A doctor's notes on torture

By Andrea Meyerhoff, MD

What is too much pain?

This is the question that Bush administration lawyers answered when they legalized now-infamous interrogation techniques.

As a former federal counterterrorism official who served through 9-11, the anthrax mailings, and the on-set of the wars in Afghanistan and Iraq, I followed the recent release of Justice Department interrogation memos with interest.

Despite numerous readings I still can't understand them. How could these memos guide interrogators? As a physician, I found statements that defied reason. Experiences with patients contradict statements in the memos.

As such, the memos are a violation of the public trust and warrant investigation. The public deserves a full account of their production on which to render judgment. Either a courtroom or Congress will do.

Now in the public domain are two memos from Justice's Office of Legal Counsel dated Aug. 1, 2002, on the subject of interrogation practices, authored by John Yoo and signed by Jay Bybee. One was written for White House counsel Alberto Gonzales, the other for the Central Intelligence Agency.

In the first, Yoo legalized harsh interrogation practices by stating that they fell short of a definition of severe pain and therefore were not torture:

"Physical pain amounting to torture must be equivalent in intensity to the pain accompanying serious physical injury, such as organ failure, impairment of bodily function, or even death."

This is a perplexing statement.

Specific symptoms are associated with the failure of individual organs such as heart, kidney, or lung. But pain is not prominent among any of them.

For example, someone with end-stage lung disease has the terrifying sensation that he cannot get enough air. In the final hours, the doctor sees the patient sweat. His face turns from deep red to blue. He leans forward and grasps the rails of the hospital bed so hard his knuckles turn white. He is intensely anxious and knows he is about to die. At what point in the approximation of this experience should the interrogator decide it's time to stop?

Maybe Mr. Yoo meant to equate the physical pain of torture with the pain of an injury serious enough to result in organ failure.

What do such injuries look like?

Someone who jumps out of a four-story window sustains multiple broken bones. The fractured pelvis severs an artery that results in hemorrhage so massive that vital organs can't get enough blood and begin to fail. As liver and kidneys shut down, the doctors race to stabilize the patient to take her to the operating room to fix the fracture. But the rate of the bleeding outstrips their best efforts. The patient dies in the emergency room.

Would it be permissible for an interrogator to deliver a blow hard enough to cause a fracture that doesn't result in organ failure, impaired function, or death? Is it OK to break a finger? A jaw?

I've read Yoo's definition many times and still don't know what it means. I'm certain of one thing. With death, there is no pain at all.

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