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captivity than those who were tortured with pain, there is no
evidence that psychological torture improved the ability of those
enemy regimes to get truth from those prisoners.
51
During the war
on terror, Secretary of Defense Donald Rumsfeld’s advisers also
cited research showing the inefficacy of harsh interrogation.
52
The National Defense Intelligence College has conducted the
most recent large-scale review of interrogation methods. This rich
historical, theoretical, and scientific review notes, among many
other things, “research indicates that a perception of coercion can
negatively affect the tenor of the relationship between the educer
and the source and decrease the likelihood that the source will
comply or cooperate.”
53
In addition to being ineffective, torture is counterproductive:
1. Inaccurate information elicited by pain stresses the
limited analytic capacity of intelligence agencies. In this
way the information acquired through coercive
interrogation makes it more, not less, difficult for analysts
to find valuable, actionable intelligence. False intelligence
can lead to misguided government policies or to needless
(and dangerous) missions. As the CIA’s 1963
KUBARK
manual put it, “Pain is quite likely to produce false
confessions, concocted as a means of escaping from
distress. Time-consuming delay results, while
investigation is conducted and the admissions are proven
untrue.”
54
2. Torture diminishes the possibility of reverting to effective
interrogation methods, such as building rapport, finding
common interests, exploiting a subject’s jealousy of
comrades, and arriving at agreements in which prisoners
come to see telling the truth as being in their best
interest. Interrogators who abuse prisoners also risk
forfeiting their own emotional equanimity, which is
necessary for effective interrogation.
55
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3. Torture alienates persons who might be recruited to
become informants. The CIA’s 1983
Human Resource
Exploitation Manual
states, “Use of force . . . may damage
subsequent collection efforts.”
56
Many Federal Bureau of
Investigation (FBI) reports of interrogations during the
war on terror tell of prisoners who refused to cooperate
with interrogators because of harsh, abusive, or
degrading treatment they meted out.
4. Torture tends to harden the prisoner’s political
commitment and perception of the evil of the
interrogating authority. Some prisoners experience torture
as validating their self-importance, the rightness of their
cause, or conversely, the evil of the torturing side. For
example, some Palestinian prisoners tortured by Israelis
considered the torture a rite of passage that bonded them
to their cause, confirmed the evil of Israel, and proved
their trustworthiness to comrades.
57
5. Coercive interrogation is ill suited to asymmetrical
warfare between a regular army and indigenous guerrillas
who live among a large sympathetic population. Terrorist
profiling by the regular army cannot identify the key
persons in the communities where guerrillas live.
58
Hundreds of citizens have bits of knowledge. Dragnets for
coercive interrogation are expensive and ineffective.
Proponents of interrogational torture sometimes cite
unvalidated accounts of French soldiers who successfully
used torture to learn about terrorist attacks during
Algeria’s war for independence from France.
59
Those
abuses and the difficult-to-confirm successes alienated
the Algerian population and fueled the resistance; France
lost the war. A similar pattern unfolded in Iraq, where the
release of the photographs of prisoner torture in Abu
Ghraib prison was followed by a drop in Iraqi support for
US forces from 63 percent to 9 percent.
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6. Abusive interrogation can foster an “arms race” between
interrogators and prisoners. Targeted groups learn the
techniques that will be used against their members and
then prepare their colleagues accordingly. They take
measures to limit the amount of damaging information
that any individual can disclose.
7. Torture might increase the duration and casualties of war
by causing potentially tortured adversaries to fight longer
to avoid torture and capture.
8. Secretary of State Gen. Colin Powell and his chief legal
adviser, Howard Taft IV, argued that torture invites
retaliatory torture and encourages dictators to justify their
own use of torture with the excuse that leading human
rights nations torture.
61
9. Evidence obtained by torture is often inadmissible at
trial.
62
The inadmissibility of that evidence is part of why
the CIA dissociated itself from harsh interrogations.
