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Doctors’ role in enhanced military interrogation ‘clearly violates’ ethics

November 4, 2013 at 12:00 AM EDT
A new report claims that U.S military medical personnel violated ethics by designing and participating in "inhumane and degrading treatment" of prisoners at Guantanamo Bay and other detention sites. Jeffrey Brown speaks with former DOJ official Lee Casey and Dr. Stephen Xenakis, a member of the task force that issued the report.
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GWEN IFILL: Now: A new report says American doctors have cooperated in what amounted to the torture of terror suspects. The claim comes from a task force of the Institute on Medicine as a Profession, an independent group affiliated with Columbia University and the Open Society Foundation.

Jeff is back with the story.

JEFFREY BROWN: The report is unequivocal. It says that, over the last decade, military and civilian physicians, nurses and psychologists violated ethical codes, under orders from the military and the CIA.

It says they designed and participated in — quote — “cruel, inhumane and degrading treatment” to prisoners at Guantanamo and other detention sites.

Among alleged practices: advising interrogators on using sleep deprivation and other methods to disorient detainees, using medical information such as phobias for interrogation purposes, and force-feeding of hunger-striking detainees.

The group says the ethical breaches took place under both the George W. Bush and Obama administrations. The CIA and the Defense Department denied the findings.

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In an e-mail to the NewsHour, a Pentagon spokesman wrote: “It is the policy of the department to protect the life and health of detainees by humane and appropriate clinical means, and in accordance with all applicable law and policy.”

In addition to seeking that response from the Pentagon, we requested an official to appear on the program, but were turned down.

We are joined now by Dr. Stephen Xenakis, a retired Army brigadier general and a member of the task force that issued today’s report. He’s now in private practice and also serves as consultant to several defense teams representing detainees at Guantanamo. And Lee Casey is a former Justice Department official during the Reagan and first Bush administrations. He practices law and writes opinion columns for The Wall Street Journal and other publications.

And welcome to both of you.

And, Stephen Xenakis, broadly speaking, the allegations in this report seem to be that the military pushed medical personnel to do certain things and that they acquiesced. Is that — is it broadly against both?

DR. STEPHEN XENAKIS, retired U.S. Army: It’s broadly against the military, the senior leadership, and in terms of the policies and practices they put in place.

And it also is against the physicians, particularly the senior physicians who acquiesced to the pressure they were getting from the government bosses.

JEFFREY BROWN: So, give us — give us an example of something, a practice that you cite there, and how it goes against medical professional ethics.

STEPHEN XENAKIS: Well, one of the most important is the involvement and assignment of clinicians, that is, health care professionals who take care of patients, to behavioral science consultation teams.

These were specifically configured teams to assist in the interrogation of the — of these prisoners who were brought to Guantanamo. That’s never been part of the role and responsibilities of military doctors. That’s never been in their area of work.

Once that’s done, that really breached a particular line there. And you find them being used as — in fact, they were labeled combatants. And then later, they were later labeled as safety officers. And they were not working as clinicians. So that’s really important.

JEFFREY BROWN: Now, let me ask Lee Casey for a response.

LEE CASEY, former Department of Justice official: Well, I think maybe that’s the answer.

They were not acting as clinicians. They were acting effectively as I suppose you would say consultants to the government to help them design interrogation strategies that would be effective with particular individuals.

JEFFREY BROWN: What do you see as the role of medical personnel in situations like this?

LEE CASEY: Well, I think there are two roles.

First of all, obviously, the United States has a number of people in custody. That means we have an obligation to those people to take care of their health, their basic well-being, and that involves, obviously, medical care. In addition, of course, when you’re putting together an interrogation strategy or assessing a particular individual, the assistance of psychological professionals, psychiatrists and psychologists, would be invaluable.

And it may not have been done before. But, then, this is the kind of war we have never really fought before.

JEFFREY BROWN: Well, that’s a — does that fit your definition of the role of medical personnel?

STEPHEN XENAKIS: No, it doesn’t.

And most medical, if not all medical personnel who are clinicians aren’t trained to do these kinds of assessments and trained to work with interrogations. There are very good professional groups. The FBI is excellent. They have people that that is all they do. They do that all the time. They have great experience and they know how to conduct interrogations.

But you don’t bring practitioners, people who treat patients, into this arena, particularly since, more often than not, they’re young doctors, just out of training. And it’s not at all what they have up to that point had as part of their experience.

JEFFREY BROWN: Your — your answer?

LEE CASEY: Well, I think if the problem is that they are not that experienced, then perhaps we should be looking or the military should be looking for more experienced practitioners to be part of this.

But I think the — in terms of the overall use of medical professionals, certainly, there’s nothing legally problematic with that. Whether there is an ethical problem for the medical profession is something obviously the medical profession is going to need to wrestle with.

JEFFREY BROWN: Is this about the policies? Is this about the medical practice, or is this about the policies of the U.S. government and intelligence?

That is, how does it — clearly, this is about enhanced interrogation vs. torture, the debate that we have had in this country for a number of years.

LEE CASEY: Right.

STEPHEN XENAKIS: So it’s about the policies and about enhanced interrogations and the involvement of clinicians in those, the practices.

And we all adamantly oppose torture and abusive treatment of detainees. The practice issue also comes into play, because taking a young practitioner and then putting them in a situation where they’re not acting as a doctor, and then expecting them at another point to put that aside is really impractical.

You know that doctors, we in the military, subscribe to a role — in fact, all the professionals, all the various branches and corps, we identify with our branch, with our professional training. And it’s that that we use to do our job the best that we can and to accomplish the mission.

JEFFREY BROWN: And what would you have doctors do when put in these situations?

STEPHEN XENAKIS: I would have them refuse.

(CROSSTALK)

STEPHEN XENAKIS: I mean, say, it clearly violates our ethical principles. It clearly violates the principles of do no harm.

And I think that they would be supported, particularly by these kinds of doctors and other experts on this panel, that they shouldn’t be involved in this.

JEFFREY BROWN: Can doctors refuse? Should they refuse?

LEE CASEY: Well, I think it’s more complicated than, in the sense of, when you say do no harm, it may well be that having a physician involved is the very thing that you need so that you do not do harm.

Whether a doctor can refuse or not, obviously, a doctor in private practice or a private contractor clearly can. Military doctors, of course, it is more complicated. They are in the military. They, of course, can refuse unlawful orders. But what is and isn’t an unlawful order, obviously, is something that is often not clear, especially in areas like this, where we have over the last 10 years basically been learning as we go along.

JEFFREY BROWN: Let me ask you briefly, what is your answer to my broader question on how this fits into the larger debate here about…

(CROSSTALK)

LEE CASEY: Oh, I think this is very much about the policies.

I certainly believe the Open Society, one of the sponsors of the report, very much has been one of the great opponents of not just enhanced interrogations, but pretty much all of the interrogations that have gone on at Guantanamo and Guantanamo itself.

But the truth is, if all the physicians were removed, interrogations would not stop. The United States is at war. It has a right to interrogate. What would happen is, the interrogations would be less safe for everybody.

JEFFREY BROWN: All right, we do have to leave it there.

Stephen Xenakis, Lee Casey, thank you both very much.

STEPHEN XENAKIS: Thank you.

LEE CASEY: Thanks for having us.