Physicians for Human Rights “Leave No Marks”.
Leave No Marks: Enhanced Interrogation Techniques and the Risk of Criminality
Following the enactment of the 2006 Military Commissions Act, PHR united the legal expertise of Human Rights First with PHR’s medical expertise to issue the report Leave No Marks in August 2007, demonstrating that ten “enhanced” interrogation methods purportedly used by the CIA amounted to war crimes. The report demonstrated that interrogation techniques are likely to cause severe or serious physical and mental harm to detainees, and that the authorization of these techniques, whether practiced alone or in combination, may constitute torture and/or cruel and inhuman treatment, and may place interrogators at serious legal risk of prosecution for war crimes and other violations.
Excerpts from the Leave No Marks report (pages 22 to 26)
The prisoner is deprived of normal sleep for extended periods through the use of stress positions, sensory overload, or other techniques of interrupting normal sleep.
Sleep deprivation is a well established form of abuse, used in breaking down interrogation subjects. In describing the use of sleep deprivation by the Soviet police in the 1930s, Aleksandr Solzhenitsyn writes in The Gulag Archipelago, “[s]leeplessness befogs the reason, undermines the will, and the human being ceases to be himself, to be his own ‘I’.” Sleep deprivation was also used in the 1970s to interrogate political opponents by the military in Chile under General Augusto Pinochet. Recently, the U.S. State Department has condemned Indonesia, Iran, Jordan, Libya, Saudi Arabia, and Turkey for using sleep deprivation as a form of torture or cruel, inhuman, or degrading treatment.
In 2002, in a memo that has since been rescinded, the Department of Defense authorized the use of sleep deprivation for use on detainees in Guantánamo Bay in the form of 20 hour interrogations. The military investigation report documented a so-called “frequent-flyer” program at Guantánamo in effect from 2003 and until March 2004 in which detainees were regularly moved from one cell to another at intervals of two to four hours to interrupt their sleep. The new Army Field Manual appears to permit some sleep deprivation, so long as four hours of continuous sleep are permitted during every 24 hour period. The detainee can be sleep deprived in this manner for up to 30 consecutive days.
The former Israeli Prime Minister, Menachem Begin, describes his experiences with sleep deprivation while being held in a Soviet prison:
In the head of the interrogated prisoner a haze begins to form. His spirit is wearied to death, his legs are unsteady, and he has one sole desire: to sleep, to sleep just a little, not to get up, to lie, to rest, to forget… Anyone who has experienced this desire knows that not even hunger or thirst are comparable with it…I came across prisoners who signed what they were ordered to sign, only to get what their interrogator promised them. He did not promise them their liberty. He promised them — if they signed — uninterrupted sleep!
Mental Pain and Suffering
Sleep deprivation is inflicted for the purpose of destroying the subject’s capacity for psychological resistance. It causes significant cognitive impairments including deficits in memory, learning, logical reasoning, complex verbal processing, and decision-making; sleep appears to play an important role in processes such as memory and insight formation.190 Sleep deprivation may also result in decreases in psychomotor performance as well as alterations in mood.
In recent years, a growing body of research has emerged that points to the complex and bidirectional relationships between sleep disturbance and psychiatric disorders. For example, evidence suggests that sleep disturbance is not only a symptom of major depression but it also independently affects the clinical outcome and the course of the disorder. Moreover, sleep disturbance seems to be associated with an independent increase in the risk of suicidal ideation and actions.
Physical Pain or Suffering
Even sleep restriction of four hours per night for less than a week can result in physical harm, including hyperten- sion, cardiovascular disease, altered glucose tolerance and insulin resistance. Sleep deprivation can impair immune function and result in increased risk of infec- tious diseases. Further, chronic pain syndromes are associated with alterations in sleep continuity and sleep patterns.
The psychological impact of sleep deprivation supports the conclusion that it would constitute torture cruel or inhuman treatment for the purposes of criminal prosecution. Sleep deprivation is known to cause mental harm— such as the deleterious psychological and neurological effects of depression and anxiety disorders — that is both prolonged and non-transitory. Sleep deprivation also is calculated to “disrupt the senses or personality” because it is designed to break down the subject’s resistance, affect mood, and disrupt memory.
Moreover, known physical effects of sleep deprivation suggest that even its limited use may cause “severe” or “serious” physical harm and therefore may amount to “torture” or “cruel or inhuman treatment.” Indeed, during the floor debate of the MCA, Senator Durbin stated that the Act’s amendments to the WCA would criminalize prolonged sleep deprivation.