63
10. Torture damages the military, intelligence institutions,
and their personnel. The CIA’s
Human Resource
Exploitation Manual
asserts, “Torture lowers the moral
caliber of the organization that uses it and corrupts those
that rely on it as the quick and easy way out.” In 2003
Defense Secretary Rumsfeld’s Working Group on Detainee
Interrogations warned him, “Participation by US military
personnel in interrogations which use techniques that are
more aggressive than those appropriate for POWs would
constitute a significant departure from traditional US
military norms and could have an adverse impact on the
cultural self-image of US military forces.”
64
It harms unit
cohesion and esprit de corps.
65
Torture psychologically
traumatizes the soldiers who perform it. Soldiers who
passively witness or who commit atrocities suffer more
severe PTSD than those who kill during combat.
66
11. Torture creates the possibility of prosecution of the
torturers or their leaders after the torturing regime loses
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power.
The ticking time bomb argument is a hypothetical scenario
crafted to support the moral case for torture. Interestingly, in 1879
Fyodor Dostoevsky wrote a version of the argument in
The Brothers
Karamazov
. Ivan poses this question to his younger brother, a
priest: “Imagine that you are creating a fabric of human destiny
with the object of making men happy in the end, giving them peace
and rest at last, but that it was essential and inevitable to torture to
death only one tiny creature—that baby beating its breast with its
fist, for instance—and to found that edifice on its unavenged tears,
would you consent to be the architect on those conditions?”
67
Ivan’s
hypothetical argument was constructed to compel Ayosha to accept
the utilitarian conclusion that if an innocent baby could be tortured
for the social good, then it was certainly permissible to torture
criminals who were a threat to society. The ticking time bomb
argument is similarly crafted: If an enemy might have knowledge of
an impending attack, then it is permissible to torture that person to
get the intelligence needed to prevent that attack. Popular fiction,
such as the television series
24
, which ran during the war on terror,
presents a seductive case for the ticking time bomb argument as
digital clocks count down while frantic government agents work to
prevent innocent people from doom. To its adherents, the ticking
time bomb argument means that it is idealistic and irresponsible to
ban torture.
68
The argument fails in that it presumes that
interrogational torture is productive, ignoring the research showing
that coercion is ineffective and counterproductive.
Coercive interrogations under the ticking time bomb argument
are still ethically problematic. First, what degree of certainty about
a prisoner’s specific knowledge is required to justify the extreme act
of interrogational torture? Can an intelligence agency use the
ticking time bomb argument to justify the torture of any person
allegedly affiliated with a criminal enterprise on the assumption that
he or she might possess knowledge that could help avert a crime? A
related corollary is, Is it moral to use interrogational torture
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knowing that most of those questioned will be either innocent or
ignorant of actionable intelligence? If so, what does society owe the
many innocent victims of torture? How can they or their families
possibly be compensated? Second, is it moral to torture an enemy
who is unlikely to give useful information despite being tortured? On
a related note, is it moral to torture that person’s spouse or child if
that is the only way to get information? Third, what are the
thresholds for the degree of damage of the attack to be prevented?
Is it justifiable to torture to save one person, ten, a thousand, a
city? Fourth, does the ticking time bomb argument require a clock?
That is, should interrogational torture be limited to situations in
which evidence points to an imminent attack, or can it be used in
the situation of an inchoate or long-range fear of possible attack? In
real world intelligence gathering, even if a prisoner knows
something about a future crime, that piece of intelligence is by itself
rarely of immediate utility. Analysts must fit the prisoner’s
knowledge into a larger set of information, a process that usually
takes a considerable amount of time.
Some propose procedural safeguards (such as torture warrants)
in which a court would weigh the gravity or probability of the crime
that interrogational torture would endeavor to prevent.
69
Some
suggest that torture should remain illegal but that courts should
allow an after-the-fact “necessity” defense, somewhat akin to
allowing a person to claim the necessity of murder in self-defense.
History does not justify confidence in such measures. Regimes that
torture have always spread the practice far beyond the narrow
justifications of the popular fictional images of ticking time bomb
scenarios as they abuse a widening circle of innocent persons and
ignorant opponents. As the Association for the Prevention of Torture
argues in a comprehensive monograph, accepting the ticking bomb
argument lights a fuse on a human rights bomb in civil societies.
