Original subtitles

HIGH PITCHED NOTE

MUSIC

The Abu Grahib pictures raised the question,

where were the doctors while this was going on?

Either they directly witnessed the abuse

or they witnessed the consequences of it.

Why hadn't they protested?

MUSIC

Here doctors weren't complicit.

They were a centrepiece of torture.

They were enablers, they were facilitators,

they were authorizers.

MUSIC

From Hippocrates to now, the standard for

the healing professions has been simple.

That the obligation is first and foremost

to the patient's interest and well being.

Torture shatters that covenant.

How have American physicians and

psychologists come to sanction and implement

torture in our military prisons?

And why haven't they been held accountable

for their actions?

FILM REEL ROLLING

On behalf of the Army of the United States,

I accept your surrender.

You, your officers, and men will

be given treatment in accordance with the principles

of the Geneva Convention.

PIANO

Sickened by the atrocities of World War Two,

the United States and its allies held trials in

Nuremberg, Germany to determine who is

responsible for the heinous acts that had occurred.

Doctors were among the first to be convicted

and executed for their war crimes.

Which included lethal medical experiments on prisoners.

The trial of the doctors lead to more rigorous codes

for medical care of captives.

In 1949, the Geneva Convention also strengthened

the prohibitions against using torture to

get information from prisoners of war.

Despite these efforts, many countries continued

to torture prisoners of war for information and propaganda.

I was in a room that was so small and I could

not lie down.

I was not familiar to stand up to close my eyes,

I like to recline.

The experience of American POW's

in Korea lead the United States to develop a program

to train soldiers how to survive torture if captured.

The program was called SERE.

At the same time, the CIA supported secret research

on how experimental drugs induced comas

and methods like sensory deprivation alter the mind.

MUSIC

ELECTRICAL BUZZING

THUMPING

TELEPHONE RINGING

SCREAMING

TELEPHONE RINGING

The CIA learned from mind control experiments

and tortures used by totalitarian regimes

that several days of sleep deprivation is

a powerful way to break a prisoner down.

TELEPHONE RINGING

My reading is for most people who've been

subjected to that, they will have psychotic like thinking,

will be very disorganized, and I think very unreliable

in terms of what they say.

And it really is kind of very harsh and

very cruel to try and keep people awake.

In 1975, a secret CIA manual of abusive

interrogation techniques was discovered and banned.

But in 1999, some of these methods surfaced

during an espionage case led by the

Naval Criminal Investigative Service, or NCIS.

A psychologist played a key role in the interrogation

of a US Naval Officer.

- Petty Officer King was a, he's a cryptologist

who was stationed in Guam in fall of 1999.

He had been given a new duty assignment in the states.

And before he could take that new job,

he had to have a polygraph.

He took his polygraph and came up with

an indeterminate result.

- Well after they told me I had failed the polygraph test,

I heard somebody say spy.

And from that time on, my life became a living nightmare.

- They launched into a full scale interrogation

of him in Guam.

That involved several days of

sleep deprivation essentially.

Excessive interrogation and threats, it was almost

a full day without sleep.

Then they let him sleep, hour or two hours,

but they would have the phone ringing constantly.

So he would never get any decent amount of sleep.

I got to the point where I just gave them

everything they wanted, just to try and get

out of there sir.

I was an emotional wreck.

I'm not proud of it.

- There was tapes of him, audio tapes,

that we eventually got where he's sobbing saying,

I don't know what you from me,

just tell me what you want me to say

so we can stop this.

He would say, I don't understand this.

I can't take this anymore.

And he had made suicidal statements.

By the time he got back into the Washington DC area,

he pleaded for help from a psychologist or psychiatrist.

They brought in NCIS psychologist

Dr. Michael Gelles to,

as far as Petty Officer King knew, to help him.

- I want to be able to recall stuff,

That, according to the polygraph...

I have inside me.

- When a enlisted man is told by NCIS, who are essentially

acting as his command, that the polygraph is infallible,

he starts to believe it.

When I look, when I try to think on this, I can't see it

and I was wondering if maybe hypnosis or drugs could help me

if it's a suppressed memory or something like that.

- We saw on the tape when they finally gave it to us,

that Dr. Gelles kept saying, "well you gotta

give 'em something.

Otherwise we can't, there's nothing I can do for you."

This was Mike Gelles acting in the role of a mental

health professional, but in fact, acting as

an interrogator or with an interrogation team,

against a person who was medically debilitated.

Against all medical, psychological ethics,

working for his client, the NCIS.

Dr. Gelles characterized himself as,

I'm not here interrogating you, I'm just the doctor here.

I'm just here to help you.

I'm not one of the interrogators.

We later find out that they actually had evidence

that showed what he said could not have happened.

And they knew it by the time that the,

Dr. Gelles was there.

Within a couple days, he grabbed a knife and went to

stab himself with it when an NCIS officer intervened.

The positive thing that came out of it

was they finally got representation.

We were finally able to get involved in the case.

The case against Petty Officer Daniel King

was dismissed and he was honourably discharged

after almost two years in prison.

I love my country, I love my baby.

