Murkier and Murkier: "The Ongoing Medicalization of Torture"

Though almost a month old now, I can't let a fascinating commentary by Luke Mitchell over at Harper's go unremarked. Mitchell's curiosity was piqued when he watched the performance of National Security Director Michael McConnell on Meet the Press back on July 22. (McConnell is also a former director of the National Security Agency, a retired vice-admiral, and was Intelligence Officer to the Chairman of the Joint Chiefs of Staff during Bush I's Operation Desert Storm -- no small-time player he!)

McConnell was talking with Tim Russert about Bush II's executive order on CIA interrogation practices, signed only two days previously, which reiterated the Bush Administrations contention that "unlawful enemy combatants" don't deserve Geneva Convention protections. The E.O. also banned certain interrogation techniques that even an uninformed U.S. citizen could recognize as torture:

...willful and outrageous acts of personal abuse done for the purpose of humiliating or degrading the individual in a manner so serious that any reasonable person, considering the circumstances, would deem the acts to be beyond the bounds of human decency, such as sexual or sexually indecent acts undertaken for the purpose of humiliation, forcing the individual to perform sexual acts or to pose sexually, threatening the individual with sexual mutilation, or using the individual as a human shield...

But Bush's order also was mum on a number of controversial forms of torture and abuse, including waterboarding and sleep deprivation. Furthermore, the order used a definition of cruel, inhuman, degrading and inhumane treatment or punishment that relies on weak federal interpretations of the U.S. Constitution, rather than international treaties and agreements, such as the Geneva Convention, to which the U.S. is a signatory. (How like the recent parsing of the American Psychological Association in its latest "statement" on the use of psychologists in coercive interrogations!)

Unnamable Doctors & Unnamable Others

Russert asked McConnell about the CIA's now-presidentially approved "enhanced interrogation measures". McConnell was evasive, as Luke Mitchell notes:

He was clear about what was forbidden -— but perfectly unclear about what was permitted. In particular, he would neither confirm nor deny whether water boarding was permissible. “If I announce what the specific measures are,” he said, “it would aid those who want to resist those measures.” (He did allow, however, that he “would not want a U.S. citizen to go through the process,” whatever it was.)

McConnell assured Russert and his viewers that, according to Mitchell, "unnamed and unnameable techniques had in fact been approved by unnamed and unnameable medical professionals", and that all interrogations were performed under "medical supervision". The safety of these interrogation procedures are supposedly "based upon professional advice". McConnell made it clear that threats of torture, at least, were involved.

And so this, this is a program where we capture someone known to be a terrorist, we need information that they possess, and it has saved countless lives. Because, because they believe these techniques might involve torture and they don’t understand them, they tend to speak to us, talk to us in very—a very candid way. [emphasis added]

The latter set off alarm bells for Harper's columnist Mitchell, who knew, for one thing, that "threats of torture" are something prohibited by the American Medical Association (AMA), which "forbids physicians to be 'present when torture is used or threatened.'" Because McConnell had stated in interview that "doctors" monitored the CIA interrogations, Mitchell called the AMA to get clarification. What he got was the runaround, packaged within a surprising admission:

I also called AMA spokesman Robert Mills to see if the organization would be investigating McConnell’s claims. His response was a bit surprising. He suggested that perhaps McConnell had meant psychologists. Psychologists do not have medical degrees, of course, and like all other people without medical degrees, they are barred from practicing medicine in the United States. Mills’s point, though, seemed to be that psychologists, unlike physicians, have a long history of involvement with enhanced interrogation....

Mills’s concern was fine as far is it went. But I found myself in the odd position of reminding a spokesman for the American Medical Association that psychologists are not doctors. McConnell had specifically said “doctors.” Was this really the sort of ambiguity that the AMA wanted to endorse? Shortly thereafter, I received this follow-up via e-mail: “The feds commonly refer to psychologists as doctors. Psychiatrists and other M.D.s are referred to as physicians. Medical supervision is a vague term that could refer psychologist, nurse, corpsman, podiatrist or any of hundreds allied health professionals.”

Calling Dr. Behnke...

Luke Mitchell then contacted Stephen Behnke, director of the APA's Ethics Office, who assured him via quick e-mail reply that

...psychologists "do not provide ‘medical’ supervision” and second that the APA “strictly forbids the presence of a psychologist at an interrogation in which the subject is tortured or is threatened with torture.”

But even Behnke was hedging his bets, as he refused to comment on the question of psychologists being sanctioned for violations. (Of course, all this was before the passage of the APA's new resolution "reaffirming" its torture policy.)

Mitchell returned to the AMA with Behnke's denial of participation and got this statement from the director of AMA's board of trustees:

Since the questions of detainee abuse first surfaced, AMA leaders have met on several occasions with high-ranking officials at the United States Department of Defense (DoD) to advocate for the treatment of detainees that is consistent with AMA ethics policy. Representatives from the AMA have also visited the detention facilities at Guantánamo. These visits provided an opportunity for the AMA to tour the facilities, but our access was limited and at no time did we have a chance to speak with the detainees. Due to the limits placed on the AMA, we are unable to determine with any certainty if ethical policies prohibiting physician involvement in torture are being adhered to by the DoD. The AMA will continue to monitor the situation and advocate for treatment of all detainees in U.S. custody to be in accordance with our AMA Code of Medical Ethics and the medical provisions of the Geneva Conventions.

In other words: see no evil, hear no evil, which amounts to the new moral guidelines of medical and behavioral health associations embedded with Bush's "war on terror".

The non-denial denial of the AMA is disturbing, as is the refusal of the Director of the APA Ethics Office to even comment on APA sanctions against any psychologist who breaks their paper resolution on torture -- a resolution that allows certain kinds of sensory and sleep deprivation, use of drugs and other coercive measures as long as they aren't used in the undefined "interrogation process".

Psychologists and the Military

I think it's clear that psychologists play a distinctive role as consultants to the military. They do this not just in interrogations, but perhaps more broadly in assessment of military commanders, of specialized forces and personnel, as medical providers and clinicians, as designers of training programs and human factors engineering, as well as on general psychological adjustment to military life. But even in histories written on the subject, such as the collection edited by U.S. Army psychologist A. David Mangelsdorff and published by APA Press, Psychology in the Service of National Security, very little is written on the role of psychologists in counterintelligence and operational interrogations activity. This is still considered secret, despite what has been linked to the press. Not secret but suppressed is the massive participation of psychologists and psychiatrists and other social science professionals in the work of preparing modern interrogation techniques, including sensory deprivation, isolation, and use of drugs.

As Mangelsdorff put it:

Security needs of the United States shaped the evolution of its society, the roles and functions of its armed forces, the organization of national security, and the development of psychology... Psychologists play a vital role in military readiness. The story of psychologists in the armed forces addressing national security challenges is the story of the evolution of the science and practice of psychology itself.

As Mitchell's essay demonstrates, the medical sciences in general have been developmentally and organizationally warped by the demands of the neo-totalitarian national security state. Now the question is: what are we going to do about it? Or is it too late to do anything? We had better hope the answer lies in the former, as only demoralization and societal disintegration resides in the latter.

For more information on medical doctors and the ethics of interrogation, see Dr. Steven Miles' excellent article from the American Journal of Bioethics, 7(4):5, "Medical Ethics and the Interrogation of Guantanamo 063".

For more on the current situation, see psychologist-activist Stephen Soldz's recent article, "APA, torture, and the CIA", in addition to CTLiberal's excellent article on the arrest and torture by U.S. forces of Navy whistleblower Donald Vance, "Whistleblowers on Fraud are Jailed and Tortured".