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4
WHAT IS A TORTURE
DOCTOR?
The question, What is a torture doctor? invites a useless tautology:
“A torture doctor is a doctor who tortures.” The tautology clarifies
nothing. It fails because a torture doctor is a sphinx, a human face
with a lion’s body. The torture doctor is a chimera of beast and
healer—the immorality of torture and the moral profession of
medicine. Defining a torture doctor requires understanding how
those two parts make a distinctive whole.
The definition begins by inspecting the moral core of medicine.
The Hippocratic precept “Do not harm” comes to mind.
1
Torture
harms. Torture violates respect for the health and choices of the
prisoner. The preface to the WMA’s 1975 Declaration of Tokyo says,
“It is the privilege of the physician to practice medicine in the
service of humanity, to preserve and restore bodily and mental
health without distinction as to persons, and to comfort and to ease
the suffering of his or her patients.”
2
The United Nations’ Principles
of Medical Ethics Relevant to the Role of Health Personnel,
particularly Physicians, in the Protection of Prisoners and Detainees
against Torture and Other Cruel, Inhuman or Degrading Treatment
or Punishment blends the moral foundation with law: “It is a gross
contravention of medical ethics, as well as an offence under
applicable international instruments, for health personnel,
particularly physicians, to engage, actively or passively, in acts
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which constitute participation in, complicity in, incitement to or
attempts to commit torture or other cruel, inhuman or degrading
treatment or punishment.”
3
In addition to being bound to the moral duty to heal, physicians
are accountable to science. A physician who promotes almond
extracts as a cure for cancer has abandoned science and thus the
claim to medical excellence. Torture may appropriate the garb of
science to claim authority, but it is at its core antiscientific. Nazi
“race hygiene” was a false science created to justify segregation
and genocide. The Soviets’ spurious concept of “sluggish
schizophrenia” was created to justify imprisoning dissidents,
invalidating their political beliefs as signs of mental illness, and to
impose brutal abuse with drugs (see chapter 6). US intelligence
agencies’ research had discredited the idea that coercion would
facilitate interrogation long before those same agencies lifted up
the gobbledygook of “learned helplessness” to empower behavioral
science consultation teams (BSCTs) to brutalize war on terror
prisoners (see chapters 3 and 13).
The chaotic advice in torture manuals reveals the unscientific
nature of torture.
4
Some manuals advise escalating harshness
quickly; others say build slowly. Some say that a prisoner should
never hear or see other tortured prisoners; others say that prisoners
should hear fellow prisoners crying out in pain at the earliest
opportunity. Lacking a scientific foundation, torture evolves from
contrivance and imitation. Its regional variants are based on
teaching by sponsors, local traditions, and available materials.
Finally, a medical license is a prerequisite for a torture doctor. In
one sense it certifies that the practitioner has medical knowledge
and skills. But torturing governments are not much interested in
clinical finesse in the healing sciences. Torture is about power. The
medical license comes with the authority to write official medical
documents (e.g., death certificates and other medical records) and
to access and order the use of certain drugs. The torture doctor puts
these powers in the service of torture. For example, the knowledge
of a painful side effect and the authority to prescribe it, both of
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which would suggest prudence and caution to a healer, become
tools for the torture doctor. The authority to create official medical
records and death certificates is a power for concealing torture. It is
difficult to overturn a death certificate that falsely records that a
prisoner died of a heart attack. Ironically, the medical license brings
torture doctors within the ambit of special forms of accountability,
boards that grant licenses, clinical facilities that grant practice
privileges, and medical associations that are a source of prestige
and collegiality after the torture career ends. These bodies, as we
will see in part 3, sometimes hold torture doctors accountable for
violating the duties of a medical career.
The 1975 version of the Declaration of Tokyo proposes four
ways to assess a physician’s complicity with torture:
The doctor shall not provide any premises, instruments, substances or
knowledge to facilitate the practice of torture . . . or to diminish the ability
of the victim to resist such treatment.