I've never betrayed it and I would never betray it.

The King case was a forerunner

of the indefinite detention and psychological

tortures that would be used extensively

on detainees after 9.11.

It also foreshadowed programs established by the CIA

and Department of Defense.

In which doctors crossed over from clinical services

to detainee interrogations.

Dr. Michael Gelles continued as Chief Psychologist

of the Naval Criminal Investigative Service.

After 9.11 he was assigned to a special Pentagon Task Force

and consulted on detainee interrogations

in Afghanistan, Guantanamo, and Iraq.

Tonight we are a country awakened to danger

and called to defend freedom.

Whether we bring our enemies to justice

or bring justice to our enemies, justice will be done.

APPLAUSE

EXPLOSION

Less than three weeks later,

US forces invaded Afghanistan in retaliation

for the September 11th terrorist attacks

on the United States.

MUSIC

In a radical new policy, the Bush administration

declared Afghan prisoners enemy combatants.

No longer protected by the Geneva Convention.

Before 9.11, prisoners of war were interrogated

according to the army field manual

that followed the Geneva Convention.

The new interrogation methods involved torture.

We have no alternative, but to meet the enemy

where he dwells.

We must and we will use every means

at our disposal to ensure the freedom

and security of the American people.

In 2001, the CIA had few agents who were expert

in legal methods of interrogating detainees.

We had no interrogators.

The closest we came were security officers who would

quiz you if your lie detector test,

they didn't turn out quite right, you know?

Or people would interview people who wanted to

come on board.

- Two psychologists, contracted by the CIA,

were among the first to introduce abusive interrogation

techniques, doctors James Mitchell and Bruce Jessen

were experts in SERE survival training.

They adapted the SERE torture regimen for use on detainees.

- Dr. Bruce Jessen was the Chief of Psychology

of the Air Force's survival school.

The psychologists were there so that if someone

actually was having a difficulty, some kind of

psychological breakdown, that then we could stop,

do a timeout, and actually bring in the psychologist

so they could talk people through.

What we were doing,

in resistance to interrogation training,

it was for the benefit of our own forces.

Seeing that these people actually were the architects

behind the torture program just

it made me physically ill.

DOGS BARKING

The brutal methods organized by

psychologists Mitchell and Jessen for CIA interrogators

came to be called enhanced interrogation techniques.

These techniques were soon adopted by army interrogators

at Guantanamo with the help of a psychiatrist

and a psychologist.

From there, they were exported to Afghanistan

and Iraqi detention sites.

The program became so widespread it was only

a matter of time before the world knew that the

United States was torturing detainees.

- As torture became more and more controversial,

and the lawyers were more and more under pressure

to find a justification for these methods.

They turned to the doctors for an opinion

on whether they impose severe pain,

mental or physical pain or suffering.

Which is the legal definition of torture.

In 2009, the special review of the

enhanced interrogation program by the CIA

Office of Inspector General was declassified

over the fierce objections of the intelligence agency.

Special guidelines from the CIA Office of Medical Services

were also declassified.

The critical role of doctors in the enhanced

interrogation program can be traced through these documents,

and the memos of the office of legal counsel.

The CIA doctors and the legal counsel lawyers

described the enhanced techniques in such detail

that their instructions could be the script

for a training video for doctors assigned

to detainee interrogations.

ELEVATOR

Captured terrorists may be subjected

to a wide range of legally sanctioned techniques

designed to psychologically dislocate the detainee,

maximize his feelings of vulnerability and helplessness.

And reduce or eliminate his will to resist our efforts

to obtain critical intelligence.

CHAINS RATTLING

FOOTSTEPS

STAMP

HEAVY BREATHING

They turned to the doctors.

They basically said, we determine that severe pain

means it's very intense.

And of long duration.

And sometimes are violent.

Could you tell us doc, does this method

meet that threshold?

And not once, according to either the legal documents

or the medical memos, not once did the doctors

ever say, "no you can't do this."

Appropriate medical and psychological

personnel must be on site during all detainee

interrogations employing enhanced techniques.

The use of each specific enhanced technique

must be approved by headquarters in advance.

In the government memos,

enhanced interrogation techniques fall roughly

into three groups.

Methods that involve physical assault.

Those that can induce dangerous levels of physical stress.

And those that can psychologically debilitate

the prisoner.

Methods are combined to increase the pressure.

This also increases the severity of the abuse.

And one of the most monstrous aspects

of the office of medical services memos,

was the reference to the Hippocratic Oath.

It says, remember you must abide by your

obligation to do no harm, it says that.

- The doctor is responsible for keeping the detainee alive,

he checks that the blood pressure and heart rate

are not dangerously high.

And measures the blood oxygen level with

this pulse oximeter.

After prolonged exposure to cold water,

he may check the body temperature

in case of hypothermia.

When there are more than 15 applications

of the waterboard in a 24 hour period,

he has to do careful medical assessments

after the later applications.

In the rare cases, when a prisoner is difficult

to resuscitate, the doctor has to perform

an emergency tracheotomy.

Physicians for Human Rights believes that

the safety officer fallacy takes

physicians from being healers to being

calibrators of harm.

