Health professionals at a Physicians for Human Rights asylum training in October 2016.

For Spyros Orfanos, PhD, a psychologist at New York University (NYU) and a Physicians for Human Rights (PHR) partner, the current negative political environment surrounding immigrants strikes a personal chord.

In the early 1960s, his uncle – an undocumented Greek immigrant working in New York City – was arrested during an immigration raid. Instead of sending him to a detention center, Dr. Orfanos says, police brought him to the prison at Riker’s Island, where he was beaten before being sent back to Greece.

“It was a very powerful and emotional experience for me,” the 66-year-old doctor said. And it inspired him to begin working on behalf of immigrant communities. “It became important to try and be helpful to people who are undocumented.”

Today, Dr. Orfanos runs a postdoctoral clinic at NYU’s program in psychotherapy and psychoanalysis. He and his colleagues provide services to patients at a low cost. And now, amid increasing hostility to immigrants in the U.S., the New York City native is working to broaden the clinic’s services to include people who are seeking asylum in the United States.

“We don’t want to just talk about things; we don’t want to curse the darkness,” he said. “We want to light the candles.”

Dr. Orfanos attended a training conducted by PHR’s asylum program this spring to recognize and document the physical and mental scars of torture, ill-treatment, and sexual violence. After completing their initial training, participants like Dr. Orfanos can join the more than 500 clinicians in PHR’s Asylum Network who volunteer their time and expertise to draft medical affidavits for people seeking asylum in the United States.

Dr. Orfanos has been working on these issues for most of his career. After becoming a licensed psychologist in 1986, he became an adult trauma specialist and set up an independent practice, diagnosing and treating patients suffering from all forms of trauma.

But Dr. Orfanos was eager to do more. In 2003, he participated in a training led by the humanitarian organization Doctors of the World, and shortly after began volunteering for their human rights clinic. There, Dr. Orfanos conducted forensic evaluations for Tibetan monks seeking asylum in the United States, documenting both the physical and psychological trauma they had experienced at the hands of Nepal’s police. One monk told him the police hadn’t just tortured his body, but also his soul.

Now, Dr. Orfanos says, in the midst of heated rhetoric about immigration in the United States and globally, he’s been inspired to incorporate what he’s learned from his own experience and from PHR into his clinic at NYU. This past March, the clinic began a pilot program with NYU Law School’s Immigration Rights Clinic to conduct psychological evaluations for adults and children facing deportation.

“The feeling of my professional community has been one of moral outrage at the gross misunderstanding of our common humanity and our global responsibilities,” he said of the current political moment.

Indeed, since the election of Donald Trump, more than 90 health professionals in his clinic have expressed interest in working with asylum seekers, Dr. Orfanos said. He is exploring the option of working with PHR to build on and harness that enthusiasm through targeted trainings and referral relationships.

Dr. Orfanos is also considering setting up a support group for his own clinicians and evaluators, which would allow them to talk about the cases they encounter in a systematic way and to discuss the vicarious trauma they may experience while treating asylum seekers.

PHR’s training came at just the right time for Dr. Orfanos. It’s given him a springboard to energize not just his own practice but to inspire those who are also moved to help asylum-seekers in the United States.

“I felt much better prepared to handle cases,” he said after attending the PHR asylum program training. “It’s exciting for me to think of organizing something at NYU with the help of PHR and their expertise and values.”

This June, Physicians for Human Rights (PHR) published a report showing that the CIA’s post-9/11 torture program constituted a regime of illegal human experimentation. Based on a review of thousands of declassified documents, the report shows that health professionals who designed and implemented the torture program committed a second and related crime: experimental research to investigate the effects of torture on detainees. This research explored the untested hypothesis that torture could psychologically “break” detainees and aid interrogation.

Senior Anti-Torture Fellow Sarah Dougherty was the lead author of PHR’s latest report and explains how she came to these conclusions.

What did you find out in the course of your research?

Sarah Dougherty: In 2010, PHR put out a report showing that CIA health professionals engaged in activities that met the definition of human subjects research and experimentation. Since then, we’ve reviewed and analyzed extensive new evidence showing that the torture program itself was a regime of experimental research. Psychologists were paid to conduct this research, while doctors, psychologists, and others were tasked with generating data on how these tactics affected the detainees. Our analysis indicates this was done to provide the Bush administration with legal cover in the case of future prosecutions for torture. Such experimentation on non-consenting prisoners violates U.S. law, international law, and medical ethics.

How do you know that this was human experimentation?