The doctor shall not be present during any procedure during which
torture . . . [is] used or threatened.
A doctor must have complete clinical independence in deciding upon the
care of a person for whom he or she is medically responsible. The doctor’s
fundamental role is to alleviate the distress of his or her fellow men, and
no motive whether personal, collective or political shall prevail against this
higher purpose.
Where a prisoner refuses nourishment and is considered by the doctor
as capable of forming an unimpaired and rational judgment concerning the
consequences of such voluntary refusal of nourishment, he or she shall not
be fed artificially.
Some argue that terms like
countenance, condone, complete clinical
independence
, and
complicity in
are too vague for the weighty task
of judging and punishing torture doctors. They argue that a torture
doctor should be judged by a set of specified behaviors.
5
That
behavioral definition of medical torture would set aside the tricky
problem of assessing the physician against the ethos of the medical
profession.
6
It would be as clear and fair as a speed limit. As we
shall see in part 3, the probable increase in accountability from such
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a behavioral approach would be small given that it does not address
the critical lack of will to hold torture doctors accountable.
It is, however, possible to develop a taxonomy of torture
doctoring that is more specific than the list in the Declaration of
Tokyo. This taxonomy would assess the clinician in two categories
of transgressions: (1) misuse of medical skills and knowledge and
(2) misuse of the authorities or duties conferred by a medical
license. Table 4.1 proposes the first tier of subcategories under
these categories.
TABLE 4.1 Taxonomy of torture doctoring
A. Misuse of medical knowledge or skills
1. The physician inflicts torture.
2. The physician misuses medical knowledge or skills to abet torture by
others.
3. The physician misuses medical skills while providing treatment.
4. The physician misuses medical knowledge and skills to clear prisoners as
fit for torture.
5. The physician misuses medical knowledge or skills to monitor prisoners
being tortured so that the torture may proceed.
6. Miscellaneous
B. Misuse of the authorities or duties conferred by a medical license
1. The physician misuses the authority to acquire and release medical
materials for the purpose of torture.
2. The physician fails to create accurate medical records in order to abet
torture.
3. The physician fails to undertake the treatment of a tortured person in a
manner that abets the abuse.
4. The physician fails to safeguard medical records for the tortured
prisoners to use for their own interests.
5. The physician fails to report torture.
6. The physician abets abusive research on prisoners that violates
established research standards.
7. Miscellaneous
The appendix at the end of this book gives case examples of
what might fall within these categories. Several cautions on the
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anecdotes in the appendix (as well as throughout this book) must
be made. First, I name countries to illustrate the diversity of nations
where torture doctors work; similar actions are seen in many other
nations. Second, the cited behaviors oversample open societies,
where human rights reporting is possible. Closed societies, like
Syria, Burma, the People’s Republic of China, or North Korea, are
very difficult to investigate. The myriad of subcategories in table 4.1
and of behaviors cited in the appendix show the difficulty of creating
a behavioral definition of torture doctoring. Finally, the behaviors
tabulated in this book are not an exhaustive compilation of torture
doctors’ work.
I do not believe that a simple list of behaviors that constitute
torture doctoring can be crafted. Torturers are creative. If abusively
loud sounds are barred, inaudible hypersonic noise will be
introduced. If complicity with methods that leave scars is to be the
definitive evidence of physician collaboration with torture, regimes
will shift to methods, such as waterboarding, that do not leave
scars, that is, to techniques Rejali calls “stealth torture.”
7
Thus,
each newly minted technique will set off a new cycle of debating
the behavioral definition. Finally, torture uses multiple techniques in
various sequences against persons of various debilities and
resilience. Even if all the individual elements of a program of torture
did not include any of a list of banned behaviors, the total,
multicomponent regimen of torture could well remain deeply
traumatizing.
This chapter began with a question: What is a torture doctor? I
propose the following definition:
Torture doctor—A licensed physician who directly or indirectly puts (a)
medical knowledge or skills or (b) the authorities, duties, or privileges
conferred by the medical license in the service of “torture” or “cruel,
inhuman, or degrading treatment or punishment” as such terms are
understood in international law.
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