This nine-page white paper, published March 17, 2010, on the eve of the U.S. Special Envoy to Sudan’s first 12 months in office, urges the U.S. Envoy to address the urgent need of women and girls in Darfur through diplomatic efforts and the resources appropriated to the office for urgent peace and security interventions.
The newly released report by the Department of Justice’s Office of Professional Responsibility (OPR report) shows not only that John Yoo and Jay Bybee created disgracefully flawed legal analysis but also that they tried to justify that reasoning by using bad science. As PHR has previously reported, the DOJ's Office of Legal Counsel (OLC) exploited certain health professionals’ opinions to establish the legal justifications for the “enhanced interrogation” program. The OPR report shows in greater detail just how sloppy and intellectually indefensible this process was.The most egregious case is John Yoo's OLC analysis of the legality of waterboarding. Yoo later admitted to OPR that he believed from the outset that waterboarding came close to the legal standard of torture. Rather than turning to the relevant case law (which includes convictions for waterboarding), Yoo relied on information provided by psychologists involved in the US military's Survival, Evasion, Resistance, Escape (SERE) program, designed to instruct service personnel in physical and psychological torture resistance.The psychologists Yoo cited were regarded as experts in waterboarding because of research they conducted into its use in training US service personnel. "Based on your research into the use of these methods at the SERE school…," Yoo concluded, "you do not anticipate that any prolonged mental harm would result from the use of the waterboard.”The SERE training setting differs dramatically from an interrogation setting. In SERE training those being waterboarded were volunteers who gave consent and were exposed to limited applications of waterboarding over a short period. They understood that they were participating in an exercise that would be ended any time they exhibit severe distress or if the participants used a previously agreed upon safe word to stop it. Though sometimes harrowing for the trainees, the situation could not approach the extreme psychological distress of detainees.The CIA Inspector General’s report publicly released last year analyzed this issue and concluded that:
The expertise of the SERE psychologists/interrogators on the waterboard was probably misrepresented at the time, as the SERE waterboard experience is so different as to make it almost irrelevant.
For Yoo, this expertise was not only relevant, it was a key factor in his finding that waterboarding was legal.The OPR report rightly faults Yoo and Jay Bybee for this misuse of the irrelevant SERE experience.? Subsequently, though, Associate Deputy Attorney General David Margolis wrote a review of the OPR report which rejected this finding, and others, in the process of overturning the OPR report’s conclusion that Yoo and Bybee should be referred for state bar disciplinary proceedings. ?Amazingly, in his review Margolis still finds the reliance on SERE training reasonable:
The SERE training—despite its differences with real world application of the waterboard—would be relevant to the threshold question of whether everyone subjected to the waterboard suffers severe mental pain or suffering.
Having established this erroneous standard, Yoo and Bybee consider the specific case of detainee Abu Zubaydah and try to determine from afar whether he would suffer severe mental pain or suffering as a result of being waterboarding. It is totally inappropriate to issue a legal opinion on an issue as important as the torture definition solely upon the basis of someone else’s unexamined and un-compared assessment of the facts. Yoo and Bybee relied on the determination of an unidentified psychologist that Zubaydah could withstand waterboarding. More bad science and bad legal reasoning.Margolis notes that:
The CIA’s psychological assessment [redacted] concluded that he [Zubaydah] would not experience any mental harm from the use of these techniques and OLC relied on that conclusion.