They serve as a sort of gasoline on the fire.

Because interrogators think that they can go harder

because there's a health professional there.

That they can push the detainee closer to the edge

because there's a safety net there

in the form of a health professional to catch them.

- The CIA Office of Medical Services instructs the

doctor to keep thorough systematic records.

In order to best inform future medical judgements

and recommendations, it is important that every

application of the waterboard be thoroughly documented.

How long each application and the entire procedure lasted.

How much water was used.

Realizing that much splashes off.

If the naso or oropharynx was filled,

what sort of volume was expelled and how the

subject looked between each treatment.

- So to warp a person, to warp a professional,

a doctor for example, into doing this kind of thing

really is quite a trick.

The sad part about it is it's so easy

with these group mentalities and all the kinds of things

that you can manipulate people into doing

against their better instincts.

For walling, a flexible false

wall will be constructed.

SLAMMING

The idea is to create a sound that will make

the impact seem far worse than any injury that might

result from the action.

The CIA had special equipment built

for the enhanced techniques.

The water board was built so that the interrogators

could swing the detainee upright in an emergency.

Cramped confinement boxes came in small and large sizes.

You have informed us that you would spend

at most two hours in this box.

You have informed us of the purpose of using this box.

It's not to interfere with his senses or his personality,

but to cause him physical discomfort that will

encourage him to disclose critical information.

SLAMS

SLAMS

We've had a lot of debate about torture in this

country and whether its ever justified,

I think it's never justified.

In part, because as we've seen, that once you start

down the road of torture, it never stops

and it gets worse and worse and worse.

PULSE BEEPING

Keep going.

Most seriously, for reasons of physical

fatigue or psychological resignation,

the subject may simply give up.

Allowing excessive filling of the airways

and loss of consciousness.

An unresponsive subject should be righted immediately.

GROANING

Doctor!

Today, doctors are essential to torturing regimes.

Half of all torture survivors report seeing a doc

supervising their torture.

The doc keeps alive the ones who are supposed

to be kept alive.

The doc devises methods of torture, such as shock,

such as cold, such as isolation or psychological stress,

that does not leave wounds that can be interpreted

as evidence.

And the doc uses the bureaucracy of the modern state

to conceal the medical records, to falsify

medical records, and to falsify death certificates.

It was clear that the abuse had been quite extensive

and involved very large numbers of prisoners.

And also involved really extraordinary levels

of gratuitous violence.

I decided, given the gravity of the issues,

to be extremely conservative in my approach.

I wouldn't use witness accounts.

I wouldn't use lawyer statements.

I wouldn't use press accounts.

I would only use first source government documents.

As it happened, the ACLU was conducting a gigantic

set of lawsuits under the Freedom of Information Act

to obtain government records.

They put these documents up on a website.

I read somewhere in the neighbourhood of

60 to 80,000 pages.

Once you start getting that many documents,

it's possible to cross link events.

The story of the ice man, for example.

That story resides in about 15 different documents.

And until you put them all together,

you can't see the extraordinary narrative.

Because this guy was picked up at his home

by Navy Seals, there was a huge fight at his home.

They took him to a Navy Seals base, he was naked.

It was November.

He said, "I feel like I'm gonna die."

And the interrogator said to him, "You're gonna

wish you were dead."

A medic watched as they worked him over

in something called the Romper Room.

Then they took him to Abu Ghraib.

He said, "I can't breathe" to the entry people.

But was not given a physical exam.

The Seals turned him over to the CIA.

The CIA took him into a shower room

and they had the guards tie his hands behind his back

and they hoisted him up.

When you hang somebody backwards by their wrists,

it prevents the lungs from expanding.

And when you add to that, broke ribs

and a sandbag over his head, it makes breathing

even more difficult.

The final cause of death was asphyxiation.

Then they called the guards back in.

And the guards, the CIA guy told the guards,

"Look, he's faking it.

He won't talk and he keeps slumping down."

Well the guards tried to lift him up, he was dead weight.

In fact, he was dead.

The CIA freaked out at this guy being dead.

They called intelligence commander Apus,

who came in and said, "I'm not going down for this,

what'd you do to this guy?"

So they sent one of their lieutenants off

to grab some ice.

And packed him in the body bag.

And then the guards had their photo shoot.

The next thing that happened was in the morning,

they had to get him out of the shower room

and they had to take him through the prison cell blocks.

So they called in a medic, who put an IV in his arm,

and wheeled him out saying he was sick.

The narrative of where his autopsy was done,

who did it, and why the death certificate

was suppressed is still classified.

Although the United States was obligated

to return his body to the al Jamadi family,

he was buried in an unmarked grave.

His family learned what happened to him

through the Abu Ghraib photos.

The world knows Mr. Jamadi as the body defiled

by Abu Ghraib guards.

The press focused on who tortured him

and whether officers would be prosecuted for his murder.

One fact is rarely noted.

Mr. Jamadi's fate was sealed by two medics, a doctor,

and the medical command responsible for his healthcare,

according to the third Geneva Convention,

ratified by the United States.

