United States of America v. Majid Shoukat Khan: Guantánamo's first ruling to consider torture in mitigating sentencing for detainees.

In June 2020, a Guantánamo military judge ruled in United States of America v. Majid Shoukat Khan that he has the legal authority to mitigate Khan's criminal sentence as a remedy for illegal pretrial punishment if his attorneys prove that he suffered torture and other cruel, inhuman, and degrading treatment in government custody. This commentary analyzes the ruling and its implications for Guantánamo's legal system, detainees, and forensic medicine.

"Befogging reason, undermining will: Understanding the prohibition of sleep deprivation as torture and ill-treatment in international law.

BACKGROUND: Sleep deprivation is a prevalent method of psychological torture. However, difficulties in documentation have meant that it is not adequately appreciated by courts and other quasijudicial institutions such as UN treaty bodies. METHOD: This paper aims to review the legal literature on deprivation of sleep, the definition, and prohibition of torture and ill-treatment, and its health impacts. A number of texts were identified and analyzed based on contextual relevance: criminal justice processes as well as medical literature on health impacts. The texts were identified via a search of key legal and health databases using the search terms "sleep deprivation," "sleep adjustment," and "sleep regulation." These texts were limited to English-language journal articles, NGO reports, court-cases and UN documents since 1950. They were then analyzed for their approaches to conceptualizing sleep deprivation from the perspective of assessing "severe pain and suffering" and the "diminishment of mental capacity". RESULTS/DISCUSSION: Sleep deprivation is an ill-defined and, in turn, poorly documented method of torture, particularly when prolonged or inflicted in combination with other methods (e.g., threats) and conditions (e.g., disruptive environment or time of day). More nuanced legal principles, informed by medical evidence, are lacking. Applying these principles would sharpen its conceptualization.

How do you say Istanbul Protocol in Hebrew? The curious case of Mr Firas Tbeish.

On 26 of November 2018, Israel's High Court of Justice decided that Mr Firas Tbeish, a Palestinian from the Hebron area in the West Bank, had not been tortured. This concluded of six-year legal battle undertaken by Mr Tbeish and the Public Committee Against Torture in Israel. The case summary outlines the context in which the decision was given, while paying particular attention to the (mis)conception of Istanbul Protocol reports in Israel's legal system.

A problematic Israeli High Court dismissal of a torture complaint. A commentary by Hans Draminsky Petersen, MD.

It is not for the documenting medical experts (Shir, 2019), but for the court to decide whether the level of pain and suffering inflicted reaches the threshold of torture [while disregarding ill-treatment], i.e., the court upholds the prerogative to apply its own interpretation of the definition of torture, no matter existing medical evidence and disregarding the Istanbul Protocol. The criteria used to determine the level of FT's pain and suffering does not appear in the ruling. The ruling states that the burden of proof that the "means" were not reasonable [constituting torture] falls upon the petitioner (para 36). In the light of the above (1, a-h) this is in practice impossible for the petitioner to establish. This aligns with Shir's statement that no ISA interrogator has been indicted in 1200 torture complaints.

Institutionalizing torture in Israel: The Firas Tbeish decision. A commentary by John W. Schiemann, PhD.

In her discussion of the court's dismissal of the IP, she says there "is a legal system that discredits the IP's potential while digging deeper into its own conception of torture.'' Shir has helped show that this is true more broadly of torture, beyond the IP. Indeed, I suspect the court may not view the IP as a "strange creature" causing "suspicion of the unfamiliar." Instead, it may be by now a very familiar creature that threatens torture's impunity in Israel, and what Shir shows is that the court has developed a systematic strategy to counter it. Torture is possible in Israel because the government and courts are complicit in deliberately creating a legal and institutional black hole where boundaries are ill-defined and obscure, and no light can shine.

Unjustifiable Means: The Inside Story of How the CIA, Pentagon, and US Government Conspired to Torture, by Mark Fallon.

Fallon documents the source of misguided interrogations and torture after 9/11.

Paul Broca's clitoridectomy as a cure for "nymphomania": A pseudo-medical mutilation.

Paul Broca (1824-1880) is considered one of the founding fathers of modern neurology, mainly because of his major contribution to the anatomo-clinical method (Figure 1) (Sagan, 1979). He has also distinguished himself by his fascination with cranial measurements at the origin of modern physical anthropology and, unfortunately, racial theories based on cranial indices (facial angle and brain volume, mainly) (Gould, 1981).But what is less known is that Broca has been illustrated by particularly archaic and mutilating therapeutic practices, such as what is now considered to be female genital mutilation.

Interpreting Evidence of Torture.

The Istanbul Protocol provides a scheme for giving evidence of signs of torture. This scheme does not conform with the principles of logical inference, revolving as it does round the concept of 'consistency'. The shortcomings of the Protocol are explained using the evidence given in the recent case of KV(Sri Lanka) and the logical approach to such evidence explained.

Torturing science Science, interrogational torture, and public policy.

Contrary to the claims of the Central Intelligence Agency (CIA) that its torture program was scientific, the program was not based on biology or any other science. Instead, the George W. Bush administration veneered the program's justification with a patina of pseudoscience, ignoring the actual biology of torturing human brains. We reconstruct the Bush administration's decision-making process to establish that the policy decision to use torture took place in the immediate aftermath of the 9/11 attacks without any investigation into its efficacy. We then present the pseudoscientific model of torture sold to the CIA, show why this ad hoc model amounted to pseudoscience, and then catalog what the actual science of torturing human brains-available in 2001-reveals about the practice. We conclude with a discussion of how a process incorporating countervailing evidence might prevent a policy going forward that is contrary to law, ethics, and evidence.

