broken laws, broken lives

130 Pages·2008·1.88 MB·English

BROKEN LAWS,
BROKEN LIVES
Medical Evidence of Torture by
US Personnel and Its Impact
A Report by Physicians for Human Rights
June 2008
BROKEN LAWS,
BROKEN LIVES:
Medical Evidence of Torture by
US Personnel and Its Impact
A Report by Physicians for Human Rights
June 2008
© 2008, Physicians for Human Rights
All rights reserved.
ISBN: 1879707543
Library of Congress Number: 2008925849
Cover image: © Fernando Botero, courtesy, Marlborough Gallery, New York.
Detail from Abu Ghraib 44 (right panel), 2005, 191 x 107 cm
Report Design: Glenn Ruga/Visual Communications
PHysiCiAns foR HumAn RigHTs
hy s i c i a n s f o r H uma n R i g h t s ( P HR ) m o bini l inztersro hgaetaiolntsh, a full Congressional investigation of
p r o f e s s i o n a l s t o a d v a n c e t h e h e a l t h atnhed u dsei gofn pistyyc hooflo gical and physical torture by the US
Pal l p e o p l e t h r o u g h a c t i o n s t h a t p r omGootver nrmeesnpt,e acndt accountability for perpetrators.
f o r , p r o t e c t i o n o f , a n d f u l f l l m e n t o f h um a nP Hr iRg hhatss s.u cPceHssRfu lly organized and mobilized thou-
h a s a t r a c k r e c o r d o f m o r e t h a n 2 0 y e a r ss adnodcs uofm heanltthi nprgof essionals and helped to secure the
t o r t u r e a r o u n d t h e w o r l d , i n c l u d i n g i n Tleuardkeresyhi,p oCf hthiel me ,a jor health professional associations
C h e c h n y a , K o s o v o , I s r a e l , I n d i a , a n d C h i taop daevse,lo pM eethxiciacl ogu. i delines related to interrogation that
P H R h a s e x t e n s i v e e x p e r t i s e i n e v a l u a t i npgr osteucrt vagi vaionrsts m oefd icine and science being employed
t o r t u r e a s w e l l a s e x p e r i e n c e w i t h p r i s o n e tro haied athl teh a biussseu oef sp.ri soners. PHR’s work contributed
P H R w a s o n e o f t h e l e a d i n i t i a t o r s a n d atuo ttheo ardso potifo nt ohfe e thical standards by the American
I s t a n b u l P r o t o c o l o n t h e i n v e s t i g a t i o n a n d Mdeodcicualm Asesnoct iaatiioon,n t he World Medical Association, and
o f t o r t u r e , a d o p t e d a s a n o f f c i a l d o c um e ntth eb Aym tehrieca Un nPsi ytcehdia tric Association prohibiting direct
N a t i o n s i n 1 9 9 9 . participation of physicians in interrogations. PHR has
A s o n e o f t h e o r i g i n a l s t e e r i n g c omm i t theelepe md meomveb theer Asm erican Psychological Association (APA)
o f t h e I n t e r n a t i o n a l C am p a i g n t o B a n L a ntod pmroihnibeits t,h eP inHvoRlv ement of its members in the Central
s h a r e d t h e 1 9 9 7 N o b e l P r i z e f o r P e a c e . Intelligence Agency’s “enhanced” interrogation techniques
and has supported a movement within the APA to end the
A b o u t P H R ’s C am p a i g n A g a i n sdtire ct participation of psychologists in interrogations.
