The Sick Logic of the CIA Memos: Abuse Isn't Torture If a Doctor Is There

By Sheri Fink, ProPublica. Posted April 25, 2009.

The memos also draw heavily on the advice of psychologists that interrogation techniques would not be expected to cause lasting harm. At times this advice sounds contradictory. While calling waterboarding “medically acceptable,” the OMS also deemed it “the most traumatic of the enhanced interrogation techniques.”

The fact that traumatic events have the potential to cause long-lasting post-traumatic stress syndrome has been well documented. Physicians for Human Rights, in interviews with eleven former detainees held in Iraq and Afghanistan, found “severe, long-term physical and psychological consequences.” “All the individuals we evaluated were ultimately released without ever being charged,” said Dr. Allen Keller, medical director of the Bellevue/New York University School of Medicine Program for Survivors of Torture.

The memos describe the techniques in highly precise and clinical detail, befitting a medical textbook. During waterboarding, in which a physician and psychologist were to be present at all times, "the detainee is monitored to ensure that he does not develop respiratory distress. If the detainee is not breathing freely after the cloth is removed from his face, he is immediately moved to a vertical position in order to clear the water from his mouth, nose and nasopharynx." Side effects including vomiting, aspiration and throat spasm that could cut off breathing were each addressed: "In the event of such spasms ... if necessary, the intervening physician would perform a tracheotomy."

While physician assistants could be present when most “enhanced” techniques were applied, "use of the waterboard requires the presence of a physician," one memo said, quoting the OMS guidelines.

Doctors were also described as having vetted the practices for safety. Certain limits on waterboarding were created "with extensive input from OMS." One memo states that OMS "doctors and psychologists" confirmed that combining the various techniques "would not operate in a different manner from the way they do individually, so as to cause severe pain."

Medical and psychological personnel were required to observe whenever interrogators came into physical contact with detainees, including slapping them and pushing them into flexible walls ("walling"). Whenever a detainee was doused with cold water, a medical officer had to be on hand to monitor for signs of hypothermia. Confining prisoners to cramped boxes required "continuing consultation between the interrogators and OMS officers." Prisoners made to stand for long periods to prevent sleep were to carefully monitor detainees for swelling of the legs and other dangerous conditions, and at least three times early in the program were switched, on medical advice, to "horizontal sleep deprivation."

This was one example of how medical personnel could, according to the CIA, help prevent "severe physical or mental pain or suffering" on the part of the detainees. However, the memos show that the OMS’ role was not merely to limit the medical impact of interrogations, but also to consult on the effectiveness of interrogations. A May 30, 2005, memo quotes the OMS suggesting that cramped confinement was "not ... particularly effective" because it provides "a safe haven offering respite from interrogation."

Some medical professionals are calling for their colleagues to be investigated and sanctioned for participating in practices that professional medical and psychological organizations and officials in the Justice Department now call torture. “We stand ready to adjudicate these issues,” said American Psychological Association spokesperson Rhea Farberman.

But finding out which professionals were involved in designing, monitoring and implementing the interrogation techniques may be difficult. The four memos were released almost in their entirety. The few redactions concerned mainly the names of the personnel involved.

See more stories tagged with: cia, torture, waterboarding, abu zubaydah, sere, office of legal counsel, torture memos, nuremberg code, office of medical service

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