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WASHINGTON, June 23 - Military doctors at Guantánamo Bay, Cuba, have aided
interrogators in conducting and refining coercive interrogations of detainees,
including providing advice on how to increase stress levels and exploit fears,
according to new, detailed accounts given by former interrogators.
The accounts, in interviews with The New York Times, come as mental health
professionals are debating whether psychiatrists and psychologists at the prison
camp have violated professional ethics codes. The Pentagon and mental health
professionals have been examining the ethical issues involved.
The former interrogators said the military doctors' role was to advise them
and their fellow interrogators on ways of increasing psychological duress on
detainees, sometimes by exploiting their fears, in the hopes of making them
more cooperative and willing to provide information. In one example, interrogators
were told that a detainee's medical files showed he had a severe phobia of the
dark and suggested ways in which that could be manipulated to induce him to
cooperate.
In addition, the authors of an article published by The New England Journal
of Medicine this week said their interviews with doctors who helped devise and
supervise the interrogation regimen at Guantánamo showed that the program
was explicitly designed to increase fear and distress among detainees as a means
to obtaining intelligence.
The accounts shed light on how interrogations were conducted and raise new
questions about the boundaries of medical ethics in the nation's fight against
terrorism.
Bryan Whitman, a senior Pentagon spokesman, declined to address the specifics
in the accounts. But he suggested that the doctors advising interrogators were
not covered by ethics strictures because they were not treating patients but
rather were acting as behavioral scientists.
He said that while some health care personnel are responsible for "humane
treatment of detainees," some medical professionals "may have other
roles," like serving as behavioral scientists assessing the character of
interrogation subjects.
The military refused to give The Times permission to interview medical personnel
at the isolated Guantánamo camp about their practices, and the medical
journal, in an article that criticized the program, did not name the officials
interviewed by its authors. The handful of former interrogators who spoke to
The Times about the practices at Guantánamo spoke on condition of anonymity;
some said they had welcomed the doctors' help.
Pentagon officials said in interviews that the practices at Guantánamo
violated no ethics guidelines, and they disputed the conclusions of the medical
journal's article, which was posted on the journal's Web site on Wednesday.
Several ethics experts outside the military said there were serious questions
involving the conduct of the doctors, especially those in units known as Behavioral
Science Consultation Teams, BSCT, colloquially referred to as "biscuit"
teams, which advise interrogators.
"Their purpose was to help us break them," one former interrogator
told The Times earlier this year.
The interrogator said in a more recent interview that a biscuit team doctor,
having read the medical file of a detainee, suggested that the inmate's longing
for his mother could be exploited to persuade him to cooperate.
Dr. Stephen Xenakis, a psychiatrist and former Army brigadier general in the
medical corps, said in an interview that "this behavior is not consistent
with our medical responsibility or any of the codes that guide our conduct as
doctors."
The use of psychologists and psychiatrists in interrogations prompted the Pentagon
to issue a policy statement last week that officials said was supposed to ensure
that doctors did not participate in unethical behavior.
While the American Psychiatric Association has guidelines that specifically
prohibit the kinds of behaviors described by the former interrogators for their
members who are medical doctors, the rules for psychologists are less clear.
Dr. Spencer Eth, a professor of psychiatry at New York Medical College and
chairman of the ethics committee of the American Psychiatric Association, said
in an interview that there was no way that psychiatrists at Guantánamo
could ethically counsel interrogators on ways to increase distress on detainees.
But in a statement issued in December, the American Psychological Association
said the issue of involvement of its members in "national security endeavors"
was new.
Dr. Stephen Behnke, who heads the group's ethics division, said in an interview
this week that a committee of 10 members, including some from the military,
was meeting in Washington this weekend to discuss the issue.
Dr. Behnke emphasized that the codes did not necessarily allow participation
by psychologists in such roles, but rather that the issue had not been dealt
with directly before.
"A question has arisen that we in the profession have to address and that
is where we are now: is it ethical or is it not ethical?" he said.
Dr. William Winkenwerder Jr., assistant secretary of defense for health matters,
said the new Pentagon guidelines made clear that doctors might not engage in
unethical conduct. But in a briefing for reporters last week, he declined to
say whether the guidelines would prohibit some of the activities described by
former interrogators and others. He said the medical personnel "were not
driving the interrogations" but were there as consultants.
The guidelines include prohibitions against doctors' participating in abusive
treatment, but they all make an exception for "lawful" interrogations.
As the military maintains that its interrogations are lawful and that prisoners
at Guantánamo are not covered by the Geneva Conventions, those provisions
would seem to allow the behavior described by interrogators and the medical
journal. The article in the medical journal, by two researchers who interviewed
doctors who worked on the biscuit program, says, "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."
The article was written by Dr. M. Gregg Bloche, who teaches at Georgetown University
Law School and is a fellow at the Brookings Institution, and Jonathan H. Marks,
a British lawyer who is a fellow in bioethics at Georgetown and Johns Hopkins
Universities.
Dr. Bloche said in an interview that the use of health professionals in devising
abusive interrogation strategies was unethical and led to their involvement
in violations of international law. Dr. Winkenwerder said on Thursday that the
article was "an outrageous distortion" of the medical situation at
Guantánamo, according to Reuters news agency.
The article also challenges assertions of military authorities that they have
generally maintained the confidentiality of medical records.
The Winkenwerder guidelines make it clear that detainees should have no expectation
of privacy, but that medical records may be shared with people who are not in
a medical provider relationship with the detainee only under strict circumstances.
Dr. Bloche said such an assertion was contrary to what he had discovered in
his research. It is also in conflict with accounts of former interrogators who
previously told The Times that they were free to examine any detainee's medical
files. After April 2003, when Defense Secretary Donald H. Rumsfeld tightened
rules on detainee treatment, one interrogator said the records had to be obtained
through biscuit team doctors who always obliged.
The former interrogator said the biscuit team doctors usually observed interrogations
from behind a one-way mirror, but sometimes were also in the room with the detainee
and interrogator.