reprinted with permission from the National Catholic Reporter
Steven Miles is a professor of medicine and bioethics at the University of Minnesota. His forthcoming book, which has the working title Oath Betrayed: Military Medicine and the War on Terror, stemmed from his attempt to learn why the U.S. medical staff in Iraq, Afghanistan and Guantánamo Bay did not report or intervene to stop the abuse of prisoners for the two years preceding the public release of the Abu Ghraib photographs. For this, he reviewed about 25,000 pages of government documents and trial testimony obtained under the Freedom of Information Act. Miles has assisted victims of war and torture in 25 years of international work with the American Refugee Committee and the Center for Victims of Torture. He is a past president of the American Association of Bioethics and served on President Clintons Bioethics Working Group on Health Care Reform. Dr. Miles was interviewed for the National Catholic Reporter by Richard Thieme about the failure of physicians to reveal torture.
Thieme: What first attracted your attention to the issue of the medical communitys responsibility toward torture?
Miles: When the Abu Ghraib pictures were published, it was clear this had been going on for a while. Clearly doctors were present in the prisons because doctors are always present in prisons so they must have seen the abuse or signs of the abuse. Why was this surfacing as a leaked CD rather than a report by the medical profession? I found somewhat to my amazement that it was not just a matter of not reporting but it was actually a matter of being involved in setting the harshness of the interrogation plans and delaying reports of homicide, which would have been an important signal to the public of what was wrong inside the prison.
Thieme: Are you aware of formal or informal pressures or influence brought to bear on the medical profession to enlist doctors in the practices you decry?
Miles: At the present time, I do not see any research agenda or set of programs comparable to MKSEARCH or MKULTRA [mind-control research conducted by the CIA from the 1950s to the late 1960s, including covert drug tests on unwitting citizens]. On the other hand, it is very clear that if you go all the way back to the beginning of the war on terror, the United States decided that the Geneva Convention did not apply. The next thing that happened was Guantánamo asked for policies to guide interrogations in the absence of the Geneva Convention. The JAG [Judge Advocate General Corps] officer at Guantánamo proposed an outline of policy for monitoring interrogation. The antecedent memos by the Department of Justice had already written off prisoner standards as not being violations of the Geneva Convention. Then [Secretary of Defense Donald] Rumsfeld set up a board to develop interrogation policy that fleshed out the role for medical monitoring and has since sketched the policy that was elaborated on as it went down the chain of command. It was not a matter of an informal pickup at the prison of various practices in the prison system but rather a matter of recruiting professionals into a centrally directed policy with guidelines. Thats an important difference.
Thieme: One antecedent for this discussion is Operation Paperclip, the program that brought formerly Nazi scientists and engineers to the United States after the war. Some were rocket scientists, but some were doctors who carried out horrific experiments with freezing, for example. One of those concentration camp doctors continued his experiments on behalf of helping American flyers downed in cold waters and I believe theres a building at Brooks Air Force Base named after him.
Miles: Paperclip was not the only one. We tried some doctors at Nuremberg [in Germany where war crimes trials were conducted by the United States following World War II] but elected not to have doctorstrials in Japan in order to secure their cooperation in getting their biological warfare data. We made a policy decision that it would endanger the appropriation of that material if we went ahead with a war crimes trial. Some experiments using vivisection were done on American POWs.
I think there is a difference, however. I am just not finding a research agenda in Iraq. I have been looking at different historical roots because there are different historical problems. For example, in terms of the neglect of prisoners, you can look back to Andersonville [in Georgia, a notorious Confederate prison in the Civil War] and Elmira [in New York, a Union prison in the Civil war]. Or alternatively go back to World War II and the Thai-Burmese railroad. [During the building of the Thai-Burmese railroad, 11,000 of 60,000 prisoners died of starvation.] The Japanese had not signed the Geneva Convention but signed the Hague Convention of 1927, which promised adequate treatment of prisoners. They waived that in World War II, but said they would treat prisoners well anyway. Their documents have astonishing parallels to United States documents in 2005. The president issued an ambiguous directive suspending the Geneva Convention directing the Armed Forces to treat detainees humanely to the extent appropriate and consistent with military necessity.The government traduced domestic and international laws to create special categories of people, illegal combatants,who had truncated rights and who were dispatched to secret prisons and subject to special Kafkaesque tribunals. Red Cross monitors were locked out of prisons, given false information and were especially kept from ghost detainees.Hundreds of people were secretly transported to nations who imprisoned, interrogated and tortured them on our behalf.