Margolis is evidently untroubled that Yoo and Bybee, when asked for an opinion about the legality of the technique of waterboarding, essentially turn over this judgment to the assessment of a psychologist. This is not legal analysis but an abdication of responsibility. If the psychologist thinks Zubaydah will be fine with waterboarding, Yoo and Bybee go along and give the green light. Leaving judgments of expected pain levels, and consequent legality, to psychologists involved in administering torture resistance training hardly sets a rigorous legal standard and is quite likely to empower those psychologists and facilitate abuse.Any advice the psychologists coming out of the SERE training program gave to John Yoo was not only irrelevant because of the differences with waterboarding as practiced in interrogations but it was also based on incomplete knowledge of the medical impact of waterboarding on SERE trainees. The combination of John Yoo’s “intentional professional misconduct” as found by the OPR report, and the willingness of psychologists to provide conclusions that were not based on rigorous science and were likely biased, resulted in approval of a technique that was clearly torture.As PHR has emphasized for years, the involvement of health professionals in designing, implementing and monitoring interrogation programs is unethical and is perhaps illegal in some cases. Health professionals should not be involved in calibrating pain; doing so violates their duty to act in the best interest of persons they treat.The Margolis Memorandum cannot be the final chapter in determining wrongdoing in the Bush Administration’s torture program. A full investigation of the role of health professionals in the whole torture regime is required and they, along with John Yoo and Jay Bybee, need to be professionally disciplined, and, if determined appropriate after a full investigation, perhaps criminally prosecuted.
In recent years, Physicians for Human Rights has done considerable research on the impact of psychological torture techniques used by US personnel on terrorist suspect detainees. Now, that work is being put to an important new use in the context of the deplorable treatment of a domestic inmate.Based on our findings about psychological coercion, PHR filed a brief on February 4 in a compelling death penalty case which is being brought before the U.S. Supreme Court for possible review. The lawyer for death row inmate Edmund Zagorski was familiar with PHR’s reports on torture of detainees and, seeing similarities with the treatment of his own client, contacted us for support of the Petition to the Supreme Court to review the case. With the Pro Bono assistance of skilled attorneys at Ropes & Gray, PHR crafted an Amicus Curiae (Friend of the Court) brief drawing on medical and psychological expertise in support of Zagorski’s appeal.At issue in the case is the question of the voluntariness of Zagorski’s statements implicating him in a murder plan. PHR’s brief argues that using Zagorski’s statements against him violates the Constitution’s prohibition on using involuntary statements against criminal defendants. The statements he made were the result of conditions of confinement that were tantamount to torture and effectively broke his will.The essential facts surrounding Zagorski’s treatment, as stated in the brief, are clear:
Arrested in May of 1983, Mr. Zagorski invoked his rights to remain silent and to counsel. The State of Tennessee then placed Mr. Zagorski in a windowless, unventilated 8' x 8' steel box. After fifty two days of near total isolation and sensory deprivation – a period punctuated by an oppressive heat wave – Mr. Zagorski was physiologically compromised and psychologically disturbed. Thirty pounds lighter and despondent, he offered a confession in return for the ability to dictate the terms of his execution. Subjected to harsh confinement conditions similar to those used for the express purpose of “breaking” pretrial detainees, it is little surprise that Mr. Zagorski’s will was broken. The State’s confinement compromised Mr. Zagorski’s ability to act volitionally, resulting in the statements that implicated him in criminal activity. The statements should be suppressed.
PHR’s analysis of the treatment of terrorist suspect detainees, found in our reports Break Them Down and Leave No Marks provided a fitting frame of reference for assessing what had happened to Zagorski in confinement. Those reports related how isolation, especially in combination with other coercive methods can cause extreme psychological distress. In Zagorski’s case there were four inherently coercive aspects of his detention – heat exposure, constant isolation, sensory deprivation, and heavy medication – which deeply affected his physical and mental health, and yielded an involuntary inculpatory statement.The extreme heat of the Tennessee summer of 1983 was a key contributing factor to breaking Edmund Zagorski’s will. During an usually brutal heat wave, with temperatures reaching 100 degrees outside, Zagorski sweltered inside the jail confined in a small, unventilated space. In the surrounding areas of Robertson County, crops were destroyed and livestock died because of the heat. Zagorski’s physical state was severely compromised by the heat, as seen in his loss of 30 pounds. He also injured his knuckles by badly beating them against the walls of his cell, and also likely suffered other physical manifestations of his deplorable condition: impaired circulatory, nervous, and neuroendocrine function.Isolation added to Zagorski’s suffering. As the brief states:
Isolated from all friendly human contact for almost two months, Mr. Zagorski suffered devastating psychological and physiological damage that rendered him incapable of making voluntary decisions as important as waiving constitutional rights. No longer able to make deliberate or conscious choices, he was unable to understand his rights, let alone effectively exercise them. Extended isolation wreaks havoc on the mind and body. Without any face-to-face interaction with other human beings and the mental stimulation of conversation, individuals begin to deteriorate. Being isolated for periods as short as two hours disrupts normal mental function, producing temporal and spatial disorientation, inability to think, concentrate, or reason; replacing normal processes with anxiety and paranoia. There are also severe physiological effects of extended isolation. Prolonged isolation results in increased stress, abnormal neurendocrine function, changes in blood pressure and inflammatory stress responses. Indeed, the effect of extended isolation ”often resembles an organic brain syndrome” – a physical disease identified by agitation, confusion, and acute, lasting brain function decline.
