First, Do No Harm

Dr. Stephen Xenakis, a former high-level army psychiatrist, has become a vocal critic of the terrorist-detention system, calling on his medical colleagues not to participate in 'special interrogation methods.'

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WASHINGTON, D.C. - In signing the Defense Law, which includes clauses banning the transfer of prisoners from the Guantanamo Bay detention camp to U.S. territory, U.S. President Barack Obama effectively finished addressing the notorious facility in Cuba. He signed the law in January, despite knowing that Congress' opposition to transferring prisoners into U.S. jails would get in the way of making good on the order he gave to close Guantanamo upon taking office.

Upon visiting Guantanamo, it's hard to understand what the uproar is about. Cuba's pleasant weather, the well-scrubbed cells, the ironed prisoner uniforms and the sports compound on the prison grounds - it all looks much better than your standard American prison. Yet the guards' plastic masks, and the explanation that "the prisoners hurl feces at us," suggest something might be amiss. And the fact that a visitor is not allowed to talk with inmates hints that the sports compound and ironed uniforms might not reflect the true nature of the place.

A Guantanamo detainee being escorted to interrogation in 2002.Credit: AP

Dr. Stephen Xenakis, a psychiatrist and former medical corps brigadier general who spent years in the U.S. Army, has become one of the most vociferous critics of the "special investigation methods" used on terror suspects. Xenakis is coming to Israel this week to speak at a two-day conference in Ramallah and Jerusalem about the responsibilities and immunity of people who employ torture tactics. The conference is sponsored by Adalah - The Legal Center for Arab Minority Rights in Israel, Physicians for Human Rights, and the Palestinian Al-Mezan Center for Human Rights.

Xenakis had his turning point when he was asked to examine Omar Khadr, 24, a native of Canada whose father sent him to an Al-Qaida training camp at age 12. Khadr was detained in Afghanistan at age 15 after throwing a grenade that killed an American soldier. At 16, Khadr was presented as the "Al-Qaida poster boy," and found himself in Guantanamo. He was tried as an adult.

"At first I didn't know about the [Khadr] case," Xenakis recalls. "I am a physician and a psychiatrist, and I think that my obligation is to be able to act professionally in the best way I can according to the ethics and principles upon which I've been trained, and I am obligated to look at something as openly and honestly as I can.

"Once I explored the case and the facts there, I felt that he was innocent, and that he was mistreated, and it was not something I could uphold as an officer or physician. I realized he was tortured - he was shot twice in the back, he suffered from wounds, and when I went to examine him he had an anxiety attack. To me, this confirmed that he was tortured and was still suffering from post-traumatic stress. But he is not a person who hates."

Xenakis says Khadr was left disabled, "having been blinded in one eye by a grenade explosion." In 2010, Khadr was sentenced to eight years in prison, on top of the seven years he spent behind bars awaiting his trial outcome. His military lawyer said he has started studying in prison, and wants to enroll in college.

"I hope he can rehabilitate," Xenakis says. "He has the potential of leading a very good life, and being a good citizen and good family man. I believe suffering like this changes a person forever. I think these experiences will shape him for the rest of his life. He is a very nice and decent young man. I've seen him in situations where he was extremely stressed and under great pressure - and he is not a person who gets harsh or mean."

Does it help America?

While Dr. Xenakis, as a civilian, was a defense expert in Khadr's trial , Dr. Michael Welner, a psychiatrist from New York, testified for the prosecution. Welner called Khadr "dangerous," and said he had been radicalized in prison and identifies with his family's politics (Khadr's father, who was killed in Pakistan, handled finances for Al-Qaida, and his sister said in a television interview that she admires suicide terrorists). Khadr, prosecutors said, has "rock star" status in prison, since he is someone who met Osama bin Laden.

"I asked myself questions all the time," Xenakis says, recalling the hesitation he felt regarding testifying on Khadr's behalf. "It certainly rattled my confidence as to what my purposes are and what my motives were. I had to try to decide whether what I was doing was in the best interests of my country, whether it promoted our mission, our laws. It has been very unsettling in lots of ways, but I can't walk away from this.

"Is it right for us to do [what we do at Guantanamo]? Does it really help America? I know what public sentiment believes. But I got back to the point that my job is to speak truth to power. And I think the truth is what's most important. If we don't uphold our principles, I am not sure we'll ever do the right job."