SD: Federal law defines human subjects research in the United States: systematic investigation about an interaction or intervention with a living individual that’s designed to create generalizable knowledge. The documents we looked at show that the CIA collected data derived from torture sessions, clinical interactions, and manipulation of detention conditions. This data was analyzed and used to create conclusions about how to conduct torture in the future.

Now, by saying that this constituted human experimentation, we’re not saying any part of it was legitimate. It was junk science peddled by charlatans to add a façade of science to torture. But just because it was flawed, sloppy, and poorly designed doesn’t change the fact it was experimentation. The claim that torture could induce “learned helplessness” – that is, make detainees profoundly passive and depressed – and that this could ultimately aid interrogation, was put forward as a hypothesis. Health professionals then took the basic steps of research whether they knew it or not.

What was the role of the two psychologists who designed the torture program in CIA research?

SD: CIA contract psychologists Dr. James Mitchell and Dr. Bruce Jessen came from the U.S. military’s Survival, Evasion, Resistance and Escape (SERE) training program, which taught survival skills to U.S. personnel in the event of capture. Mitchell and Jessen proposed weaponizing these tactics for use on prisoners – to overcome their resistance to stress rather than build it up. They claimed that this would psychologically break detainees down to the point that they would give up and cooperate with interrogators.

Mitchell and Jessen claimed that torture would “work” and be “safe.” None of this was true or supported by any evidence. The SERE tactics were modeled on Cold War techniques designed to coerce false confessions, not produce intelligence. The brutality of the torture program was unlike anything done in the SERE program, and it was done to people who were not volunteers and who could not stop the pain.

This is partly why the CIA framed the torture program as a research endeavor: Mitchell and Jessen needed to describe how these techniques impacted detainees, and they didn’t have safety or efficacy data. Their initial research set in motion parallel research by the CIA’s Office of Medical Services. Health professionals documented the effects of torture, measured the harm inflicted, developed medical limits for different techniques, and shared their findings inside and outside the CIA.

What shocked you?

SD: I was profoundly disturbed by the torture of Abu Zubaydah, a detainee often referred to as the “guinea pig” of the CIA program. His waterboarding began in August 2002, and it was apparently so horrific to watch that it moved black site personnel to tears. You can only imagine how excruciating it was for Abu Zubaydah. In at least one instance, he lost consciousness and stopped breathing – that is, he was waterboarded to the point of near-death. This episode had such a profound effect that medical staff continually referenced it in emails throughout the span of the torture program.

These details reinforce that it was the conscious objective of the CIA’s program to reduce human beings to the psychological state of tortured dogs in cages. And this was done by health professionals, who are sworn to “do no harm” and to respect the dignity and autonomy of individuals. Instead, they worked to make torture more clinical, more scientific, more efficient – and they violated basic standards of research and clinical care to do so. That’s something we all need to reflect on.

Today, judges, court staff, and addiction counselors from all over the United States will storm Capitol Hill to tout the virtues of expanding drug courts as an alternative to incarceration for people arrested on drug-related charges. What they will fail to address is the intense debate surrounding the efficacy of drug courts and the need for policy reforms that will allow people to access treatment outside of the criminal justice system.

The National Association for Drug Court Professionals (NADCP) – an industry group established in 1994 to support the expansion of drug courts – has organized an annual conference since 1996 to bring together thousands of drug court staff from across the country. One of the main goals of the conference is to send drug court professionals to their respective members of congress on a dedicated “Capitol Hill Day” to “ensure drug courts … remain a funding priority in Congress.”  

As members of congress grapple with addressing the opioid crisis, expanding drug courts is an attractive option for legislators who want to avoid appearing “soft on crime” in their attempts to prevent overdose deaths. But while drug courts may satisfy political optics, they are a poor substitute for robust, community-based treatment options. They often deliver ineffective, poorly-resourced treatment options and services that are often not based on medical evidence and set their participants up for failure, sometimes landing them behind bars, an outcome drug courts claim to prevent.

While drug courts may play a role in providing treatment for some truly high-risk, high-need individuals – the population the NADCP argues should be prioritized for access to drug court programs – many people are disqualified in practice. The courts in general are vastly overused and unduly popular as a way to address all problem drug use in the United States, not just those who are high-risk and high-need.  

Drug courts are designed to provide court-supervised treatment for problem drug use. But, in addition to treatment, participants are often required to sign a contract that obligates them to abstain from using all substances, including alcohol and prescription medications, even if those medications are prescribed to them by a doctor.  

