Doctors and Torture

Dr. Steven Miles is hopping mad. And with good reason...

Like most of humanity, Miles was shocked by the outrageous pictures from Abu Ghraib. But he also asked himself this basic question: "Where were the prison doctors, nurses and medics while this abuse was happening?"

Miles went on to review page after page of testimony and came to the following conclusion:

Many armed forces physicians, nurses and medics have been passive and active partners in the systematic neglect and abuse of prisoners. At facilities in Iraq, Afghanistan and Guantanamo Bay, Cuba, the United States often failed to provide prisoners with minimally adequate medical and health systems. Some physicians and psychologists provided information that was used to determine the harshness of physically and psychologically abusive interrogations, which were then monitored by health professionals. Some doctors responsible for the medical records of detainees omitted evidence of abuse from their official reports. Medical personnel who knew of this system of neglect, abuse and torture remained silent.

Steven Miles is a Professor of Medicine at the University of Minnesota Medical School. He is also faculty at U Minn's Center for Bioethics. I first heard Dr. Miles on Democracy Now (June 30th), when he spoke to Amy Goodman and Juan Gonzalez about his findings. Miles has compiled his research on doctors and torture into "Oath Betrayed: Torture, Medical Complicity, and the War on Terror." Here is a quick excerpt from that interview:

DR. STEVEN MILES: Well, one of the most famous pictures from Abu Ghraib, of course, is the body of Monadel Jamadi wrapped in ice. He was arrested at his home and put up a fight. He was then bound. He was flipped into a Humvee. He was kicked and beaten and hit with a rifle butt while he was transported to Camp Jenny Pozzi, just outside of Baghdad. There, a medic was in the room, as he was saying, “I can't breathe. I feel like I'm going to die.” He was interrogated briefly at Camp Jenny Pozzi. At that point, he was taken to Abu Ghraib.
He was admitted to Abu Ghraib in the early hours of the morning. He was admitted as a CIA ghost prisoner. Now, what this meant was that he was not given the customary medical enrollment. In fact, he wasn’t registered in the prison at all.
He was naked. He was cold. He was complaining of shortness of breath. His head was in a sandbag, and then he was tied to -- his wrists were tied together behind his back and then lifted up and tied to a window bar behind him, so that if he sank down, that his shoulders would be wrenched. And, in fact, about an hour later, he did sink down. Now, keep in mind the man was in a sandbag over his head, and he was found to have died.
Now, at that point the army did an autopsy, but the autopsy was concealed, as was the death certificate. It did find that he died of torture. And, in fact, the first time we learned of this case was about six months after it happened. By concealing this, what the Armed Forces Institute of Pathology and the Defense Department did was, they delayed public knowledge of a profound problem inside the prisons and essentially disabled an early warning system about torture.

Miles also explained how doctors used forced-feeding (something I find absolutely horrifying):

DR. STEVEN MILES: Well, hunger-striking is a form of political protest by prisoners. It’s against medical ethics for prison physicians to force-feed prisoners, because what it’s felt that it does is that by keeping a prisoner alive, it basically extends the abuse of the prisoner, okay? And that's exactly what’s happening in Guantanamo. These prisoners have no rights, they have no correspondence, anything like that, and so by feeding them, all that’s being done is their indeterminate sentences, their lack of correspondence, and the other types of interrogational abuse are being extended. And so the military is tying them into six-point chairs -- legs, thorax, abdomen and arms -- and then sticking a tube down them, running a bunch of food in, pulling the tube out, and because docs object to this professionally, they're selecting a subset of docs to take down to Guantanamo to do this procedure.

This past Sunday, Dr. Miles published another account in the Washington Post ("Outlook" section, p. B01). This is truly shocking:

In November 2003, an Iraqi guard smuggled a pistol into the U.S. military prison at Abu Ghraib and gave it to a prisoner, Ameen Saeed al-Sheik. Tipped off, military police quickly began a cell-to-cell search. When they reached his cell, Sheik went for the hidden pistol; gunfire was exchanged and a sergeant was hit. According to sworn testimony, the soldiers wrestled the prisoner to the floor and sent him to the hospital with a dislocated shoulder and shotgun wounds to his legs.
When Sheik returned to prison, he was beaten with a baton and his arms were handcuffed over his head, putting stress on his injured shoulder and leg. On a cold night, a medic, Sgt. Theresa Adams, saw Sheik naked and bleeding from a catheter that should have been connected to a bag to prevent infection. According to a sworn statement, the physician on call (who held the rank of colonel) agreed that the hospital had erred in leaving the catheter open but refused to remove it or to transfer Sheik to a hospital. When Adams asked him whether he had ever heard of the Geneva Conventions, the physician answered, "Fine, Sergeant, you do what you have to do; I am going back to bed."

In all, Dr. Miles found 120-150 such incidents involving medical personnel. Perhaps most troubling of all, Miles found that clinicians and scientists were used to design some of the torture techniques used at GTMO etc.*:

According to the 2004 report by Army Maj. Gen. Antonio M. Taguba on abuse at Abu Ghraib, medical personnel vetted prisoners for interrogations that were designed in accordance with the medical findings to include stress positions, sleep deprivation, isolation and dietary manipulation.
This process required the use of Behavioral Science Consultation Teams (BSCTs or "biscuits"), which helped design interrogation plans to exploit prisoners' psychological and physical vulnerabilities. The BSCTs used clinical information to clear prisoners for harsh interrogation plans; they also used medical information to develop a plan to break a prisoner's resistance to questioning. Clinicians at Guantanamo Bay met with BSCT personnel to offer insight on prisoners' weaknesses, according to the report by Maj. Gen Geoffrey D. Miller, who took command of the Abu Ghraib prison after the abuse scandal broke out.
At times, behavioral clinicians reportedly micromanaged some interrogations; one Guantanamo Bay psychiatrist even suggested rationing toilet paper to seven sheets per day and limiting water for bathing. Similarly, a military intelligence specialist in Iraq applied her background in psychology to design approaches to "interrogate those who could not be broken." She approved coercive interrogation plans involving sleep deprivation but vainly protested the use of dogs or nudity. She eventually asked to be relieved of interrogation duties.

If you missed it, you can read a transcript of a WaPo Q&A with Dr. Miles here. This is something to watch, mes amis. If nothing else, it tells us that doctors aren't socialized in a vacuum. They can be every bit as sick as our society.

*FOOTNOTE: These so-called "BSCT" teams were first brought to my attn. by Jane Mayer of the New Yorker, last July. Amy Goodman discussed this with the head of the Am. Psychological Asscn. last month; the APA refuse to bar their membership from participation in military interrogation.