Xenakis calls it "chilling" to visit Guantanamo. "I've been there many times ... The paradox is that as compared to other prisons in the U.S., where many of these detainees may go if they are convicted, the conditions in Guantanamo are actually not as harsh. So even though there are many concerns about the legal rules that underlie Guantanamo, the conditions there are better than in many U.S. prisons."

So why should it be closed?

Xenakis: "The reason it should be closed has to do with what it symbolizes - that the U.S. decided to act extrajudicially, outside the bounds of either our laws or international laws. The prison is a statement symbolizing the idea that we are not going to conform to the same moral or legal principles which we are telling the world to conform to.

"We have a responsibility as doctors and as senior officers to challenge contradictions and moral ambiguities, explain them as best as we can, and reach decisions that are in line with principles to which we are beholden professionally as officers and doctors."

Controlling the beast

In the years that have passed since reports surfaced about the involvement of psychologists in interrogations, Xenakis has voiced stringent criticism about violating the ethical precept to do no harm, and he has tried to persuade the American Psychological Association to prohibit its members from taking part in interrogations.

He has also tried to lobby for legislation in Congress that would enforce clear standards for the humane treatment of prisoners. His analysis of Bush administration documents, which he published in professional journals, was not popular with peers who offered differing evaluations of interrogation tactics that Xenakis calls torture.

"The rationalization used to defend 'special interrogation methods' is that they yield information that can save human lives," he explains. "But there is no evidence that this is true. I've heard it, explored the claims, I've talked with interrogators - but there is just no data to justify the rationalization."

It could be that Omar Khadr stirs sympathy due to his life circumstances, since his father dragged him into terror. Do you think interrogation restrictions for a case like Khadr's ought to apply to a suspect in the September 11 terror attacks, Khalid Sheikh Mohammed, who has not voiced any regret for his actions?

Xenakis: "I think we have to apply the same standards. Five of these [9/11] terror suspects are nasty and belligerent; if released, they will continue with their terror activity and will do anything in their power to hurt Americans. They are enemies and we have the responsibility and the right to protect ourselves from them, and we should use the means that enable us to defend ourselves. These suspects should probably be confined for the rest of their lives.

"But just because they are bellicose, I don't think it's justified for us to act as they do, because that's when our own inner beast comes out. These are ugly people, but we've got ugly people in our jails too, prisoners who did horrible things. And we need to protect our citizens, but that doesn't mean we act the same way" as the terrorists.

All, this, says Xenakis, raises a larger question: How moral can an army be when it is involved in real warfare?

"I believe that an army and soldiers, particularly young people, are liable to act in immoral ways. Gen. George Marshall said in 1942: Once an army is involved in war, there is a beast in every fighting man that begins tugging at its chains, and a good officer must learn from the start how to keep the beast under control, both in his men and himself. We've all been in situations where we've said or done things that were mean or ugly, and war brings them out."

Physicians who took part in special interrogations, who helped plan the techniques and monitored the interrogation process, have not been indicted. What would you recommend in their cases?

Xenakis: "There was no accountability. I think the first step in accountability is transparency. People need to know what happened. There needs to be recognition that doctors should not participate in these actions. The Department of Defense should formulate a new policy prohibiting any care provider whose principal job is to treat patients from becoming involved in interrogations. That needs to be done.

"I also think that individuals who had been involved in [interrogation] policy at least should be held accountable in the press. I am very cynical about any kind of legal proceedings or hearings to reprimand these officials, but I think their names should be public, and what they did should be public."

The Obama administration was very proud of its ban on torturing suspects, as well as its order to close "black holes," the CIA's secret international prison facilities. Dr. Xenakis suspects that this order is not being consistently implemented. "There is no direct information concerning what the CIA does in these secret sites," he says.

The grisly photographs of U.S. soldiers posing with dead bodies in Afghanistan did not surprise Xenakis.

"I was very disappointed, but I also felt that our army has faced considerable stress with the repeated deployments. I think we have a very professional army, and that it does its missions as well as or better than other armies, but it is under considerable pressure, and I think that mistakes happen," he says.

"Psychiatrists, in any event, have to speak truth to power. That takes courage. There have to be checks and balances. Armies have to deal with the rawest of instincts, and mistakes happen. Controlling such mistakes is where political leadership has to come into play, along with public sentiment."



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