techniques, which previously had been limited mostly to data from experiments using US military volunteers under very limited, simulated conditions of torture. It served 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. It also served as an attempt to provide a basis for a legal defense against possible torture charges against those who carried out the interrogations, since medical monitoring would demonstrate, according to the Office of Legal Counsel memos, a lack of intent to cause harm to the subjects of interrogations.

Yet the Bush administration’s legal framework to protect CIA interrogators from violating US statutory and treaty obligations prohibiting torture effectively contravened well-established legal and ethical codes, that, had they been enforced, should have protected prisoners against human experimentation, and should have prevented the “enhanced” interrogation program from being initiated in the first place.

There is no evidence that the Office of Legal Counsel ever assessed the lawfulness of the medical monitoring of torture, as it did with the use of the “enhanced” techniques themselves.

The use of torture and cruel and inhuman treatment in interrogations of detainees in US custody has been well-documented by Physicians for Human Rights (PHR) and others. The role of health professionals in designing, monitoring and participating in torture also has been investigated and publicly documented. This current report provides evidence that in addition to medical complicity in torture, health professionals participated in research and experimentation on detainees in US custody.

The use of human beings as research subjects has a long and disturbing history filled with misguided and often willfully unethical experimentation. Ethical codes and federal
regulations have been established to protect human subjects from harm and include clear standards for informed consent of participants in research, an absence of coercion, and a requirement for rigorous scientific procedures. The essence of the ethical and legal protections for human subjects is that the subjects, especially vulnerable populations such as prisoners, must be treated with the dignity befitting human beings and not simply as experimental guinea pigs.

The use of health professionals to monitor intentionally harmful interrogation techniques places them in the service of national security objectives which are in conflict with the interests of those who they are monitoring. The result has been a co-opting of health professionals by the national security apparatus and a violation of the highest medical admonition to “do no harm.” Until the questions examined in this paper are answered and, if ethical violations or crimes were committed, those responsible are held accountable, the misuse of medical and scientific expertise for expedient and non-therapeutic goals jeopardizes the ethical integrity of the profession, and the public trust in the healing professions risks being seriously compromised.

Methods and Limitations

This PHR report draws primarily upon US government documents in the public record, including memoranda from the Office of Legal Counsel and the CIA’s Office of Inspector General Special Review of the CIA Enhanced Interrogation Program.

Most of these documents are heavily redacted and many additional, relevant documents remain classified. While the observational medical monitoring data are not publicly available for the instances indicating human experimentation cited by PHR, and while the specific extent to which medical personnel complied with requirements of the CIA’s Office of Medical Services (OMS) monitoring requirements is not known, there is clear evidence that medical personnel were required to monitor and document all EIT practices and that generalizable knowledge derived therefrom subsequently was used to refine harmful EIT practices.

While this report provides evidence that data from human research were compiled, apparently analyzed, and used to affect subsequent interrogations and to set policy, a comprehensive federal investigation is required to answer the questions this evidence raises.

Recommendations

Physicians for Human Rights calls on the White House and Congress to investigate thoroughly the full scope of the possible human experimentation designed and implemented in the post-Sept. 11 period. The War Crimes Act must be amended to restore traditional human subject protections. Those who authorized, designed, implemented and supervised these alleged practices of human experimentation — whether health professionals, uniformed personnel, or civilian national security officials — must be held to account for their actions if they are found to have violated what international tribunals previously have held to constitute war crimes and crimes against humanity.

If any victims of research and experimentation perpetrated by the United States are found, they must be offered compensation, including health care services, to address ongoing health effects related to the experimentation, and a formal apology. Based on the findings of this investigation, the United States should take the following actions:

1. President Obama must order the attorney general to undertake an immediate criminal investigation of alleged illegal human experimentation and research on detainees conducted by the CIA and other government agencies following the attacks on Sept. 11, 2001.

2. The secretary of the Department of Health and Human Services must instruct the Office for Human Research Protections (OHRP) to begin an investigation of alleged violations of the Common Rule by the CIA and other government agencies as part of the “enhanced” interrogation program.

3. Congress must amend the War Crimes Act to eliminate changes made to the Act in 2006 which weaken the prohibition on biological experimentation on detainees, and ensure that the War Crimes Act definition of the grave breach of biological experimentation is consistent with the definition of that crime under the Geneva Conventions.

4. Congress should convene a joint select committee comprising members of the House and Senate committees responsible for oversight on intelligence, military, judiciary and health and human services matters to conduct a full investigation of alleged human research and experimentation activities on detainees in US custody.

5. President Obama should issue an executive order immediately suspending any federally funded human subject research currently occurring in secret — regardless of whether or not it involves detainees.

