"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.

Read rest of report....

Gaza Flotilla LiveBlog (6 June): Israel Blames "Islamist Mercenaries"

2030 GMT: Turkey's minister of energy and natural resources, Taner Yildiz, has announced that there will be no new energy or water projects with Israel until relations between the two countries improve: "At a time when we are focused on the humanitarian aspects of what Israel did, we can't talk about commercial and economic matters. We won't start any project with Israel until relations with them have been normalized."

NEW Gaza Flotilla: Israel "Passengers Linked to Hamas, Al Qa'eda, Terrorist Organisations"
Turkey Inside Line: Erdogan Roars at Israel, Extends His Hand to Iraqi Kurdistan
Gaza Flotilla LiveBlog (5 June): Israel Forces Board the Rachel Corrie

1920 GMT: A group of senior Israel Navy officers have publicly called on Prime Minister Benjamin Netanyahu and Defense Minister Ehud Barak to establish an independent and external commission of inquiry to investigate the Mavi Marmara raid: "We believe that the operation ended in a disaster on a military and diplomatic level," the reserve officers who served as commanders of Navy ships wrote in the letter.


1845 GMT: We have posted, in a separate entry, the dramatic press release from the Israeli military that five of the passengers of the Mavi Marmara are linked to Hamas, Al Qa'eda, and other "terrorist organisations".

1815 GMT: This Should Be Interesting. Israel's Foreign Minister Avigdor Lieberman, not noted for diplomatic subtlety, is reportedly planning to meet "with envoys and representatives of Israel, and Jewish communities in the US and Canada, to explain the Israeli government's position on the flotilla affair".

There are no indications Lieberman will meet US Government or UN officials during the trip.

1650 GMT: It appears that, contrary to earlier reports (1105 GMT), Israel will reject the UN's proposal of an international enquiry into the attack on the Mavi Marmara. Michael Oren, Israel's Ambassador to the US, has told Fox News, "We are rejecting an international commission. We are discussing with the Obama administration a way in which our inquiry will take place."

Mark Regev, the Israeli Government's primary spokesman, has just repeated the line on CNN.

1639 GMT: The Battle of the Photographs. We noted in our initial update (1045 GMT) that defenders of the Israeli military action have been circulating a photograph, taken from the Turkish newspaper Hurriyet, that they claim shows passengers attacking an injured Israeli soldier.

Defenders of the Flotilla are now pointing out that the one picture is out of context: the full set of nine photographs from Hurriyet, Turkish newspapers, and other sources show the Flotilla's activists caring for Israeli troops (see inset photograph).

1635 GMT: The Free Gaza Movement reports that the five Irish passengers from the Rachel Corrie have been deported and will return to Ireland tomorrow.

1615 GMT: Israel has deported eight Flotilla activists to Jordan. Seven are from the Rachel Corrie; the eighth is an Indonesian who was injured in the attack on the Mavi Marmara.

No word on the other passengers of the Rachel Corrie.

1545 GMT: Blame Turkey, An illuminating clash in approach between two of America's largest newspapers: while The New York Times has an analysis noting the re-assessment amongst some US insiders of the relationship with Israel, The Washington Post's editorial team directs its fire at Ankara:

Western governments have been right to be concerned about Israel's poor judgment and botched execution in the raid against the Free Gaza flotilla. But they ought to be at least as worried about the Turkish government of Recep Tayyip Erdogan, which since Monday has shown a sympathy toward Islamic militants and a penchant for grotesque demagoguery toward Israel that ought to be unacceptable for a member of NATO.

1230 GMT: Eyewitness Testimony. Journalist Abbas Al Lawati, who was aboard the Mavi Marmara, has posted the third part of his account, focusing on his interrogation by Israeli authorities.

1210 GMT: Israeli Foreign Ministry officials have said that West Jerusalem not apologize to Turkey for the deaths of eight Turkish and 1 Turkish-American activists on the Mavi Marmara.

A "top official"laimed that the Turkish demand for an official apology was mainly an excuse to allow Turkish Prime Minister Recep Tayyip Erdogan to cut diplomatic ties with Israel.

The Foreign Ministry officials said they were surprised by the request for an apology from Turkey's Ambassador to the US, Namik Tan, who "was known to be a supporter of Israel".

(Hmm.... If a "supporter of Israel" is calling for the apology, I would think that Israeli officials might consider how serious the diplomatic situation has become.)

1130 GMT: The New Israeli Line. Speaking at the opening of a Cabinet meeting,Israeli Prime Minister Benjamin Netanyahu has announced, ""Evidence shows separate group of violent Islamists boarded flotilla....[They] boarded the ship at a separate port, did their own provisioning, and were not subject to the same security check of their luggage as all the other passengers.”

The Israeli Defense Forces are briefing the press that a group of about 50 men of the 700 on board the Mavi Marmara were trained fighters recruited from the northwestern Turkey city of Bursa. None had ID cards or passports; each carried an envelope with $10,000 in cash.

