In November 2014, the Board of Directors of the American Psychological Association (APA) asked David Hoffman, a former federal prosecutor, to lead an independent review of allegations that the APA colluded with government officials to sanction the use of interrogation techniques tantamount to torture. The APA asked Hoffman to investigate these allegations just weeks before the release of the Senate Intelligence Committee’s report on the CIA’s use of torture, a report that raised major questions about the participation of psychologists in interrogation sessions.
Hoffman was specifically asked to investigate questions about ethical guidelines issued by the APA in 2002 and 2005 that dictated when psychologists could ethically participate in national security interrogations.
Hoffman’s report was leaked on July 10 and confirmed many people’s (including my) worst suspicions.
Here, then, is what we now know – and here is my analysis of how the country’s biggest association of psychologists could choose its “ethics policy based on its goals of helping [the Department of Defense].”
The APA and DOD: a special relationship
Hoffman has confirmed that that officials at the APA colluded with the Department of Defense (DOD) as well as the CIA to allow psychologists to participate in interrogations from the beginning of the “war on terror” until Obama came into office in 2009 and rescinded authorization for enhanced interrogation techniques.
Although I have been working in medical ethics for 20 years, I first became aware of and alarmed by health care personnel’s participation in the use of torture a decade ago, when photos were leaked from the Iraqi prison of Abu Ghraib.
More specifically, this led me to study what medical students and graduate psychology students were learning about military medical ethics and their obligations as health professionals under the Geneva Convention.
It also prompted me to look at the close relationship between the Department of Defense (DOD) and the American Psychological Association.
How the APA drafted its ethical guidelines
Drafting policy and ethical guidelines for psychologists is one of the central tasks the APA performs. And to craft these statements and guidelines, the APA uses panels of psychologists.
The Hoffman report reveals that the collusion between the APA and government affected both the composition of panels designed to craft APA policy and the content of their proclamations.
‘… a failure to live up to our core values’
The following is an excerpt of a statement from the APA:
The American Psychological Association (APA) [on July 10] announced an initial series of policy and procedural steps in response to findings of individual collusion and organizational failures in the group’s activities related to the Bush Administration’s war on terror.
The actions come as the APA released a 542-page report produced by attorney David Hoffman, of the Sidley Austin law firm, detailing the relationship between various activities of the APA and Bush Administration policies on interrogation techniques. Mr. Hoffman was retained by the APA Board of Directors last November to conduct a thorough and independent review, and the APA cooperated fully during the eight-month process.
“The Hoffman report contains deeply disturbing findings that reveal previously unknown and troubling instances of collusion,” said Dr. Susan McDaniel, a member of the Independent Review’s Special Committee. “The process by which the Presidential Task Force on Psychological Ethics and National Security (PENS) was created, the composition of the membership, the content of the PENS report and the subsequent activities related to the report were influenced by collusion between a small group of APA representatives and government officials.”
The Hoffman report states that the intent of the individuals who participated in the collusion was to “curry favor” with the Defense Department, and that may have enabled the government’s use of abusive interrogation techniques. As a result, the 2005 PENS report became a document based at least as much on the desires of the DoD as on the needs of the psychology profession and the APA’s commitment to human rights.
“Our internal checks and balances failed to detect the collusion, or properly acknowledge a significant conflict of interest, nor did they provide meaningful field guidance for psychologists,” said Dr. Nadine Kaslow, chair of the Independent Review’s Special Committee. “The organization’s intent was not to enable abusive interrogation techniques or contribute to violations of human rights, but that may have been the result.
“The actions, policies and the lack of independence from government influence described in the Hoffman report represented a failure to live up to our core values. We profoundly regret, and apologize for, the behavior and the consequences that ensued. Our members, our profession and our organization expected, and deserved, better.”
These proclamations set APA policy and, in effect, dictate what is ethically permissible or not for psychologists. The Psychological Ethics and National Security (PENS) task force 2005 report – that fully gave permission to psychologists to participate in interrogations – is an example of this.
The PENS report was authored in partial secrecy and approved by a panel carefully selected by APA officials, the majority of whom had close ties to DOD. As Hoffman reveals, the PENS task force was “the result of close and confidential collaboration with certain Defense Department officials before, during, and after the task force met.”
The PENS report allowed psychologists to participate in interrogations if they adhered to US law, but they violated every international code of medical ethics.
The point is that the way the Bush administration crafted US law flew in the face of medical ethics, allowing for detainees to be tortured, for example, because they were not “prisoners of war,” and therefore not protected by the Geneva Conventions.
The APA didn’t change guidelines on interrogations until 2013
The APA’s permissive ethical stance allowed psychologists to participate in interrogations, providing necessary cover for dubious so-called “enhanced techniques” to continue.
In this the APA stood alone among the major organizations for health professionals in the United States. By 2006, both the American Medical Association and the American Psychiatric Association issued decrees prohibiting their members from participating in interrogations.
If the APA had done the same and prohibited psychologists from participating, harsh interrogations and torture would have come to a screeching halt because their presence, as health professionals, provided an air of legitimacy to interrogations. And this was needed (at least in part) to confer protection against future prosecutions of the interrogators. Any interrogators who were questioned could easily point to the psychologists then present to illustrate that their methods had to be safe and ethical.
In fact, the APA did not rescind the 2005 PENS report until 2013.
And even then, there remained significant holes that still allowed psychologists to be present during interrogations.
The APA thwarted efforts to oppose unethical behavior and took active steps to protect the psychologists involved in the interrogation program from professional ethical complaints.
In fact, it was the APA’s ethics director, Stephen Behnke, who oversaw much of this effort. To top things off, unbeknownst to the APA board, Behnke himself reportedly received a Pentagon contract to help train interrogators.
And – as all of this was happening behind the scenes – the APA leadership was telling the APA general membership that the goal of the association’s standards was to protect the health and welfare of the prisoners at Guantanamo.
Young psychologists aren’t learning military medical ethics
How could this happen?
Part of the answer must lie in the fact that psychologists receive little training about the ethical duties of health care personnel in military settings. Without that training, many of them simply didn’t know better.
In a paper published last year, colleagues and I found that 74% of graduate students in psychology had received less than an hour of instruction on military medical ethics.
We also found that only one-third to one-half of students in these courses could correctly answer questions about when they would be required to disobey an unethical order, for instance, according to the Geneva Conventions.
The Geneva Conventions are clear in stating that prisoners are required to give only their name, rank, branch of service and serial number to interrogators. Additionally, they should be given food, shelter and medical treatment and never humiliated, threatened or harmed in any way.
The APA colluded with the DOD. Now what?
In the wake of the Hoffman report, APA ethics director Steve Behnke has gone (whether voluntarily or not is not yet clear) and, in an official statement, the organization has acknowledged the “deeply disturbing findings” that were “a failure to live up to our core values” and has outlined various recommendations.
The APA has also announced the departure of three other staff members: CEO Norman Anderson, Deputy CEO Michael Honaker, and the Executive Director for Public and Member Communications Rhea Farberman.
More, however, is to be done.
The APA should also publicly praise those dissident psychologists who have over the last decade steadfastly protested APA’s support of interrogations and torture – despite the chiding they received from the APA administration.
Additionally, the APA ought to call for significant investment in in ethics education for practicing psychologists as well as psychology trainees.
The fact that the United States resorted to torturing prisoners – many of whom are innocent, or in the words of the Senate Report on torture, “wrongfully detained” – will likely go down as one of our country’s most egregious ethical lapses. The fact that a major health care association colluded in this lapse is unconscionable.