Navy Continues to Persecute Nurse Who Refused to Force-feed Guantanamo Hunger Strikers

Carol Rosenberg reported today that a Navy commander had decided not to court-martial a Guantanamo nurse for refusing to participate in the forced-feeding of hunger strikers at the U.S. military prison. Announcement of the "pending court-martial" was made in late August.

While on Twitter it appeared that many were relieved the nurse would not be going to jail for taking a principled stand against the medically unethical practice of forced "enteral" feeding -- and that must be some relief, after all -- the fact is the Navy announced that after some months of investigation, the nurse is now subject to an administrative review, or "Board of Inquiry," that may continue on for up to nine more months, according to Rosenberg.

The nurse, who is threatened with expulsion from the military and loss of his military benefits, is a 40-ish year old, possibly Latino, Navy Lieutenant. The discovery of his protest against the forced feeding of Guantanamo hunger-strikers, which he had participated in for many months, noted first in a letter from Guantanamo prisoner Abu Wa'el Dhiab, a Syrian prisoner cleared for release in 2010. Dhiab languishes in ill-health at the Cuban-based prison, as he awaits possible transfer to Uruguay. (See this latest report on Dhiab from Andy Worthington.)

The military is not interested in doing its conscientious-objector nurse any favors. The Board of Inquiry will no doubt cause the Navy Lieutenant a great deal of stress and money, with no certain outcome. Anyone who has been under administrative investigation and "review" for many months knows how difficult such a procedure really is. Whatever the outcome, the continued legal wrangling by the Navy amounts to persecution of a medical officer who had decided not to obey an unlawful order.

Forced feeding of prisoners is denounced as both medically unethical and in the form practiced at Guantanamo to amount to torture, according to a report from the prestigious Institute on Medicine as a Profession (IMAP) report released last year.

The Navy certainly had little interest in an actual court-martial proceeding. As Rosenberg reported, "The administrative review, also known as a Board of Inquiry, keeps the circumstances of that episode secret. A military trial could have put a very public spotlight on both Guant獺namo’s hunger-strike policy and how the military manages medical-ethics issues." 

A very different fate for former BSCTs

It is very embittering for anyone who cares about this country's mainstreaming of torture to reflect upon the experience of this Navy nurse. It strongly reminds me of the case of former Guantanamo guard Albert Melise, who was threatened with dishonorable discharge and forfeiture of all his military benefits because he spoke to reporter Jason Leopold about his experiences with former Guantanamo prisoner David Hicks. (Hicks today is fighting to have his conviction in the Guantanamo military commissions overturned.)

While the military continues to persecute those who stand against torture and medical maltreatment, key personnel who participated in interrogations and torture at Guantanamo are rewarded. I recently was made aware that one of the members of Guantanamo's infamous Behavioral Consultation Science or BSCT ("biscuit") teams, Lisa Teegarden, is today the chief of Psychology at Walter Reed National Medical Center in Bethesda, Maryland (not to be confused with Walter Reed Army Hospital, which, plagued with scandals over patient neglect, closed in 2011).

According to her LinkedIn page, she was Behavioral Science Command Consultant from May 2008 to October 2010. Teegarden indicates that during this period she "[s]erved as Special Staff to Commander, Joint Task Force, Guantanamo Bay, Guantanamo Bay Cuba. Served as the subject matter expert to the Commander, JTF-GTMO on matters pertaining to clinical psychology, organizational psychology / dymanics [sic] and social psychology principles as they pertain to military organizations. Specialized in behavioral management of detainees, behavioral drift, and counter-interrogation / intelligence operations."

The BSCTs were notorious for their participation in abusive interrogations, including use of SERE-derived torture. The American Psychiatric Association went so far as to prohibit its members from participating, while the American Psychological Association was (and to some degree still is) embroiled in controversies over allowing psychologists to staff the interrogation consultant role at Guantanamo. (For a full discussion of the pertinent issues, see this excellent article by psychologist Stephen Soldz.)

Teegarden's stint at Guantanamo, providing her expertise on clinical psychology and "behavioral management of detainees" and intelligence operations, at the time of the mysterious death of Mohammad Ahmed Abdullah Saleh Al Hanashi in June 2009. Al Hanashi was found dead in a constantly-monitored cell in Guantanamo's Behavioral Health Unit. An NCIS report on his death has not been released.

I requested a copy of the report via FOIA in January 2012. NCIS to date refuses to even give me a date of completion for the FOIA request. A separate request for the AR 15-16 report on Hanashi's death has been sitting in Southcom's FOIA office since January 2013.

