NYT on Lancet Letter: "Doctors Decry Guantanamo Treatment"

In a letter in this week's British medical journal The Lancet, some 260 signatories, mostly doctors, described their outrage at the American Medical Association for turning a blind eye to U.S. detainee abuse, and in some cases, participating in it.

The letter is headlined "Biko to Guantanamo: 30 years of medical involvement in torture" [link requires free registration]. The Lancet correspondence caught the attention, too, of the New York Times, which printed the AP story on it.

LONDON (AP) -- The U.S. medical establishment appears to have turned a blind eye to the abuse of military medicine at the Guantanamo Bay prison in Cuba, doctors from around the world said in a letter published Friday in a prestigious British medical journal.

Health care workers in the U.S. military seem to have put their loyalty to the state above their duty to care for patients -- and American regulatory bodies have done nothing to remedy the situation....

The letter compared the ongoing role of U.S. doctors working at Guantanamo, who have been accused of ignoring torture, to the South African doctors involved in the case of anti-apartheid activist Steve Biko, who died while being detained by security police....

The American Medical Association did not immediately respond to a telephone message seeking comment left at their press office Thursday evening.

Looks like the AMA is giving the New York Times the same brush off it gave journalist Luke Mitchell of Harper's a couple of months ago when he enquired about doctor participation in torture and abuse at CIA sites. As I noted then, the AMA sought to shift the blame for collaboration with torture over to the American Psychological Association, which has not requited itself well of late on this issue, as described multiply elsewhere (here and here, for instance).

But it seems the doctors do not have clean hands themselves, despite a formal position of not participating in American detainee abuse. A huge controversy has arisen, for instance, over doctor involvement in force feeding of Guantanamo hunger strikers. From The Lancet letter:

There are strong parallels between the Biko case and the ongoing role of US military doctors in Guantanamo Bay and the War on Terror. Last year, we suggested that the physicians in Guantanamo force-feeding hunger strikers should be referred to their professional bodies for breaching internationally accepted ethical guidelines. One of us (DJN) lodged formal complaints with the medical boards for Georgia and California as well as pointing out to the American Medical Association (AMA) that the former hospital commander at Guantanamo, John Edmondson, was a member. After 18 months, there had been no reply from the AMA, the Californian authorities stated that they “do not have the jurisdiction to investigate incidents that occurred on a federal facility/military base”, and the authorities in Georgia stated that the “complaint was thoroughly investigated” but “the Board concluded that there was not sufficient evidence to support prosecution”. Yet an analysis of the same affidavit by the Royal College of Physicians concluded that “in England, this would be a criminal act”....

The attitude of the US medical establishment appears to be one of “See no evil, hear no evil, speak no evil”.

There has been a lot of suggestions on listservs and in discussions in general among medical and psychological professionals about what to do to rein in the profession and stop professionals from participating in torture. Paper resolutions seem to be worth even less than the paper they're written on. And now it appears that appeals to state medical or licensing boards have no effect. Even in England, where the RCP concludes such collaboration is a criminal act

The UK government has refused a request from the British Medical Association for a group of independent doctors to assess the detainees...

When it comes to affecting the current situation vis-a-vis doctors and psychologists assisting U.S. torture abroad, a sense of impotence and despair is permeating the health professions. In the end, the solution will not be found by appealing to narrow guild interests, whether in the associations that represent the professions or to the conservative state agencies that regulate them. The fight against torture must be part of a larger political struggle to bring down the Bush regime, and install a political order that is not dedicated to imperial conquest and nationalist supremacy, whether pushed by Republicans or Democrats.

Insider Politics of the Torture Chamber

In a blockbuster article by Seymour Hersh over at The New Yorker, "The General's Report," two-star general Antonia Taguba describes how he came to write the first report investigating the abuse at Abu Ghraib prison. Taguba describes how he was shunned and ultimately forced to retire because he tried to be honest in his report. Most stories reporting on Hersh's article have not focused on the aspect that concerns how the CIA and military special operations forces both collaborated and contested over the issue of coercive interrogations. I want to look more in depth at that.

A Washington Post article summarized well Taguba's charges:

In interviews with New Yorker reporter Seymour M. Hersh, Taguba said that he was ordered to limit his investigation to low-ranking soldiers who were photographed with the detainees and the soldiers' unit, but that it was always his sense that the abuse was ordered at higher levels. Taguba was quoted as saying that he thinks top commanders in Iraq had extensive knowledge of the aggressive interrogation techniques that mirrored those used on high-value detainees at Guantánamo Bay, Cuba, and that the military police "were literally being exploited by the military interrogators."

Reading Hersh's article myself, I was struck by the opaque quality that characterized the interactions between military intelligence, the Pentagon command structure and the CIA. We have some sense of how part of this worked by reading the recent Office of Inspector General report on detainee abuse, which describes how Survival, Evasion, Resistance, and Escape (SERE) military personnel, including psychologists, were used in training Guantánamo interrogators in coercive techniques.

