A National Research Council (NRC) 2008 report on a conference on Emerging Cognitive Neuroscience and Related Technologies examined briefly what it characterized as a “contemporary problem,” the possibility of doing research on “war on terror” detainees, removed by the U.S. government from Geneva protections against experiments done on prisoners of war.
In a section of the report that looked at the “Cultural and Ethical Underpinnings of Social Neuroscience,” the report’s authors examined the “Ethical Implications” of these new technologies. The section explored the birth of the new field of bioethics, in response to the scandalous revelations of the Tuskegee experiments. The report noted that “On the whole, however, the system of protections for human research subjects is not well designed to capture instances of intentional wrongdoing,” providing “rather… guidance for well-motivated investigators who wish to be in compliance with regulatory requirements and practice standards.”
The report further described the history surrounding the importance of the rules that constitute the need for informed consent of research participants, and how the Nazi-era experiments led to the Nuremberg principle that “The voluntary consent of the human subject is absolutely essential.” While claiming the current “formal procedures in place for the use of military personnel in medical experiments” are “stringent,” that doesn’t imply “that no abuses can occur, nor that convenient alternative frameworks (such as field testing) cannot be used to circumvent the research rules, but only that the official policies and procedures in the military are rigorous.”
But even with such supposedly “rigorous” policies, the report’s authors see a problem. They ominously ask whether “classified research can ever be ethically sound inasmuch as it lacks transparency, such as in the form of public accountability. For example, if a member of an ethics review board disagrees with a majority decision involving a classified human experiment, that member would be unable to engage in a public protest of that decision.”
At this point in the discussion, another interesting, and even more ominous question rises up before the NSC panel (emphasis added):
A contemporary problem is the status of detainees at military installations who are suspects in the war on terrorism. Presumably, the ethical standards that apply to all human research subjects should apply to them as well. But if they are not protected by the provisions of the Geneva protocols for prisoners of war, the question would be whether as potential research subjects they are nonetheless protected by other international conventions, such as the Universal Declaration of Human Rights (United Nations, 1948). Those technical questions of international law are beyond the scope of this report.
Why should the question of research on detainees arise in this discussion at all?
Evidence of Military Research and Experimentation on Detainees
Jason Leopold and I have been investigating the possibility of research being conducted upon detainees at Guantanamo and other “war on terror” prisoners held by the Defense Department and the CIA. Back in September 2009, I published articles at Firedoglake, The Public Record, and Truthout that noted the research on “uncontrollable stress” conducted upon SERE survival school students subjected to mock torture predated the institution of the so-called “enhanced interrogation program of the CIA. The research was conducted by, among others, a CIA-linked psychiatrist, Dr. Charles A. Morgan III, who is affiliated with Yale University and the National Center for Post-traumatic Stress Disorder.
Morgan has denied his CIA affiliation, but for documentary evidence, see this list of participants at this 2004 DoJ/FBI conference.
This research used methods that were similar to those later instituted under a plan developed by James Mitchell and Bruce Jessen, formerly employed by the military’s Joint Personnel Recovery Agency (JPRA), parent organization to the SERE program, to use coercive forms of interrogation on the new “war on terror” detainees, who the White House and their attorneys at the Office of Legal Counsel removed from the protection of Geneva Convention protocols. In a report on CIA experiments on torture, Physicians for Human Rights (PHR) noted in an appendix the existence of the Morgan research, but failed to make public the CIA connections, even though they certainly were aware of them.
Originally, the PHR report was going to include a footnote on the existence of a new protocol on human experimentation protections in the military signed by Paul Wolfowitz in early 2002. While they chose not to follow up on this, Leopold and I conducted a seven-month long investigation into the March 2002 issuance of Department of Defense Directive 3216.02, “Protection of Human Subjects and Adherence to Ethical Standards in DoD-Supported Research.” We noted that “the Wolfowitz directive weakened protections that had been in place for decades by limiting the safeguards to ‘prisoners of war’.” Even more, it allowed for waivers of informed consent if the head of a DoD department thought it necessary. There had never been such loose rules on informed consent ever explicitly allowed in the history of military research, although no prominent ethicist had discussed this until we published our article. Prominent ethicist Alexander Capron was quoted in our story for calling these changes “controversial both because it involves a waiver of the normal requirements and because the grounds for that waiver are so open-ended.”