Drug courts have increasingly come under fire for endorsing outmoded practices – namely punishing relapse with jail time and stigmatizing medication-assisted treatment, or even banning it outright. This comes as harm reduction approaches like needle exchanges, “housing first,” and law enforcement-assisted diversion programs have gained recognition in the United States. 

While the NADCP has acknowledged the need for drug courts to update their practices, the organization remains hostile to outside criticism of the drug court model.  

In 2015, the NADCP released two publications outlining “best practice standards” meant to bring evidence-based practice to more drug courts. Key best practices included targeting high-risk, high-need populations for drug court participation; responding to relapse with therapy, not jail or punishment; and allowing the full spectrum of medication-assisted treatment (like methadone, buprenorphine, and naltrexone). Given that the NADCP is a non-profit organization and has little leverage over individual drug courts, the best practice standards are spottily implemented at best, and in some courts there is little awareness of their existence.

In a study published this year, Physicians for Human Rights (PHR) found that, across the board, drug courts struggle to update their practices, even when attempting to incorporate the NADCP’s recommended standards. PHR found vast inconsistencies between drug courts in funding, resources, treatment options, and methods of accountability for treatment compliance. Lack of resources, including health insurance for participants in particular, affected access to quality, evidence-based treatment.  

PHR also found a critical lack of case management services like housing, transportation, education, and health care unrelated to problem drug use – all services that drug court staff told PHR were not only key to successfully completing drug court programs, but also to long-term recovery. On the whole, PHR reported that drug courts still prioritize surveillance and abstinence rather than examining the participant’s needs and providing the support necessary for long-term recovery.

As members of congress meet with drug court professionals today, they should keep in mind that funding for drug courts should first and foremost go to treatment, and that funding should come with strings attached – namely adherence to medicine and evidence-based practices. Legislators should remember that drug courts are not a cure-all, and that community-based treatment and case management services outside the justice system are necessary to truly support long-term recovery.

This article originally appeared in STAT on July 7, 2017.

Barely two decades ago, the International Criminal Tribunal for the former Yugoslavia first treated rape and sexual assault as distinct war crimes. That decision revolutionized our understanding of rape as a weapon of war, leading in 1997 to the first-ever prosecution of rape as a war crime in Rwanda.

Today we are seeing another cruel method of warfare emerge on the battlefield: the weaponization of disease, particularly in Syria and Yemen.

Targeting health care facilities during conflict has occurred before. But unlike the attacks on hospital ships during World War I, or even sporadic attacks in more recent conflicts, the pace of attacks on health facilities, workers, and resources in Syria and Yemen is massive and unrelenting.

In the past three years, combatants in these conflicts have actively targeted health and humanitarian facilities and indiscriminately decimated civilian infrastructure. Hospitals are out of service. Clinics have been destroyed. Water treatment plants have been turned to rubble. Vaccines and other lifesaving drugs have been intentionally blocked from reaching civilians.

All of this has created public health catastrophes — a massive cholera outbreak in Yemen, and new outbreaks of once-vanquished diseases like polio and measles in Syria and Yemen. These put millions of children at risk for death and illness.

My organization, Physicians for Human Rights, has mapped the systematic attacks on hospitals, clinics, and other medical facilities in Syria. Our data show that, since 2011, there have been a staggering 477 attacks on medical facilities, as well as the deaths of 820 medical personnel. Nine out of 10 of these attacks were launched by the Syrian government or its Russian allies. Each of these strikes puts essential medical care further out of reach for thousands of sick and injured Syrians.

None of the conflict’s belligerents have acknowledged that their actions are purposefully creating a public health disaster. In fact, after launching a lethal chemical weapons strike in April, the Syrian government then brazenly struck the hospital where survivors were being treated. There have been few, if any, substantive consequences for these blatant violations of international law.

Such attacks have dire consequences. For each doctor killed or clinic destroyed, an untold number of patients suffer. As hospitals, clinics, and water treatment and sanitation facilities have become targets, civilian survivors of bombs or bullets or poison gas have fallen victim to previously controlled infectious diseases.

Take, for example, the recent polio outbreak in eastern Syria. It started when an oral form of the live polio vaccine mutated. Abysmal sanitation helped it spread through the population. Children who hadn’t been vaccinated against polio contracted the crippling and potentially deadly virus. It’s a perfect epidemiological storm, enabled by warfare.

