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The Professionalization of Torture

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By Melina Milazzo
Pennoyer Fellow, Law and Security Program

This week, the Journal of American Medical Association (JAMA) published a commentary entitled "Roles of CIA Physicians in Enhanced Interrogation and Torture of Detainees" by Leonard Rubenstein, JD and Brigadier General Stephen Xenakis, MD which examined the disturbing roles physicians played in both providing guidelines to interrogators as well as opinions to lawyers on the CIA's enhanced interrogation program.

As we now know, the CIA subjected detainees to abusive techniques including: stripping, diapering, isolation, loud music, continuous light or darkness, extreme cold, food deprivation, shackling, sleep deprivation, insult (facial) slap, water dousing, extreme stress positions, walling, confinement boxes, and waterboarding. According to the Office of Medical Services' (OMS) guidelines, these techniques were designed to "psychologically 'dislocate' the detainee, maximize his feeling of vulnerability and helplessness, and reduce or eliminate his will to resist our efforts to obtain critical intelligence." However, they also amounted to torture.

Despite medical ethical standards which prohibit physicians from facilitating torture or being present when torture takes place, medical professionals performed on-site medical evaluations of detainees before and during interrogation. Moreover, even while recognizing that these techniques created serious medical risks (e.g. waterboarding creates risks of drowning, hypothermia, aspiration pneumonia, or laryngospasm; cramped confinement could result in thrombosis; and lengthy exposure to cold water could lead to death), the CIA Office of Medical Services (OMS) approved that these methods did not amount to torture if certain medical limitations were in place.

For example, a detainee could be diapered until evidence of skin loss; exposed to temperatures right up to the development of hypothermia; exposed to noise just under the decibel levels associated with permanent hearing loss; deprived of food up to the point of significant malnutrition; subjected to shackling in upright sitting or horizontal position for 48 hours (longer allowed with medical monitoring); and confined to a box for 8 consecutive hours or 18 hours a day if placed in the larger box. No medical limitation was placed on slaps, stress positions, walling, cramped confinement, and waterboarding so long as a preexisting injury was not aggravated.

However, the OMS based its medical limitations and analysis on irrelevant medical authorities - failing to take into account authoritative sources in interrogation and detention programs. Sound familiar? The lawyers who provided perverse legal justifications for the torture and abuse of detainees in U.S. custody similarly failed to take into account relevant legal sources in reaching their conclusions.

Interestingly, JAMA's commentary comes on the heels of the 8 year anniversary of the now infamous torture memos and provides further evidence how the torture and abuse committed on detainees in U.S. custody was a product of a widespread, systematic torture policy which included medical and legal professionals - not just a product of a "few bad apples."

Torture, however, can never be a policy choice. There are no exceptions and no justifications for committing a crime of torture, despite what former administration officials may claim. It is illegal - period.

When members of the Obama Administration say that they desire to look forward and not backward, they incorrectly suggest that whether or not the United States engages in torture is, in fact, simply a policy choice. Not only does the United States risk relinquishing its legal and moral obligations to other countries when it fails to account for its past abuses, it also undermines any effort to restore its moral leadership. And, make no mistake: the United States' commitment to the rule of law is essential to its national security.