Elsevier

Social Science & Medicine

Volume 171, December 2016, Pages 1-8
Social Science & Medicine

Standardizing psycho-medical torture during the War on Terror: Why it happened, how it happened, and why it didn't work

https://doi.org/10.1016/j.socscimed.2016.11.014Get rights and content

Highlights

  • Standards played key functions in the enhanced interrogation, or torture, programme.

  • Health professionals caught between competing standards can experience ambivalence.

  • Certain standards cannot be easily contravened because of their hegemonic nature.

  • It may be impossible to implement certain standards due to their destructive nature.

Abstract

After 9/11/2001 the United States launched a global War on Terror. As part of this War, terrorism suspects were detained by the U.S. military and by the C.I.A. It is now widely recognized that the United States tortured a number of these detainees in the context of its ‘enhanced interrogation’ programme. This article examines how and why U.S. organizations developed standards that allowed healthcare professionals to become involved in torture; why the standards developed by U.S. security institutions failed to control the actions of enhanced interrogation personnel on the ground; and what the role of standards were in stopping the enhanced interrogation initiative. The article concludes by discussing the general lessons that the enhanced interrogation programme has for social science research on standards, namely that individuals can experience ambivalence when caught between competing organizational and professional standards and that it might be inherently difficult to successfully enact certain protocols when these relate to deviant or destructive acts.

Introduction

After 9/11/2001 the United States launched a global War on Terror. Suspects were captured by the U.S. military and by the C.I.A. and detained at various acknowledged and black sites across the world. It is now widely recognized that the United States tortured a number of detainees in its custody in the context of its ‘enhanced interrogation’ programme (IMAP/OSF, 2013, SSIR, 2014).

This torture had a number of features. One was a strong reliance on healthcare professionals, who supported, designed and carried out enhanced interrogation. A second feature was the emphasis placed by the programme on clean (Rejali, 2007) violence. A third was the role played by standards, protocols and guidelines in the torture programme.

To date, no study has fully considered the role that standards played in enhanced interrogation. This is an important absence because standards were key to the entire initiative. They were invoked throughout all its stages, from its development through to its termination. One of the key documents that initially justified the programme's violent tactics, for example, was called the “Standards of Conduct for Interrogation 18 USC 2340-2340A” (Department of Justice, 2002). Without the standards developed in this and related documents, the enhanced interrogation programme could not have been created, let alone operationalized.

Standards were also significant because they were responsible for drawing health professionals into torture. Research on standards suggests that, because of their ability to systematise technical information, scientific experts are often called upon when standards are being formulated (Jordan and Lynch, 1998). Health professionals became involved in the enhanced interrogation programme out of a perceived need to regulate interrogation practices and thereby protect detainees from harm. This shows that health professionals can become drawn into serious medical deviance through a mixture of moral and bureaucratic imperatives bound up in standards.

Finally, a third reason to consider the role played by standards in the enhanced interrogation programme is because the programme highlights that certain activities cannot be standardized. Although the point that health professionals often find it difficult to standardize their activities has been previously noted (Timmermans, 2005), it is worth emphasising it again in this context given that the programme's authorization was based on a belief on the part of policy and operational architects that brutal interrogation tactics could be standardized.

This article has two purposes. The first is to consider the overall role played by standards in the enhanced interrogation programme. The second is to consider the wider lessons that the case study of enhanced interrogation has for the more general field of the sociology of standards. The first section of this article therefore considers recent sociological research on standards. This is followed by sections on the creation of enhanced interrogation standards, why health professionals became involved in standard creation, how torture standards played out in practice, and the role played by standards in stopping the programme. The discussion considers the wider lessons that the enhanced interrogation programme offers.