1105 GMT: Ha'aretz reports that UN Secretary-General Ban Ki-moon has given Israel a proposal for an international committee of inquiry into the raid on the Mavi Marmara. The newspaper says that senior Israeli officials are recommending a positive response because Turkey will probably oppose it.

The committee would be headed by former New Zealand Prime Minister Geoffrey Palmer, an expert on maritime law, and include representatives from the US, Turkey, and Israel. Ban made the proposal in a phone call to Israeli Prime Minister Benjamin Netanyahu.

1045 GMT: The immediate tragedy and dramas of two Israeli boardings of Freedom Flotilla ships may be over, but there is still a lot of uncertainty and political tension about today.

Israel's official line is that most of the activists from the MV Rachel Corrie, the ship seized by the Israeli military yesterday and towed to Israel's port of Ashdod, will be deported.

The Free Gaza Movement, however, says, "Nothing from the kidnapped passengers. [Nobel Prize laureate] Mairead [Corrigan]'s husband said no contact with her. Israel refuses to allow lawyers to talk to them."

The battle of words and pictures also continues. There are claims that Israel altered the audio on supposed communications with the Mavi Marmara (see Friday's updates for the Israeli version of the exchange), the ship attacked on Monday, to create the impression of passengers shouting insults such as "Shut up, go back to Auschwitz".

And discussion is heating up over photographs in Hurriyet,  the Turkish newspaper, showing an injured Israeli commando surrounded by passengers of the Mavi Marmara.

Gaza Flotilla Analysis: US Official Position "My Israel, Right or Wrong" (Yenidunya)

U.S. Secretary of State Hillary Clinton said on Tuesday that "the situation in Gaza is unsustainable and unacceptable". However, when she turned from the "humanitarian side" of the issue, she emphasised: "Israel’s legitimate security needs must be met."

Translated: We are sorry for some Gazans who are suffering from the blockade but Israel needs to continue its struggle against Hamas and we do support this cause.

Gaza Flotilla LiveBlog (3 June): Pressure on Israel Grows

(Clinton also did not emphasize the need of an international investigation. On Tuesday, Israel's ambassador to the U.S., Michael Oren, was offered an investigation led by an "international" judge as a chair with a US representative as an observer. West Jerusalem has not responded.)


On Wednesday, Vice President Joe Biden, appearing on the US Public Broadcasting Service, put all the blame on Hamas and said, "I think Israel has an absolute right to deal with its security interest". As for the enquiry, he opened the door for West Jerusalem, "Well, an investigation run by the Israelis, but we're open to international participation..."

Here is a part of the transcript of Biden's interview:

Charlie Rose: Prime Minister Netanyahu was scheduled to come to Washington. He did not. He went back to Israel. There is a blockade. Should they end the blockade in lieu of what's happened here?

Joe Biden: I think Israel has an absolute right to deal with its security interest. I put all this back on two things: one, Hamas, and, two, Israel's need to be more generous relative to the Palestinian people who are in trouble in Gaza. Let me explain that very briefly. Sometimes, because we deal so much at least which you know so much about, we have to remember how we got here. Remember, it was Ehud Barak who decided to pull all Iraqi troops --- I mean, excuse me, all Iraqi --- all Israeli troops out of Gaza. He did that back in '06.

Then there was an election, an election for their Parliament with a president named Mahmoud Abbas who in fact was the successor of [Yasser] Arafat in the Fatah [Party]. That produced a majority of members of the Parliament, which was the West Bank and Gaza, of Hamas.

The international community, the so-called Quartet; the United States, Europe, Russia, and the U.N., said, "Look, in order for you to be part of that government, you have to agree to four conditions. One, you'll abide by previous agreements that have been made by the government of --- by the Palestinians. Two, you are going to renounce terror. Three, you're going to recognize Israel, and basically that you have to accept” --- and here's what happened. They then got in a fight among themselves. They physically took over by force of arms, killed members of the existing government, exile them, took over and started firing rockets into Israel. Over 3,000 went in last year.

And as we put pressure, and the world put pressure on Israel to let material go into Gaza to help those people who are suffering, the ordinary Palestinians there, what happened? Hamas would confiscate it, put it in a warehouse, sell it, they were -- so the problem is this would end tomorrow if Hamas agreed to form a government with the Palestinian Authority on the conditions the international community has set up.

And so I mean again, look, you can argue whether Israel should have dropped people onto that ship or not and the -- but the truth of the matter is, Israel has a right to know --- they're at war with Hamas --- has a right to know whether or not arms are being smuggled in. And up to now,

Charlie, what's happened? They've said, "Here you go. You're in the Mediterranean. This ship --- if you divert slightly north you can unload it and we'll get the stuff into Gaza." So what's the big deal here? What's the big deal of insisting it go straight to Gaza? Well, it's legitimate for Israel to say, "I don't know what's on that ship. These guys are dropping eight --- 3,000 rockets on my people." Now, the one thing we have to do is not forget the plight of these Palestinians there, not Hamas, the --- they're in bad shape. So we have put as much pressure and as much cajoling on Israel as we can to allow them to get building materials in, glass....