Torture
Physicians for Human Rights
PHR has documented the systematic use of torture by the 2 Arrow Street, Suite 301
United States during its interrogations of detainees at US Cambridge, MA 02138
detention facilities, including those at Guantánamo Bay, Tel. [phone]
in Iraq and Afghanistan, and elsewhere. It has previously
published two groundbreaking reports on the human Washington Offce
impact and the legality of abusive interrogation tactics 1156 15th Street, Suite 1001
authorized by the Bush Administration: Break Them Washington, DC 20005
Down: Systematic Use of Psychological Torture by US Forces Tel. [phone]
and Leave No Marks: “Enhanced” Interrogation Techniques www.physiciansforhumanrights
and the Risk of Criminality. PHR has repeatedly called
for an end to the use of the “enhanced” tactics by all US
personnel, an end to all health professional participation
i i i
i v
TAble of ConTenTs
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . .vi Sleep Deprivation . . . . . . . . . . . . . . . . . . . . . . . . . . 83
List of Acronyms . . . . . . . . . . . . . . . . . . . . . . . . . vii Sexual, Religious, Cultural, and Other Forms of
Degrading Treatment . . . . . . . . . . . . . . . . . . . . . . . 83
Executive Summary . . . . . . . . . . . . . . . . . . . . . . . 1
Witnessing Torture and Cruel Treatment . . . . . . . 84
Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Health Professional Complicity and Denial of
Summary of Findings . . . . . . . . . . . . . . . . . . . . . . . . 2 Medical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Legal Prohibitions Against Torture and Response by US Personnel to ICRC Visits . . . . . . 87
Ill-Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Chapter 5: Short-Term and Lasting Harm
Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . 9 from Torture and Ill-Treatment . . . . . . . . . . . . 89
Chapter 1: Introduction . . . . . . . . . . . . . . . . . . . 11 Acute Impact of Ill-Treatment . . . . . . . . . . . . . . . . 89
Chapter 2: Methods . . . . . . . . . . . . . . . . . . . . . . 13 Chronic Physical Consequences of
Identifcation of Study Population . . . . . . . . . . . . . 13 Ill-Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Evaluators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Lasting Psychological Consequences of
Ill-Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Medical Evaluations in Accordance with the
Istanbul Protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Diminution of Social and Work Life
After Detention . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Source of Information for Medical Evaluations . . 15
Chapter 6: Legal Analysis . . . . . . . . . . . . . . . . . 95
Human Subjects Protection . . . . . . . . . . . . . . . . . . 15
Legal Prohibitions Against Torture and
Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Ill-Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Chapter 3: Medical Evidence of Ill-Treatment
Systematic Torture by the United States . . . . . . . . 98
in US Detention Facilities . . . . . . . . . . . . . . . . . . 17
Applicability of the Law to Acts Committed by US
Chapter 4: Patterns of Torture and
Personnel Against Detainees . . . . . . . . . . . . . . . . . 99
Ill-Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Reparations and Justice for Victims
Beatings and Other Ill-Treatment During Arrest, of Torture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Transport, and Initial Custody . . . . . . . . . . . . . . . . 73
Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Deprivation of Basic Necessities and Sanitary
Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Chapter 7: Conclusion and
Recommendations 113
Stress Positions: Forced-Standing, Handcuffng,
and Shackling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Appendix I: Torture: Psychological
and Medical Consequences 117
Isolation, Sensory Deprivation, or
Bombardment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Psychological Trauma: The Common
Denominator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Threats of Harm to Detainees and
Their Families . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Physical Consequences of Torture . . . . . . . . . . . 119
Instilling Fear Through Use of Military Dogs . . . . 80 Physical Evidence of Torture . . . . . . . . . . . . . . . . 120
Use of Temperature Extremes . . . . . . . . . . . . . . . . 80
Beatings and Other Physical Assault . . . . . . . . . . 81
v
ACknowledgmenTs
h e l e a d a u t h o r f o r t h i s r e p o r t w a sE mFia MrancLoeoans, hJD , Staff Attorney, Center for Constitutional
H a s h em i a n , M PH , R e s e a r c h A s s o c i a t e ,R iPghtys;s Pi caui la Rnosc klin, JD, former PHR Senior Program
Tf o r H u m a n R i g h t s ( P H R ) , w h o w a s Ajsosoi cniaeted; Bianrr y Rosenfeld, PhD, Professor and Director
i t s w r i t i n g b y S o n d r a C r o s b y , M D , B o s t oonf CClienincat le Trr afinoirn g, Fordham University; Susannah
R e f u g e e H e a l t h a n d H u m a n R i g h t s ; V i n c eSnirkt i nI,a PcHoRp Dienpout,y Director; and Ronald Waldman, MD,
M D , P h D , P H R S e n i o r M e d i c a l A d v i s o r ; A l lMe nPH K, Perlolfesrs,o rM ofD C,li nical Population and Family Health,
B e l l e v u e / N Y U P r o g r am f o r S u r v i v o r s o f ToMratilumraen; S cLheooaln ohf P ublic Health, Columbia University,
N g u y e n , P h D , B e l l e v u e / N Y U P r o g r a m f o r aSndu mr veimvboerr so f oPHf R Board of Directors.