While retaining the blanket prohibition against experimenting on prisoners of war, Wolfowitz softened the language for other types of prisoners, using a version of rules about “vulnerable” classes of individuals taken from regulations meant for civilian research by the Department of Health and Human Services (DHHS).
By removing the detainees from Geneva protections, and taking away “prisoner of war” protections, Bush and the White House lawyers, among them Jay Bybee, John Yoo and Alberto Gonzales, opened up the captured prisoners, many of them sold to the Americans for bounty reward, to possible experimentation.
DoD and HHS Acting Together on Experiments?
Buried in the Wolfowitz directive was a provision (4.4.1) that “actions authorizing or requiring any action by an official of the Department of Health and Human Services (HHS) with respect to any requirements” of research on “vulnerable populations” like prisoners “shall be under the authority of the Director, Defense Research and Engineering.” The reason for HHS involvement was because research “supported or conducted by the Department of Defense that affects vulnerable classes of subjects” had to meet the protections of HHS’s Common Rule language that covers protection of human subjects.
When queried whether there had ever been any DoD research on any kind of prisoner, or the use of HHS personnel to monitor such research, a spokesperson for Defense Research and Engineering indicated that they had no comment.
In 2002, there was another assault on prisoner protections for research, when Bush’s Secretary of HHS asked for and received a year later a blanket waiver for all informed consent on prisoner experimentation for “epidemiological” reasons, including the taking of biological samples. In a future article, I will explore the repercussions of this new policy — also never discussed by any ethical panel, and certainly not by the NRC — on research upon prisoners, and more specifically the possibility of experiments done on the detainees at Guantanamo.
This further investigation may throw light upon the Guantanamo SOP wherein all detainees were subjected to a never-before-attempted use of mass administration of treatment doses of the controversial anti-malaria drug mefloquine (Lariam), as also reported in a special investigation by Jason Leopold and myself last December. The scandal was also the subject of an independent investigatory report published at the same time by Seton Hall University Law School’s Center for Policy and Research.
In a 2002 report on mefloquine adverse events, “Unexpected frequency, duration and spectrum of adverse events after therapeutic dose of mefloquine in healthy adults,” published in top medical journal Acta Tropica, it was noted that 73% of the participants suffered “severe (grade 3) vertigo…” which “required bed rest and specific medication for 1 to 4 days.” Nevertheless, DoD maintains that the use of mefloquine was for public health purposes, to prevent malaria from spreading in Cuba. But as our investigation showed, talking with military medical experts, and examining other military responses to malaria threat, including in Cuba, no such use of such mass treatment doses, with its attendant dangers, was ever used or even proposed. Nor did DoD medical officers at Guantanamo demand the same protocols be used on foreign workers from malarial areas brought into the camp at this same time to work on building Camp Delta and other facilities at the naval base. The workers were employed by Kellogg Brown and Root, a subsidiary of Halliburton.
Was the mefloquine use part of an experimental protocol on the adverse side effects of the drug, a subject of much controversy within DoD at the time? Was it a method of softening up prisoners for interrogation? While calls for greater transparency go unheeded, further investigation by the press may bring answers to these explosive questions.



59 Comments

Thank you for your continuing coverage of this topic, Jeff.
Thanks for this and This reminds me.re: malaria and mefloquine
The ACLU has released FOIA autopsies detainee deaths. http://www.aclu.org/national-security/deaths-detainees-us-custody-documents-released-january-14-2011
Atawi al-Awani, Camp Bucca Iraq pg. 306 is listed as having a “natural death”, “peritonitis due to small bowel perforation, ” which according to the military coroner/pathologist was due to some complications having to due with advanced stage of malaria (according to them). Toxicology:lidocaine, mefloquine, cloroquine, metoclopramide, oxycodone, oxymorphone, lorazepam.
It’s one of many suspicious deaths. A few cases later, Sweidan is listed as having died after an emergency thyroid surgery. 6 weeks later he dies a blood soaked death, “asphyxia due to surgical sponge penetrating lumen of trachea.” Medical malpractice or something else? I’ve heard of doctors who almost got sued for referring someone to a surgeon who left cottons in a patient. The result, I believe, is usually infection.
I list this, not because I like looking at this kind of stuff, but because I think there is something very very very wrong with these deaths. Please take a look at the report if you have a chance.
Great. my comments got disappeared. Due to toxicology? C’mon.
