9
Apr2009

The comments and opinions in this post reflect the opinion of Dr. Moreno, Professor of Biomedical Ethics at the University of Pennsylvania, and do not necessarily represent the opinion of PRIM&R or its Board of Directors.

The Washington Post report of March 30, 2009 that nothing of value was learned from one of the several detainees who was water boarded at the Guantanamo prison facility could fuel the efforts of Senator Patrick Leahy to undertake a systematic investigation of detention and interrogation practices. In an interesting historic irony, if Senator Leahy's judiciary committee does move this initiative forward its final report is likely to appear in 2010, exactly 25 years after Senator Frank Church's committee report was issued, which disclosed intelligence community abuses starting in the 1950s and extending through the Watergate scandal. Among the operations discussed were experiments with hallucinogens like LSD as they might be used in interrogations of, say, a kidnapped American nuclear scientist by an enemy and how to defend against such practices.

It is clear that innocent people, both in the U.S. and abroad, were caught in these un-consented and often clumsy experiments, and that there were deaths in at least two cases. Yet a number of respected historians and journalists argue that the subsequent reforms within the American intelligence community led to a catastrophic over-reaction that gravely impaired the ability of the CIA and other agencies to conduct clandestine operations. Some, like former Vice President Cheney, believe that the 9/11 attacks were partly the upshot of a hamstrung covert system. Journalists like Thomas Ricks and Jane Mayer have brilliantly documented the complexities of this experience.
I have theorized that innovative interrogation practices were applied in Guantanamo that were not limited to harsh tactics that have historically been considered forms of torture. Certainly the use of humiliation and sleep deprivation as techniques to elicit information are not new in the history of prisoner interrogation. The provocative question is whether other systematic programs were covertly initiated in the past few years by, for example, federally employed psychologists that could be considered research to create generalizable knowledge. Both the American Psychiatric Association, after much consternation and debate, and the American Psychological Association have created strictly limited parameters for psychiatrists' and psychologists' role in interrogation. But experimental activities by federal agencies could be brought within the ambit of the Common Rule, introducing an intriguing new dimension to the story of Guantanamo and the war on terrorism.If Senator Leahy's inquiry does go forward, it will be interesting to observe whether psychological experiments are addressed (some perhaps involving drugs or artificially induced neural hormones like oxytocin), and how the ultimate reaction in the intelligence community resembles that of 25 years ago.

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3 thoughts on “Guest Blogger: Dr. Jonathan Moreno

  1. Renée LLanusa-Cestero

    It is important to keep in mind that it was prisoners, detained and segregated in camps, and subjected to hideous abuses inflicted under the guise of scientific research that gave rise to the Nuremberg Code (1) and the research ethics codes that have followed. The historical connection between the prohibition of nonconsensual medical experiments and torture is demonstrated by George Annas in a commentary recently published in the New England Journal of Medicine (2). Annas cites the codes relied upon by the courts in establishing the prohibition against nonconsensual medical experimentation as a norm of customary international law:

    • Nuremberg Code (articulated in 1947 by U.S. judges): “The voluntary consent of the human subject is absolutely essential . . . [and includes] legal capacity . . . free power of choice . . . sufficient knowledge and comprehension of the [nature, duration, and purpose of the experiment] . . . to make an understanding and enlightened decision.”
    • International Covenant on Civil and Political Rights (international treaty became effective in 1976): “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his free consent to medical or scientific experimentation.”
    • Declaration of Helsinki of the World Medical Association (promulgated in 1964 and revised eight times since): “The physician should obtain the subject’s freely-given informed consent, preferably in writing. . . . [But in clinical research] if the physician considers it essential not to obtain informed consent, the specific reasons for this proposal should be stated in the experimental protocol for transmission to [an] independent committee.”
    • International Ethical Guidelines for Biomedical Research Involving Human Subjects (published in 1993, and since revised, by the Council for International Organizations of Medical Science): “The investigator must obtain the voluntary, informed consent of the prospective subject [or legally authorized representative]. . . . Waiver of informed consent is to be regarded as uncommon and exceptional, and must in all cases be approved by an ethical review committee.”
    The unambiguous connection is stated in Article 7 of the International Covenant on Civil and Political Rights, cited above, where nonconsensual medical experimentation is characterized as a particular form of torture, cruel, inhuman or degrading treatment.
    (1) Nuremberg Code (1947). Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law, No. 10, Vol. 2:181-182. Washington, D.C.: U.S. Government Printing Office, 1949, http://www.hhs.gov/ohrp/references/nurcode.htm.
    (2) Annas, G. Globalized Clinical Trials and Informed Consent. NEJM Vol. 360, No. 20:2050-2053, May 14, 2009, http://content/full/360/20/2050?query=TOC.
    Renée LLanusa-Cestero, M.A., C.I.P.
    La Cesta Consultants, LLC

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  2. Anonymous

    Too bad today's research does humiliate, degrade, and is cruel to many of its' subjects. All of whch is done without letting the subject know what, how,why it is being done and that their problems are mostly caused by researchers living a comfortable life without the same fears, abuse and cruelty while their life is slowly taken away from them.

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