Torturing the Evidence
From the January 24, 2005 issue: The truth about the doctors at Guantanamo.
Jan 24, 2005, Vol. 10, No. 18 • By HEATHER MAC DONALD
SUCH FURTHER exposés of professional complicity in "torture" are undoubtedly just around the corner, now that the New England Journal of Medicine has condemned the participation of doctors in terrorist interrogations. M. Gregg Bloche, a medical ethicist at Georgetown and Johns Hopkins, and Jonathan H. Marks, a biological anthropologist at the University of North Carolina, Charlotte, announce in the January 6 issue of the Journal that doctors who oversaw detainee interrogations "breached the laws of war" and probably engaged in "torture." This accusation echoes an earlier complaint by the International Committee of the Red Cross. The press has gleefully picked up the story as more proof of detainee torture.
So what did the military physicians and psychiatrists actually do? Review interrogation plans to make sure that they posed no health risks to detainees. Observe interrogations in process to make sure they posed no health risks to detainees. Provide interrogators with access to detainees' medical records so the interrogators could put together plans that exploited detainees' psychological weaknesses without posing a health risk. Allegedly consult on interrogation plans to maximize the chance of getting information without compromising detainee care. Bloche and Marks provide little backing for this last claim. The interrogators I have spoken to are unaware of any such involvement and say that the doctors at Guantanamo confined themselves exclusively to overseeing medical care. Psychiatrists were involved with interrogators, however, advising on detainees' mental states. They might inform intelligence officers that Ahmed was crazy as a loon, and would not be responsive to interrogation, or that Khalid was too emotionally fragile for questioning without Zoloft, or that Zacarias was faking his mental disability.
The "doctors who torture" story conjures up images of Nazi doctors fiendishly experimenting on concentration camp victims or sadistically calibrating levels of unbearable pain. But the actual interrogation techniques that were used in Guantanamo Bay and Iraq do not come close to torture: "dietary manipulation," such as putting a detainee on vacuum-sealed Army rations, rather than hot meals, with a minimum base of bread and water, sleep manipulation, and isolation, among others. The military began experimenting with such "stress techniques" only after it became clear that traditional Army methods of questioning lawful prisoners of war, which play on homely emotions such as pride or homesickness, were ineffective in getting war on terror detainees to talk. The stress methods aimed to increase a detainee's sense of uncertainty about the interrogator's limits, and thus to persuade him to cooperate. They did not seek to produce pain or harm. If an authorized interrogation had injured a detainee, and it came out that interrogators had ignored his medical history, the human rights advocates would undoubtedly have accused the Bush administration of medical malpractice and neglect as vociferously as they are now accusing medical professionals of complicity in torture.
Bloche and Marks criticize the military doctors for breaching the privacy of a detainee's medical records, thus undermining "detainees' trust in their doctors, a prerequisite for adequate care." But detainees were told that their medical information was not protected. And the notion of scrupulously preserving patient confidentiality in a war zone is absurd. The alleged "undermining of trust" that the authors predict does not, in any case, seem to have had an adverse effect: The prisoners received better medical care than ever before in their lives; they gained weight, and were treated for longstanding ailments. One detainee received half a million dollars worth of surgery to correct a childhood deformity. After the operation, interrogators approached him to ask if maybe now he'd be willing to cooperate. "Death to America!" was the only response.