APA "Casebook" on Psychologist Ethics and Interrogations Fails to Convince

A new proposed "casebook" on psychologist ethics in national security settings, written by the Ethics Committee of the American Psychological Association (APA), tells psychologists that when assessing whether an interrogation technique is abusive or not, they should consider, among other factors, whether there are "data to support that the technique is effective in gathering accurate information." This determination, which places the needs of the military or intelligence gathering entity above that of the person the psychologist is examining, demonstrates how blatantly unethical it is for psychologists to participate in these interrogations.

While it's shocking that APA would call upon psychologists to weigh an interrogation technique's "effectiveness" with other ethical standards, it's even crazier when one considers it took them six years to write this up, having been originally tasked with writing an "ethics casebook" for interrogations back in 2005.

The vignettes that would compose the "casebook" were apparently posted (PDF) by APA for public comments last June, but APA failed to notify their membership, or really anyone. The earliest comment posted was on August 18. In a comment posted by Nina Thomas, a psychologist who was one of the few non-military, non-intelligence-linked members on the 2005 Psychological Ethics and National Security (PENS) panel hastily assembled to formulate APA policy on psychologists and interrogations, Thomas decried the lack of notification of the membership.

"A barely three month period for responses does not seem adequate when we have not previously known anything about the progress on this work," Thomas wrote. She also indicated that progress on the casebook's development had not been regularly reported to APA's Council of Representatives. (The mandate to produce such a "casebook" goes back to 2005.) Thomas had other criticisms as well, writing, "It is my hope and aim that the Ethics Committee will seriously rethink its charge and return to Council with a request for a revised mandate."

The petition resolution affirmed by the membership of APA [in 2008] makes perfectly clear that psychologists are prohibited from working in settings in which people are held outside of or in violation of either international law or the U.S. Constitution. The only exceptions to this prohibition are in cases in which a psychologist is working directly for the person being detained, for an independent third party working to protect human rights or providing treatment to military personnel. These major and ultimately most important points do not have sufficient presence in this casebook as currently devised.

Over and over the APA "casebook" advises members to seek "consultation" about any difficult ethical situation, while advising psychologists to rely on a host of human rights documents, APA resolutions, and the APA ethics code to "guide" them. But psychologists shouldn't even be in these torture settings to begin with!

The petition resolution referenced by Thomas was a member-initiated petition that was passed in a referendum vote in 2008 by a membership unhappy with APA's policy on interrogations, and implemented by APA's Council in 2009. The resolution states that "psychologists may not work in settings where persons are held outside of, or in violation of, either International Law (e.g., the UN Convention Against Torture and the Geneva Conventions) or the US Constitution (where appropriate), unless they are working directly for the persons being detained or for an independent third party working to protect human rights."

But APA has adamantly refused to set up a process that would actually determine when such a detention setting is in violation of the law, even while sententiously expressing "grave concern" over reports of torture and abuse at U.S. military and CIA interrogation and detention centers. According to one "casebook" instruction, "the psychologist ... would need to determine whether the site is a lawful or unlawful detention setting." If APA can't or won't make such a determination, how can they expect an individual psychologist to do this, and feel they will be backed up by their organization for doing so?

APA has refused to follow the policy of the American Medical Association and the American Psychiatric Association in instructing their membership not to participate in interrogations. Indeed, it was the contention of the 2005 APA PENS panel that "it is consistent with the APA Ethics Code for psychologists to serve in consultative roles to interrogation and information-gathering processes for national security-related purposes, as psychologists have a long-standing tradition of doing in other law enforcement contexts."

Nothing in the new "casebook" is really any different than the position APA derived in the 2005 PENS report (PDF). The psychologist is supposed to walk an ethical tightrope while serving as "consultant" to interrogations, admonished to report torture or other cruel, inhumane or degrading treatment (as defined by law), and to engage in research beneficial to national security aims. All the while, APA's seemingly benign admonishments cover a policy of support to detention and interrogation policies that amount to torture, using various legalistic loopholes built into a 2002 rewrite of the Ethics Code to allow the unethical use of psychologist expertise to brain-trust the torture.

