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PHR Calls on Congress to Vote Against Military Commissions Bill; Interrogation Tactics that Could Be Authorized Cause Severe Short- and Long-term Mental and Physicial Harm

Psychological and Physical Impact of Certain CIA Interrogation Tactics

For Immediate Release

Physicians for Human Rights (PHR) today urged all members of Congress to vote against the Military Commissions Bill this week. PHR is gravely concerned that the bill allows coerced testimony to be admitted in trials, eliminates the right of habeas corpus and could authorize the continued use of tactics that amount to torture and cruel, inhuman and degrading treatment.

"This 'compromise' bill hands the President, who has repeatedly authorized abusive and illegal interrogation tactics, the power to reinterpret Common Article 3 of the Geneva Conventions," stated Leonard Rubenstein, Executive Director of PHR. "If passed, much of the abuse of the past five years, particularly the CIA's so-called 'enhanced interrogation methods,' could be interpreted by the President to be officially sanctioned, with immunity granted for these violations of US and international law, even retroactively."

Additionally troubling is the fact that passage of the bill would result in two standards of conduct for US personnel-one generally strict set of guidelines for the armed forces that lists prohibited techniques and another, dangerously permissive standard for the intelligence services, the group said. The Army Field Manual released this month adheres to the Geneva Conventions and the basic guidelines of the Uniform Code of Military Justice, banning many of the techniques that the President seeks approval for the CIA and other intelligence services to continue to use.

"As a practicing doctor, former soldier, and active citizen, I cannot support this bill," stated Brigadier General Stephen N. Xenakis, MD (USA-Ret.), an advisor to PHR. "My responsibility to protect the health of all people, the security of this nation, and America's institutions is antithetical to a bill whose main aim is to legalize tactics that are against the spirit and the letter of the Uniform Code of Military Justice, the Hippocratic Oath and US law."

The group singled out tactics that may be interpreted by the Administration to be permitted if the bill passes in its current form, highlighting some of the short and long-term mental and physical damage that these techniques have been known to cause. PHR pointed out that while the language of the bill can and should be read to prohibit certain techniques that lead to suffering and harm, it lacks the clarity needed to assure that the Administration would not undermine other restrictions on draconian interrogation techniques, as it has done in the past.

"The most common adverse consequence of the infliction of physical pain or fear in an adversarial interrogation setting is prolonged psychological injury," explained Dr. Scott Allen, MD, a physician with experience in correctional medicine and a Medicine as a Profession Fellow with PHR. "This 'non-transitory' harm can include major depression, anxiety, post-traumatic stress disorder and personality change."

Interrogation techniques that the Military Commissions Bill could be interpreted to allow include, but are not limited to, the following tactics, which have been attributed to the CIA in media reports:

  1. Water Boarding is when a prisoner is bound to an inclined board, feet raised and head slightly below the feet. Cellophane is wrapped over the prisoner's face and water is poured over him. This tactic simulates drowning. Water boarding creates the sensation of imminent death by drowning. Survivors of death threats suffer high rates of post-traumatic stress disorder and depression. Despite the "simulated" drowning, hypoxia can and probably does occur. At the same time, a dramatic physiologic stress response, with tachycardia, hyperventilation and labored breathing is almost unavoidable. The combined psychiatric and physiologic stress resulting from this technique could induce cardiac ischemia and other cardiac issues in vulnerable individuals, and even brief hypoxia can cause neurological damage.
  2. Prolonged Sleep Deprivation results in a number of deleterious psychological effects, most prominent among them being cognitive impairment. Cognitive impairments include memory, learning, logical reasoning, complex verbal processing, and decision-making. Sleep restriction can also result in hypertension, cardiovascular disease, a decrease in immune function, altered glucose tolerance and insulin resistance.
  3. The cold cell/induced hypothermia (dangerously low body temperature): The prisoner is left to stand naked in a cell kept near 50 degrees. Throughout the time in the cell the prisoner is doused with cold water. Hypothermia can cause reduced psychological function and mental capacity; loss of muscle function, harm to the cardiovascular, gastrointestinal, respiratory, and nervous, systems; and even death.
  4. Shaking: The interrogator forcefully grabs the shirt front of the prisoner and shakes him. Shaking a prisoner has been outlawed by Israel's Supreme Court. Shaking can result in trauma to the brain through an acceleration-deceleration mechanism. Consequences may include intracranial hemorrhage, potentially leading to increased intracranial pressure and herniation, a potentially fatal complication. Some brain trauma from shaking can potentially result in more subtle but clinically significant cognitive impairment.
  5. Striking/slapping: While a slap diffuses the force a blow over a greater area than a closed-fist punch, a slap nevertheless causes blunt force trauma. Depending on where applied to the body, the resulting injury can be significant. Slaps delivered to vulnerable areas of the face including nose, eyes or mouth can result in soft tissue injury, bruising and laceration. Facial bones may also be fractured. A slap to the face also creates a torsion force that may result in neck injury. A slap to the abdomen can cause soft tissue injury, and even rib fracture. Internal organ damage includes such serious injuries as the rupture of the spleen.
  6. Prolonged standing: According to media reports, prisoners are forced to stand, handcuffed with their feet shackled to an eye bolt in the floor for more than 40 hours. Prolonged standing is associated with venous thrombotic phenomenon such as deep vein thrombosis and pulmonary embolism. Thrombo-embolic sequelae can be both acute and chronic. In addition, prolonged standing carries the risk of fainting, which can result in significant blunt force trauma including head injury, fractures and other soft tissue injury.
  7. Threats of harm and mock execution: These tactics, like water-boarding, are based on threats of death or severe harm. Mock execution and other threats of harm to the subject, or to the subject's family and loved ones, have been clinically found to cause the highest rates of depression, anxiety, post-traumatic stress disorder and personality change.

This month, when releasing the revised Army Field Manual, Deputy Army Chief of Staff for Intelligence, Lt. General John (Jeff) Kimmons, stated that no actionable intelligence had been obtained through abusive interrogation methods. At the press conference, Kimmons said the following:

"No good intelligence is going to come from abusive practices. I think history tells us that. I think the empirical evidence of the last five years, hard years, tells us that. And, moreover, any piece of intelligence which is obtained under duress, through the use of abusive techniques, would be of questionable credibility, and additionally it would do more harm than good when it inevitably became known that abusive practices were used. And we can't afford to go there. Some of our most significant successes on the battlefield have been-in fact, I would say all of them, almost categorically all of them, have accrued from expert interrogators using mixtures of authorized humane interrogation practices."

Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.

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