In his new book, “Oath Betrayed,” Dr. Steven H. Miles, a physician and expert in medical ethics, human rights, and international health care, investigates the role of medical personnel in torture in U.S. military prisons in Afghanistan, Iraq, and Guantanamo Bay, Cuba. He recently spoke about it with Beliefnet senior editor Alice Chasan. 
You write that without medical accomplices, torture in U.S. prisons couldn’t happen. What happened to American doctors to make them do this?
What happened was that the government set up two programs, one of which was to use medical personnel who did autopsies on people who died of torture to conceal public knowledge of that abuse.
The second thing was that cultural psychologists and psychiatrists were used to develop ways to break prisoners down, using the particular beliefs and habits of Muslim people. And this was supplemented with information from the medical records on the prisoner’s emotional and physical vulnerabilities to create a plan of sleep deprivation, humiliation techniques, food deprivation, and so on.
What first alerted you to doctors’ complicity in abuses?
I’ve worked a lot in international rights. And physicians are present in all prisons. In fact, it would be fair to say that prisons’ doctors and nurses are the frontline human-rights workers. So, when I saw the Abu Ghraib pictures, the question was, why hadn’t the doctors and nurses blown the whistle over two years that these abuses were going on at prisons across Iraq, Afghanistan, and at Guantanamo Bay?
My investigation was based on 35,000 pages of government documents that were obtained by the ACLU under the Freedom of Information Act.
What motivated you to take this extensive look at doctors’ role in torture?
In all countries that practice torture, physicians have to assume a key role in blocking these abuses. And in fact, when they do, they often reshape the country’s practices. This is true, for example, in Chile or the former Soviet Union or in Turkey today. Somebody needed to take a look at this data.
Your adopted son is a refugee from Cambodia. Did his experience sensitize you to this troubling subject?
I’ve long seen the horrible effects of torture in refugee camps. And certainly, my son’s experience--he was a victim of torture from Cambodia’s killing fields--is also a factor.
Part of it was not just torture itself as a horrendous human-rights abuse, but also the fact that I’ve worked with American military people for a long time, and this simply doesn’t look like the military that I know.
What happened? Did 9/11 transform the behavior of military medical personnel?
I think that was part of it. The irony is that the United States conducted about 25 years of research on coercive interrogation. So did the British and so did the Israelis. And they all found that it didn’t work. In fact, the Defense Department told Secretary of Defense Rumsfeld it wouldn’t work, and he ordered it anyway.
And coercive interrogation practices have failed. We took a guy, we tortured him in Egypt. He gave the false information that Saddam Hussein and Al-Qaeda were developing bio-weapons. That became critical information in securing U.S. congressional and U.N. approval for the adventure in Iraq.
And a U.S. intelligence official told me that torture was obtaining bad information that was sending our soldiers out on dangerous wild-goose chases in Iraq, because people under torture will say anything.
So, the practical angle is that torture doesn’t work. Was it the moral angle that drew you to do this study?
Sure. But I think that it’s important to understand from the standpoint of preventing and stopping torture, that experience showed us in Europe that you need to combine both an argument about the immorality of torture with an understanding that it doesn’t work. And throughout America there has been an irresponsible discussion, for example, of the use of torture for “ticking time-bomb” scenarios.
Is that Harvard law professor Alan Dershowitz’s argument?
Right. And the argument of a TV show called “24.” Dershowitz argues that we can use what he calls “torture warrants” [signed by the president] to control this practice. But experience shows that torture has never been confined to narrow channels. In fact, the premise of the dehumanization which lies behind torture ensures that it’ll be used widely against people who know nothing of crimes.
U.S. military intelligence says that 85 percent of the prisoners held in Iraqi prisons, and around 60 percent of those held at Guantanamo, are entirely innocent or ignorant of any insurgency or Al-Qaeda activity.
One of the things that torture scholars point out is there’s a difference between the alleged reason for using torture and its social function. Torture has been used, for example, as an instrument of political repression to achieve political control.
But, this whole war-footing society of the “war against terror,” and torture, has also been used to mobilize political support in the United States. In that respect we’re very similar to other countries, which have used a strong sense of a dehumanized enemy as a way to create a political base. The war on terror would be better constructed as an international police action rather than as a war.
Can you explain what you mean?
There are terrible things being done: the attacks in New York, Washington, Bali, Nairobi, Egypt, Spain. But these are handled through international policing. There is no way that we can bomb Iraq into eliminating torture throughout the world. In fact, experience suggests that what we’ve done is we’ve mobilized a larger base for the radical Islamic groups.
You say in your book that “Americans know little about the realities of torture, but they’re steeped in fictional torture.” Do they accept these practices because of violence in our popular culture?
Fictional torture shows torture working. And the reality of torture today is that torture destroys civil societies. It prevents democratic movements from emerging in dictatorships. And Americans have very little sense of how destructive torture is. When we torture, we undermine the framework of law that is used to build civil societies--which is what the fight about terrorism should be about.
After World War II, we said an appeal to national sovereignty cannot justify genocide, slavery, or torture, and we have now undone that principle. We’ve introduced the idea that the U.S. Chief Executive can, with the assent of Congress, engage in torture.
Prof. Dershowitz says that the post-World War II principles of human rights in the Geneva Conventions are outdated.
Dershowitz is flat out wrong, on three counts. Number one, he is wrong on the idea that the ticking time-bomb scenario exists in real intelligence work. He’s wrong on the ethicality of torture; and he’s wrong on the ability of torture warrants to confine torture. None of those arguments stands up to real historical arguments. He’s living in an imaginary world.
And his argument is destructive. Let me give you an example. The administration claims that torture identified a plot to blow up eight airliners leaving the Philippines and traveling across the Pacific. But, the information about that plot was obtained from the laptop of the guy who was arrested. And under subsequent torture, all he gave was bad information.
You cite author and psychiatrist Robert J. Lifton’s idea of “atrocity-producing situations” to help explain why people who previously lived according to moral norms begin to behave in sadistic ways. Are Americans now living in that kind of atrocity-producing situation?
We are living in a world that is an atrocity-producing situation. We’ve created a mysterious and omnipresent enemy that we’ve dehumanized. And then we created a special category of human beings called “illegal combatants,” and we have created secret institutions. We have demolished the system of command accountability for abuses, except for a handful of very low-level soldiers. That is the situation that produces torture.
On the ground [in Iraq], increasing frustration on the part of our troops with a mission that they can no longer understand or figure out how we’re going to win is leading to an increased level of atrocities. But, that’s mainly in the battlefield areas, and my book is not about battlefield ethics; it’s about prison ethics.
Has American society lost what we saw before as the moral high ground?
I think it will be very difficult for us to claim the moral high ground. I don’t think that this is a Nazi medicine situation. In Nazi medicine, the medical profession created a concept of race hygiene and eugenics, which supported genocide. This looks more like medicine as it was practiced during Argentina’s Dirty War, where the doctors simply went to work, falsified death certificates, and assisted in designing and monitoring abusive interrogation.
Our use of torture has radicalized the people in Iraq and in the Islamic world against us. And so, in taking down the system of international law, we have made the world a much more dangerous place.
Prof. Dershowitz calls for a robust, honest debate about which kinds of torture we accept. He uses the example of inserting sterile needles under prisoners’ fingernails instead of techniques that would kill them.
Dershowitz obviously has a rich fantasy life. It’s interesting he can design these methods. But the world decided that genocide, slavery, and torture cannot be justified by an appeal to national sovereignty. And the discussion is not for us to hold, it's for the world to hold.