In addition to his nearly complete isolation, Zagorski was deprived of significant sensory stimulation which intensified the harmful effects of his isolated detention. Locked in his 8’ by 8’ metal box, Zagorski had no visual variety, no fresh air or sunlight, no physical exercise and no ordinary human interaction. This kind of sensory deprivation has significant cognitive effects. In one well-known experiment, volunteer humans subjected to confinement like Zagorski’s developed psycho-motor and cognitive responses that would be clinically diagnosed as depression and in some cases post-traumatic stress disorder, with symptoms including apathy, helplessness, and hopelessness. The impacts of sensory depression are discussed in PHR’s 2009 report, Aiding Torture: Health Professionals’ Ethics and Human Rights Violations.Zagorski also exhibited perceptible psychological harm, with frequent attacks of anxiety and uncontrollable rage, self-abusive and suicidal behavior, confusion, and disorientation. To control his behavior he was treated with powerful psychiatric drugs, several of which can impair the ability to think clearly, and some of which lower the level of consciousness and self-control.The bridge between the powerful physiological effects of the conditions of confinement and Zagorski’s loss of ability to act voluntarily is laid out in the brief:
The signs and symptoms described in Mr. Zagorski’s case are highly consistent with extreme physical and psychological duress, with predictable global impacts on his entire nervous system. The physiological stresses on his nervous system impaired Mr. Zagorski’s brain function and his ability to exercise higher cognitive function like voluntary decision making. This effect is demonstrated in a loss of his self-control, a loss of his autonomy, and a loss of the ability to control his thoughts or effect his will.
While the Zagorski domestic murder case and cases of suspected international terrorism are different in many respects, they share an important common lesson: Extreme coercive confinement can break a detainee to point where he can no longer fully exercise his cognitive functions. Skilled interrogators, whether in intelligence or domestic law enforcement understand that they get the most reliable and legally usable information from detainees who are functioning effectively cognitively and psychologically. Attempts to “break” detainees are not only immoral and potentially illegal, but they are not the most effective means of gathering usable intelligence or confessions.We believe the Supreme Court should agree to hear the Zagorski case (Edmund Zagorski, Petitioner v. Ricky Bell, Warden, Respondent) and address the important issues of abusive pretrial confinement and coercion of involuntary statements. Beyond the issues within PHR’s expertise, addressed in our Amicus brief, the case also involves an important question about the circumstances in which a defendant initiates contact with the police and makes an inculpatory statement. This issue, along with others, is analyzed in the Petition filed by the Counsels for Petitioner, the Yale Law School Supreme Court Clinic, the Office of the Public Defender in Tennessee, and Mayer Brown LLP (PDF).
