Monday Physicians for Human Rights (PHR) released a report on research on interrogation methods undertaken by the CIA under the Bush administration. (Disclosure: My boss Allen Keller is a longtime member of PHR and one of the co-authors of the report.) The report goes to great pains to document medical professionals’ judgments as to the extent of pain inflicted by such techniques as waterboarding, sleep deprivation (in one case as much as 180 hours), and forced stress positions, all in the service of protecting CIA personnel from prosecution under anti-torture statutes.
At issue here is the “severe pain or suffering” threshold of the United States’ antitorture statute. Medical professionals were apparently asked to figure out whether these acts, alone or in combination with one another, caused pain or suffering that was sufficiently “severe” to make their abuse count as torture. In the course of this research, the report makes clear that medical professionals were asked to violate their golden rule: Do no harm.
Reading through the report (16 pages, with Appendices on the SERE program and ethics statutes against health professionals’ participation in interrogation) one is struck by the absurdity of trying to fit what are essentially barbaric acts into the framework of modern law. For instance, it seems that in order to address the severity of waterboarding doctors recommended that saline solution be used (instead of fresh water) in order to reduce the risk of infection. So, you can suffocate someone and it won’t cause severe pain as long as you take precautions against infecting them.
I also have to wonder if the fact that PHR feels the need to call attention to the fact that research ethics were violated is not also a bit absurd. The following passage about the failure of the CIA’s Office of Medical Services (OMS) to get informed consent from their subjects makes my point:
OMS personnel were likely performing this particular experiment without informed consent because they were engaging in purposeful torture of the subject. Even with some form of IRB approval, this research and subsequent modification of waterboarding or any other torture technique would still represent a serious violation of medical ethics and international human rights law because of the nature of the two acts being carried out — research on a prisoner and the infliction of torture.
As the second sentence makes clear, the real problem isn’t that they didn’t get their research ethics right, it’s that they didn’t get their morality right. Of course I understand that PHR has good reason for pointing out that OMS personnel undertook unethical research — and that fact alone is indeed chilling, particularly given the roots of modern research ethics in Mengele’s research at Auschwitz and Ishii’s on Chinese prisoners of war — but to emphasize the lack of informed consent and IRB approval in light of the gross human rights violations feels a bit like burying the lead. I applaud PHR for their work, but have to shake my head that this is what must be done to draw attention to our continuing failure to hold anyone accountable for these acts.