title: Neglect of medical evidence of torture in Guantánamo Bay: a case series.
abstract: BACKGROUND
  In the wake of the September 11, 2001 attacks on the US, the government authorized the use of "enhanced interrogation" techniques that were previously recognized as torture. While the complicity of US health professionals in the design and implementation of US torture practices has been documented, little is known about the role of health providers, assigned to the US Department of Defense (DoD) at the US Naval Station Guantánamo Bay, Cuba (GTMO), who should have been in a position to observe and document physical and psychological evidence of torture and ill treatment.
  
  
  RESULTS
  We reviewed GTMO medical records and relevant case files (client affidavits, attorney-client notes and summaries, and legal affidavits of medical experts) of nine individuals for evidence of torture and ill treatment and documentation by medical personnel. In each of the nine cases, GTMO detainees alleged abusive interrogation methods that are consistent with torture as defined by the UN Convention Against Torture as well as the more restrictive US definition of torture that was operational at the time. The medical affidavits in each of the nine cases indicate that the specific allegations of torture and ill treatment are highly consistent with physical and psychological evidence documented in the medical records and evaluations by non-governmental medical experts. However, the medical personnel who treated the detainees at GTMO failed to inquire and/or document causes of the physical injuries and psychological symptoms they observed. Psychological symptoms were commonly attributed to "personality disorders" and "routine stressors of confinement." Temporary psychotic symptoms and hallucinations did not prompt consideration of abusive treatment. Psychological assessments conducted by non-governmental medical experts revealed diagnostic criteria for current major depression and/or PTSD in all nine cases.
  
  
  CONCLUSIONS
  The findings in these nine cases from GTMO indicate that medical doctors and mental health personnel assigned to the DoD neglected and/or concealed medical evidence of intentional harm.
authors.affiliation: Physicians for Human Rights, Cambridge, Massachusetts, USA. viacopino@phrusa.org
authors.forename: Vincent
authors.initials: V
authors.lastname: Iacopino
authors.forename: Stephen N
authors.initials: SN
authors.lastname: Xenakis
mesh_terms: D000328:Adult; D028661:Complicity; D003462:Cuba; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D006282:Health Personnel / Q000941:ethics*; D006801:Humans; D008297:Male; D008499:Medical Records; D008887:Military Medicine / Q000941:ethics*; D010819:Physician's Role; D011329:Prisoners / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D014104:Torture / Q000941:ethics / Q000331:legislation & jurisprudence / Q000523:psychology; D014481:United States; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology