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

Former CIA Director Michael V. Hayden was fond of saying that when it came to handling high-value terror suspects, he would play in fair territory, but with "chalk dust on my cleats." Four legal memos released by the Obama administration make it clear that the referee role in CIA interrogations was played by its medical and psychological personnel.

According to the U.S. Department of Justice’s Office of Legal Counsel, which authored the memos, legal approval to use waterboarding, sleep deprivation and other abusive techniques pivoted on the existence of a "system of medical and psychological monitoring" of interrogations. Medical and psychological personnel were assigned to monitor interrogations and intervene to ensure that interrogators didn’t cause "serious or permanent harm" and thus violate the U.S. federal statute against torture.

The reasoning sounds almost circular. As one memo, from May 2005, put it: “The close monitoring of each detainee for any signs that he is at risk of experiencing severe physical pain reinforces the conclusion that the combined use of interrogation techniques is not intended to inflict such pain.”

In other words, as long as medically trained personnel were present and approved of the techniques being used, it was not torture.

The memos provide official confirmation of both much-reported and previously unknown roles of doctors, psychologists, physician assistants and other medical personnel with the CIA’s Office of Medical Services (OMS). The government’s lawyers characterized these medical roles as "safeguards" for detainees.

Medical oversight was present from the beginning of the special interrogation program following the 9/11 attacks and appears to have grown more formalized over the program’s existence. The earliest of the four memos, from August 2002, states that a medical expert with experience in the military’s Survival Evasion Resistance, Escape (SERE) training would be present during waterboarding of detainee Abu Zubaydah and would put a stop to procedures “if deemed medically necessary to prevent severe medical or physical harm to Zubaydah.” (All interrogation techniques, the memos said, were "imported" from SERE.)

Later, OMS personnel were involved in "designing safeguards for, and in monitoring implementation of, the procedures" used on other high-value detainees. In December 2004, the OMS produced a set of "Guidelines on Medical and Psychological Support to Detainee Rendition, Interrogation and Detention," a still-secret document that is heavily quoted from in three legal memos that were written the following year.

The CIA declined our request to comment further on the OMS’ role in detainee treatment. The OMS employs physicians, psychologists and other medical professionals to care for CIA employees and their families.

Perhaps the most chilling aspect of the memos is their intimation that medical professionals conducted a form of research on the detainees, clearly without their consent. "In order to best inform future medical judgments and recommendations, it is important that every application of the waterboard be thoroughly documented,” one memo reads. The documentation included not only how long the procedure lasted, how much water was used and how it was poured, but also “if the naso- or oropharynx was filled, what sort of volume was expelled ... and how the subject looked between each treatment." Special instructions were also issued with regard to documenting experience with sleep deprivation, and "regular reporting on medical and psychological experiences with the use of these techniques on detainees" was required.

The Nuremberg Code, adopted after the horrors of "medical research" during the Nazi Holocaust, requires, among other things, the consent of subjects and their ability to call a halt to their participation.