Health professionals who assisted in the CIA’s torture programme of terror suspects “betrayed the most fundamental duty of the healing professions” and may have committed war crimes, according to a hard-hitting report released on Tuesday.

Physicians for Human Rights (PHR) called for a federal commission to investigate the full extent of health professionals’ participation in CIA torture following last week’s release of the US Senate Select Committee on Intelligence (SSCI) report on the agency’s detention and interrogation programme.

“Under the auspices of the Bush administration, the CIA systematically tortured suspected terrorist detainees, in at least one instance to the point of death. This torture program heavily relied on the participation and active engagement of health professionals to commit, conceal, and attempt to justify these crimes,” PHR concludes.

The report comes days after Dick Cheney, the former US vice president, defended the practices disclosed in the report including “rectal feeding” – arguing the practice was done for medical reasons. Former CIA director Michael Hayden has also claimed that the practice was carried out on medical grounds.

According to PHR, rectal hydration is almost never practiced in medicine because there are more effective methods, and it is never considered as a first option for rehydration or nutritional support. PHR notes that the report indicates that rectal hydration was used to “control and/or punish the detainees ... Insertion of any object into the rectum of an individual without his consent constitutes a form of sexual assault.”



'Insertion of any object into the rectum of an individual without his consent constitutes a form of sexual assault'

“Rather than reject such brutal practices, medical officers appear to have modified them to increase pain: ‘we used the largest Ewal [sic] tube we had,’ stated one officer in a February 2004 email,” writes PHR.

Dr Vincent Iacopino, PHR’s senior medical advisor and an author of the analysis, said Cheney was “either terribly misinformed or propagating a lie. Any reasonable person knows feeding does not take place rectally.”

The report sets out eight areas where doctors, psychologists and physician assistants may have violated “medical and psychological ethics, domestic and international law, and federal research guidelines”:

Designing, directing and profiting from the torture program;



Intentionally inflicting harm on detainees;



Enabling US department of justice lawyers to create a fiction of “safe, legal and effective” interrogation practices;



Engaging in torture research that could potentially violate the Nuremberg Code, brought in after World War II to ban “experiments” like those practiced by the Nazis, and could constitute a crime against humanity;



Monitoring torture and calibrating the level of pain;



Evaluating and treating detainees for the purposes of torture;



Conditioning medical care on cooperation with interrogators;



Failing to document physical and/or psychological evidence of torture.

The report is especially damning of the work of psychologists James Mitchell and Bruce Jessen. The SSCI described how the pair – given the pseudonyms “Grayson Swigert” (Mitchell) and “Hammond Dunbar” (Jessen) in the report– designed the so-called “enhanced interrogation techniques” (EITs) used to interrogate suspects.

Mitchell has disputed the accuracy of the SSCI report, while Jessen has not publicly commented.

The CIA paid $81m to a company owned by the pair, the SSCI report said. Their work consisted of “reverse-engineering” survival techniques taught to US military personnel to withstand Chinese and North Korean torture techniques if captured during the Korean War. Techniques conducted and overseen by the two included waterboarding, stress positions, sensory deprivation and overload and sexual humiliation.

The SSCI report documents examples where Mitchell and Jessen oversaw and administered the waterboarding of detainees Abd al-Rahim al-Nashiri and Khalid Sheikh Mohammed.

“They had so much to do with the programme overall that the accountability of those two individuals has great significance,” said Iacopino.

“The American public should be surprised, the world should be surprised, that the US so thoroughly deceived itself that methods it called ‘safe, legal and effective’, and which it previously called torture, were applied in a systematic fashion by health professionals. They couldn’t have done it without the health professionals,” he said.

PHR said while unauthorized interrogation methods – such as rectal hydration, mock burials and threats to family members – might easily be recognized as torture “given their capacity to shock the conscience” medical professionals were aware that even authorized practices including sleep deprivation, isolation and sensory deprivation, were known to cause “devastating and lasting effects and therefore also must be understood as constituting torture”.

According to CIA records, when briefed in April 2006, then president George W Bush expressed discomfort with the “image of a detainee, chained to the ceiling, clothed in a diaper, and forced to go to the bathroom on himself.”

The PHR report said: “Yet, physicians and psychologists participated in the ongoing monitoring of these practices, and – through their silence and inaction – aided the CIA and OLC lawyers in creating a fiction of ‘safe, legal and effective’ interrogation practices. Moreover, it appears that this legal farce was and continues to be instrumental in attempts to justify a policy of systematic torture.”