By Angela Nitzke-Martin
I have no doubt that at some point after having my blood drawn, I have likened the experience to torture. Those minutes spent prospecting for gold in my evidently intractable veins is certainly unpleasant, and on occasion painful, but torturous — no. It is an attempt to add drama to a pretty boring story, and absurd to suggest that a medical professional would support suffering that wasn’t ultimately in the patient’s best interest. After all, they do have to take an oath.
Maybe that is why “Medical Complicity in Torture,” the title of a lecture given by New York University’s Allen Keller was a bit shocking. CIA physicians and psychologists seem out of place in military prisons, but they do play a role in interrogations and were present at Guantanamo Bay. Should medical professionals participate in torture or enhanced interrogation? “Moral and scientific reasons ultimately lead to the same conclusion: That, no, we shouldn’t be doing this,” said Keller, an associate professor of medicine and director of the Bellevue/NYU Program for Survivors of Torture.
Keller spoke at the University of Chicago on Wednesday as part of the MacLean Center for Clinical Medical Ethics seminar series. In his lecture, Keller drew from vast experience dealing with torture victims and the report he coauthored for Physicians for Human Rights titled, “Aiding Torture.” The paper cites the CIA Inspector General’s report released in 2004 that said psychologists not only monitored enhanced interrogation techniques like waterboarding, but also kept data on the prisoners’ reactions.
It is impossible to separate the physical, psychological and social dimensions of health, said Keller. “The consequences of torture are all interrelated.” Prisoners who are not mortally wounded may still experience intense psychiatric trauma with long lasting effects. Preventing death or severe injury does not preclude inflicting harm.
Although not as mind-boggling as what the definition of “is” is, there is still debate about what constitutes torture. We have the UN’s definition and the American Medical Association’s definition, but it boils down to something much simpler for Keller. “If it looks like torture, smells like torture, it’s probably torture,” said Keller.
It has been suggested that having a physician present during interrogations makes it safer for the detainee. Like a referee in a boxing match, if things get too dangerous, the physician calls off the interrogator and everyone steps back to their corners.
Keller says the presence of a health professional can actually be a “catalyst” for torture. The interrogator may think that someone else is responsible for stopping anything that exceeds the limits of safe interrogation, and the physician may hesitate to step in because he or she is there to serve the CIA in addition to monitoring the health of the prisoner, a situation referred to as dual loyalty.
Professional organizations differ on where the lines are drawn for military medical professionals. The American Psychological Association has taken some heat for not going far enough to prevent ethical transgressions.
Psychologists in military prisons have taken information obtained during detainee evaluations and drawn on their clinical insights and knowledge of behavioral science to make interrogations more effective. Keller recounted an instance of a prisoner named Youssef, held at Guantanamo, who asked to speak with a psychologist about his distress and his concern for a brother with leukemia. When the interrogations resumed, the focus shifted to threats of permanent separation from his family and his brother’s health.
The prisoner had been subjected to physical stressors, but he said that such psychological anguish was what caused him to “come undone,” Keller said. Youssef believed that his psychologist had violated his confidentiality so that interrogators could exploit the information.
Certainly it is hard to find sympathy for terrorists who support killing Americans, but Keller argues that this kind of torture happens to innocent civilians who are swept up along with terrorists. The physical and psychological effects are not limited to the detainee. They ripple through the community, which ends up putting the United States in a more vulnerable position and threatens our moral authority when trying to stop abuses in other countries, said Keller.
In a previous post, Rob wrote about stress, memory and studies questioning the value of information obtained by using torture techniques. A scientific article published in August by Shane O’Mara in the journal Trends in Cognitive Sciences (summarized nicely by Newsweek’s Sharon Begley), “reviewed neurobiological literature on what stress does to areas of the brain associated with memory and concluded ‘coercive interrogations involving extreme stress are unlikely to facilitate the release of veridical information from long-term memory, given our current cognitive neurobiological knowledge.’ In other words: torture isn’t just morally questionable, it’s also ineffective.”
Taking psychologists out of the mix may solve one ethical dilemma, but does not address the larger issue of the United States’ involvement in torture, according to Keller. Enhanced interrogation techniques are torture, and America should be held accountable for it, he said.
“I think a shift will happen, where ultimately the next time something happens we’ll say, alright, we are not going to torture, but I believe….In order to prevent this from happening again, we need to understand the dynamics,” Keller said. “This wasn’t just the Department of Defense, or just the Department of Justice, or just the Executive, it was a perfect storm of all of the above.”