Thieme: The book Journey into Madness by Gordon Thomas discusses Dr. Aziz al-Abub, who assisted Hezbollah in the torture of William Buckley, CIA station chief in Beirut, who was tortured to death over a long period of time, with video tapes of his treatment provided to document the event. Thomas drew a parallel with what we did during MKULTRA, Bluebird, Artichoke and similar programs when we experimented on people without their consent in often-horrific ways. He suggested that perhaps the moral high ground so often claimed by Americans had been surrendered through those programs and practices.
Miles: There are a couple of ways to look at that which are of great interest to ethicists. One is to speak of creating a precedent. For example, there was the business of Spc. Keith Maupin, an American soldier in Iraq who was kidnapped and killed -- but only after the Abu Ghraib photos were shown. Before the photos became public, every POW returned alive, but not afterward. [Television carried the Abu Ghraib photographs on April 29, 2004. The first of the 11 beheadings in Iraq occurred 12 days later.]
The other way to look at it is using the concept of legitimacy. A world power does not simply have power, it has legitimacy. By behaving in these ways, we undermine our legitimacy as a world leader. Thats a different problem than establishing precedents for others to follow.
Thieme: The State Department issued a report, for example, that criticized China for violation of human rights, for detentions and torture, and China blew off the United States and so did Russia. How do we speak on behalf of these matters? What is the legitimacy of our protests in the present climate?
Miles: There seem to be things Americans need to believe about themselves that require that we filter certain facts out of our awareness. In my work with the Hoover archives at Stanford, I came across documentation from an authoritative source who named 10 specific countries with which we partner in torture. We may not be the ones turning on the electricity, but our people are present when it happens. He claims this did not begin with 9/11.
Thieme: Another source discussed the use of children in those experiments done decades ago.
Miles: Its interesting that there was a certain coyness about the data that came out of Iraq. The photographs that have been released so far are all photographs of men. Photographs of women have been retained and have not been released by the media sources that have them.
[Investigative journalist] Sy Hersh said the other photos are much worse. He mentioned audio recordings of children screaming while being sodomized.
All of the prisoner deaths that have been included in official tabulations, which are admittedly incomplete -- curiously, you find references to the death of children by the Department of Defense only in footnotes. There is no reporting of kids deaths in official lists or in death certificates or anything else. So there are sets of this data that remain hidden. The data has obviously been scrubbed.
Thieme: What have you seen?
Miles: I have seen the footnotes referring to the kids deaths and have seen credible evidence of sexual abuse described in Army investigations. I have not seen photos. I do not need to see them, but I have seen investigators reports.
Thieme: Steve, arent we describing war crimes?
Miles: Yes. We are describing war crimes and I think its important to name them for what they are for a couple of reasons. First, when you name it as a war crime, you hint at the reality of the things we have described, the gravity of the harms that have occurred. Second, in describing it as a war crime you also describe accurately the transgressions against a framework of justice and the damage to the civil order that would be avoided by pretending these are not war crimes. I think thats important to do.
Thieme: If there are war crimes, there are war criminals. Do you anticipate trials of named war criminals? They would probably include Rumsfeld, Cheney and Bush, wouldnt they?
Miles: As you know, many war criminals have never been tried for a variety of political reasons. That does not mean it is not worth stating that they are war criminals, that indictable war crimes have been committed and that the people who created the policies that led to them are responsible. It is the nature of war crimes that they are patterns of offense, not isolated events. You cannot track an individual act -- for example the arrest of Anne Frank -- to Adolph Eichman. Instead you see broad policy implications and a pattern, a series of acts at many different sites over a long period of time. In this case, there were all those things and these are war crimes. Its worthwhile naming what they are because historical accountability is important. In the case of Pinochet, we see that the long-term tracing of the acts can result in increasing accountability.
Now, I think this is a very important point. The world is at a very interesting tipping point as to war crimes as we steadily ratchet up degrees of accountability. We see, for example, Slobodon Milosevich tried in almost real time. We have seen action around Nazi stolen art totally change in the last 15 years. Swiss bank accounts no longer lack transparency. So even if indictments and trials do not follow, it sets the stage for greater accountability and thats a good thing.
