Friday, June 24, 2005

Doctor Gulago

Both the NYT and the New England Journal of Medicine have come out with convincing evidence that military doctors and psychologists have actively participated in the abusive interrogations of detainees at Guantanamo Bay, advising interrogators on how to maximize stress levels and fears, in some cases volunteering clinical data to provide leverage over individual detainees.

The Times interviewed former interrogators, who revealed that 'the military doctors' role was to advise them and their fellow interrogators on ways of increasing psychological duress on detainees, sometimes by exploiting their fears, in the hopes of making them more cooperative and willing to provide information.' Such advice included revelations of one patient's severe phobia of the dark, and another's longing for his mother, along with suggestions for exploiting these vulnerabilities in interrogation.

As one interrogator baldly put it, 'Their purpose was to help us break them.'

The prerequisite for this strategy, as a report in the NEJM documents, is the wholesale abrogation of internationally-recognized standards of patient confidentiality. Although the Pentagon, in the loathsome-yet-liberally-alliterative person of Dr. William Winkenwerder Jr., Asst. Secretary of Defense for Health Affairs, claims that no ethical guidelines have been violated by military doctors and further, that 'limits on detainees’ medical privacy are “analogous to legal standards applicable to U.S. citizens,"' the authors make clear that this is simply a lie:
Health information has been routinely available to behavioral science consultants and others who are responsible for crafting and carrying out interrogation strategies. Through early 2003 (and possibly later), interrogators themselves had access to medical records. And since late 2002, psychiatrists and psychologists have been part of a strategy that employs extreme stress, combined with behavior-shaping rewards, to extract actionable intelligence from resistant captives.
As founding members of the Behavioral Science Consultation Team (or 'Biscuit'; doesn't it just make you want to sit down with them for a nice civilized cup of tea?), a psychiatrist and a psychologist were detailed to 'engineer the camp experiences of "priority" detainees to make interrogation more productive.' This included preparing psychological profiles of detainees for interrogators' use, as well as sitting in on some interrogations, observing others through one-way mirrors and offering feedback to interrogators.

Upshot: these docs were neck-deep in detainee interrogations which have been widely evaluated as constituting torture. And yet somehow, according to the Times article, there's debate as to whether they've violated professional ethics.

The chair of the American Psychiatric Association's ethics committee said in an interview that there was 'no way that psychiatrists at Guantanamo could ethically counsel interrogators on ways to increase distress on detainees.' Correct.

However, the American Psychological Association is making no such definitive statements, allowing only that 'the issue of involvement of its members in "national security endeavors" was new', and that a members' committee, including military personnel, will meet this weekend to discuss it. The 'issue' may be new, but the involvement sure ain't. The first Biscuit was baked in 2002, complete with Crispy Psychologist Goodness.

According to The Tool Winkenwerder, 'the new [issued last week] Pentagon guidelines made clear that doctors might not engage in unethical conduct.' Always with the 'mights' and 'coulds', these people. Is that meant to reassure us? Besides, do these new guidelines have special retromojo power to undo the violations military docs have been ordered to commit, and have compliantly committed, up to now?

According to Dr. Stephen Behnke, head of the American Psychological Association's (clearly rather somnolent) ethics committee, 'A question has arisen that we in the profession have to address and that is where we are now: is it ethical or is it not ethical?'

Drop me a line, Dr. Behnke, and I'll make it real simple for you.

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