The number of doctors involved in detainee abuse is unknown.

But in declassified government documents,

the al Jamadi case is just one among many

involving medical complicity and cover up of torture.

The pathologist working for the

Armed Forces Institute of Pathology collectively

and systematically and uniformly suppressed

death reports in US prisons

in Afghanistan and Iraq.

To the extent that they ever became aware of them

in the CIA rendition presence as well.

There have been detainees here since last July.

Nobody knows what cave they are in.

Nobody can reach the detainees.

The Americans dominate the detainees.

They dragged them out of bed naked.

Three of them were released.

Two were kept.

One was taken to Basra.

Secret deaths in prisons alienate populations profoundly.

And in fact, when you look in Iraq and what happened

after the Abu Ghraib experience,

including the death of Jamadi came out,

what happened was that support for our

presence in Iraq dropped from around 70 percent

to around 20 percent.

We lost the moral authority that we had at Iraq.

We lost the Iraq people in a way that radically

transformed the Iraq military and political landscape.

And then of course, the ultimate folly of all this was

that according to military intelligence,

85 percent of the prisoners at Abu Ghraib were

entirely innocent or ignorant of any insurgency

activity whatsoever.

MUSIC

As a doctor who's been evaluating in caring

for torture victims from all over the world,

for over 15 years, individuals that I examine who've been

detained at Abu Ghraib or Guantanamo are among

the most traumatized, scarred both

physically and psychologically and for lack of a better

way at putting it, most damaged individuals

that I've examined.

- Under pressure to obtain useful intelligence,

the Department of Defense established behavioural

science consultation teams.

Made up of both psychiatrists and psychologists

to advice interrogators on strategy

after observing interrogations on TV monitors like this.

(indistinct speech)

- He said it's healthy. I can't move my arm.

- I requested medical for a long time.

They don't do anything about it.

- No, I mean they look like they're healing well to me.

You know I'm not a doctor but I think...

you're getting good medical care.

- No I'm not. You're not here.

The Behavioral Science Consultation Teams,

or BSCTS, helped interrogators

exploit the physical and emotional

vulnerabilities of the detainees.

These doctors were pulled out of clinical services

and thrust into the role of consultants

without any experience with interrogation.

- We like to think of torture as mainly this

physical phenomenon, that it's only torture

if you're beating someone or hanging them

from their thumbs.

It's really important to recognize and understand

that most, if not all torture, has both physical

and psychological components.

According to the Guantanamo standard

operating procedures, on arrival each detainee

is isolated for four weeks and allowed contact

only with interrogators and the

behavioral science consultants.

Step up.

Turn around.

Human beings are social, we're creatures that

thrive on communication with others, connection with others.

So when you deprive someone of that, you automatically

start raising risk factors for the kinds of reactions,

for reactions such as depression,

anxiety, panic attacks,

suicidality, in sort of more extreme cases

and psychosis even in more extreme cases.

SCREAMING

SLAMMING

SLAMMING

Isolation is often combined with

sleep deprivation to further disorient the detainee.

- Soccer?

TEASING AND TAUNTING

SLAM

Stay the fuck awake, no sleeping, no sleeping.

None, none.

SLAMMING

Investigative journalists were among

the first to expose some of the techniques

recommended by the behavioral science consultants.

There was one plan in particular that a detainee's

lawyer described to me in which the

detainee was told that a psychiatrist had monitored

the amount of toilet paper he was allowed,

he was only allowed seven squares a day.

And that was actually an improvement over earlier

when the psychiatrist, according to these sources,

had taken away all of his toilet paper.

Each detainees had kind of a psychological assessment

and a plan kind of created for interrogating

him depending on his weaknesses and vulnerabilities.

Another common form of abuse that I heard

from almost every former Abu Ghraib and Guantanamo

detainee was these horrific recountings

of sexual humiliations.

There was one individual, for example,

who told me how he was forced to be naked

in a room where it was made very hot and very cold.

He was forced to stand in uncomfortable

and painful positions.

But what was most devastating to him about that experience,

was when he said, a woman who was naked

came into the interrogation room

and touched herself and then touched him

with what he believed was menstrual blood.

It was this moment when he was utterly

and completely helpless and humiliated.

That was most traumatizing to him.

That was when he hung his head in shame.

Probably overwhelmingly, most of the individuals

who were detained at Abu Ghraib or Guantanamo

were not terrorists.

They were individuals who were picked up and sweeped,

who were in the wrong place at the wrong time,

got arrested, put through this hell like no other,

that they or I could describe, and then were released.

But really shells of who they were.

Mohammed Jawad was one of these detainees.

In 2002, he was arrested in a crowded marketplace

in Kabul after a grenade exploded injuring

three US servicemen.

Jawad did not have a birth certificate and his

age at the time is uncertain.

But he was estimated to be between 14 and 16.

After a short detention in Afghanistan,

he was moved to Guantanamo Bay.

- Guantanamo Bay is sort of supposed to be you know,

where you keep the worst of the worst, you know,

the really bad people.

And you have a child who's being accused of

throwing a hand grenade at US soldiers being called

a war criminal, it just didn't make sense.

