The American Way of Torture

When Steve Miles saw the pictures from Abu Ghraib, his first thought was to wonder how the hell the medics in the system had let it happen. "The immediate question was, why haven't the docs blown the whistle?" he remembers now. "Docs are in every prison, and so in essence they are the frontline human rights monitors. They are there when the Red Cross isn't. They are in places where the Red Cross never gets to go. They should be performing that role, and in fact they are mandated to play that role by their professional ethics." Miles began collecting all the available medical records of prisoners who had died in U.S. custody, discovering along the way, he says, that "about 50 percent of people who have been tortured report that docs are involved."

That research turned into an August 2004 article in the British medical journal The Lancet titled "Abu Ghraib: Its legacy for military medicine," the first study of the military medical corps' involvement in the prisoner abuse taking place in Iraqi prisons and detention camps. It has now grown into a book, Oaths Betrayed: Military Medicine and the War on Terror, that the 55-year-old Miles, a physician and professor of bioethics at the University of Minnesota, expects to see published in the first half of 2006.

It will be the fourth book in a career defined more by Miles's actions than his writings. I spoke with him in mid-November, on the eve of his most recent trip to Thailand. Back in the late '70s and early '80s, Miles spent a lot of time working there in Cambodian refugee camps. He developed a standard for tuberculosis care in such camps that is still in use around the world. He also developed TB and hepatitis himself, and nearly died. Locally, he is probably best known for his political work on behalf of medical practices reform and universal health care, which was the keynote of his failed 2000 campaign for the Democratic nomination in that year's U.S. Senate race. He also played a vital role in shepherding and promoting the program that became MinnesotaCare, the state's health care safety net.

City Pages: Can you detail further some of the injuries you've seen evidence of, and some of the specific practices that caused them? The Jane Mayer New Yorker article from November 14, for instance, referred to the practice of cuffing people's arms behind their backs and then suspending them by their arms.

Steve Miles: The range of interrogation techniques, or abuse techniques, is pretty much the whole array of usual stuff that happens in countries that torture. It includes beatings, suspension, near-asphyxia, chemical burns--there were instances of burns with lighter fluid--kicks, slamming against the wall. There was at least one thumbscrew I saw. Electrical shocks with, in our case, external electrodes. I did not see any internal electrodes. There were instances of asphyxiation, food and water deprivation, deprivation of access to toilets, deprivation of access to medical care, forcing people to urinate on themselves, forcing people to masturbate, to renounce their religion, to put the urine or feces of other people on themselves, other forms of nudity, forced fondling, verbal abuse, threats against family, mock executions, forcing the victims to watch other family members being abused. They also used what's called "perceptual monopolization," which included loud noise...

CP: Sensory assault, basically.

Miles: Right. There was apparently also some administration of drugs to enable interrogation as well.

CP: How were medical personnel involved in the abuses at Abu Ghraib and elsewhere?

Miles: Actually, I found there had been four separate kinds of abuses or neglect by the medics in the system. There had been silence. There had been an active involvement of the medical system in the interrogation system. There had been a wholesale failure to meet minimal standards for the health and sanitation of the prison camps. And there had been a deliberate effort to delay public reporting of homicides of prisoners.

CP: Explain what you mean when you say they had "active involvement...in the interrogation system."

Miles: When [Secretary of Defense Donald] Rumsfeld wrote his April 2003 memo [approving more extreme interrogation techniques], he described integrating the medical system into interrogation by, first, having medical personnel assess the suitability of a prisoner for the course-of-interrogation plan, and second, setting monitoring and termination criteria for that plan. So essentially what he did was lay down a rule that the severity of the interrogation plan would be adjusted in consultation with medical people to exploit emotional or physical weaknesses.

[Rumsfeld] then sent that plan south to Guantánamo, where [base commander] General [Geoffrey] Miller implemented it and created a specific mechanism called a Biscuit--that's BSCT, for Behavioral Science Consultation Team--to perform that function. Biscuits are a standard military type of committee. For example, if you need a combination of medical and military advice, say, to evaluate the flight-readiness of a depressed pilot, or to help POWs integrate back into society, that's a standard BSCT-type role.