Section snippets

Methods

This article is based on an analysis of data extracted from key government (e.g. SSIR, 2014) and health professional reports (e.g. IMAP/OSF, 2013), and government protocols that the enhanced interrogation programme used (Department of Justice, 2002, Department of Justice, 2005). The article also draws upon news media articles from sources of record (e.g. the New York Times, the New Yorker) that discuss the standards used by the programme. Information from all these sources was extracted and

Sociology of standards

The past decade have seen significant research interest in standards, and the impacts that standards have for organizations and individuals. A standard, broadly speaking, is a convention or requirement (Timmermans and Epstein, 2010), usually outlined in a formal document, that describes the uniform methods and processes that need to be undertaken if the standard is to be met. Standards fit somewhere between laws and norms in their ability to direct action, and have, as such, been called ‘soft

Medical standards and torture

All healthcare professions produce ethical standards, manifested in guidelines, protocols and principles, that govern their members’ behaviour; regulation of ethical behaviour through codes is in fact one of the defining features of a profession. These standards of conduct outline the behaviours that healthcare professionals should and should not engage in.

For doctors, a foundational ethical standard or principle is ‘do no harm’; another is ‘do good’ (Miles, 2006). Torture and other forms of

Developing violent interrogation standards

During the initial phases of the War on Terror, sectors of the U.S. state developed new behavioural and interrogation standards that allowed their staff to participate in what were presented as new, ‘safe’, methods of torture and cruel, inhumane and degrading punishment. These organisations included components of the C.I.A. and the U.S. military, and further included healthcare professionals who worked for both of these organisations. These new standards contravened the standards outlined

Standardizing interrogation techniques

Immense effort went into controlling these interrogation techniques. Even the extrajudicial rendition process that led to the capture and incorporation of detainees into the enhanced interrogation programme was standardized. During each rendition medical personnel were given a detailed medical standard operating procedure that they needed to follow. Rendition SOPs also noted that “the background and circumstances of the detainee do not override the obligation to maintain the highest

Why did health professionals become involved?

Health professionals played key roles throughout the enhanced interrogation programme. Health professionals (doctors and psychologists) were involved in designing, carrying out and monitoring the military's interrogations (in their roles as Behavioural Science Consultants, or BSCTs) (IMAP/OSF, 2013) and also the CIA's programme. The CIA, for example, hired psychologists to develop its violent interrogation programme “because their experience with ‘nonstandard’ interrogation was ‘unparalleled’”

Standards in practice

Significant resources went in to standardizing the enhanced interrogation programme. The reality, however, was that attempts to control the programme often failed in practice.

FBI agents reported finding detainees chained hand and feet with no food or water (Mayer, 2005a). They found detainees who had pulled out their own hair from distress (Mayer, 2005a). One detainee recovering from abdominal surgery was apparently waterboarded (Physicians for Human Rights, 2014). Others were subjected to ice

The role played by standards in stopping the enhanced interrogation programme

Standards were key to the eventual dismantling of the programme; as Busch (2000) notes, standards are often used to discipline things and people who do not conform to accepted definitions of good. Although U.S. security services developed new standards and definitions to allow violent interrogations and the involvement of health personnel in those interrogations, this was not an uncontested process. Both core and allied security services came under sustained criticism for violating fundamental

Discussion

The enhanced interrogation programme was notable for many reasons, not least in relation to widespread the role played by standards in its construction, maintenance and dismantling. Standards were evoked in all of these stages, and were used to both support and attack enhanced interrogation, or torture as it is now widely recognized as being (Baquet, 2014), and the involvement of healthcare professionals in it. The enhanced interrogation programme has key lessons for researchers working on the

Conclusion

The enhanced interrogation initiative ran from the early to mid 2000s. It was responsible for the capture and interrogation of large number of detainees, and generated huge international controversy. It had transformational impacts on the individuals and organisations who developed and were caught up in it. Designed for efficiency, predictability, control and calculability (Deshotels et al., 2012), it became inefficient, unpredictable, uncontrollable and incalculable. While it was created to

Acknowledgements

I would like to thank the three reviewers for their useful comments.

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