APA concludes that psychologists should report torture to the "appropriate authorities." Furthermore, "If the psychologist was not satisfied with the result of reporting such concerns, the psychologist would consider other reporting avenues such as the judge advocate and/or the inspector general." It all sounds good, until you realize that such reporting rarely goes anywhere, and it beggars all knowledge of social psychology to believe that one individual will buck an entire system and put their careers on the line to protest. This is even more true when one considers that previous investigations of detainee torture have either minimized or covered up significant aspects of the torture.

The one case that APA often cites where a psychologist protested torture concerns NCIS psychologist Michael Gelles, who protested the torture protocol for Mohamed Al Qahtani. Two salient points are connected with that case. One is that it didn't stop the torture, both of Al Qahtani, nor the spread of the torture program throughout the Department of Defense. Two, Gelles was not just protesting a torture protocol, he was proposing a different program of psychological torture based primarily on the application of extreme isolation of the prisoner, who was reportedly already manifesting psychotic behavior.

Another example of the impotency of the policy of protest concerns the CIA torture of Abu Zubaydah. Planned by two former SERE psychologists, James Mitchell and Bruce Jessen, the "enhanced interrogation techniques" applied to Zubaydah, which included stress positions, placing him into a closed box with insects, waterboarding, sleep deprivation and more, led then chief operational psychologist for the C.I.A.'s counterterrorism center, R. Scott Shumate to leave the interrogation "in disgust, leaving before the most dire tactics had commenced," according to a 2007 article by Katherine Eban in Vanity Fair.

There is no evidence that Shumate protested the torture up the chain of command. Indeed, the torture continued, and was extended to others. Shumate, whatever he did, was rewarded by being put on the APA PENS panel.

APA cannot help but confuse the "casebook" instructions by mixing use of the ethics code as a guideline with advice laid down by DoD in the Army Field Manual for interrogations: "'If the proposed approach technique were used by the enemy against one of your fellow soldiers, would you believe the soldier had been abused?'.... if the answer to this question is yes, 'the contemplated action should not be conducted.'" The problem is, as has been amply documented, it is the military and/or CIA psychologists who are proposing the "techniques" to begin with, or following orders from those higher in the chain of command (see here, and here, and here, for instance).

Psychologists Speak Out

Dan Aalbers, one of the authors of the APA petition resolution told The Dissenter, "I didn't understand until fairly recently how few obligations remain in the APA's ethics code: if you use these quite useful pdfs [comparing the 1992 and 2002 ethical codes] and search for words and phrases that denote obligation -- 'must' 'should', 'do not' and 'obligation' itself -- you will quickly find that most of these phrases appear in the 1992 revision of the ethics code and, more often than not, the 2002 code saddles psychologists with no obligation greater than due consideration. Psychologists 'must' consider the consequences their actions -- but they are not prevented from doing much.... The 2002 ethics code should be thrown out and the 1992 code -- with its strictures on informed consent, on clarification of role, and obligations to avoid multiple relationships -- reinstated."

One good example of what Aalbers is talking about is Section 3.04 of the Ethics Code, to which the "casebook" authors often refer. It states, "Psychologists take reasonable steps to avoid harming their clients/patients..." Not "Do Not Harm," but the taking of "reasonable steps." Indeed, until the membership and some of the human rights community raised a hullaballoo, and even then only after eight years of stalling, did APA change its code last year regarding ethical conflicts with organizational authorities. Before this change, since 2002 the APA has instructed its membership that resolution of such conflicts could be resolved by simply following the authority in question (like the military) and not the ethical standard, should they be in conflict. Critics called this the Nuremberg Defense, referencing many a Nazi's defense against war crimes with the refrain that he was "only following orders."