During an interrogation of Mohammed Jawad,

the interrogator became alarmed when the youth

began talking to a wall.

He asked a psychologist assigned to detainee

interrogations to observe Jawad and check

his mental state.

Her response was reported by another officer

in a sworn deposition.

He appears to be rather frightened and it looks

as if he could break easily if he were

isolated from his support network and made

to rely solely on the interrogator.

Make him as uncomfortable as possible,

work him as hard as possible.

The psychologist concluded that Jawad

was faking homesickness and depression.

And recommended more severe isolation to

induce his cooperation.

After a period in this extreme isolation, Mohammed Jawad

attempted to kill himself by banging his head

off metal structures in his cell.

He survived and was kept relatively isolated

for five more years,

when Dr. Katherine Porterfield examined

him at the request of Jawad's defense team.

Over the course of my evaluation with Mr. Jawad,

it was clear he was suffering with major depression.

He had intense sadness and despair.

Difficulty sleeping, he had severe sleep problems.

Appetite had been basically profoundly impaired.

You know, he barely ate very much and he had

almost, he said, no taste for food anymore.

He was a very, very depressed young man.

- When I went into Jawad, I wanted to take

the initiative and you know, get to the point

as quickly as possible.

And he basically stopped me.

And I was with an interpreter, he doesn't speak English

or didn't at that time.

And he said, "I don't wanna talk about who you are

or why you're doing what you're doing

or anything, all I wanna do is find out when

I can go see my mom."

All of a sudden, the curtain got pulled back

and you know, there was this boy sitting in a chair

asking for his mom.

And it really changed the way that I approached that case.

- When I would ask him to recount anything

about his time at Guantanamo, he would become

very distressed, put his head in his hands,

and just say, "I can't, it's too hard."

I wrote a declaration stating that I felt that

the conditions he was in were not appropriate

or harming him.

And his lawyers basically then argued,

to the authorities, that he should be moved

out of a situation of isolation.

And that response did not come for many months.

- He was never viewed as an innocent person, you know,

within the system.

It was always, he's guilty, so how do we get

to the conviction as fast as possible?

Jawad's lawyer, Eric Montalvo,

went to extraordinary lengths for his client.

To get missing records and depositions,

he travelled to Kabul.

An unarmed marine without the protection

of US forces, he returned with messages of support

from Jawad's family and powerful evidence

that Mohammed Jawad was innocent.

And I think that at the end of the day,

it was such a mess of a case.

And it was so emblematic of all the things wrong

with Guantanamo, that they just got him out of there.

And tried to make it go away.

After seven years in prison,

Mohammaed Jawad was finally released.

Eric Montalvo kept his promise to be in Kabul

when the young man arrived.

His mother couldn't even recognize him

because he had physically changed so much,

because he was just a boy.

And he apparently had a certain shape to the back of his

head from either a fall or what have you,

and she was in total disbelief until she

felt the shape of his head.

And then at that point she knew and collapsed on the floor.

In the case of involvement of health professionals,

when does it rise to the level of national scandal?

How many more revelations about physician involvement,

about research, about approval of interrogations

for people who are clearly injured, to be injured again.

How much more?

The American public does not hear much

about doctor involvement in detainee abuse.

Since the Abu Ghraib scandal, both administrations

have gone to great lengths to present detainee

treatment as humane.

We are going to treat them exactly right.

We're gonna treat them humanely and

it will be appropriate to their circumstance.

The press is given tours of modern

medical facilities in Guantanamo.

And army psychologists who report on the condition

of detainees, make no mention of symptoms of trauma.

The diagnosis we see, are the same ones we've

seen in the states.

The main or most prevalent diagnosis here

are personality disorders.

Do you see any signs of desperation

by some detainees?

Uhh...

not really.

Well...

A few of 'em have maybe well...

Maybe a few of 'em.

I can't... I don't know really any specific details though

where they have done anything

out of desperation.

Doctors at detention sites are divided

between those who work in treatment services

and those who work under the intelligence command.

Although the two are officially separate,

there are many reports of doctors in the medical services

supporting the programs of the intelligence command.

Released detainee Adel al Gazzar.

One day I remember I was crying terrible from the pain.

A doctor turned up with pain killers but he said,

"I will give you the medication, but first you need

to sign a confession that you're a member of al Qaeda."

I told him I'm not a member of al Qaeda

and cannot confess to a lie.

He put the medication in his pocket and walked off.

What's interesting is that the medical personnel

at Guantanamo never go by their real names.

So they always rely on pseudonyms.

You know, Doctor Scarlet, you know, Doctor Geneva.

So it's very hard to identify medical personnel.

MUSIC

There were doctors who actually lived up

to their ethical obligations.

And the perception among the prisoners

was that those doctors were very quickly,

you know, shuffled out of Guantanamo.

Or rotated out of their posts.

Were not renewed or maintained in those positions.

Journalists are not allowed to

interview detainees in the detention sites.

Reports of how detainees are force fed at Guantanamo

come from released prisoners and their defense lawyers.

