Over the last year, there have been an increasing number of accounts suggesting that, along with the CIA's "enhanced interrogation" torture program, there was a related program experimenting with and researching the application of the torture.
For example, in the seven paragraphs released by a British court summarizing observations by British counterintelligence agents of the treatment of Binyan Mohamed (BM) by the CIA, the first two of these paragraphs stated:
It was reported that a new series of interviews was conducted by the United States authorities prior to 17 May 2002 as part of a new strategy designed by an expert interviewer ....
BM had been intentionally subjected to continuous sleep deprivation. The effects of the sleep deprivation were carefully observed. [Emphasis added.]
The suggestion was that a new strategy was being tested and the results carefully examined. Several detainees have provided similar accounts, expressing their belief that their interrogations were being carefully studied, apparently so that the techniques could be modified based on the results. Such research would violate established laws and ethical rules governing research.
Since Nazi doctors who experimented upon prisoners in the concentration camps were put on trial at Nuremberg, the US and other countries have moved toward a high ethical standard for research on people. All but the most innocuous research requires the informed consent of those studied. Further, all research on people is subject to review by independent research ethics committees, known as Institutional Review Boards or IRBs.
In the US, there was a major push toward more stringent research ethics when the existence of the Tuskegee Syphilis Study was publicly revealed in the early 1970s. In that study, nearly 400 poor, rural, African-American men were denied existing treatment for their syphilis, and, indeed, were never told they had syphilis by participating doctors. The study by the US Public Health Service was intended to continue until the last of these men died of syphilis. When the study became public, the resulting outcry helped cement evolving ethical standards mandating informed consent for any research with even a possibility of causing harm. These rules were codified in what has become known as the Common Rule, which applies to nearly all federally-funded research, including all research by the CIA.
Experiments in Torture
A new report of which I am a coauthor, "Experiments in Torture: Evidence of Human Subject Research and Experimentation in the 'Enhanced' Interrogation Program", just released by Physicians for Human Rights (PHR), confirms previous suspicions and provides the first strong evidence that the CIA was indeed engaged in illegal and unethical research on detainees in its custody. The report, the result of six months of detailed work, analyzes now-public documents, including the "torture memos" from the Justice Department's Office of Legal Counsel and the CIA's Inspector General Report and the accompanying CIA Office of Medical Services (OMS) guidelines for monitoring of detainees.
The report points to several instances where medical personnel - physicians and psychologists - monitored the detailed administration of torture techniques and the effects upon those being abused. The resultant knowledge was then used both as a legal rationale for the use of the techniques and to refine these abusive techniques, allegedly in order to make them safer.
For example, the OMS guidelines contain this note emphasizing how important it is "that every application of the waterboard be thoroughly documented" by medical personnel, and clarifying the nature of this documentation:
"how long each application (and the entire procedure) lasted, how much water was applied (realizing that much splashes off), how exactly the water was applied, if a seal was achieved, if the naso- or oropharynx was filled, what sort of volume was expelled, how long was the break between applications, and how the subject looked between each treatment."
This type of documentation was not part of routine medical care as it was not being done in the interests of the person being waterboarded. Rather, the OMS made clear that this was being done "[i]n order to best inform future medical judgments and recommendations" (regarding how to torture people).
The purpose of this systematic monitoring was to modify how these techniques were implemented, that is, to develop generalizable knowledge to be utilized in the future. As Renée Llanusa-Cestero demonstrated in a recent paper on CIA research in the peer-reviewed journal Accountability in Medicine, the medical personnel conducting these observations were primarily present as researchers to observe and monitor, not as treating doctors.
Other examples in the PHR report describe instances in which OMS staff investigated the degree to which severe pain that may meet the legal definition of torture arose from the applications of a specific technique (sleep deprivation) or from combinations of individual techniques. In the combined techniques example, they apparently experimented with different combinations of abusive techniques - "for example, when an insult slap is simultaneously combined with water dousing or a kneeling stress position, or when wall standing is simultaneously combined with an abdominal slap and water dousing" - and studied the suffering that each combination created. The Office of Legal Counsel drew upon this research in one of the torture memos to argue that, because they claimed the individual enhanced techniques were not harmful, combining these varied techniques also would not cause interrogators to slip over the line allegedly separating legal techniques from illegal "torture."
It is hard not to conclude that the CIA was conducting research upon detainees. These observations and experiments were not conducted for the benefit of the individuals being brutally interrogated, but for the purpose of creating generalizable knowledge and, thus, constituted research subject to the laws and ethical rules regulating research, including the Common Rule.
Evidence Techniques Are Harmful
The PHR report also argues that literature existing in 2002 when the torture program began provides strong reason to believe that these enhanced interrogation torture techniques might well cause severe harm to those subjected to them. In an appendix, the report summarizes a set of studies on the military's Survival, Evasion, Resistance, and Escape (SERE) program that demonstrated a whole panoply of potentially serious effects that occurred when these techniques were administered to US service members over a few days. The resistance portion of the SERE program attempts to inoculate special forces and others at high risk of capture against breaking if subjected to techniques banned by the Geneva Conventions, that is, to torture. In SERE, soldiers are subjected to brief periods of enhanced interrogations in order to prepare them for the real thing if captured and tortured. It was to SERE that the CIA and Bush administration turned when they decided to adopt torture as official policy.