In Yemen, the targeting of hospitals, clinics, water treatment plants, and sanitation facilities has caused the largest cholera outbreak in the world, with 5,000 new infections every day. To date, more than 200,000 people have been infected, and 1,300 have died. All parties to the conflict share responsibility, as combatants on all sides — including the Saudi coalition using U.S.- and European-made arms — have attacked the country’s health infrastructure. Such targeting has also paved the way for a measles outbreak in Yemen.

Cholera and measles, both preventable and treatable diseases, prey on the vulnerable. With 1.5 million children facing malnutrition in Yemen, both of these diseases may ultimately claim an unconscionable number of young lives.

There are many signs of hope and humanity in both Syria and Yemen. Despite a lack of pay and protection, thousands of health workers are making incredible sacrifices to identify individuals who need medical help and provide whatever treatment is available. The World Health Organization, UNICEF, Doctors Without Borders, and other international organizations are making headway in efforts to broaden vaccination and treatment.

We must not make the mistake of thinking of these deaths and illnesses as collateral damage of war. They are not accidental, and the destruction of medical and sanitation infrastructure is part of a cruel, illegal, and intentional strategy.

As the world acknowledged two decades ago in the Balkans and Rwanda, wars aren’t just waged on the battlefield with bombs and bullets. And even though modern warfare is insidious and battlefields are sometimes uncertain, the laws of warfare still apply.

That means there must be independent investigations of violations of international law when it comes to targeting health and humanitarian resources. There must also be regular and public reporting of incidents at the United Nations Human Rights Council and Security Council. We must recognize and prosecute these acts as war crimes, specifically as violations of the Geneva Convention.

Hundreds of thousands have already died in Syria and Yemen. And without accountability and clear condemnation from the international community, millions more lives are at stake.

Homer Venters, M.D., is the director of programs at Physicians for Human Rights.

Homer Venters, MD, MS, recently joined PHR as director of programs. A physician and epidemiologist, he is an internationally recognized leader in health and human rights. Prior to joining PHR, Dr. Venters led health services in the New York City jail system as assistant commissioner and chief medical officer, and worked internationally to train physicians on the intersection of human rights and public health.

What do you, as a doctor, bring to the fight for human rights?

Doctors have a unique role to play, in part because of the credibility that we bring to almost any discussion. We have consistently been one of the most respected professions, and our ability to leverage insights around human rights and promote more humane policies is critical. Another important role is in understanding evidence, and in promoting the use of evidence-based practices – things we know work – in the areas we work on. The third critical role is the training and commitment that physicians have in ethics – there is a set of ethical norms that must guide every patient-doctor interaction, and promoting human rights is consistent with that.

How have you used your expertise around evidence since joining PHR?

The recent chemical weapons attacks in Syria are a good example. Physicians are very accustomed to working with other specialists who have different skill sets to quickly diagnose and treat problems in individual patients. So when we started receiving evidence of a possible chemical weapons attack in Khan Sheikhoun, it was then a natural pathway for me and my medical colleagues at PHR to review the information and together develop an assessment. I had seen and cared for immigrant farm workers exposed to poisoning by organophosphates, which are present in fertilizers and also in nerve agents, so I was able to contribute that knowledge to our analysis.

An important issue we encounter at PHR is dual loyalty – the potential conflict between doctors’ duties to their patients and to their employers, particularly governments. We’ve seen it with U.S. Navy nurses being asked to force-feed detainees at Guantánamo, or Afghan government doctors being required to perform so-called “virginity testing” on women suspected of adultery. How did you tackle the problem of dual loyalty in the New York prison system?

The second you pick up a stethoscope in a jail setting, you feel the pressure of dual loyalty. It can be the most minor decision, such as whether to prescribe someone an albuterol inhaler, which requires a detainee to be front-cuffed, so he can access the device in his pocket. But security forces may tell doctors that a detainee is dangerous and that he doesn’t need an inhaler, because they don’t want him to be front-cuffed. As a doctor, you have to take care of the patient based on their medical needs, as you would any other.

In the jail system where I worked, 23 percent of health care staff reported that their ethics were routinely challenged – and we created the country’s first and only dual loyalty training program to address that. We know this is happening everywhere, including to the health professionals who work at Guantánamo.
The dual loyalty issue is prevalent all over the world, and it has a negative impact on health outcomes. We need to acknowledge its pervasiveness and reduce the harm it does.

How do you hope your expertise and training will strengthen PHR’s work?