When the autopsy report for Hanashi's death was finally released, it raised many questions about what actually happened to the former hunger-striking prisoner. But one aspect of the latter document is especially relevant when it comes to Teegarden, as the autopsy stated Hanashi suffered from "stressors of confinement."

If true, Teegarden, a psychologist who as BSCT had great responsibility in regards to "behavioral management of detainees," should answer for what kind of conditions of confinement drove Hanashi to make multiple suicide attempts, and what the actual circumstances of his death were.

But Teegarden is not being investigated, unlike the nurse who protested the brutal process of forced cell extraction and forced feeding of hunger-striking prisoners, despairing of years of indefinite detention, psychological torture, beatings, forced drug injections, isolation and more.

Instead, Teegarden isn't worried about her medical benefits or her job. Like scores of others involved in the torture of prisoners, including Department of Defense SERE officials, Pentagon attorneys, psychologists and doctors and nurses, flag officers, CIA and JSOC officers, Teegarden is rewarded with plum assignments for her adherence to a torture regime. Meanwhile, a lowly Navy lieutenant can only count himself lucky that he isn't being thrown into the brig, and only must endure a stressful "inquiry" about whether to throw him out of the military.

Teegarden is not alone in being an ex-BSCT who has gone on with her career. Former head BSCT and chief psychologist at Abu Ghraib, Larry James, who personally led the rendition and detention of young teens from Afghanistan, went on to a career as dean of the School of Professional Psychology at Wright State University in Dayton, Ohio. (James ultimately left, and his subsequent attempt at a career has not been without controversy.)

At least one BSCT psychologist, Lt. Col. Dianne Zierhoffer was called to account for her participation in the torture of another Guantanamo juvenile prisoner, Mohammed Jawad (now released), but was allowed to plead the Fifth Amendment in order not to testify. John Leso, yet another BSCT, who had been identified in helping organize Guantanamo's SERE-inspired torture regime, was exonerated of ethics charges by the American Psychological Association

The real message is for those who staff or would staff the military and intelligence bureaucracy of 21st century America: Don't make waves. Do your job in support of or conducting torture, and you will be rewarded.

Crossposted from The Dissenter/FDL

The Punitive Use of Medical Restraints on Guantanamo Hunger Strikers

A partially redacted set of medical records released in the aftermath of the 2006 deaths of three Guantanamo prisoners shows that the use of "medical restraints" in the use of forced feeding of hunger striking detainees was used as a threat on hunger striking prisoners. At least one detainee was told over and over that use of "medical restraints" was due to his voluntary refusal to eat.

While Guantanamo medical authorities said the need for restraints was due to "medical necessity," such necessity was never documented. Instead, it was clear the use of restraints was punitive in nature.

The use of medical restraints in forced feeding, for which DoD uses a restraint chair, is not a normal procedure at other penal institutions. In a letter nearly one year ago from the Chair of the Senate Intelligence Committee, Sen. Dianne Feinstein, to Secretary of Defense Chuck Hagel, Feinstein noted, "When force-feedings do occur within the Bureau of Prisons, we have been told that nearly 95% of the time they are conducted with a fully compliant inmate requiring no restraints. At Guantanamo Bay, on the other hand, all detainees being force-fed—regardless of their level of cooperation—are placed in chairs where they are forcibly restrained." (Emphasis added.)

In the medical records (PDF) for Ali Abdullah Ahmed (ISN 693) in March 2006, a "Gitmo Nurse" noted in Ahmed's medical chart numerous discussions with the prisoner about his refusal to eat and the policy to feed him forcefully, a policy that insisted that the prisoner's behavior "must change":

Detainee placed in [redacted] Reason for Restraint: Medical Necessity [last two words are circled]

Detainee was advised by the Medical Staff that hunger striking is detrimental to his health. His behavior is due to his refusal to eat and not due to mental status change or illness. Medical Staff/Guards attempted to get the detainee to eat on his own. He is being offered food at every meal, yet he refuses to eat. Because the detainee refuses to eat, restraints were initiated for medical necessity for feeding. Detainee will be observed continually and he will be reminded of how his behavior must change (he must eat voluntarily) to avoid the use of medical restraints for present and future feedings. Detainee was told that he will remain in medical restraints until feed and post feed observation (60-120 minutes)

GITMO Nurse

Elsewhere in the medical notes (3/7/2006), the nurse states, "There is no evidence that medications or a medical process is causing this detainee's refusal to eat."