Despite the fact that those subjected to SERE were volunteers, had a "safe word" to end their abuse and knew that their torment would end in a few days, an extensive program of research demonstrates that those subjected to the techniques, even to a very limited degree, suffered a whole range of potentially serious physical and psychological effects, including severely increased stress hormone levels and high rates of psychological dissociation, which can lead to post-traumatic stress disorder. Despite this body of published research, when the Bush Justice Department worked on the torture memos, they argued - ignoring this SERE research as well as many accounts from torture survivors - that the SERE experience demonstrated that the techniques were not harmful. In later memos, however, Justice Department lawyers apparently tried to strengthen their case by citing the CIA research derived from its torture implementation as further evidence that the techniques did not cause serious harm. Thus, one of the main finding in the PHR report is that one set of potentially criminal acts, illegal and unethical research, was used, incorrectly, to justify another set of potentially criminal acts: torture of detainees.
Reason for CIA Torture Research
The language of the documents might be interpreted as suggesting that the CIA engaged in this research to avoid harming the detainees, to keep the interrogations "safe and ethical." This was far from the truth. Rather, the Justice Department torture memos argued that torturers could be protected from prosecution for their acts of torture if they demonstrated a "good faith" effort to avoid causing the "severe pain" involved in legal definitions of torture irrespective of how much suffering and harm the torturers actually caused.
One way they could demonstrate such a good faith effort was to consult with health professionals, the researchers, who could assure them that their actions would not cause harm. Another way to demonstrate good faith was to collect and analyze evidence of prior interrogations demonstrating, allegedly, that they did not cause severe harm. Thus, the quality of the research did not matter. Its very existence would provide the CIA torturers and responsible officials with a get-out-of-jail-free card.
The SERE studies described in the PHR report provided good reason to suspect that the CIA's torture would cause harm. That is likely why they were ignored by the CIA and the lawyers writing the torture memos. But the CIA's torture research claiming that the enhanced interrogation tactics were safe could be used as a legal defense for the torturers, possibly counteracting the body of legitimate research demonstrating the opposite. The CIA's research was junk science. But that was no problem because its purpose wasn't increasing understanding, but ass covering, CYA, for the CIA.
Call for Investigation
This PHR report provides evidence that the CIA likely violated federal ethics rules as well as a prohibition in the War Crimes Act on biological experiments on prisoners "without a legitimate medical or dental purpose." Thus, PHR calls for both a criminal investigation of this research and these experiments, which may well constitute a war crime, and an investigation by the Office of Human Research Protections of research ethics violations.
Regarding the call for a criminal investigation, it is important to realize that the logic used by the Obama administration to refuse an investigation of torture claims - that the torture memos allowed the torturers to believe their actions were legally sanctioned - does not apply to potential research on detainees. As far as is publicly known, there exist no "torture research" memos authorizing ignoring laws and regulations prohibiting research on torture techniques.
American Psychological Association
In addition to criminal and federal penalties, another necessary response to these reported torture experiments is professional sanctioning of any health professionals found to have participated in the research. Physician organizations such as the American Medical Association and the American Psychiatric Association have adopted clear ethical rules prohibiting their members' participation in either the enhanced interrogation program or in research such as that described here. The exception among major health professional organizations is the American Psychological Association (APA).
In 2002 the APA modified its ethics code to allow psychologists to dispense with informed consent "where otherwise permitted by law or federal or institutional regulations. " (Ethics code standard 8.05.)
Whatever the reason for the APA making this modification, it could be interpreted as allowing psychologists to follow CIA (or military) directives authorizing exemption from the informed consent requirement. This lowered standard does not change psychologists' legal or ethical obligations in terms of causing harm, but it does unacceptably weaken research standards. This modification should be removed.
In February 2010, after eight years of stalling, the APA removed from its ethics code a related loophole, ethics code standard1.02, often described as the "Nuremberg Defense," that allowed dispensing with any section of the code when it was in conflict with "the requirements of the law, regulations, or other governing legal authority." But even with the long-delayed correction to 1.02, changes permitting psychologists to perform research on subjects without their consent remain in the ethics code. To date, there has been no explanation offered by the APA for reducing the standard on informed consent, nor has there been any response to longstanding calls from PHR, Psychologists for Social Responsibility, and numerous other psychological and human rights groups to restore psychologists' informed consent ethical obligations, the standards that all other health professional associations have instituted since Tuskegee and Nuremberg. Psychologists and others should demand that the APA immediately remove this ethics code section.
Note: Work such as the production of this report takes extensive resources. It is only possible because of the generosity of those who contribute to PHR. Readers who value this information might consider going to PHR's web site for the report and making a contribution.