Okay I was going to give this one last try before I lose patients.
Mefloquine-pg. 306. Detainee Death report. Here.http://www.aclu.org/national-security/deaths-detainees-us-custody-documents-released-january-14-2011
patience.
I don’t have patients. That was not a freudian slip. I am not a doctor.
Complicity + torture + doctors + coroners is an outrageous thing. All of them should be sued into a paper bag.
I was only following orders.
I’ll certainly be looking through these documents, as I hope and presume will others, as it’s too much data for me to handle. I’m curious about the mefloquine reference. As for the detainee with malaria, the latter is endemic in parts of Iraq, and it’s not unusual that people may go untreated and have malaria for many years. The vivax type in particular will have an acute outbreak and then subside, many times over, if not treated.
Not mentioned in my article here, but noted in others, according to DoD only three or four detainees (out of ultimately over 800) actually were diagnosed (via lab tests) with malaria coming into Guantanamo… another fact that belies the reasons for the extraordinary health measures they said they needed to take.
We noted that “the Wolfowitz directive weakened protections that had been in place for decades by limiting the safeguards to ‘prisoners of war’.” Even more, it allowed for waivers of informed consent if the head of a DoD department thought it necessary.
Rummy has stock in Tamiflu I’m sure he had several monetary reasons to think it necessary.
Great. More experimenting. Wonder what wonderdrug will come out of this.
“They ominously ask whether “classified research can ever be ethically sound inasmuch as it lacks transparency, such as in the form of public accountability.”
Duh.
Buried in the Wolfowitz directive was a provision (4.4.1) that “actions authorizing or requiring any action by an official of the Department of Health and Human Services (HHS) with respect to any requirements” of research on “vulnerable populations” like prisoners “shall be under the authority of the Director, Defense Research and Engineering.”
I take this to mean that the Department of Health and Human Services (HHS) must bow to the Director, Defense Research and Engineering.” in regards to prisoners.
The reason for HHS involvement was because research “supported or conducted by the Department of Defense that affects vulnerable classes of subjects” had to meet the protections of HHS’s Common Rule language that covers protection of human subjects.
What I don’t hear are reasons for this change. If left to speculate none of the reasons I can think of sound any good.
How many Bushies started to buy medical and drug company stocks after they got in the Bush WH is my next question we need to know who in the WH profited off of other peoples misery. Bushschadenfreud ( my own word meaning enjoying making a dollar off the misery of others).
Nevertheless, DoD maintains that the use of mefloquine was for public health purposes, to prevent malaria from spreading in Cuba. But as our investigation showed, talking with military medical experts, and examining other military responses to malaria threat, including in Cuba, no such use of such mass treatment doses, with its attendant dangers, was ever used or even proposed.
The strain of Malaria in South America is less dangerous than Africa. Cuba has the best healthcare in South America so the number of infected people around spreading the disease is very low remember poor people get healthcare in Cuba free unlike America.
Malaria problems in South Florida are more likely is the army doing these drug treatments their or in our Panama canal zone army base? Or do we only do this in Cuba because we have prisoners there?
What… the USA is contemplating reviving the Nazi experimentation on prisoners?
Wonderful.
That’s. Just. Great.
In 2002, there was another assault on prisoner protections for research, when Bush’s Secretary of HHS asked for and received a year later a blanket waiver for all informed consent on prisoner experimentation for “epidemiological” reasons,
Bush gave them a pass to test drugs to stop epidemics? Epidemics kill people testing vaccines and drugs on people means exposing them to the germs that cause epidemics.
Bill Gates has been spending a ton of cash to find a malaria vaccine so why would the Bush WH bother looking for a malaria drug? Its not like malaria is a problem in Pakistan, Afghanistan or Iraq.
It seems we went beyond contemplating.
These are war crimes. When will they be held to account for their actions?
How do you get Malaria in jail is buying a can of bug spray for when the prisoners exercise outside assuming the WH even lets them do that to much to expect?
Also if Malaria was such a problem in Cuba can the WH show any evidence Cuba was facing an epidemic that did not respond to conventional medical treatment?
Bugs fly especially in hurricane season was Florida and nearby islands effected by this super malaria were any American solders on the base where the prisoners were held infected?
What?
I’ll bet you $100 malaria is a problem in Iraq and Pakistan, Especially lose to the sea.