6. The Department of Justice’s Office of Professional Responsibility should commence an investigation into alleged professional misconduct by OLC lawyers related to violations of domestic and international law and regulations governing prohibitions on human subject
experimentation and research on detainees.

7. President Obama should appoint a presidential task force to restore the integrity of the US regime of protections for human research subjects. This task force, comprising current and former officials from the Department of Health and Human Services, the Food and Drug Administration, the National Institutes of Health, the human rights community, and leading health professional associations, should review current human subject protections for detainees, and recommend changes to ensure that the human rights of those in US custody are upheld.

8. States should adopt policies specifically prohibiting participation in torture and improper treatment of prisoners by health care professionals. Such participation is considered professional misconduct and is grounds for loss of professional licensure. Proposed legislation in New York State provides a model for such policy.

9. The United Nations special rapporteur on torture should undertake an investigation of allegations that the United States engaged in gross violations of international human rights law by engaging in human subject research and experimentation on detainees in its custody.

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War on Terror Analysis: Was Bush Detention Programme "Human Experimentation"? (Leopold)

Jason Leopold write for Truthout:

High-value detainees captured during the Bush administration’s “war on terror” who were subjected to brutal torture techniques were part of a Nazi Germany-type program involving illegal human experimentation, the purpose of which was to collect research “data,” according to a disturbing new report that calls on President Barack Obama, Congress and other government agencies to immediately launch inquiries and Attorney General Eric Holder to investigate the allegations.

"Experiments in Torture": Text of Physicians for Human Rights Report

The findings contained in the 27-page report, “Experiments in Torture: Human Subject Research and Evidence of Experimentation in the ‘Enhanced’ Interrogation Program,” is based on extensive research of previously declassified government documents that shows the crucial role medical personnel played in in establishing and justifying the legality of the Bush administration’s torture program.


The report said the research and experimentation of detainees its authors have documented is not only a violation of the Geneva Conventions, but is a grave breach of international laws, such as the Nuremberg Code, established after atrocities committed by Nazis were exposed in the aftermath of World War II.

“Health professionals working for and on behalf of the CIA monitored the interrogations of detainees, collected and analyzed the results of [the] interrogations, and sought to derive generalizable inferences to be applied to subsequent interrogations,” states an executive summary of the report, prepared by Physicians for Human Rights. “Such acts may be seen as the conduct of research and experimentation by health professionals on prisoners, which could violate accepted standards of medical ethics, as well as domestic and international law. These practices could, in some cases, constitute war crimes and crimes against humanity.”

For example, PHR said the drowning method known as waterboarding was monitored in early 2002 by medical personnel who collected data about how detainees responded to the torture technique. The data was then used by Steven Bradbury, the former head of the Justice Department’s Office of Legal Counsel (OLC), to write a legal opinion in 2004 advising CIA interrogators on how to administer the technique, referred to in the PHR report as “Waterboarding 2.0.”

“According to the Bradbury memoranda, [CIA Office of Medical Services] teams, based on their observation of detainee responses to waterboarding, replaced water in the waterboarding procedure with saline solution ostensibly to reduce the detainees’ risk of contracting pneumonia and/or hyponatremia, a condition of low sodium levels in the blood caused by free water intoxication, which can lead to brain edema and herniation, coma, and death,” the report says. In Bradbury’s torture memo, he wrote that “based on advice of medical personnel, the CIA requires that saline solution be used instead of plain water to reduce the possibility of hyponatremia (i.e. reduced concentration of sodium in the blood) if the detainee drinks the water.”

PHR noted that the presence of CIA medical personnel during the waterboarding sessions “could represent evidence of human experimentation” because it underscores “the danger and harm inherent in the practice of waterboarding and the enlistment of medical personnel in an effort to disguise a universally recognized tactic as a ‘safe, legal and effective’ interrogation tactic.”

CIA medical personnel also obtained experimental research data by subjecting more than 25 detainees to a combination of torture techniques, including sleep deprivation, according to the report, as a way of understanding “whether one type of of application over another would increase the subjects’ susceptibility to severe pain.” The information derived from the research informed “subsequent [torture] practices.”

“This investigation had no direct clinical health care application, nor was it in the detainees’ personal interest, nor part of their medical management,” the report says. “It appears to have been used primarily to enable the Bush administration to assess the legality of the tactics, and to inform medical monitoring policy and procedure for future application of the techniques.”

Frank Donaghue, PHR’s chief executive officer, said the report appears to demonstrate that the CIA violated “all accepted legal and ethical standards put in place since the Second World War to protect prisoners from being the subjects of experimentation.”

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