They explained away the bone fractures, didn't ask what caused the lacerations, and called the hallucinations routine. Rather than blowing the whistle, medical professionals entrusted with the care of the detainees at Guantanamo Bay turned a blind eye when there were clear indications of abuse.
That's according to a newly published report from two physicians with unprecedented access to the medical records of nine Gitmo detainees.
Writing in the online journal PLoS Medicine, Physicians for Human Rights senior medical adviser Vincent Iacopino and retired Brig. Gen. Stephen Xenakis, a psychiatrist now in private practice, found that medical personnel at Guantanamo concealed mental and physical ailments that signaled abusive treatment.
The report - which represents the first independent review of any Guantanamo detainee's medical record - is the clearest evidence yet that members of the base's medical staff were complicit in the torture regime there.
"Medics have an independent, professional responsibility to identify and report incidences of cruel, inhumane and degrading treatment and torture," Xenakis tells Danger Room. "They had a responsibility to speak up."
"Personality disorders" and "routine stressors of confinement" were catch-all explanations for psychological disturbances, according to the report. "Temporary psychotic symptoms and hallucinations did not prompt consideration of abusive treatment."
Neither did apparent physical symptoms. Three of the detainees showed evidence of physical maltreatment: contusions, bone fractures, lacerations, peripheral nerve damage and sciatica. But the medical staff turned a blind eye in their reports. "There was no mention of any cause for these injuries," Iacopino and Xenakis write.
In their professional opinion, "the specific allegations of torture and ill treatment were highly consistent with and supported by physical and psychological evidence observed in all cases."
Ever since it became public that psychologists were involved in creating abusive interrogation practices for detainees, Physicians for Human Rights and other medical professional organizations have expressed fears that military medical staff were complicit in abuse at Guantanamo. Last month, Truthout published the handwritten notes of a former Air Force psychologist, Bruce Jessen, who reverse-engineered military programs on surviving the "stresses" of detention" for use against terrorism detainees. ("If these stresses are manipulated and increased against us, the cumulative effect can push us out of the optimum range of functioning.")
Jessen's work on a psychology-heavy detention and interrogation regimen started with the CIA; a Senate report revealed the CIA instructed the military on these tatics at Guantanamo Bay. Detainees at the facility have gone so far as to claim that medical staff forcibly administered them drugs that made them woozy ahead of interrogation sessions.
But the medical records of detainees haven't been made public, leaving little evidence to settle the question of medical staff complicity in detention operations. Iacopino and Xenakis, however, have served as medical experts for defense lawyers at Guantanamo. That's given them unique, privileged access to detainee medical records, which form the basis of their assessment. (They don't substantiate the allegation of forcible injections.)
Xenakis is dismayed by what he's found. The great majority of the medical lassitude he says he's witnessed occurred between 2002 and 2006. But, he says, "the implications of this conduct, including the fact that the medics did not identify it, still has an effect on what happens there."
In some cases, medical treatment appeared to be conditionally administered. "Several detainees indicated that access to medical care was linked to cooperation with the interrogators," Iacopino and Xenakis write. In one case, medical personnel certified a detainee as fit to continue being interrogated "after several periods of unconsciousness."
Neither the Pentagon nor Joint Task Force-Guantanamo, which oversees detention operations at the base, have seen Iacopino and Xenakis' article. (See update below.) But Maj. Tanya Bradsher, a Pentagon spokeswoman, says the task force's medics treat detainees "regardless of disciplinary status, level of cooperation or legal status."
"The Joint Medical Group conducts humane care of detainees," Bradsher says. "The JMG operations are completely independent of Joint Detention Group and Joint Intelligence operations. Detainees are treated at a dedicated medical facility with state-of-the-art equipment and an expert medical staff."
Not being a lawyer, Xenakis says he's not accusing any medical staff at the base of breaking the law. Nor can he specify which detainees have been subject to treatment he considers torture without violating the rules of the military commissions before which he's testified. But as much as he's concerned with upholding his profession's ethical obligations, he says his article is also motivated by a concern for the ways torture jeopardizes the ability to bring detainees to trial for a final adjudication.
"How do we make decisions today about what's going to be the disposition of these people when they've been subjected to such treatment?" Xenakis asks. "How does that help our national security?"
Update: Now that the Defense Department has seen Iacopino and Xenakis' article, Bradsher emails the following response:
The Joint Medical Group is committed to providing unconditional appropriate comprehensive medical care to all detainees regardless of their disciplinary status, cooperation, or participation in a hunger strike. The healthcare provided to the detainees being held at Guantanamo Bay rivals that provided in any community in the United States. Detainees receive timely, compassionate, quality healthcare and have regular access to primary care and specialist physicians. The care provided to detainees is comparable to that afforded our active duty service members. All medical procedures performed are justified and meet accepted standards of care.