Agree and Seconded
Egyptians want accountability. If that happens, then perhaps the U.S. can send their war criminals to Egypt for justice instead of torture. /s
…and we are a source for good on the planet?
“If we ever pass out as a great nation we ought to put on our tombstone, ‘America died from a delusion that she has moral leadership.” Will Rogers
Fine links how many of our solders got sick in Iraq from malaria? How many died remember we are talking Malaria so bad experimental human testing had to be rushed through.
Define problem if getting sick is a problem then yes if dying is the problem then no it seems we can treat malaria and have no reason to rush drug testing on human subjects.
http://findarticles.com/p/articles/mi_qa3912/is_200612/ai_n17195621/
They have a case against Bush I’m sure:)
They will probably receive better treatment in Egypt than in Poland.
Malaria is a problem in Iraq and South Asia in general. If you read the links to the original stories by Jason Leopold and myself, you will get the answer to your questions or concerns.
Thanks Jeffrey. I hope so. I’ll report mefloquine as I find it. You should FB me. It’s the easiest way for me to communicate. Otherwise I’ll have to look here.
There was malaria 94-95 in Iraq, post war. UN and other stats report zilch or maybe three at the most. http://mdgs.un.org/unsd/mdg/SeriesDetail.aspx?srid=663
This kid (the deceased) was 19 years old, plus sundry other info. The pathologist is BS-ing as in the Sweidan case. And others. They’re listing final outcomes (heart failure) as primary causes of death.
I’d be intersted to see that DoD link. BS detectors should be at an alltime high.
I want to stress, we don’t know what experiments, if any, were conducted. I have my suppositions. This is a case where there is a he’ll of a lot if smoke, in the form of serious loosening on human subject protections, especially for the detainees. Why? Why won’t, for instance, DR&E respond to the query I made them when they have on others?
The mefloquine case is very strange. Moreover, there is a subsequent issue surrounding certain human rights people and their association with Gitmo personnel from that time which has thrown confusion into the story. I don’t want to comment on that further until I’ve spoken to all the individuals involved.
I have to check his age again. I think he was pretty young.
Good point. UN statistics also show zilch zero malaria death in Cuba. Unlike detainee deaths in Camp Bucca Iraq.
Somone should compare cause of death in Camp Abu Ghraib, Gitmo, Bucca v. population in general (Iraq).
http://mdgs.un.org/unsd/mdg/SeriesDetail.aspx?srid=663
Why assume, when you can do the research. Yes, malaria apparently *was* a problem 94-95.
After Tuskegee and Mengele, why are any medical, pharmaceutical or psychological experiments done on these prisoners, regardless of whether they have POW status? These men and women are prisoners of the greatest democracy, the brightest beacon for individual and collective freedom the world has ever known; they are not guinea pigs.
And for all I know, Iraq may be like places certain places in the Far East. So many goddamned chemicals were sprayed, that mosquitos remain a problem, malaria not.
There *was* no epidemic. Of that, I’m pretty sure of. See UN or World health statistics.
Here’s one. Malaria__Zero:
http://www.who.int/quantifying_ehimpacts/national/countryprofile/cuba.pdf
If you google, Cuba and malaria, seems they’re interested in industrial type control. I do wonder what they get out of hosting Gitmo at times.
That’s reasonable. I understand. Your response needs to be more measured than ours, the readers’. I do hope you allow us to run a few ideas by you though.
Why won’t they respond? They have a lot to hide. Of that last I’m pretty sure.
WHO links are giving me trouble. I still want to check their statistics on malaria and Iraq though.
Jeff, Malaria is a problem everywhere. Especially this country. We have more deaths in this country than Iraq, according to UN, WHO 2006, 2008, *and* more infections (I have to recheck that, but one chart showed we have more robust numbers of infection than Iraq or Yemen or a lot of other countries). Iraq had a reported 3, I believe. Is it just coincidence that one of those deaths (not reported) just happened to be a detainee in Camp Bucca with meflquine in his blood?
As for S. Asia. That’s different. Places like Taiwan, I think there may be real sporadic incidences, and that’s it.
There is a DoD document we cited in a previous document that states there is no malaria in Cuba or Guantanamo. There are mosquito species capable of transmitting malaria however, though they are quite localized to certain areas.
To fully understand the issues, please follow through with the links provided in the story. I haven’t time to repeat the here.
Another good point. It’s treatable in many cases. So why use this absurd and nasty experimental drug?
