Cite Doctors' Aid at Guantánamo
By NEIL A. LEWIS
Published: June 24, 2005
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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
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
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
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
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
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
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
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
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.
U.N. Inquiry on Guantánamo
By The New York Times
UNITED NATIONS, June 23 - A four-member team of United Nations human rights
experts accused the United States on Thursday of stalling on requests over
the past three years to visit detainees at Guantánamo and said it would
begin its own investigation without American assistance.
"Such requests were based on information from reliable sources of serious
allegations of torture, cruel, inhuman and degrading treatment of detainees,
arbitrary detention, violations of their right to health and their due
process rights," the four, all independent authorities who serve the United
Nations as fact-finders on rights abuses, said in a statement.
Pierre-Richard Prosper, the United States ambassador for war crimes, said
the United States had been unable to meet the fact-finders' deadline to
answer its request but intended to keep the matter open.