Charlie Rose: That's what they're trying to bring in, building materials.

Joe Biden: Yes, we know that, but they could have easily brought it in here and we'd get it through. And so now the question is what do we do? Well, we had made it clear, the President of the United States has spoken three times, yesterday with Bibi, or the day before yesterday, he's spoken once yesterday with a guy that I have spent a fair amount of time with, with Prime Minister Erdogan in Turkey; the Turks, we passed a resolution in the U.N. saying we need a transparent and open investigation of what happened. It looks like things are ---

Charlie Rose: International investigation ---

Joe Biden: Well, an investigation run by the Israelis, but we're open to international participation, just like the investigation run on the sunken sub in -- off the coast of Korea. That was run by South Korea, but the international community joined in that investigation. And so that is very possible here as well. I might add by the way for all those who say the Israelis, you know, you know, you can't trust them, the Israeli Supreme Court ruled today that every one of the people on those ships had to be released immediately, immediately.

Charlie Rose: So what's the ---

Joe Biden: It's a rule of law. It works.

Charlie Rose: I said it was my last question, so I'll make it my last question then. So are you saying that the relationship between Israel and the United States is okay, that there are ---

Joe Biden: It's more than okay. Look, we always have had disagreements tactically with the Israeli government, but when I was in Israel, Bibi Netanyahu and I held a press conference before all the flap about a new settlement, etc, and ---

Charlie Rose: Right, yeah, yeah. Exactly, oh, the President got very upset about that because of what he did while you were in the country. I mean, that was the ---

Joe Biden: That's true but here's the point. We stood there at that press conference I'm making a major speech at the University of Tel Aviv, major meaning laying out U.S. policy, and Bibi pointed out that no administration in history has been as up-front and supportive of Israel's security as this administration. We've done everything from provide missile defense. We've made sure they've maintained their qualitative edge. There's a new program they call Iron Dome that we're helping fund for them to be able to protect themselves. We have joint maneuvers. They've never been closer on the strategic side with Israel than today.

Gaza Flotilla Video & Transcript: Hillary Clinton's Statement (1 June)

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Gaza Flotilla LiveBlog: The Politics After the Attack (1 June)

Question: Madam Secretary, I’d like to ask you a couple things about the Israeli situation which, as you know, is getting more and more serious by the day. I know there are many unknowns at this point, but do you accept Israel’s argument of self-defense? And do you think that the investigation should be done by Israel or by a third independent party, as other Security Council members have said?

And more broadly, we all know there are so many moving pieces to this. There’s Turkey, there’s Israel and in the Palestinians, there’s Iran, there’s Syria. What are the implications in your mind of this situation to the peace process and in the larger issues in the Middle East? Thanks.


SECRETARY CLINTON: Well, Nick, on your last day, you’ve asked a very complicated set of interrelated questions. And let me put it into context as I respond. First, let me say how deeply we regret the tragic loss of life and injuries suffered among those involved in the incident aboard the Gaza-bound ships, and we offer our condolences to the families of the deceased and the wounded.

Turkey and Israel are both good friends of the United States, and we are working with both to deal with the aftermath of this tragic incident.

The United States supports the Security Council’s condemnation of the acts leading to this tragedy. And we urge Israel to permit full consular access to the individuals involved and to allow the countries concerned to retrieve their deceased and wounded immediately. We urge all concerned countries to work together to resolve the status of those who were part of this incident as soon as possible.

We support in the strongest terms the Security Council’s call for a prompt, impartial, credible, and transparent investigation. We support an Israeli investigation that meets those criteria. We are open to different ways of assuring a credible investigation, including international participation, and we will continue to discuss these ideas with the Israelis and our international partners in the days ahead.

The situation in Gaza is unsustainable and unacceptable. Israel’s legitimate security needs must be met, just as the Palestinians’ legitimate needs for sustained humanitarian assistance and regular access for reconstruction materials must also be assured.

We will continue to work closely with the Israeli Government and the Palestinian Authority along with international NGOs and the United Nations to ensure adequate access for humanitarian goods, including reconstruction and building supplies. And we welcome efforts to promote the reunification of Gaza and the West Bank under the legitimate and internationally recognized Palestinian Authority.

Ultimately, the solution to this conflict must be found through an agreement based on a two-state solution negotiated between the parties. This incident underscores the urgency of reaching this goal and we remain committed to working with both sides to move forward these negotiations.

I think the situation from our perspective is very difficult and requires careful, thoughtful responses from all concerned. But we fully support the Security Council’s action last night in issuing a presidential statement and we will work to implement the intention that this presidential statement represents.