And my guess is that Saddam Hussein had these technocratic tendencies.
That’s obfuscation. There are mosquitos capable of transmitting malaria everywhere.
I mean I got the rationale. I don’t buy it. Not for a minute.
US.Common malaria mosquito
http://entnemdept.ufl.edu/creatures/aquatic/Anopheles_quadrimaculatus.htm
Especially in the US. See link below
http://entnemdept.ufl.edu/creatures/aquatic/Anopheles_quadrimaculatus.htm
If that’s the case, how come the whole North East isn’t being treated to experiemental cocktails?
You should start. Today. I’m already working on it.
This country needs serious denazification.
I have a question about resolution for Torture victims:
Given that it is highly unlikely that one’s Torturers will be prosecuted of successfully sued,
and given that very few media will publish a victim’s first-person Torture story,
what can or should a Torture victim do to bring the crimes against him to light?
Thank you once again, Jeff, for your amazing work.
Caged prisoners. Contact them.
http://www.cageprisoners.com/
Forget the BS, about them being an “extremist” group. That’s not true and it’s pure Islamophobia. They lobby for stuff like ya know habeas corpus.
Also the Center for Constitutional Research maybe.
It’s ok you want to be doctor… but please don’t test our patients. We don’t have much left. They all died… painfully!
You’re a funny kid.
Correction. This is death rate. I did see an infection rate chart for the US that was a lot higher than Iraq.
Also seeing differing reports for ’90s Iraq.
Only certain species of mosquitoes of the Anopheles genus transmit malaria. They are not everywhere, but are on almost all continents. Here’s a link to a map showing distribution.
According to CDC:
CDC also says, in relation to the U.S., “Outbreaks of locally transmitted cases of malaria in the United States have been small and relatively isolated, but the potential risk for the disease to re-emerge is present due to the abundance of competent vectors, especially in the southern states. At the request of the states, CDC assists in these investigations of locally transmitted mosquito-borne malaria.”
Malaria/mosquito control is a major element of public health programs. Hence, malaria is basically under control in many countries. See this map where malaria transmission occurs. Note Cuba does not currently suffer malaria, although Haiti does.
You may think that illegal and harmful medical experimentation on unconsenting research subjects may have been limited to DoD transgressions against prisoners in a specially manufactured legal limbo. However, compare the abuses Jeff Kaye describes with the SUPPORT trial of premature babies run by the National Institutes of Health that treated the captive American preemies even worse than those prisoners, or than the unconsenting subjects in the past syphilis studies in Guatemala and Tuskegee, in that this recent preemie study casually and preventably killed many of them.
This trial was conducted in the US from 2005 to 2009 and published in the May 16, 2010, online edition of the New England Journal of Medicine. Its “eminent” US medical researchers had restricted the life-saving breathing help of supplemental oxygen to a low level which they knew to increase the risk of death for the preemies. Indeed, they predictably killed an “extra” 23 preemies in their low-oxygen group, with a probability of 96% that this was not a random
fluke.
The NIH researchers committed this pre-meditated medical mass infanticide because they wanted to see if the combined total of death and blindness would get lower with less oxygen. They equated the severity of blindness with that of death and ignored all the rules, from the Nuremberg Code on, that insist the degree of risk imposed on the research subject should never exceed the humanitarian importance of the problem to be solved by the experiment. Please note that even intact eyes are of no use to a dead patient.
This SUPPORT trial killing spree was approved by all the grant givers and institutional review boards, and four similar trials are currently going on in the UK, Australia, New Zealand, and Canada. For details about this intentional and officially accepted preemie-killing trial run by the NIH, see my open letter to the National Bioethics Commission at
http://retinopathyofprematurity.org/BioethicsSUPPORT.htm
Respectfully submitted, Peter Aleff
prevent@retinopathyofprematurity.org
Jeff, that is an interesting interactive map. My point stands though. We have more malaria vectors in the US than Iraq.
Al Anbar None. None in Ramadi. Not applicable
Malaria in Country:
Country Name Malaria in Country Drug Resistance Malaria Type Prophylaxis for Areas with Malaria
Iraq Previously in areas at altitudes <1,500m (4,921ft) in provinces of Duhok, Erbil, Ninawa, Sulaymaninya, and Ta\\''mim. No cases reported in 2009. None P. vivax 100% Mosquito avoidance
Our country needs serious ethical wakeups for sure.