What Hersh's article adds is a sense of how CIA personnel and higher-ups viewed the usurption of "higher-level" prisoners for interrogation by "special operations units", including possibly -- though Taguba doesn't say this -- by contractors. (The latter is a huge and controversial aspect of the Abu Ghraib story, and was addressed in the original Taguba report. For more information on this, please reference an excellent UK Guardian story from 2004.)

White House preempts civilian/military chain of command

According to Hersh, the CIA, even while "cooperating" with military special ops, were critical. They may (or may not) have had differences with the SERE-type torture being implemented, but CIA wanted some legal reassurances "before aggressively interrogating high-value targets". The CIA operates under presidential mandate, and is used to getting formal findings to legitmate their actions, with such findings communicated officially to the senior leadership of the House and the Senate Intelligence Committees. But this wasn't happening, because the White House refused to follow legal protocol and issue the findings, at least for awhile. When they finally did, a number of countries were said to become "free-fire zones" for the CIA. The Company was also given carte blanche to conduct its secret prison program.

I wish Hersh would have expanded this portion of his article, because it's unclear what finally happened with the CIA, who now awaits a new set of findings from the President on how to conduct interrogations. Evidently, Hersh couldn't get the full story here, or the evidence was contradictory. You'll see this as you read the article.

To get a flavor of what Taguba was up against, as he encountered the web of interrogator politics at Abu Ghraib, consider the case of Lieutenant Colonel Steven L. Jordan, whom assorted MPs had mentioned as involved with the detainees. Jordan is also the only officer to be charged in the Abu Ghraib scandal, adn is to go on trial this summer.

From Hersh's article:

For the first three weeks of the investigation, Jordan was nowhere to be found, despite repeated requests. When the investigators finally located him, he asked whether he needed to shave his beard before being interviewed—Taguba suspected that he had been dressing as a civilian. “When I asked him about his assignment, he says, ‘I’m a liaison officer for intelligence from Army headquarters in Iraq.’” But in the course of three or four interviews with Jordan, Taguba said, he began to suspect that the lieutenant colonel had been more intimately involved in the interrogation process -- some of it brutal -- for “high value” detainees....

Taguba said that Jordan’s “record reflected an extensive intelligence background.” He also had reason to believe that Jordan was not reporting through the chain of command. (emphasis mine)

This begs the question: who was Jordan reporting to? Hersh has been telling us for some time that to understand what's happened since 9/11 and in Iraq that we should look to the chain of command. His book on Abu Ghraib is called Chain of Command. At the top of the command structure is the President, as the latter is so fond of telling us. Hersh has some choice words about President Bush:

Whether the President was told about Abu Ghraib in January (when e-mails informed the Pentagon of the seriousness of the abuses and of the existence of photographs) or in March (when Taguba filed his report), Bush made no known effort to forcefully address the treatment of prisoners before the scandal became public, or to reëvaluate the training of military police and interrogators, or the practices of the task forces that he had authorized. Instead, Bush acquiesced in the prosecution of a few lower-level soldiers. The President’s failure to act decisively resonated through the military chain of command....

Taguba went on, “There was no doubt in my mind that this stuff” -- the explicit images -- “was gravitating upward. It was standard operating procedure to assume that this had to go higher. The President had to be aware of this....

"We violated the tenets of the Geneva Convention. We violated our own principles and we violated the core of our military values. The stress of combat is not an excuse, and I believe, even today, that those civilian and military leaders responsible should be held accountable.” (emphasis mine)

Taguba doesn't say how they should be held accountable. But we could start with the impeachment of the commander-in-chief and courts martial for all involved in the chain of command. The above should be followed with referral to appropriate bodies for war crimes trials, to begin concurrent with a full withdrawal from Iraq.

UPDATE:

I wanted to include here a very useful comment from the Daily Kos thread for this story, by Snarcalita. It's an excellent analysis of what Hersh is reporting, and is often the case, is captured best by one of my readers:

Hersh hints around the SAP or Special Access Program, a highly-classified, compartmentalized operation that seems to have involved, among other things, Spec. Op.s teams operating from US Embassies with a literal license to kill, who formed kidnap teams filling the secret interrogation facilities. It seems the CIA was squeezed out of the covert ops business as a deliberate policy to avoid congressional oversight and covert ops reporting requirements. The Pentagon lawyers concluded that the unitary executive C-in-C could launch op.s to "prepare the battlefield" with no reporting requirements. Since, in a "Global War on Terror" the whole world is the battlefield, they basically seized carte blanche to run their own covert death squads. None of the investigators could be 'read in' to the details of these secret operations, though it seems they tried to indicate that the techniques of sexual humiliation and torture were taught by someone to the MP scapegoats who actually carried them out. It seems no accident that the prison was guarded by untrained National Guard units, rather than professional soldiers who would have known about procedure and their duty to refuse illegal orders and report war crimes.