Forced Drugging of Guantánamo Prisoners: A Crisis for Health Professionals

A major article in Tuesday's Washington Post collects the accounts of U.S. detainees who, in large numbers, report that they were the recipients of unknown psychotropic drugs -- a topic recently discussed by Jeff Stein in Congressional Quarterly. The Post has gone further in collecting evidence, making the case that involuntary psychotropic drug use on detainees, including as an interrogation aid, has been a common practice. The Post ran the story on the front page -- a strong statement that catapults the issue of detainee drugging to a top slot in the long list of Bush administration abuses.

The drugging was extremely traumatic for many detainees:

"The injections left a searing impression among some former detainees, said Emi MacLean, a lawyer for the Center for Constitutional Rights, which represents dozens of current and former detainees …

'Many speak about forced medication at Guantánamo without knowledge about what medication they were being forced to take,' MacLean said. 'For some released [military] detainees, the forced medication they experienced was the most traumatic part' of their captivity."

As the Post describes, the drugs were often used as part of the interrogation process:

"(Adel al-Nusairi) is among a handful of former detainees who directly allege the use of drugs in interrogations at the military prison in Guantánamo. Others described being forcibly given sedatives that knocked them out or made them groggy before being transferred, or being forced to take pills or receive shots for unclear reasons and suffering unusual symptoms afterward. At least one detainee has alleged in a written statement through his attorney that he was drugged after being 'renditioned' or transferred by U.S. officials to a prison in Morocco.

Nusairi, in prison interviews in 2005 with Anant Raut, his attorney, described a six-month period in which he says his captors subjected him to drugs and temperature extremes to extract information about al-Qaeda connections they believed he had.

"They thought he was hiding something," said Raut, who represented Nusairi and other Saudi detainees in 2005 and 2006 while working for the Washington office of the law firm Weil, Gotshal & Manges. "He was injected in the arm with something that made him tired -- that made his brain cloudy. When he would try to read the Koran, his brain would not focus. He had unusual lethargy and would drool on himself."

Such treatment, like many of the other "interrogation" techniques supposedly necessary to obtain accurate intelligence, often led to false confessions instead:

"It was during one such episode, in an interrogation room Nusairi remembers as ice-cold, that he became so desperate for sleep that he signed a confession professing to involvement in al-Qaeda, according to his attorney's notes. The interrogator watched him sign his name, and 'then he smiled and turned off the air conditioner. And I went to sleep,' Nusairi said, according to the notes."

After the confession-- which Nusairi later said was a lie -- the Saudi remained at Guantánamo Bay for another three years before being turned over to his home country, which released him. "He signed the statement, and they declared him an enemy combatant," Raut said, "yet they released him anyway with no explanation." The Saudi Embassy declined to comment."

Other detainees describe being administered drugs as part of what appeared to be punishment:

"Other detainees, in interviews or in statements provided by their attorneys, described pills and injections being forcibly administered for reasons that were not always clear to them. Mourad Benchellali, a French national who was held for three years at Guantánamo Bay, said that prison workers sometimes described the medications as antibiotics or vitamins, yet they frequently left him in a mental fog.

'These medicines gave us headaches, nausea, drowsiness,' Benchellali, who is now living in France, said in an e-mail. 'But the effects were different for different detainees. Some fainted or threw up. Some had reactions such as pimples.' He also described periodic injections, often administered by force, that left him feeling nauseated and light-headed, and noted, 'We were always tired and always felt groggy.'

A different type of injection seemed to be reserved for detainees who were particularly uncooperative, Benchellali said, describing episodes that four other former detainees also cited in interviews or legal documents. 'The injection would make them crazy,' he said. 'They would have a crisis or dementia -- yelling, no longer sleeping, soiling themselves. Some of us suspected they were given LSD.'"

While both the military and the Defense Department deny the reports, as the Post carefully notes, these reports are especially plausible as it is known that the CIA conducted a decades-long research program to develop truth serums and pharmacological approaches to manipulating human behavior. And, as discussed below, the CIA in 2003 was actively discussing the use of drugs in interrogations. Further, as both CQ and the Post point out, the recently released Yoo torture memo went out of its way to provide legal cover for the use of drugs in interrogations.

In recent years it has become clear that psychologists have been pivotal actors in the Bush administration interrogation abuses, as they designed, conducted and standardized "enhanced interrogations amounting to torture. As Vanity Fair reporter Katherine Eban explained:

"I discovered that psychologists weren't merely complicit in America's aggressive new interrogation regime. Psychologists, working in secrecy, had actually designed the tactics and trained interrogators in them while on contract to the CIA."

At this point it is unknown if psychologists are involved as among those "health" professionals who involuntarily administered drugs. But we do know that, thanks partly to military support, a number of psychologists can now legally prescribe drugs. And some of those prescribing psychologists were with the Behavioral Science Consultation Teams [BSCTs] at Guantánamo. Moreover, in 2003 the American Psychological Association co-sponsored with the CIA an invitation-only "Science of Deception" workshop that discussed, among other topics, "What pharmacological agents are known to affect apparent truth-telling behavior?" CIA consultant torturers James Mitchell and Bruce Jessen were among those invited to attend, as were several of their superiors. Now, given recent revelations, the APA should speak openly and forthrightly about this conference, how it was organized, who attended and how they were selected, and what was discussed there. It is long past time for these actions of the psychological association to be openly discussed among the APA membership and the broader public.

This story constitutes further evidence that health professionals, likely including physicians as well as the psychologists previously known about, were central agents in the Bush administration's abusive detention and interrogation program. This is a clear violation of medical ethics, going well beyond these professions' guiding "do no harm" standard. It is incumbent upon Congress to investigate these serious allegations. Additionally, associations of health professionals need to make clear, unequivocal statements that participating in these activities is unethical and will not be tolerated.

This would be a first step. Health professions need a truth and reconciliation process going forward to explore the actions of health professional, psychologists included, in aiding the varied abuses of detainees that are coming to light. This process must explore the actions, not just of individual professionals, but of professional associations in looking the other way at, or perhaps even actively aiding these abuses.

We need a committee of health professionals, human rights advocates, and retired intelligence professionals concerned about detention abuses to hear testimony and create a detailed account of what is available in the public record on health professional involvement in these abuses. Including intelligence professionals would help penetrate the fog of denial that surrounds classified intelligence activity. Such a committee would also examine and make recommendations for policy and structural changes in professional organization to reduce the likelihood that these organizations will turn their backs on future abuses.

The health professions failed to come to terms with the extent of their involvement in the CIA's earlier mind-manipulation research, making them less alert to their potential roles in the contemporary "war on terror." Now that these professions are directly implicated in publicly-exposed detention abuses, they cannot afford again to avoid clarifying their ethical responsibilities. To fail to face squarely these abuses will change the image of the health professions for decades to come. Rather than be known as those that improve human welfare and "do no harm," these professions will be known as those that do the harm demanded by the powers that be. Should that eventuality come to pass, these professions will suffer greatly. But so will all of us who rely upon health professionals to care for our welfare.