An Army surgeon general's review of detainee medical operations in Afghanistan, Iraq and Guantanamo Bay, Cuba, found isolated incidents of abuse but, like several other internal military investigations of U.S. detention operations, found no systemic problems linked to U.S. military personnel and their care of detainees.
Lt. Gen. Kevin C. Kiley said yesterday that a five-month "assessment" of medical operations found a few inadequacies in the training of medical personnel for dealing with detainees, that policies were lacking in their guidance, and that record keeping was inconsistent. But he said a seven-person team that interviewed 1,000 medical personnel found just 32 incidents of abuse, ranging from the use of harsh language to assault.
Kiley, speaking at a Pentagon news briefing yesterday, said most medical personnel are dedicated and committed to the proper care of detainees, and that their desire is to provide high-quality health care for each patient they treat. He said isolated incidents -- in which some medics saw abuse and in which some participated in abusive acts -- were reported to investigators. In particular, he said, there were cases in which medical personnel delayed providing pain medication to detainees, had physical altercations with unruly patients or saw them arrive with evidence of abuse.
"The majority of medical personnel interviewed did not observe any abuse, and with few exceptions, those medical personnel who did observe suspected abuse reported it," Kiley said. "The assessment results demonstrate that the nation can be proud of our military medical professionals."
Kiley said his assessment was never meant to be an investigation and instead was a broad review of operations.
Responding to questions about recent reports that medical personnel were working with interrogators to break down detainees at the U.S. detention facility at Guantanamo Bay, Kiley denied that any medical personnel providing direct care to detainees assisted interrogators. He did acknowledge that some psychologists at Guantanamo had access to clinical information at the beginning of operations there but that a "firewall" between clinical providers and interrogators was quickly erected.
"We found no evidence that . . . there was a passing of clinical information that would be used in a detrimental way to torture," Kiley said.
But Kiley's team did not ask the psychologists what their advice or recommendations to interrogators were, but instead asked what those people thought their roles should be. They answered that they saw their roles as first advising interrogators and second ensuring the well-being of detainees. Kiley also said that he thinks it is appropriate in a safe, ethical and legal environment for psychologists to assist in interrogations.
Leonard S. Rubenstein, executive director of Physicians for Human Rights, said the review appears to have failed because it did not delve into the real problem: the ethical responsibilities of psychologists who worked with interrogators to protect the detainees from harm. Rubenstein, who has not yet read the report because it has not been released, said more needs to be learned about how the operations were carried out.
"The heart of the problem is the conduct of medical personnel who advised interrogators but did not give medical care," Rubenstein said. "People who do not provide direct care are still bound by ethical duty. If you're trying to respond to allegations that health personnel have been involved or were complicit in abuse during interrogations of detainees, you should have looked at what those people did. The report, according to the briefing, didn't do that."
Kiley said his assessment was driven by the abundance of speculation about the role of medical personnel in abuse after the Abu Ghraib cases erupted publicly in the spring of 2004. He said that about 20,000 medical personnel have worked in Iraq, Afghanistan and Cuba in support of the war on terrorism, but he said that only a small fraction of those have worked in detainee care.
Medical personnel now get detailed training about detention operations, filling gaps that were discovered after the abuse scandal hit.
Amnesty International decried the assessment even before the Defense Department released the results, calling it another review that falls short of what an independent commission could do.
"Yet another piecemeal internal review of detainee ill-treatment continues a pattern of refusing to examine the linkages between the policies approved by senior officials and the practices of interrogators in Guantanamo, Abu Ghraib, and other overseas detention facilities operated by the United States," Jumana Musa, advocacy director for domestic human rights and international justice at Amnesty International, said in a statement. "As with past investigations, this myopic examination of the involvement of medical personnel is narrowly drawn to exclude investigation of the broader systemic violations."