House Resolution (H.R.) 1064, which condemns Uganda's Anti-Homosexuality Bill, was introduced in the House last week and currently has 39 cosponsors. Representative Howard L. Berman (D-CA), chairman of the House Foreign Affairs Committee, is the primary sponsor of the bill. He is joined by other cosponsors, including the House Foreign Affairs Committee’s Ileana Ros-Lehtinen (R-FL), House Financial Services Committee Chairman Barney Frank (D-MA), Subcommittee on Africa and Global Health Chair Donald Payne (D-NJ), Congressional Black Caucus Chair Barbara Lee (D-CA), and Congressional LGBT Equality Caucus Co-Chair Tammy Baldwin (D-WI).The Senate introduced a similar resolution — S.R. 409 — on February 4, 2010, that recognizes the unjust nature of Uganda’s Anti-Homosexuality Bill and includes a clause that addresses the threat the bill poses by way of stigmatization and criminalization to the efficacy of the President’s Emergency Plan for AIDS Relief (PEPFAR) program. Original cosponsors of the resolution include Senators Feingold (D-WI), Coburn (R-OK), Cardin (D-MD), and Collins (R-ME).Want more background on the Ugandan anti-homosexuality bill? Check out our blog posts from December and January.
While both resolutions have garnered strong bipartisan support, more cosponsors are urgently needed. Tomorrow, we'll be sending out an action alert which will give you the chance to email your Senators and Congressperson to urge them to support these resolutions.In the meantime, please contact your House and Senate representatives and urge them to cosponsor these resolutions. Call the congressional switchboard, 202-224-3121, to easily connect with House Representative and Senate offices. Let your Congress members know why you support the bill. And check back tomorrow for an email action on this critical health and human rights issue!
One year ago, Dr. Kamiar Alaei and his brother Dr. Arash Alaei were sentenced to prison in Iran. Iranian officials accused the brothers of using trips to AIDS conferences in the US and around the world to “foment a velvet revolution.” They were convicted on charges of communicating with an enemy government — the US — all because they reached out to scientists from around the world to help prevent HIV.We say: Treating AIDS is not a crime.Now, the UN is reviewing Iran’s human rights record — and we need the US and other governments to stand up for the rights of these two Iranian physicians. Join us TODAY for a National Call-In Day to free Arash and Kamiar Alaei.The UN Universal Period Review is a new mechanism that reviews the human rights record of every country, once every four years. Iran is up for review during the 7th Session on the UPR, which runs Feb 8- 19, 2010.Member states can pose questions to the Iranian delegation on February 15. Ask UN Ambassador Susan Rice to ask about the Alaei brothers, and to urge Iran to grant their appeal and release them. If you are not from the US, please convey similar requests to your UN representatives.Call Ambassador Rice today at 212-415-4062 and use the following script. You have just 16 seconds: make them count!
Ambassador Rice, my name is ______ and I am from city/state or country. During the Universal Periodic review, please urge Iran to free Drs. Kamiar and Arash Alaei, who have been imprisoned in Iran since 2008. Treating AIDS in not a crime: please urge their release during the UPR this month.
PHR is sending formal letters to Ambassador Rice and other key UN representatives about the UPR and the Alaeis, which will give these leaders more details about Kamiar and Arash and their case, but we need you to add your voice to the call for their release.Take part in the National Call-in Day today–16 seconds can make a big difference for Kamiar and Arash. Call Ambassador Rice today at 212-415-4062 — and tell six friends to do the same. We must tell Iran: Free the Alaeis. Treating AIDS is NOT a Crime!(For more on the Alaeis' story, see IranFreeTheDocs.org)
Attacks on health workers and facilities have become a feature of modern war; they are not simply committed by rogue countries or forces.