To r t u r e ; O n d e r O z k a l i p c i , M D , I n t e r n a t i o n a l RPeHhR aibs igl irtaatetfiuoln f or the dedication and exten-
C o u n c i l f o r To r t u r e V i c t i m s ; C h r i s t i a n P r ossivse ,r eMseDa,r cBh easrsliisnta nce over many months by Klara
C e n t e r f o r t h e T r e a t m e n t o f To r t u r e V i c t iBmolsen; . aTnhed foJlluodwain g individuals contributed to legal
S t r a w c z y n s k i , L L B , f o r m e r P H R R e s e a racndh o tFherl rleoswea.r ch: Patrick Childress, Joanne Cossitt,
L e o n a r d R u b e n s t e i n , J D , P H R P r e s i d e n t ,J eosvse rHsaamwlin t, hLoeu ise Place, Brent Savoie, and Daniel
r e p o r t a n d p r o v i d e d c r u c i a l g u i d a n c e t hSrcoaruvaglhonoeu. Rt e mo ny Gerstein and Majid Jumoor assisted
r e p o r t ’ s s t r u c t u r e a n d c o n t e n t ; A l i c i a Ya mwitihn t,h eJ loDg,is tMicsP aHnd, played an essential role in ensuring
f o r m e r P H R D i r e c t o r o f R e s e a r c h a n d I ntvheats int viegsatigt ai toionnss were carried out successfully.
oversaw the planning and implementation of the inves- PHR extends special gratitude to the following organi-
tigation its initial stages. zations for their pivotal support: Akeel & Valentine, PLC,
Scott Allen, MD, PHR Medicine as a Profession Fellow; Bellevue/NYU Program for Survivors of Torture, Berlin
Vincent Iacopino, MD, PhD, PHR Senior Medical Advisor; Center for the Treatment of Torture Victims, Boston
and Brigadier General Stephen Xenakis, MD, USA (Ret.) Center for Refugee Health and Human Rights, Burke
offered detailed comments on the medical evaluations and, O’Neil, LLC, Center for Constitutional Rights, Fordham
along with Drs. Ozkalipci and Pross, reviewed the medical University, and International Rehabilitation Council for
records of one of the detainees held at Guantánamo. Torture Victims. Two centers affliated with IRCT facili-
Nathaniel Raymond, PHR Senior Communications tated the medical evaluations and made this investigation
Strategist, reviewed, edited, and provided technical possible; they cannot be named to protect the confden-
expertise for the report. This report was edited and tiality of the participants.
prepared for publication by Tara Gingerich, JD. PHR thanks the JEHT Foundation, the Morton and
This report has benefited from review by Shereef Jane Blaustein Foundation, The Open Society Institute, and
Akeel, JD, Akeel & Valentine, PLC; Barbara Ayotte, former The Herbert Block Foundation for fnancial support that
PHR Director of Communications; John Bradshaw, JD, made this investigation and report possible.
PHR Director of Public Policy; Carolyn Patty Blum, JD, PHR would like to acknowledge the artist Fernando
Consultant, Center for Constitutional Rights; Susan Botero for granting PHR permission to use one of the
Burke, JD, Burke O’Neil, LLC; Colonel Daniel L. Cohen paintings from his Abu Ghraib series on the cover of
MD, USAF (Ret.); Frank Davidoff, MD, and Vice President this report.
PHR Board of Directors; Benjamin Davies, former PHR We are most indebted, however, to the eleven former
Chief of Staff; Frank Donaghue, PHR Chief Executive detainees who were willing to share their painful expe-
Officer; Sebnem Korur Fincanci, MD, Professor of riences with us, sometimes at signifcant risk to them-
Forensic Medicine, Istanbul University; Justice Richard selves and their families.
