Psychological and Physical Torture
The US Regime of Psychological Torture and the Role of Health Professionals in Interrogations and Abuse
Almost immediately after the attacks of September 11, 2001, the Bush Administration began dismantling US anti-torture law and policy. As disclosed by the 2006 report of the Defense Department’s Office of the Inspector General, Pentagon leadership, in collaboration with military psychologists, including members of “Behavioral Science Consultation Teams” or “BSCTs”, played a central role in systematically designing and implementing the regime of psychological torture and physical abuse that became “standard operating procedure” for interrogations at Guantánamo Bay and in Iraq and Afghanistan. Similar techniques comprise the CIA’s notorious “enhanced interrogation methods.”
The earliest reports of torture and abusive interrogation methods by US personnel were accompanied by disturbing reports of health professional complicity, from withholding or modifying medical care to compel cooperation, to disclosure of confidential medical information about physical or mental vulnerabilities to interrogators, to failure to report torture and ill-treatment. PHR’s Campaign Against Torture seeks abolition of the BSCTs and full ethical protection for health professionals to allow them to refuse complicity in torture or ill-treatment of prisoners and detainees.
The Abuse of Hunger Strikers in US Detention Facilities
Both the World Medical Association and the American Medical Association ethical guidelines clearly state that hunger striking patients who have made informed refusals for medical intervention should not be force fed. Current US military guidelines in use at Guantánamo and other US detention settings permit involuntary force feeding of detainees. Such action has been undertaken at Guantánamo on multiple occasions, and in some reported cases appear to have been used for punishment rather than preservation of life.
PHR strongly recommends that US policy be changed to be consistent with established medical ethics regarding the treatment of hunger strikers such that:
- Patient autonomy is respected and informed refusal from competent patients is honored,
- Physicians treating patients retain clinical autonomy essential to the establishment of trust, and clinical intervention is not directed by non-clinical personnel in the chain of command,
- The physician's primary obligation to the patient is honored, and
- Medical intervention is never used as punishment.
The deaths of detainees in US custody raise several serious concerns about their treatment, from questions about the quality of medical care to the prospect of extraordinary brutality in interrogations, and more. The number of detainees who have died in US Custody remains unknown. A review of 112 detainee deaths published in Medscape General Medicine revealed at least 11 of the 43 homicide cases involved blunt trauma or asphyxiation. At least three of the homicides reported have resulted in murder charges. Another three have resulted in charges of voluntary manslaughter. The 36 deaths caused by enemy mortar attacks, many of which occurred at Abu Ghraib, suggest clear violations of Geneva prohibitions against placing detainees in range of enemy attack. In light of the findings, PHR has called on the US Secretary of Defense to promptly authorize an independent investigation of possible military negligence and take action to ensure that the United States is living up to its obligations under the Geneva Conventions.