U.S. federal courts have also recognized sleep deprivation by other countries as torture. One court concluded that deprivation of sleep over two days and three nights was a key element in the torture of religious dissidents by the Chinese police. The Board of Immigration Appeals has listed sleep deprivation as a common method of torture used by the Iranian government along with “suspension for long periods in contorted positions” and “burning with cigarettes.”
U.S. federal courts have repeatedly found instances of sleep deprivation to violate both the Eighth and Fourteenth Amendments. These decisions provide support for a finding that use of sleep deprivation violates the Detainee Treatment Act. The Supreme Court has held that a confession obtained by depriving a prisoner from cruel and inhuman punishment because sleep is “considered a basic life necessity.”
Sensory Bombardment: Noise and Light
The prisoner is exposed to bright lights, flashing strobe lights and/or loud music for extended periods of time.
Sensory bombardment with light and noise can inflict extreme mental and physical harm, whether it is used as a discrete interrogation tool or to disrupt sleep. State police in the former Soviet Union used the technique routinely, barraging interrogation subjects with intense light. In its annual reports on Turkey’s human rights practices from 1999 to 2002, the U.S. State Department condemned the Turkish authorities’ use of sensory bombardment with loud music as a form of torture. The State Department has also criticized Burma’s authoritarian military regime for interrogating prisoners for long periods of time under bright lights.
The systematic use of sound and light bombardment by U.S. personnel has been extensively documented. Military guards and intelligence agents have confirmed that subjecting detainees to strobe lights was regularly used in interrogation procedures at Guantánamo Bay. The ICRC associated the use of constant, bright light and blaring music with sleep deprivation, and condemned the sensory assault allegedly infl ed by coalition forces in Iraq.207
Lt. Col. V. Stuart Couch, a Marine Corp pilot and veteran military prosecutor, recently described an example of light and sound bombardment in an interview with the Wall Street Journal. On a visit to Guantánamo in 2003, Col. Couch described his intense dismay when he witnessed a detainee shackled to the floor of a cell with heavy metal music blaring. The detainee was “rocking back and forth, mumbling as strobe lights flashed.” Col. Couch told the Journal that “the treatment resembled the abuse he had been trained to resist if captured; he never expected Americans would be the ones employing it.
The new Army Field Manual on interrogations explicitly prohibits sensory deprivation but does not include information on the subject of sensory bombardment.
Physical and Mental Pain and Suffering
Use of lights and loud music is intended to cause physiologic distress and encourages disorientation and withdrawal from reality as a defense. The body can interpret certain noises as danger signals, inducing the release of stress hormones which may increase the risk of heart disease or heart attack. Loud music can also cause hearing loss or ringing in the ears; these consequences can be both short term and chronic, with chronic tinnitus, or ringing in the ears, being more common.
Strobe lights may also induce a stress response with increased heart rate according to data from studies.
In studies involving professional drivers, headlight glare was shown to increase blood pressure, especially in drivers with underlying cardiac disease. Adverse effects of headlight glare in the laboratory include electrocortical arousal, EEG desynchronization, a rise in diastolic blood pressure and even ventricular arrythmias, potentially life threatening electrical rhythm disturbances of the heart.212 Loud noise and bright lights can also be used to interrupt sleep, resulting in sleep deprivation and its associated health effects.
Exposure to lights and sounds may constitute “torture” or “cruel or inhuman treatment” under the Torture Act or the War Crimes Act if it causes severe or serious physical harm. At least one U.S. federal court has found that treatment that included keeping detainees under bright lights for 24 hours a day thereby preventing them from sleeping constituted cruel, inhuman or degrading treatment prohibited by international law.
U.S. federal courts have found that exposure to extreme noise and light in detention and interrogations violates the Eighth Amendment, supporting the conclusion that such treatment may violate the Detainee Treatment Act. For example, courts have permitted prisoners to proceed with their claims in cases where constant lighting of a cell resulted in loss of sleep and psychological harm. The Supreme Court also found that the use of a confession obtained by shining a bright light in the eyes of a subject in a 36 hour interrogation violated due process. U.S. federal appeals courts have found excessive noise to violate the Eighth Amendment, particularly when it adversely affects the hearing of the detainee. However, where constant illumination or noise results in no loss of sleep or other psychological or physical harm the courts have found no constitutional violation.