J. Goldstone, Justice of the South African Constitutional
Court, Retired, and member of PHR Board of Directors;
v i
lisT of ACRonyms
BHS : B e h a v i o r a l H e a l t h S c i e n c e Te am s
C I A : C e n t r a l I n t e l l i g e n c e A g e n c y
C I D T : C r u e l , I n h um a n , o r D e g r a d i n g T r e a t m e n t
D o D : D e p a r t m e n t o f D e f e n s e
D TA : D e t a i n e e T r e a t m e n t A c t o f 2 0 0 5
E C H R : E u r o p e a n C o u r t o f H um a n R i g h t s
E R B : E t h i c s R e v i e w B o a r d
F B I : F e d e r a l B u r e a u o f I n v e s t i g a t i o n
I A C H R :I n t e r - Am e r i c a n C o u r t o f H um a n R i g h t s
I C R C : I n t e r n a t i o n a l C omm i t t e e o f t h e R e d C r o s s
I C C P R :I n t e r n a t i o n a l C o v e n a n t o n C i v i l a n d
P o l i t i c a l R i g h t s
I C T R : I n t e r n a t i o n a l C r i m i n a l T r i b u n a l f o r R w a n d a
I C T Y : I n t e r n a t i o n a l C r i m i n a l T r i b u n a l f o r Y u g o s l a v i a
I R F : I mm e d i a t e R e a c t i o n F o r c e
I R C T : I n t e r n a t i o n a l R e h a b i l i t a t i o n C o u n c i l f o r
To r t u r e V i c t i m s
M CA : M i l i t a r y C omm i s s i o n s A c t o f 2 0 0 6
M D D : M a j o r D e p r e s s i v e D i s o r d e r
N O S : N o t O t h e r w i s e S p e c i f e d
O LC : O f f c e o f L e g a l C o u n s e l , D e p a r t m e n t
o f J u s t i c e
P H R : P h y s i c i a n s f o r H um a n R i g h t s
P OW : P r i s o n e r o f Wa r
P T S D : P o s t - t r a um a t i c S t r e s s D i s o r d e r
S E R E : S u r v i v a l , E v a s i o n , R e s i s t a n c e , a n d
E s c a p e t r a i n i n g
S O P : S t a n d a r d O p e r a t i n g P r o c e d u r e
T V PA: To r t u r e V i c t i m s P r o t e c t i o n A c t o f 1 9 9 1
WCA : Wa r C r i m e s A c t
v i i
PRefACe
his report tells the largely untold human story of After years of disclosures by government inves-
what happened to detainees in our custody when tigations, media accounts, and reports from human
Tthe Commander-in-Chief and those under him rights organizations, there is no longer any doubt as to
authorized a systematic regime of torture. This story is whether the current administration has committed war
not only written in words: It is scrawled for the rest of crimes. The only question that remains to be answered
these individual’s lives on their bodies and minds. Our is whether those who ordered the use of torture will be
national honor is stained by the indignity and inhumane held to account.
treatment these men received from their captors. The former detainees in this report, each of whom
The profles of these eleven former detainees, none is fghting a lonely and diffcult battle to rebuild his life,
of whom were ever charged with a crime or told why require reparations for what they endured, comprehen-
they were detained, are tragic and brutal rebuttals to sive psycho-social and medical assistance, and even an
those who claim that torture is ever justifed. Through offcial apology from our government.
the experiences of these men in Iraq, Afghanistan, and But most of all, these men deserve justice as required
Guantanamo Bay, we can see the full-scope of the damage under the tenets of international law and the United
this illegal and unsound policy has inficted —both on States Constitution.
America’s institutions and our nation’s founding values, And so do the American people.
which the military, intelligence services, and our justice
system are duty-bound to defend. Major General Antonio
In order for these individuals to suffer the wanton Taguba, USA (Ret )
cruelty to which they were subjected, a government Maj. General Taguba led the US Army’s offcial
policy was promulgated to the feld whereby the Geneva investigation into the Abu Ghraib prisoner abuse
Conventions and the Uniform Code of Military Justice scandal and testifed before Congress on his
were disregarded. The UN Convention Against Torture fndings in May, 2004.
was indiscriminately ignored. And the healing profes-
sions, including physicians and psychologists, became
complicit in the willful infiction of harm against those
the Hippocratic Oath demands they protect.
v i i i B R O K EN L AW S , B R O K EN L I V E S
exeCuTive summARy
his report provides first-hand accounts and war crime — at the hands of US personnel. Additionally,
medical evidence of torture and cruel, inhuman, this report provides further evidence of the role health
Tor degrading treatment or punishment (“ill- professionals played in facilitating detainee abuse by
treatment”1) of eleven former detainees who were held being present during torture and ill-treatment, denying
in US custody overseas. Using internationally accepted medical care to detainees, providing confdential medical
standards, Physicians for Human Rights (PHR) conducted information to interrogators, and failing to stop or docu-
medical evaluations of the former detainees to docu- ment detainee abuse.