I have a strong belief in using the tools of epidemiology and public health to promote a human rights agenda, and I want to build our capacity at PHR to use these approaches. PHR did this in the 1990s in Cambodia, where we analyzed thousands of cases of landmine injuries and were able to show that one in 256 people had been maimed by those weapons – a horrifying statistic that was key to passing the international Mine Ban Treaty. In the prison system, I used this approach to advocate against solitary confinement; by analyzing 250,000 jail admissions, we showed that people who had been in solitary confinement had an eight times greater risk of self-harm than other prisoners. Right now, PHR is working in northern Iraq to increase capacity to document torture and other war crimes. My hope is that we can strengthen the case of the brave people who have come forward to report sexual violence by training local partners to assess the incidence and prevalence of this horrific violation, as well as many other human rights abuses. Similarly, our Syria team is working every day to provide data to the entire world about the rate and location of attacks against health care facilities. In conjunction with the personal stories that we hear every day, these are very powerful tools for advancing human rights.

I also want to introduce dual loyalty trainings through health care professional organizations; I’m doing one for the American Psychological Association in November with the goal of reaching up to 5,000 American psychologists. And we could scale up this type of engagement through the hundreds of doctors in our Asylum Network who have a special insight into health issues in immigrant and other detention facilities – an area that promises to present significant human rights challenges going forward.

Drug courts in the United States routinely fail to provide adequate, medically-sound treatment for substance use disorders, with treatment plans that are at times designed and facilitated by individuals with little to no medical training.  In a report published today by Physicians for Human Rights (PHR), researchers found that drug courts – designed to reduce incarceration and provide necessary treatment – struggle to meet medical and human rights standards.

“Our study shows that while drug courts promise treatment rather than punishment, they face serious challenges in living up to that promise,” said PHR’s Christine Mehta, one of the paper’s lead authors. “Drug courts regularly set participants up for failure. Few communities have adequate treatment facilities, insurance plans often won’t finance effective treatment programs, and the criminal justice objectives of drug courts often overrule the medical needs of the patient in ways that threaten the rights and health of participants.”

PHR’s report – “Neither Justice nor Treatment: Drug Courts in the United States” – is based on interviews with health care professionals, social workers, judges, lawyers, drug court staff, and drug court participants, focusing on the U.S. states of Florida, New Hampshire, and New York.

“Unfortunately, drug courts often prioritize punishment over treatment,” said PHR’s director of programs, Dr. Homer Venters. “For instance, instead of treating relapses as a natural part of the recovery process, some drug courts punish participants for relapsing, compromising their successful recovery. What’s more, some drug courts require total abstinence from substance use, including prescribed medications, and refuse to allow medication-assisted treatment, despite the fact that treatment for opioid use disorder often requires long-term medication. Such approaches are counterproductive and unsupported by evidence.”

Among its recommendations, PHR urges federal and local officials to enact clearer standards for drug courts, defund drug courts that disallow medication-assisted treatment, decriminalize the possession of drugs for personal use, ensure government health insurance plans cover comprehensive treatment, and put in place supportive services to make treatment plans more effective.

“The U.S. federal government has historically failed to adopt harm-reduction strategies in place of draconian criminal justice methods that treat substance use disorders as crimes,” said PHR’s Dr. Venters. “In such a climate, drug courts and other diversion programs must be reformed and backed up by sound science. As it is, the United States is pushing overly-punitive, dysfunctional drug policies that are harmful to health and human life.”

At 19 years old, Joshua Smith (not his real name) was diagnosed with an opiate use disorder. Following several attempts at treatment, Smith moved from California to a town in Arizona known for being home to recovery houses for those struggling with substance use disorders. Six months after he arrived in Arizona, Smith relapsed and overdosed on heroin.

Local authorities revived Smith, arrested him, and then gave him two options: he could go to jail or he could go into treatment. Smith chose treatment — or at least that’s what he thought. What Smith chose, more specifically, was to go through the alternative sentencing program known as drug court, which allows those who plead guilty to undertake community service and court-supervised treatment instead of going to prison.

When Smith pled guilty to a drug-related felony in October 2016 and was sent to court-supervised treatment, he recognized that he needed additional medical help in overcoming his opiate use disorder. Like many other people with this disorder, however, Smith could not simply quit “cold turkey.” To detox and prevent a relapse, he needed medication-assisted treatment.

