LEAVE NO MARKS
Enhanced Interrogation Techniques and the Risk of Criminality
August 2007
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Some of the enhanced techniques, particularly waterboarding, hitting, induced hypothermia, and stress positions are capable of causing ?severe? or ?serious? physical pain and suffering, the intentional infliction of which violates the ?torture? and ?cruel or inhuman treatment? provisions of the WCA. Each of the techniques can also cause significant psychological harm. According to one recent study, in fact, the significance of the harm caused by non-physical, psychological abuse is virtually identical to the significance of the harm caused by physical abuse.21
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Defenders of the use of severely coercive treatment in interrogation settings argue that such techniques are ?aggressive? and ?tough? but not particularly harmful. Secretary of Defense Donald Rumsfeld was reported to dismiss concerns about the use of prolonged standing by noting that he himself spent most of the day standing at a desk.29 Others have compared some permitted sexualized techniques to those used by college fraternities in hazing practices.30 Some have even ?tested? techniques such as waterboarding under controlled conditions and falsely concluded that the technique is not that harmful.31 Such arguments fail to acknowledge the actual context in which abuse takes place and the cumulative effects associated with the use of multiple techniques of interrogation. Moreover, they ignore the fact that these techniques have been historically designed and used by the CIA and other U.S. personnel to cause states of debility, dependency and dread in the detainee.
In fact, an extensive body of medical and psychological literature and experience with victims of torture and abuse show that although ?enhanced? interrogation techniques may not result in visible scars, they often cause severe and long-lasting physical and mental harm. This is directly related to the purpose of these techniques: to ?break? detainees, mentally and physically.32 The medical consequences of such abuse have been well documented through years of research and treatment of survivors of violence and severe trauma.33 According to a recent study, abuse during captivity that does not emphasize physical pain ? such as psychological manipulation, forms of deprivation, humiliation and stress positions ? causes as much mental pain and traumatic stress as does torture designed to inflict physical pain.34
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4. Waterboarding (mock drowning)
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The United States has historically prosecuted waterboarding as a war crime: in 1947, the United States convicted a Japanese military officer of a war crime and sentenced him to fifteen years of hard labor for using a form of waterboarding against a U.S. civilian.139
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Physical Pain or Suffering
During ?simulated? drowning, hypoxia (shortage of oxygen in the body) caused by deprivation of adequate oxygen can and probably does occur. At the same time, a dramatic physiologic stress response, with tachycardia (rapid heart beat), hyperventilation (rapid respiratory rate) and labored breathing (airway obstruction and breathlessness) is almost unavoidable. The stress resulting from this technique could induce the obstruction of blood flow to the heart (cardiac ischemia) or irregular heart beat (arrhythmia) in vulnerable individuals. Brief oxygen deprivation can cause neurological damage.
Complications of near asphyxiation include bleeding into the skin (known as petechiae), nosebleeds, bleeding from the ears, congestion of the face, infections of the mouth, and acute or chronic respiratory problems. 145 Studies show that even more than a decade after the event, survivors of suffocation torture continue to suffer from pain in the back and head.146 Breathing fluid into the lungs can result in aspiration pneumonia which can be fatal.
Mental Pain or Suffering
Studies indicate that simulated drowning ? calculated as it is to ?disrupt profoundly the senses?? can also cause severe psychological harm, in violation of the ?torture? and ?cruel or inhuman treatment? provisions of the WCA.147 The experience of near-suffocation is also associated with the development of predominantly respiratory panic attacks, high levels of depressive symptoms,148 and prolonged posttraumatic stress disorder.149 This literature is consistent with clinical experience: clinicians who treat torture survivors at the Bellevue/NYU Program for Survivors of Torture have observed that survivors of water torture and other orms of near-asphyxiation suffer from long-lasting trauma. 150
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Medical findings suggest that waterboarding results in both ?severe? and ?serious? mental pain and suffering as defined by the WCA and the Torture Act. Studies suggest that waterboarding and other forms of torture by suffocation have been found to result in both ?prolonged? and ?non-transitory mental harm,? such as posttraumatic stress disorder. Waterboarding is designed to create the sensation of drowning and thus is likely ?calculated to disrupt profoundly the senses or the personality.?157
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Appendix B: Overview of the Medical Consequences of Torture and Cruel Treatment
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Physical Consequences
Empirical evidence has shown that the most important physical consequences in torture survivors involve pain in multiple sites that is long-lasting. Most frequent pains experienced by the survivors are in the head, neck, shoulder girdle, and the lower back.359 These disabilities often remain years after release from detention and limit the survivors? capacity to do anything other than light work. These pains have been associated with beating and painful stress positions, and confinement in cramped, damp, unsanitary conditions.360
It must be noted that torture is often designed to maximize stress and physical pain without causing serious physical injury or death. In advocating for various aggressive interrogation procedures, a working group established in the Department of Defense by Secretary Donald Rumsfeld argued that the removal of prisoners? clothing would create ?a feeling of helplessness and dependence? and that slapping a prisoner ? ?a quick glancing slap to the fleshy part of the cheek or stomach? ? could be useful ?as shock measures.? 361
It is important to note that, ?the absence of ? physical evidence should not be construed to suggest that torture did not occur, since such acts of violence against persons frequently leave no marks or permanent scars.?362