Another psychologist who has been active in opposing APA's policies on interrogation, former president of Psychologists for Social Responsibility Stephen Soldz, also told The Dissenter that he was worried about aspects of the Ethics Code that relate to research. "Remember," Soldz said, "that [Ethics Codes] 8.05 ['Dispensing with Informed Consent'] and 8.07 ['Deception in Research'] still remain. 8.05 removes the requirement for informed consent for institutional research. And 8.07 raises the bar for psychological distress to rule out research deception, using language similar to the Convention Against Torture's definition of psychological torture. Meanwhile, the High Value Detainee Interrogation Group currently has former APA fellow Susan Brandon as Research Director. The HIG may have conducted and is apparently intending to conduct research on detainees. There are persistent rumors that research on detainees occurred as recent as last year (I'm not saying it ended, just have no current sources) in both Iraq and Afghanistan. While we don't know the nature of this research, there are some indications in the press that raise alarm.

"All this is simply to say that the interrogation issue is not a matter of the Bush administration and the past. Rather, it is still alive. And we should remember that research may have played a larger role in the need for psychologists than many of us originally realized."

Martha Davis, a forensic psychologist who has just completed a documentary about psychologists, interrogations and torture, "Doctors of the Dark Side," in a statement to The Dissenter cautioned that no fine tuning of the "casebook" would make things better (for the record, I was interviewed by Davis as part of the documentary):

I worry that IF the Ethics Committee were ever to do the right thing, extend the deadline, open the discussion up, and somehow put together another, much better Casebook that incorporated these suggestions and other good ones, then in effect, the casebook process would reinforce and "legitimize" the practice of having psychologists directly involved in interrogations. Every significant health and human rights organization has condemn this practice except the APA. The simple versions of "no direct involvement in interrogations" adopted by the AMA and ApA are understandable to everyone and the only way to guarantee that doctors "keep in their lane" etc., etc. We know so much more now than we did in 2005 -- so much of it ominous and disturbing. The practice is spreading beyond "national security" interrogations to US law enforcement settings. BSCT psychologists violate at least 10 parts of the APA Ethics Code (and that's without torture), and the role is incompatible with the new Specialty Guidelines of Forensic Psychology.

Len Rubenstein, Senior Scholar, Center for Human Rights and Public Health, Johns Hopkins Bloomberg School of Public Health, wrote an op-ed at Huffington Post last week, indicating he believed that a recent rewrite by APA of its forensic psychology guidelines should apply to psychologists and interrogations. Rubenstein, calling the PENS ethical guidelines "ethically untenable, little more than a shabby rationalization for severe ethical violations," noted that APA's new Specialty Guidelines for Forensic Psychologists call for complete transparency with the client, and eschews use of deception, both the opposite of military/CIA practice.

The guidelines also render intolerable the conflict of interest at the heart of the psychologists' role -- at once to advance intelligence gathering and to act as a "safety officer." The conflict, moreover, is likely to be resolved in favor of pressing for information, since the psychologists involved are classified as combatants, not clinicians (though they must be licensed to practice), and assigned to an intelligence chain of command. Whereas PENS sought to fudge the conflict by urging a "delicate balance of ethical considerations" the Specialty Guidelines insist on adherence to core obligations of integrity and fairness and avoidance of involvement in roles with conflicts of interest.

But according to forensic psychologist Karen Franklin, "These guidelines are not enforceable. And, like all such professional guidelines, they will be subject to diverse interpretations."

And it is in such a forest of conflicting interpretations, vague instructions, unenforceable prohibitions against torture, and the like, that APA hides complicity in the U.S. torture program, having determined that "national security psychology" is the wave of the future. The lack of accountability for psychologist collaboration with torture is the background for the entire discussion. It is more incumbent than ever that psychologists and other mental health professionals speak out against this amalgam of psychological science and practice with the art of coercive interrogation and persuasion, of the marriage of psychology with torture.

Also posted at Firedoglake/The Dissenter