Thieme: Who are your allies in this work?
Miles: Dr. Robert J. Lifton is one. Looking at why people or how people can do these things, Lifton coined the term atrocity-producing situationsin a study of veterans of the war in Vietnam. Some soldiers suffered severe psychic damage by participating in atrocities. Lifton, a psychiatrist, proposed that extreme stress, a dehumanized enemy, and encouragement to commit moral transgressions create atrocity-producing situations.He quotes a combat medic in Vietnam. I delighted in the destruction and yet was a healer.That medics words strikingly resemble a medic who described his feeling while beating prisoners during his service in Iraq: You get a burning in your stomach, a rush, a feeling of hot lead running through your veins, and you get a sense of power. ... Imagine wearing point-blank body armor, an M-16 and all the power in the world, and the authority of God. That power is very attractive.
Its also important to look at groups like HRW [Human Rights Watch] and the ACLU [American Civil Liberties Union]. By pulling out the documents and working on their largely legal pieces, they make it possible for more specialized scholars like myself to do our work. If the ACLU had not put all those documents on their Web site, Id be just another guy with opinions and a pen.
Thieme: Groups like HRW, because they scrutinize the practices of nations cooperating with us in counterterror, are designated terror support groups and the police in those countries are encouraged to treat them accordingly. This can be daunting.
Miles: Yes, but thats an epiphenomenon of being a torturing society. A torturing society is a society that is abraded by the process of dehumanization. In that process, we essentially create our own mirrored netherworlds. We posit a secret omnipresent anarchist non-Christian entity against which we put up the people of the true faith,and thats one reason torture is so dangerous to societies, because torturing societies do have these epiphenomenon that spill out into the broader society and result in less discriminating thinking and less understanding. People ask me all the time if I think Ill be killed for doing this work, which to me is an astonishing statement. I dont see a risk in getting killed. What I do see in the question is a direct indication of the degree to which living in a torturing society has damaged our larger civil society.
One of our problems is the paradox that we are one of the most parochial and provincial empires ever to exist on earth. That creates real problems for us because many of our political debates wind up being hermetically sealed and that hurts our ability to engage constructively with the world. Our ability to contextualize our own internal discussions of what it means to be a global empire is impaired. We wind up misreading our incredible impact not only on the world but on our own desires to project a civil society around the world. We cant contextualize our actions internationally if we dont have an international vision within our own domestic conversation.
Thieme: That brings us full circle. We start with transparency and accountability and the need for third-party points of view and contributions. Why are so many Americans incapable of hearing how others perceive us?
Miles: Americans have kept the reality of torture far from consciousness. Although we are steeped in fictional torture, we are nearly insensate to the reality of torture. We are unfamiliar with its techniques, its effects on individuals and civil societies, and with how widely it is used. Fictional governmental torture is usually depicted as occurring in developing countries. We are only dimly aware of the United Statesdisastrous complicity with torturing regimes in El Salvador, [Fulgencio] Batistas Cuba, Cambodia, Chile, Iran, South Vietnam, Guatemala, Argentina, Israel or Egypt.
There are creative voices in the United States that can speak to the larger international issues, outside the provincial paradigm, groups like Human Rights Watch that are perceived as a threat within the provincial perspective because of their cosmopolitan view of society and thats why they are marginalized and precisely why they are necessary. They are necessary because of the torture issues but also because, if we want to globalize the economy, we have to transcend our limited point of view.
Thieme: Do you get much negative response, that is, hate mail?
Miles: Many people express a fear that writing a book on the subject endangers my life. That disturbs me, as I said, because of what it says about fear of our government, a fear that reveals the damage that a torturing society does to the sense of civil liberties. That fear fosters a silence in which torture thrives. The implication that I, a citizen of the United States, should acquiesce to that fear strikes me as deeply disrespectful to my colleagues in Turkey, Egypt, Chile, South Africa, Cuba, and the former Soviet Union who have assumed much greater risks to fight torture in their nations. Some have been jailed, tortured or had their children murdered. For most Americans, it takes little more than the courage to be inconvenienced to speak against torture in the United States. If we are truly at risk of greater danger, it is all the more necessary that we should speak out.
Richard Thieme ThiemeWorks PO Box 170737 Milwaukee WI 53217-8061 www.thiemeworks.com 414.351.2321