It’s time for an organized international system for reporting attacks on hospitals and health workers in armed conflicts and to hold perpetrators of such acts accountable, say PHR’s past President, Leonard Rubenstein, and Melanie Bittle in an important recent article in The Lancet. The authors have conducted a review of reporting by governments, human rights organizations and the International Committee of the Red Cross over the past 20 years, looking for incidents and descriptions of bombing and shelling of hospitals, attacks on ambulances and medical convoys, harassment, arrest, torture and killing of medical workers, and more.In reviewing the violations of international law that these acts entail, Rubenstein and Bittle find little or no accountability for perpetration of these human rights violations and war crimes, and conclude that reporting by NGOs, UN agencies and governments is also deficient.Disturbingly, but not surprisingly, their review identified three trends in such assaults. The authors report:
Attacks on medical functions seem to be part of a broad assault on civilians; assaults on medical functions are used to achieve a military advantage; and combatants do not respect the ethical duty of health professionals to provide care to patients irrespective of affiliation.
Given the obvious health threats for affected populations when medical care itself comes under attack, Rubenstein and Bittle call on the World Health Organization (WHO) to lead a “robust and systematic documentation of these violations, and demand accountability.” Since many, if not most, of these violations and war crimes are perpetrated by government actors, this may be a tall order for the WHO, which works largely through government ministries of health. Nonetheless, this ambitious review is most welcome to PHR and our colleagues, many of whom have documented violations of “medical neutrality” since the 1980s or sustained these outrageous attacks themselves. For two decades, PHR has probed violations of medical neutrality and advocated for protection against them–most recently in Iraq, Sri Lanka, former Yugoslavia, Chechnya, El Salvador, occupied Palestine and Kashmir. An excellent appendix attached to the Lancet article provides citations to major existing studies, including PHR’s.PHR supports the call to the health community to speak out more vigorously when systematic attacks on patients and medical functions occur in war. It is indeed high time for a much more robust and concerted global effort to protect medical care and patients in armed conflicts.
PHR has done considerable research on the impact of psychological torture techniques used by US personnel on terrorism suspect detainees and has now applied that work in a new context: Domestic US incarceration and treatment of prisoners.
PHR filed a brief on February 4, 2010, in a death penalty case which is being brought before the US Supreme Court for possible review. At issue in the case is the question of the voluntariness of statements implicating a defendant in a murder plan. PHR's brief argues that the statements the defendant made were the result of abusive conditions of confinement that were tantamount to torture, damaging his cognitive functions and making it impossible for him to voluntarily exercise his will. PHR's brief argues that using his statements against him violates the Constitution's prohibition on using involuntary statements against criminal defendants.
UPDATE 6/27: We will be streaming this event live over at The Torture Papers, starting at 7pm Pacific/10pm Eastern.
Please join PHR, the National Religious Campaign Against Torture and community partners for:
Tune in tomorrow, when we will post live streaming video from the event, which will also be available here. This event focuses on the new PHR report, Experiments in Torture: Evidence of Human Subject Experimentation in the ‘Enhanced’ Interrogation Program. This will be one of three national events in faith communities focused on this report. Keynote Speaker:John Bradshaw, JD, Director of Policy, Experiments in Torture co-author, Physicians for Human Rights Response: Ed Bacon, Rector, All Saints Church-Pasadena Panel Discussion Moderated by: Eisha Mason, American Friends Service Committee Sponsored by:National Religious Campaign Against Torture |?Los Angeles Region Religious Campaign Against Torture |?Physicians for Human Rights |?American Friends Service Committee–Pacific Southwest Region |?Program for Torture Victims | All Saints Church–Pasadena Co-Sponsors:
Further Information: 818-225-0410 or vclassick at aol dot com Download the event flyer (PDF)
