1 Boring Old Man

First They Did Harm
Washington Post
By Eugene Robinson
September 4, 2009

For the Bush administration, torture was a delicate business. The aim was to injure but not incapacitate – to inflict precisely enough pain and terror to break a subject’s will, but no more. To calibrate the proper degree of abuse, the torturer needed an accurate sense of how much agony the subject’s mind and body can tolerate. In the administration’s program of "enhanced interrogation," this expertise was provided by doctors and psychologists – professionals who are supposed to heal and comfort. A new report by Physicians for Human Rights assembles the evidence and reaches a sickening but inescapable conclusion: "Health professionals played central roles in developing, implementing and providing justification for torture"…

The interrogation program – using 11 abusive "enhanced" techniques, including waterboarding – was designed by two PhD psychologists. The techniques, according to a statement released in April by American Psychological Association President James H. Bray, "are tantamount to torture as defined by APA and international law." Said the APA: "The central tenet of psychology’s code of ethics is, like that of medicine, to do no harm. It is unthinkable that any psychologist could assert that stress positions, forced nudity, sleep deprivation, exploiting phobias, and waterboarding — along with other forms of torture techniques that the American Psychological Association has condemned and prohibited — cause no lasting damage to a human being’s psyche." According to Bray, "There is one ethical response to an order to torture: Disobey the order."

We know that medical doctors were asked to sign off on the "enhanced" techniques. We know from detainees themselves, as quoted by the International Committee of the Red Cross, that there was medical monitoring of waterboarding sessions. We know from the CIA inspector general’s report that a 2004 letter from a Justice Department official reauthorizing the use of waterboarding specified a maximum of two two-hour sessions per day, with both a doctor and a psychologist present… The American Medical Association’s code of ethics "forcefully states medicine’s opposition to torture or coercive interrogation and prohibits physician participation in such activities," according to a letter AMA officials sent President Obama in April. AMA guidelines state that "physicians must neither conduct nor directly participate in an interrogation," and that doctors "must not monitor interrogations with the intention of intervening in the process, because this constitutes direct participation"…

Doctors and psychologists might have been able to prevent this whole shameful episode by refusing to participate. Instead, professionals who were trained in the healing arts used their experience and skill in a way that facilitated harm. They played a vital role in enabling torture. I like to believe that some psychologists and physicians took a stand and said no. As for those who said yes, the law should hold them accountable – just as conscience, one hopes, is already doing.

• "The interrogation program – using 11 abusive ‘enhanced’ techniques, including waterboarding – was designed by two PhD psychologists." I don’t care if it was designed by Salad Chefs or Rodeo Riders – whomever designed it should be held accountable.
• "We know that medical doctors were asked to sign off on the ‘enhanced’ techniques. We know from detainees themselves, as quoted by the International Committee of the Red Cross, that there was medical monitoring of waterboarding sessions." This one gives me something of a headache. When I got inducted into the service during the Viet Nam War, I pondered this one. As I thought it was a wrong war, what should I do? As a non-combatant physician, I wouldn’t be asked to fight or kill, just to take care of injured soldiers. As I mused  about whether to refuse to go or to go take care of our troops, I got an assignment to Europe instead. Relieved, I never had to decide and had a fine time in Europe. In retrospect, I think I would’ve probably gone, and been haunted for the rest of my life that I went, in part, to avoid the stigma of refusing. Is monitoring these techniques similar? – without monitoring the Torture might have been much worse. I think that’s a rationalization. Robinson is right. They should’ve said "No."