more:
http://www.zmag.org/content/showarticle.cfm?SectionID=40&ItemID=8163M. Gregg Bloche, M.D., and Jonathan H. Marks, M.A., B.C.L.
New England Journal of Medicine 353;1
http://www.nejm.orgJuly 7, 2005
Mounting evidence from many sources, including Pentagon documents, indicates that military interrogators at Guantanamo Bay have used aggressive counter-resistance measures in systematic fashion to pressure detainees to cooperate. These measures have reportedly included sleep deprivation, prolonged isolation, painful body positions, feigned suffocation, and beatings. Other stress-inducing tactics have allegedly included sexual provocation and displays of contempt for Islamic symbols. (1) The International Committee of the Red Cross (ICRC) and others charge that such tactics constitute cruel and inhuman treatment, even torture.
To what extent did interrogators draw on detainees' health information in designing and pursuing such approaches? The Pentagon has persistently denied this practice. After the ICRC charged last year that interrogators tapped clinical data to craft interrogation strategies, Defense Department officials issued a statement denying "the allegation that detainee medical files were used to harm detainees."(2) This spring, an inquiry led by Vice Admiral Albert T. Church, the inspector general of the U.S. Navy, concluded: "While access to medical information was carefully controlled at GTMO
, we found in Afghanistan and Iraq that interrogators sometimes had easy access to such information."(3) The implication is that interrogators had no such access at Guantanamo and that medical confidentiality was shielded, albeit with exceptions. Other Pentagon officials have reinforced this message. In a memo made public last month, announcing "Principles . . . for the Protection and Treatment of Detainees," William Winkenwerder, the Assistant Secretary of Defense for Health Affairs, said that limits on detainees' medical privacy are "analogous to legal standards applicable to U.S. citizens." But this claim, our inquiry has determined, is sharply at odds with orders given to military medical personnel â?? and with actual practice at Guantanamo. Health information has been routinely available to behavioral science consultants and others who are responsible for crafting and carrying out interrogation strategies. Through early 2003 (and possibly later), interrogators themselves had access to medical records. And since late 2002, psychiatrists and psychologists have been part of a strategy that employs extreme stress, combined with behavior-shaping rewards, to extract actionable intelligence from resistant captives.
A previously unreported U.S. Southern Command (SouthCom) policy statement, in effect since August 6, 2002, instructs health care providers that communications from "enemy persons under U.S. control" at Guantanamo "are not confidential and are not subject to the assertion of privileges" by detainees. The statement, from SouthCom's chief of staff, also instructs medical personnel to "convey any information concerning . . . the accomplishment of a military or national security mission . . . obtained from detainees in the course of treatment to non-medical military or other United States personnel who have an apparent need to know the information. Such information," it adds, "shall be communicated to other United States personnel with an apparent need to know, whether the exchange of information with the non-medical person is initiated by the provider or by the non-medical person." The only limit this policy imposes on caregivers' role in intelligence gathering is that they cannot act as interrogators.
The statement, embedded â?? along with policies on parking and alcohol â?? in the personnel section of the SouthCom Web site,(4) not only requires caregivers to provide clinical information to military and Central Intelligence Agency interrogation teams on request; it calls on them to volunteer information that they believe might be of value. It thereby makes them part of Guantanamo's surveillance network, dissolving the Pentagon's purported separation between intelligence gathering and patient care.
<snip>
Well worth the read.