Torture has long been associated with political repression and with regimes without any semblance of an independent judiciary or media. The Soviet Union’s imprisonment of dissenters and forced use of psychotropic medication on them, the Khmer Rouge’s torture of thousands of people in Cambodia, and the Augusto Pinochet regime’s brutality against prisoners in Chile all bear witness to the association between totalitarian or authoritarian regimes and their use of torture.
The human rights lawyer Leonard Rubenstein and I wrote in March 20102:
The medical staff at the CIA and the Pentagon played a critical role in developing and carrying out torture procedures. Psychologists and at least one doctor designed or recommended coercive interrogation methods including sleep deprivation, stress positions, isolation, and waterboarding. The military’s Behavioral Science Consultation Teams evaluated detainees, consulted their medical records to ascertain vulnerabilities and advised interrogators when to push harder for intelligence information. Psychologists designed a program for new arrivals at Guantánamo that kept them in isolation to “enhance and exploit” both their “disorientation and disorganization.”
Medical officials monitored interrogations and ordered medical interventions so they could continue even when the detainee was in obvious distress. In one case, an interrogation log obtained by Time magazine shows a medical corps-man ordered intravenous fluids to be administered to a dehydrated detainee even as loud music was played to deprive him of sleep.
We cannot dismiss the psychiatrists who participated in interrogations in Guantanamo and the mental health professionals who helped devise the abusive practices as mere rogues or outliers. They were actors on a much larger stage. They were swept up by a pervasive and persuasive attitude that subsumed the country and energized a military plan to “hunt down the criminals wherever they may be hiding.” The Department of Defense issued policy accordingly, and the Office of the Assistant Secretary for Health Affairs contended that the legitimate objective of fighting terrorism trumps the ethical responsibility of the healing practitioner. In their eyes, “the ends justify the means” and a few brutalized prisoners were a small price to pay for protecting the citizens of the United States.
But, in truth, the use of torture and the practice of cruel, inhuman, and degrading treatment detracted from the military mission and compromised the international stature of our country. It undermined the effectiveness, credibility, and ethical foundations of the medical professionals. Torture and abuse harmed the victims, damaged the perpetrators, and weakened national security. My findings and opinions reflect hundreds of hours of clinical interviews with detainees in Guantanamo and hundreds more reviewing medical records and reports of interrogations. Both the interviews and records expose the techniques of harsh interrogation, including stress positions, extremes of temperature, long-term isolation, waterboarding, sleep deprivation, instilling fear through the use of dogs, threats of death or severe harm, bombardment by loud music, severe humiliation, and physical force.
Research studies, direct clinical observations, and reviews of medical records document the adverse and harmful effects of enhanced interrogation. Sleep manipulation contributes to cognitive impairment and disruption, with psychotic features emerging within 1 week, and it can lead to self-harm, including symptoms resembling paranoid schizophrenia. Sensory deprivation, including hooding and isolation, leads to severe anxiety, depression, and psychotic-like thinking, with serious health consequences. Repetitive exposure to frightening and life-threatening circumstances contributes to debilitating PTSD.