But there was a problem: Smith’s drug court program banned participants from trying the medication-assisted approach, even on doctor’s orders. Unable to implement the medication-assisted treatment, Smith relapsed, tested positive for opiates at a screening, and was given a 60-day jail sentence as punishment. When his mother asked the court to reconsider its policy on medication-assisted treatment, she was ordered to refrain from contacting her son and warned that if she didn’t, he could spend more time in jail.

Ever since they were first established in 1989 in Miami, Florida, drug courts have found political supporters on both the right and the left. Both sides want to cut costs, lower incarceration rates, and offer rehabilitation — and proponents of drug courts claim they do all three. It’s unsurprising, then, to find that the drug court model has become wildly popular in the United States. (So much so, in fact, that it’s even become a part of U.S. foreign policy.)

Yet as Smith’s story — and a new report from Physicians for Human Rights — makes all too clear, drug courts are far from perfect. In fact, despite being one of the most heavily studied elements of the U.S. criminal justice system, the efficacy of drug courts is still a topic of intense debate. It’s true, for example, that studies have shown them to be better than prison when it comes to reducing recidivism. But these studies have themselves been contested, with critics arguing that they are poorly designed and fail to compare drug court outcomes with those of voluntary, community-based treatment.

The real question, therefore, is not whether drug courts are better than prisons. It’s whether drug courts represent a truly health-centered policy response to those struggling with substance use disorders. Are drug courts the answer? Or are they merely a stopgap on the road to something better? From a public health and human rights perspective, at least, the answer to that final question is a clear, resounding “yes.”

For a sense of how drug courts fall short of their professed goals, simply consider one of their fundamental tenets: that people with substance use disorders who choose to go into drug court rather than spend years in prison are making a truly voluntary decision. The reality, of course, is much more complicated. By their very design, these courts put defendants in a situation where choosing treatment — regardless of its quality and regardless of their ability to comply with it — is the only way to avoid an official prison sentence, although many, like Smith, still face significant time in jail during the drug court program.

Yet if they agree to undergo treatment through the drug courts, some defendants are still positioned to fail, either because they lack necessities such as housing, food, and transportation, or because they, like Smith, are not allowed to use the best treatment for their specific disorder. Worse still, many drug courts — especially those in rural areas, where access to quality treatment may be scarce — are significantly underfunded and understaffed.

Drug courts are also wildly inconsistent when it comes to providing evidence-based treatment. For example, despite even the National Association of Drug Court Professionals recommending against it, medical professionals are sometimes overruled by probation officers or judges who prefer a less therapeutic approach. “Treatment gets trumped by legal,” as Jessica Stucker, the clinical director for the drug court program in Strafford County, New Hampshire, once said to this author.

To be fair, much of what ails drug courts is a product of larger, structural failures in the U.S. criminal justice and health care systems: the criminalization and routinely severe punishment of drug possession, the lack of health insurance and other ways to pay for quality care, the wariness of prosecutors who fear the political repercussions of being labeled “soft on crime,” and so on. Ultimately, though, supporters of drug courts have a responsibility to engage with their critics, respect international law, and improve.

Back in July of 2015, a now-former director of standards at the National Association for Drug Court Professionals told the magazine Pacific Standard, “Now that we have almost 3,000 drug courts across the country and in every single state, we want a drug court that works in reach of everyone in need.”

By that standard, drug courts in the United States are not “working” — not for people like Smith, not for their communities, and not for the public at large.

Originally published at www.opensocietyfoundations.org.

Based on an analysis of thousands of pages of documents and years of research, Physicians for Human Rights shows that the CIA’s post-9/11 torture program constituted an illegal, unethical regime of experimental research on unwilling human subjects, testing the flawed hypothesis that torture could aid interrogators in breaking the resistance of detainees. In “Nuremberg Betrayed: Human Experimentation and the CIA Torture Program,” PHR researchers show that CIA contract psychologists James Mitchell and Bruce Jessen created a research program in which health professionals designed and applied torture techniques and collected data on torture’s effects. This constitutes one of the gravest breaches of medical ethics by U.S. health personnel since the Nuremberg Code was developed in the wake of Nazi medical atrocities committed during World War Two.

Delving into the role health professionals played in designing and implementing torture, the report uses newly released documents to show how the results of untested, brutal torture techniques were used to calibrate the machinery of the torture program. The large-scale experiment’s flawed findings were also used by Bush administration lawyers to create spurious legal cover for the entire program.

PHR calls on all medical and scientific communities to convene a commission to lay out what is known about the torture program, including the participation of health professionals, and urges the Trump administration to launch a criminal investigation to get a full accounting of the crimes committed by the CIA and other government agencies.