I represented Ahmed Zuhair, who's a Saudi national

who was in US custody from 2002 until 2009.

He was on hunger strike as a form of peaceful protest

at sort of his unlawful and indefinite

imprisonment away from his family, away from his life,

and also in protest of the torture that he had survived.

And he said, you know, he would continue his hunger

strike until the United States stopped referring

to him as an enemy combatant.

You know, over the course of my two years

representing him and meeting with him at Guantanamo,

his health fluctuated sharply.

You know, we had some meetings where he was in a gurney.

There were some meetings where he could not move

and where he was in physical pain.

I saw him vomit repeatedly.

So it was a physically traumatizing experience

for him, but somehow you know, really almost magically

he remained lucid throughout.

You know, initially, force feeding was done on a bed

in a relatively unfettered position.

So the authorities went from a protocol that

accommodated the prisoners and made the

force feeding experience more comfortable

and more tolerable, to another protocol.

Which was designed specifically to inflict

maximum pain and discomfort so as to pressure

the hunger strikers to suspend their hunger strikes.

The subsequent protocol that my client described

involved what he referred to as the Torture Chair.

Which was a chair, which was a six point restraint

chair where prisoners were restrained at the arms,

legs, torso, head, and neck.

They took away lubrication, they took away

local aesthetics, they took away soothing lozenges.

All to make the experience as uncomfortable as possible.

SCREAMING

Some of the men refused to come out.

Because they objected to being force fed.

And in a brutal manner.

And so they wished to remain in their cells.

And so what the medical authorities at Guantanamo

do at that point, was to order basically a riot squad,

six man teams in full riot gear,

with padding, shields, sticks, helmets, visors, mace,

and they would basically march into a cell block

as loudly as possible to intimidate and terrorize

the prisoner population.

And then they would go into the cell.

And drag them out to the restraint chair.

And then one of the US military medical personnel

would insert the force feeding tubes.

And a single feeding session would last,

you know, two to three hours.

Depending on how much nutrition was to be administered.

That experience was so traumatic that a lot of the

prisoners developed inflamed nasal passages.

The medical personnel, they would leave the tubes

in their noses for days on end.

But he was in a position where that was the only

possible gesture of protest that was left to him.

The people in Guantanamo Bay, we have not

forgotten about you.

Even though I've been released for over two years,

the burden of Guantanamo is still there with me.

And until that place is closed down,

I can never forget what happened there.

We were able to get a federal judge to order

the government to either

force feed Mr. Zuhair in humane conditions, on a bed,

in a clinic, and not in the restraint chair.

Or justify to the judge, to the federal court,

why it was necessary to force feed him

in that restraint chair.

But the other hunger strikers who were not

subject to that order, they were still being

force fed pursuant to the old protocol.

And to my knowledge, that force feeding protocol,

that's a protocol that is still alive and that is

still being applied at Guantanamo today in 2010.

Ahmed Zuhair was released from Guantanamo

after being imprisoned for seven years without charge.

But Shaker Amair, a leader of the hunger strikes,

remains in isolation.

The only British resident still detained at Guantanamo.

I'm dying here everyday, mentally and physically.

I have got kidney problems from the filthy yellow water.

I have lung problems from the chemicals they

spread all over the floor.

I'm already arthritic at 40 because I sleep

on a steel bed.

And they use freezing air conditioning as part

of the interrogation process.

I have ruined eyes from the permanent 24 hour

fluorescent lights.

I have been made paranoid so I can trust nobody,

even my lawyer.

Because the Americans play with my mind.

I would just like to die quietly by myself.

I want no feeding, no force tubes.

No help.

No intensive assisted feeding.

From everything we've seen about how this policy

of torture was designed and implemented,

that health professionals were a critical cog in the wheel.

And that if you were to take the health professionals out,

the system as we know it, I believe would've come

to a grinding halt.

- Had the senior physicians come out forcefully

and more or less unified, that clinical practitioners

were not gonna participate or condone

any of these practices, that there could've very likely

been at least a curtailment and a serious

limitation of their happening.

For the army, it would've meant that the army

surgeon general would have said,

absolutely we are not going to comply with this.

It violates all our ethical principles, it is wrong.

And no medical people will be involved

in these practices.

Doctor Kylie, who then was a surgeon general,

had the opposite viewpoint.

That the military mission of getting the

intelligence information superseded what had

been the traditional medical ethics and medical practice.

Some intelligence and military officials

did protest the torture program.

- In simple words, your own soldier's language,

how did this happen?

- Failure in leadership sir from the brigade

commander on down.

Lack of discipline.

No training whatsoever.

General Antonio Taguba was forced

into retirement for his rigorous investigation

of the abuses.

The military command severely punished

Sargent Sam Provance for refusing to retract

his testimony about tortures at Abu Ghraib.

I do know military doctors who

either directly indirectly did resist cooperating,

voiced their dissent.

And they feel and I really

agree with them that their careers one way

or another were hurt.

In contrast, the officers who developed

and conducted the enhanced techniques program

remain well protected.

The CIA has provided doctors James Mitchell

and Bruce Jessen with a five million dollar

legal defense fund in case they are charged

with torturing detainees.