Reuters South Africa reported on Monday that Chadian official General Oky Dagache has asked the UN not to renew the mandate of the United Nations Mission in the Central African Republic and Chad (MINURCAT). While not unexpected, the Chadian government’s reluctance to extend the MINURCAT operation, in particular the military component, is concerning due to the essential role played by the MINURCAT force in enabling humanitarian operations in eastern Chad and in north-eastern Central African Republic (CAR). Without the presence of MINURCAT, all food distribution, water, sanitation, health, and education, would have to cease immediately with the evacuation of International NGO (humanitarian) and UN staff.The current MINURCAT mandate is due to expire on March 15, 2010, after one year of operation. The security situation in eastern Chad would make humanitarian operations in the region would be impossible without the MINURCAT force. The force was established by the UN Security Council to provide a multidimensional presence of police and military personnel to eastern Chad and north-eastern Central African Republic, responsible for ensuring security for humanitarian actions. The reality of this situation, in which UN security phase IV has been in effect in eastern Chad since November 2006, means that all UNHCR (UN Refugee Agency), World Food Programme (WFP) and other humanitarian staff are dependent on daily convoys to escort them to the twelve Darfuri refugee camps near the Chad/Darfur border.The limitations of the phase IV security measures, implemented to protect UN and humanitarian staff, mean that it is the presence of the MINURCAT police force (the D_tachement int_gr_ de S_curit_ or DIS) that allows continued international NGO operations in eastern Chad, by providing the required military escort. While there have been shortcomings with the DIS force (conduct issues?reported by Amnesty International (PDF)?in September 2009 include disorderly conduct, reckless driving and abuse of refugees), the impact on operations if the force was discontinued in the next twelve months would be catastrophic. Even with DIS and MINURCAT presence, two attacks have taken place recently: a convoy of UNHCR and WFP vehicles travelling between camps at Goz Beida and Koku at the end of December, and a similar convoy en route to the camp at Oure Cassoni on the northeastern Chad-Sudan border at the beginning of January.The Chadian government’s statement on non-renewal of MINURCAT now creates an immediate need for the international community to re-engage with the MINURCAT force, and to honor troop, logistical and material commitments to MINURCAT (which remains at only 50% capacity). PHR continues to advocate for the full deployment of MINURCAT uniformed personnel, specifically encouraging all troop contributing countries and police contributing countries to recruit female officers. Furthermore, the UNSC should expedite the appointment of a Special Representative for Women, Peace and Security (in accordance with Security Council Resolution 1820 ), to assess the state of protection for refugee and IDP women and girls, and report back to the Security Council no later than March 2010 on a comprehensive assessment of current needs and programs in place. Crucially, the assessment should include Sudanese, Chadian and CAR authorities’ cooperation with aid operations and new or ongoing civilian protection concerns—with clear and strategic recommendations for realizing the goals of Resolution 1820.In addition to the above issues, however, it is important that the MINURCAT mandate be expanded, and not just extended, beyond March 15. The UNSC should further extend the mandate of MINURCAT to meet the benchmarks for withdrawal (outlined in the UN Secretary-General’s report of December 2008) and strengthen current work to combat sexual and gender-based violence (SGBV) against Darfuri women and girls. It is essential that MINURCAT cooperates with the competent Sudanese, Chadian and CAR authorities to support the disarming, arrest and detention of criminals involved in gender-based violence: any MINURCAT, UN or international NGO personnel reasonably suspected of crimes under Sudanese, Chadian and international human rights law should be immediately discharged, and access to treatment and support for survivors of rape and sexual violence must be realized.
Want to help the people of Haiti? Below are several volunteer and job opportunities for both? health workers and for those with logistical/humanitarian aid experience. If you know of more opportunities, please post them in the comment section below.Partners In Health is looking for both medical supply donations and health professional volunteers.?They are currently prioritizing the deployment of full surgical teams. Ideally, team composition would include 2 orthopedic surgeons: 2 anesthesiologists or nurse anesthetists: 5 nurses (2-3 OR; 2-3 post-op/critical care).? That said, they are also looking for people with significant trauma experience to join teams–especially nurses with perioperative and medsurg experience. Apply here today.Oxfam America is looking for a Deployable Humanitarian Logistics Coordinator: check out the job description here.UPDATE: The information, below, is no longer accurate. Please visit the USAID website for information on volunteering and other ways to offer assistance. You may also visit this web page on the Department of Health and Human Services website for more information.Finally, the US Department of Health and Human Services is working to identify doctors who would be able to go to Haiti on government-sponsored disaster medical/surgical response teams.Criteria: