US government doctors who cared for the prisoners at Guantanamo Bay deliberately concealed or ignored evidence that their patients were being tortured, the first official study of its kind has found.
A detailed review of the medical records and case files of nine Guantanamo inmates has concluded that medical personnel at the US detention centre were complicit in suppressing evidence that would demonstrate systematic torture of the inmates.
The review is published in an online scientific journal, PLoS Medicine, and is the first peer-reviewed study analysing the behaviour of the doctors in charge of Guantanamo inmates who were subjected to "enhanced interrogation" techniques that a decade ago had been classed by the US government as torture.
Vincent Iacopino, senior medical adviser for Physicians for Human Rights, and Brigadier General Stephen Xenakis, a retired US Army medical officer, had access to the medical records and case files while acting on behalf of defence lawyers.
They concluded that no doctor could have failed to notice the medical signs and symptoms of the extreme interrogation techniques and unauthorised assaults that other physicians would recognise as torture, such as severe beatings resulting in bone fractures, sexual assaults, mock executions, and simulated drowning by "waterboarding".
"The findings in these nine cases indicate that medical doctors and mental health personnel assigned to the US Department of Defence neglected and/or concealed medical evidence of intentional harm," the authors of the study concluded. "The full extent of medical complicity in US torture practices will not be known until there is a thorough, impartial investigation including relevant classified information. We believe that, until such time as such an investigation is undertaken, and those responsible for torture are held accountable, the ethical integrity of medical and other healing professions remains compromised."
Many of the prisoners said they were also subjected to unauthorised abuses resulting in severe and prolonged physical and mental pain. These abuses could not have gone on for so long without the Guantanamo doctors being aware of the pain inflicted, the study found.
"They effectively concealed the medical evidence of torture," said Dr Iacopino. "Even in the absence of any standard operating procedures, the physicians involved had an ethical duty not to do any harm but it is clear this principal was breached. They could have and should have had the courage to document the abuse, but unfortunately that wasn't done. We need a full investigation and the release of classified information to find out what happened."
In 2002, the US government redefined acts such as waterboarding, sleep deprivation, temperature extremes, the use of stress positions, and prolonged isolation as "safe, legal, ethical and effective" when dealing with the interrogation of suspected terrorists.
All of the nine detainees investigated in the study claimed to their own legal teams that they were also subjected over many months – and in some cases years – to additional, unauthorised episodes of ill-treatment, such as severe beatings, threats of rape, or forced nudity.
"The abuses reported in this case series could not be practised without the interrogators and medical monitors being aware of the severe and prolonged physical and mental pain that they caused," the study found.
Dr Iacopino said that if individual doctors are found to have breached professional ethics by ignoring the evidence of torture, they should have their medical licence removed at the very least.
"In the case of individuals who aided or abetted torture, or knowingly neglected to document torture, then at the minimum they should have their licence removed, but they should also be subject to adjudication under the rule of law," Dr Iacopino said.