ment the severe, long-term physical and psychological Methods of torture experienced by the former
consequences that have resulted from the torture and ill- detainees evaluated by PHR included interrogation and
treatment. The evaluations provide evidence of violation detention practices such as isolation, sleep deprivation,
of criminal laws prohibiting torture and of the commis- forced nakedness, severe humiliation and degradation,
sion of war crimes by US personnel.2 and sensory deprivation that were offcially authorized
Four of the men evaluated were either arrested in or by military and civilian offcials during certain periods
brought to Afghanistan between late 2001 and early 2003 when these men were incarcerated.3 Additional prac-
and later sent to Guantánamo Bay, Cuba, where they tices recounted by the interviewees including beatings
were held for an average of three years before release and other forms of severe physical and sexual assault
without charge. The other seven were detained in Iraq that, while not offcially authorized by government docu-
in 2003 and released without charge later that year or in ments now part of the public record, came to be part of
2004, with an average period of detention of six months. a regime of brutality at the facilities where the detainees
All of the former detainees evaluated by PHR reported were held.
having been subjected to multiple forms of torture or This report demonstrates that the permissive environ-
ill-treatment that often occurred in combination over a ment created by implicit and explicit authorizations by
long period of time. senior US offcials to “take the gloves off”4 encouraged
The medical evaluations were based in each case forms of torture even beyond the draconian methods
on intensive two-day clinical interviews that included approved at various times between 2002 and 2004.5 In an
diagnostic testing and, in two cases, review of medical environment of moral disengagement that countenances
records. With this evidentiary record, this report provides authorized techniques designed to humiliate and dehu-
the most detailed account available thus far of the experi- manize detainees, it is not surprising that other forms
ence of detainees in US custody who suffered torture — a
3 R elevant documents containing these authorizations are included
1 I ll-treatment refers to “cruel, inhuman or degrading treatment or i
tno rtwtuor ep u(2b0li0s7h)e; dt hbeo otkorst: uJraem PeealP eJraSf:f etrh &e r aomardi tt oS iangbhu, gahdrmaiinbi S(tKratrieon oJf.
punishment” as is defned in the UN Convention Against Torture Greenberg & Joshua L. Dratel eds., 2005).
and Other Cruel, Inhuman, or Degrading Treatment or Punishment.
Convention Against Torture and Other Cruel, Inhuman, or Degrading 4 C ofer Black, head of the CIA’s counterterrorist center, famously told
Treatment or Punishment, G.A. Res. 39/46, U.N. GAOR. 39th Sess. a September 26, 2002 Congressional hearing, “After 9/11, the gloves
Supp. No. 51, entered into force June 26, 1987, U.N. Doc. A/Res/39/46, came off.” Joint Investigation Into September 11th: Hearing Before the
available at http://www.unhchr.ch/html/menu3/b/h_cat39.htm [here- Joint House-Senate Intelligence Comm., 109th Cong. (2002) (statement
inafter UN Convention Against Torture]. of Cofer Black, Former Chief of the Counterterrorist Center, Central
2 T he defnition of US personnel for the purpose of this report encom- I
Wnitlelilalimge Hnacyen Aesg,e Gnecnye).r Aalc Ccorudnisnegl otof tah eJ uDleyp 2a0rt0m7 eVnatn oitfy D Feafeirn asert, itcolled,
passes: service members with the US Armed Forces, US civilian the “admiral in charge of detainees in Afghanistan “to ‘take the gloves
personnel of other government agencies outside the Department of off’ and ask whatever he wanted” in the questioning of John Walker
Defense, and US government private contractors. This defnition is Lindh.” Katherine Eban, Rorschach and Awe, Vanity fair online, July 17,
intentionally broad due to the fact that the detainees evaluated often 2007. available at http://www.vanityfair.com/politics/features/2007/07/
knew little specifc information about the affliation of the personnel torture200707?printable=true&currentPage=all.
at the facilities where they were held, other than that they were
Americans in most cases and often wore US military uniforms. 5 See supra note 3.
1