Other notes show that while Ahmed was kept in restraints, he remained under "Line of Sight Observation." Circulation checks were made every 15 minutes for the first hour, and then hourly thereafter. Vital signs were checked immediately after the restraints are attached, and every hour thereafter. The medical restraints order expired only after 12 hours. No reason why it is medically necessary to restrain the prisoner was ever given in the notes I saw. No evidence of opposition to the process of enteral feeding by Ahmed was ever described.

The policy of keeping Ahmed in medical restraints through his "post feed observation" was not consistent with the SOP for hunger striking as later revealed in the March 3, 2013 Standard Operation Procedure for hunger strikes and forced feeding obtained by Jason Leopold for Al Jazeera last year.

According to the portion of the policy titled "Chair Restraint System Clinical Protocol for the Intermittent Enteral Feeding of Detainees on Hunger Strike," "Medical restraints chair restraint system) should be used for the safety of the detainee, medical staff, and guard force.... Upon completion of the nutrient infusion and removal of the feeding tube, the detainee is removed from the restraint chair and placed in a 'dry cell'. The guard force will observe the detainee for 45-60 minutes for any indications of vomiting or attempts to induce vomiting."

But this is not what happened to Ahmed, who perhaps along with other detainees was kept as long as possible in a five point restraint chair, or possibly a restraint bed. The purpose of prolonging his restraints could only be punitive in nature, to teach him a lesson and get him to "change."

Only three months after the notes quoted above, Ahmed was one of three prisoners found supposedly hanged in their cells. The government maintains the three prisoners hanged themselves in an act of "asymmetrical warfare," but recent revelations by researchers at Seton Hall Law School (and Scott Horton at Harper's) show that the Naval Criminal Investigative Service (NCIS), charged with investigating the deaths, withheld crucial information from their report, hiding information about the deaths that came from witnesses and even the Senior Medical Officer on site which contradicted the government's own narrative.

The new information which has come to light argues that Ahmed and the two other men died with socks or rags stuffed down their throats, possibly part of an interrogation session meant to force the prisoners to turn informants for the CIA or the Department of Defense. The Senior Medical Officer (SMO) at Guantanamo who attended at least two of three high-profile “suicides” at Guantanamo concluded at the time that, contrary to the conclusions of the NCIS investigation, the detainees did not die by hanging but by “likely asphyxiation” from “obstruction” of the airway. His conclusion was never mentioned in the NCIS report, and later interventions by the Department of Justice prevented inquisitive congressional representatives from knowing that fact.

"The Torture Chair"

The secretive, abusive Guantanamo regime is under new scrutiny of its hunger striking procedures, thanks to a lawsuit by a Guantanamo prisoner.

According to Ben Fox at AP, attorneys for Guantanamo prisoner Abu Wa'el Dhiab have been viewing almost three dozen videotapes a federal judge ordered government authorities to turn over to the defense in Dhiab's appeal to stop his forced feeding. Dhiab is one of a number of hunger strikers currently refusing food at Guantanamo in protest of inhumane conditions and their indefinite detention.

Dhiab himself has been cleared for transfer or release from the Cuba-sited prison since 2009. The next hearing in his case is on June 18.

Due to a change in policy last December, DoD will not report the actual number of active strikers, or those refusing food, in what many believe was an attempt by authorities to reduce the political effectiveness of the prisoners' strike technique.

A lot has been written on the torture that is Guantanamo's forced feeding policy, which includes brutal beatings -- so-called Forced Cell Extractions (FCEs) -- to bring the hunger striking prisoner to a restraint chair, where he is strapped down and has liquid food put down a tube forced down his nose and into his stomach. The speed at which the liquid is forced down a prisoner's gullet is something defense attorneys have likened to the ancient "water cure torture."

The UN high commissioner for human rights, the World Medical Association, and other medical and human rights organizations have said forced feeding of prisoners amounts to torture.

In a June 3 filing by one of Dhiab's attorneys, Jon Eisenberg, wrote, Dhiab "does not object to being force-fed in order to keep him alive, as long as the force-feeding is 'civilized.' He states: 'I am willing to be force-fed in a humane manner.' His recent force-feedings, however, have not been humane. He asks: 'Is it necessary for them to torture me? Is it necessary for them to choke me every day with the tube? Is it necessary for them to make my throat so swollen every day? Do I have to suffer every day? Is it necessary for them to put me on the torture chair in order to feed me?'”

A new version of the Guantanamo SOP for use on hunger strikers, who are now called "Detainees With Weight Loss" on "long-term non-religious fasts," placed instructions on use of the restraint chair into its own new SOP. That document, like almost everything else at Guantanamo, is currently classified.

Cross-posted at FDL/The Dissenter