Now if we got professionals who are trained in this

kind of work to get information that'll

protect the American people, and by the way,

we have gotten information from these

high valued detainees,

that have helped protect you.

In 2006, President Bush announced

that the enhanced techniques provided

invaluable intelligence.

But by then, the program was so widely condemned

that a high army official could publicly

refute him without getting punished.

No good intelligence is gonna come from abusive practices.

I think history tells us that.

I think the empirical evidence of the last

five years, hard years, tell us that.

So and moreover, any piece of intelligence

which is obtained under duress, through the use

of abusive techniques, would be of questionable credibility.

And additionally, it would do more harm than good

when it inevitably became known that abusive

practices were used.

- There's a guy speaking truth to power.

Didn't deter Dick Cheney or George Bush

from doing this anyway.

But Kimmons was laying down the law saying look,

my army is not gonna do that.

If it's done that in the past, it's gonna stop doing that.

Because they don't work.

In 2002, FBI and other federal investigators

tried to stop abusive methods that military interrogators

were adopting at Guantanamo.

Dr. Michael Gelles, who had been involved in

the Daniel King espionage case, was among those

who protested the brutality.

The federal investigators, including Dr. Gelles,

proposed an alternative way to interrogate

a high valued detainee.

It was rejected by the military in favour

of more physical coercion.

The alternate plan remained classified until 2009.

Well when we actually read the plan, it was chilling.

It was not a model for an ethical interrogation,

but it was based on instilling complete

dependency and debility over many months.

I think what we're finding out is that what

Colonel Larry James, who claims to have abolished

abuses at Guantanamo in January of 2003,

what Larry James and Michael Gelles felt was abusive

was only the most extreme techniques.

The so called physical techniques.

Slapping or banging against a wall.

Not sleep deprivation and isolation

and sensory deprivation.

Significant but incomplete reform,

banning extreme physical tortures but not some of the

psychological abuses, can also be seen in 2006

revisions of the army field manual.

Endorsed by the Obama administration.

- Any interrogations taking place are gonna

have to abide by the army field manual.

We believe that the army field manual

reflects the best judgement of our military.

That we can abide by a rule

that says we don't torture.

- When President Obama came into office,

he also indicated that the interrogations

by the United States forces, including the CIA,

should follow the parameters laid down in the

current army field manual.

That's the same army field manual that carries

appendix M, with all of its different abusive

forms of interrogation.

It also is the same army field manual that changed

the definition of the use of fear up from the

previous army field manual to allow for the

induction of new phobias, new fears.

It changed the language of the previous army field manual,

which had banned sleep deprivation.

Now there was no such ban.

- My reading of the appendix M of the field manual

was that it did open a door to some of these

techniques that are mostly being used

by the CIA.

The question of detainee abuse

and the role that doctors play in it,

is no longer limited to the military or CIA

operations oversees.

Detainees awaiting trial in the United States

may be subject to special administrative measures,

or SAM's, that resemble the isolation and deprivation

found in Guantanamo.

We're gathered here on a very wet and damp day

outside of the Metropolitan Correctional Center,

where for nearly three years, Fahad Hashmi has been held

in severe solitary confinement.

- In 2006, Fahad Hashmi, an American citizen,

was arrested for material support for al Qaeda

and kept in highly restricted lockdown.

His treatment raised an issue rarely debated in public.

Prolonged isolation can jeopardize a prisoner's health.

Do the special administrative measures supersede

the orders of a doctor responsible

for the detainee's care?

- So we say tonight to Fahad

and to his family, that we stand with you

and remain committed to struggle alongside you

towards a light that surely must come and emerge

from these dark days.

As we leave, I'd like everyone to place

a flower, you're not allowed to stand on the sidewalk

in front of the MCC, but as you walk by,

please place a flower.

The detention practices of the war

on terror have come home.

If extreme isolation is harming a detainee,

can US prison doctors stop it?

Do doctors have the authority to protect

the healthcare of the prisoner?

Although much is classified, there is evidence

that decisions by doctors treating detainees

may be countermanded by government officials.

When I hear about psychologists participating

in CIA black sites, in the kidnapping of children,

I know that something is wrong in the state

of psychology and how psychology is being used.

APPLAUSE

Many human rights and healthcare organisations

have protested the role of doctors

in the torture program.

In 2005, Doctor Steven Sharfstein,

the newly elected president of the

American Psychiatric Association wrote to

Secretary of Defense Donald Rumsfeld,

raising concerns about psychiatrists assisting

interrogations at Guantanamo.

Well what happened was I didn't hear a word

in response to my letter.

And then in the beginning of October I got a call,

"Would you like to go next week?"

I guess that's the way things work in the military.

And I said absolutely.

We landed and we went, took a boat trip

across the bay, to the prison.

And then we had a briefing on the prison,

very extensive one.

What we heard was that there were these

Behavioral Science Consultation Teams, BSCT teams,

they were never in the room when interrogations took place.

They were in another room.

They were listening in.