Palliative Care and Human Rights: A Decade of Evolution in Standards.

CONTEXT: Human rights standards to address palliative care have developed over the last decade. OBJECTIVES: This article aims to examine key milestones in the evolution of human rights standards to address palliative care, relevant advocacy efforts, and areas for further growth. METHODS: The article provides an analysis of human rights standards in the context of palliative care through the lens of the right to health, freedom from torture and ill treatment, and the rights of older persons and children. RESULTS: Significant developments include the following: 1) the first human rights treaty to explicitly recognize the right to palliative care, the Inter-American Convention on the Rights of Older Persons; 2) the first World Health Assembly resolution on palliative care; 3) a report by the UN Special Rapporteur on Torture with a focus on denial of pain treatment; 4) addressing the availability of controlled medicines at the UN General Assembly Special Session on the World Drug Problem. CONCLUSION: Development of human rights standards in relation to palliative care has been most notable in the context of the right to health, freedom from torture and ill treatment, and the rights of older persons. More work is needed in the context of the rights of children, and human rights treaty bodies are still not consistently addressing state obligations with regards to palliative care.

From Nuremberg to Guantanamo Bay: Uses of Physicians in the War on Terror.

Seventy years after the Nuremberg Doctors' Trial, health professionals and lawyers working together after 9/11 played a critical role in designing, justifying, and carrying out the US state-sponsored torture program in the CIA "Black Sites" and US military detention centers, including Abu Ghraib, Bagram, and Guantanamo Bay, Cuba. We analyze the similarities between the Nazi doctors and health professionals in the War on Terror and address the question of how it happened that health professionals, including doctors, psychologists, physician assistants, and nurses, acted as agents of the state to utilize their medical and healing skills to cause harm and sanitize barbarous acts, similar to (though not on the scale of) how Nazi doctors were used by the Third Reich.

Preventing torture for people deprived of freedom: The Atlantic Hope and Black Swan Prison Model.

International law and minimum standards provide certain protection for detainees and prisoners of war (POW) against torture and ill-treatment. Places of detention and parties to conflicts are often monitored to ensure that they adhere to the required standards through, for example, visits to individual detainees and the assessment of facilities. However, monitoring between the point of arrest and eventual remand in prisons is largely inadequate. This paper explains an emerging model to enhance protection of prisoners through readiness training for prospective humanitarian personnel. The Atlantic Hope simulation exercise on monitoring detainees and visits to the mock Black Swan prison represents a teaching model to enhance sustainable protection of detainees and POW during incarceration. The simulation entails comprehensive monitoring, assessment, visits and provision of services to prisoners from the point of arrest, during the transition to places of custody, and imprisonment. These enhance protection of detainees to avoid deaths in custody, disappearance and torture throughout the chain of imprisonment.

The compulsory psychiatric regime in Hong Kong: Constitutional and ethical perspectives.

This article examines the compulsory psychiatric regime in Hong Kong. Under section 36 of the Mental Health Ordinance, which authorises long-term detention of psychiatric patients, a District Judge is required to countersign the form filled out by the registered medical practitioners in order for the detention to be valid. Case law, however, has shown that the role of the District Judge is merely administrative. This article suggests that, as it currently stands, the compulsory psychiatric regime in Hong Kong is unconstitutional because it fails the proportionality test. In light of this conclusion, the author proposes two solutions to deal with the issue, by common law or by legislative reform. The former would see an exercise of discretion by the courts read into section 36, while the latter would involve piecemeal reform of the relevant provisions to give the courts an explicit discretion to consider substantive issues when reviewing compulsory detention applications. The author argues that these solutions would introduce effective judicial supervision into the compulsory psychiatric regime and safeguard against abuse of process.

Special competencies for psychological assessment of torture survivors.

In spite of the absolute prohibition against torture in international law, this grave human rights abuse is still practiced systematically and with impunity in the majority of countries around the world. Mental health professionals can play a positive role in the fight against torture and impunity, by developing competencies to assess the psychological sequelae of torture. High-quality psychological evidence can help to substantiate allegations of torture, thereby increasing the likelihood of success in civil, administrative, and criminal proceedings. This article will orient mental health professionals to issues specific to forensic assessment of torture survivors. It provides a brief introduction to the sociopolitical context of torture, reviews literature on the psychological sequelae of torture, introduces the reader to key competencies, offers information on strategies for producing documentary evidence and expert opinion, highlights ethical considerations, and suggests areas for development in the field.

A comparative study of the use of the Istanbul Protocol amongst civil society organizations in low-income countries.

The Istanbul Protocol (IP) is one of the great success stories of the global anti-torture movement, setting out universal guidelines for the production of rigorous, objective and reliable evidence about allegations of torture and ill-treatment. The IP is explicitly designed to outline 'minimum standards for States'. However, it is all too often left to civil society organizations to investigate allegations of torture and ill-treatment. In this context, important questions remain as to how and where the IP can be used best by such organizations. These questions are particularly acute in situations where human rights groups may have limited institutional capacity. This paper explores the practical challenges faced by civil society in using the IP in Low-Income Countries. It is based on qualitative research in three case studies: Nepal, Kenya and Bangladesh. This research involved over 80 interviews with human rights practitioners. The conclusions of the paper are that the Istanbul Protocol provides a useful framework for documentation, but more comprehensive forms of documentation will often be limited to a very small - albeit important - number of legal cases. In many cases, the creation of precise and standardized forms of evidence is not necessarily the most effective form of documentation for redress or accountability. In the absence of legal systems willing and able to respond effectively to allegations of torture and ill-treatment, there are severe limitations on the practical effectiveness of detailed and technical forms of documentation.