They had direct way to talk to the

interrogators and to advise them about

what ways to proceed and their role they

emphasized was to try to establish rapport with

these detainees and not really stress them in any way.

So they were trying definitely to convince us

that what they were doing was humane, ethical,

you know, on the up and up.

Doctor Sharfstein and his colleagues

were not convinced that psychiatrists should

assist in interrogations.

I didn't think that psychiatrists

had any competency

to be doing this kind of work.

We're trained to diagnose, treat.

Beyond the ethical position of do no harm,

what training do we have in interrogations

and police interrogations, or any of those

kinds of issues?

- In 2006, after much internal debate,

the American Psychiatric Association passed

a resolution stating that it was not appropriate

for psychiatrists to directly assist

in the interrogation of detainees.

The American Psychiatric Association just drew

the line and said, no.

And actually many...

I was contacted by a number of military psychiatrists

saying thank you, because now we can say to superiors,

"I don't wanna go against the policy, position,

and the ethical rules of my association."

Though the standards of the AMA and the

American Psychiatric Association are as they should be,

strong unequivocal prohibitions against direct

involvement in interrogation, the fact remains

that neither of those associations have taken

ethical action against members who allegedly

were directly involved in the abuse

of prisoners in US custody.

Only one professional association

approved of its doctors assisting interrogations,

the American Psychological Association or APA.

In 2005, it followed the recommendations

of its task force on psychological ethics

and national security, or PENS.

So for us, the question is not whether

psychologists may be involved in these processes,

it's how psychologists may be involved

in these activities in an ethical manner.

We know from records and accounts of what went

on at the task force that there was never

a question, a discussion, about whether

it was ethical for psychologists to participate

in these interrogations.

That was assumed from the very first moment.

The APA has never, except when absolutely forced to

by the public record, acknowledged that there are

even problems in the policy.

Psychology's profession has been intimately

involved with the military intelligence establishment,

something that's sort of invisible to a large

number of practical psychologists.

APA officials appointed a task force

guaranteed to approve psychologists involvement

in detainee interrogations.

Doctor Morgan Banks helped to write the standard

operating procedures manual for BSCT interrogation doctors.

Doctor Scott Shumate attended the launch

of enhanced interrogation procedures at a CIA black site.

Doctor Larry James was the first psychologist

to advise on interrogations at Abu Ghraib.

Doctor Bryce Lefever, another member of the task force

majority, asserted that a psychologist assisting

interrogations has no responsibility

for detainee welfare.

Contradicting the most basic ethical principles

of psychology practice.

- America happens to be my client.

Americans are who I care about.

I have no fondness for the enemy.

And I don't feel like I need to take care

of their mental health needs.

Producing some pain just seems to be,

you know at first blush, something that would be wrong

because we do no harm, but if it does the most

good for the most people, it's entirely ethical.

And to do otherwise would be unethical.

Doctor Michael Gelles was the

psychologist involved in the Daniel King espionage case.

In 2001, one of King's lawyers found Gelles

treatment of King so unethical that he submitted

a complaint to the APA Ethics Committee.

The complaint was dismissed.

Four years later, the Ethics Director helped

appoint psychologists to the PENS task force,

including Michael Gelles.

APA officials stressed the organisation's

strong resolutions against torture.

And claimed that psychologists keep the

interrogations safe, ethical, and effective.

In 2008, thousands of APA members effectively

rejected this claim and voted down

the interrogation policy.

In spite of this referendum, psychologists still

assist detainee interrogations and their work

remains highly controversial.

Today, behavioral science consultants and

research psychologists have a prominent role

in the Obama administration program for

interrogating high valued detainees.

When people committed these same acts,

we prosecuted them in the past at places like Nuremberg.

And places like the International Criminal Tribunal

for the former Yugoslavia.

What's different here?

The difference is, is that we just don't care enough.

- There's been no accountability at all.

No investigation that we're aware of.

No attempt to question the doctors about

what they did, reveal what they did fully.

In fact, both the Bush administration, the Obama

administration have utterly refused and opposed

any attempt to investigate.

And the doctors have completely escaped

any ethical or legal responsibility

for what they've done.

The fight for accountability

is now turning to institutions separate

from the United States government and military.

Doctors, including those in the CIA and military,

must be licensed by their state boards,

which are responsible for disciplining any

involved in malpractice.

To my knowledge, to date, there have been complaints

filed against health professionals in California,

New York, Louisiana, Alabama, Guam, and Ohio.

Before health professional boards, licensing boards

in all of those states.

Not one of them to our knowledge has even

investigated, officially seriously investigated

any of the allegations.

Some boards have not bothered to give written answers,

but over the phone when consulted,

have said that they don't have jurisdiction.

We don't believe that that's true in any of the cases.

The Texas State Board of Examiners

dismissed a complaint against Doctor James Mitchell,

the psychologist who according to government documents,

led the team that waterboarded a detainee 83 times.

Until congress, until the National Institutes of Health,

institutes of medicine, realize that this

is arguably the single greatest scandal

in the history of American medical ethics,

and act that way, we will be not even

knowing what we don't know about.

Not even knowing the questions to ask.

Hold it.

Okay.

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