Off the Record: Medical Records in the 9/11 Military Commission

This post continues the blog series by Dr Kasey McCall-Smith which examines some of the contentious legal issues raised in the US v. Khalid Shaikh Mohammad, et. al. military commission proceedings against the five men charged with various war crimes and terrorism in relation to the 11 September 2001 attacks on the US. The series is a continuation of her project ‘Torture on Trial’ which was funded by a grant from the Royal Society of Edinburgh and is supported by the Edinburgh Law School.

Personal Data and National Security: Medical Records in the 9/11 Military Commission

Almost since the inception of the 9/11 military commissions, defense lawyers have fought to obtain the full medical records of their clients. In any normal court, a client’s ownership and access to their personal medical records would go unchallenged. The right to privacy is fairly clear on this. Whether relying on the Fifth and Fourteenth Amendments of the US Constitution or article 17 of the ICCPR, individuals have the right to control their personal medical information with some exceptions (notably those outlined in HIPAA in the US). However, in the largest criminal justice trial in US history, access to medical records is shrouded in secrecy and national security privilege is reinforced through redactions to files covering even the simplest of medical treatment, such as providing ibuprofen for pain relief.

Joint Task Force Guantánamo, the cross-branch military force created by the US Department of Defense to run detention operations in Guantánamo, is responsible for assessing and delivering care for the medical needs of all detainees. As a result, it maintains full medical records on the 40 men still held in the detention facility. Government prosecutors also have copies of the full records. However, neither the defendants, nor their attorneys, are able to gather a full account of their medical information because full access is consistently rejected by the Government in the name of national security.

The complete medical records sought begin with those documenting the intake of the defendants in 2006 when they arrived in Guantánamo following years on CIA black sites. The records covering the medical treatment of the five 9/11 defendants is crucial to the case due to the systematic torture they endured at the hands of the CIA and the statements of guilt some are alleged to have given to the FBI shortly after arriving in Guantánamo. The physical and psychological impact of the enhanced interrogation techniques on the men, as documented in the Senate Intelligence Committee Study on CIA Detention and Interrogation Program (SSCI Summary Report) further speaks to a range of issues that are highly relevant to the trial, not the least their ability to participate in their own defence and their competence to even be in the dock.

A primary point of contention comes in response to the public availability of the record of torture, inhuman and degrading treatment the defendants suffered on black sites. The SSCI Summary Report is very clear on the issue of the defendants’ treatment. The CIA shredded all pretence in terms of legality with regard to the treatment of these five men and many others. Constructing an understanding of their physical and mental states in the lead up to the FBI interrogations in January 2007 will shed light on whether those statements may be excluded as torture evidence, an issue that remains unclear at the close of the 35th round of pre-trial hearings.

Redacted medical records

While there is a great amount of writing and authority on the issues of confidentiality, privacy and security of medical records, those discussions are predominantly focused on keeping personal records closed for the benefit of the patient. In the 9/11 case, the reverse is true. Defense teams have spent years trying to gain full access to their clients’ personal medical files. In many instances it is not only about their variable litigation strategies but also about helping explain their client’s individual health issues to them more fully. As has often been raised in court, a number of the defendants suffer conditions akin to post-traumatic stress disorder and there have been suggestions of brain damage following MRI scans, all indicia of the ill-treatment they endured in CIA captivity.

Trial counsel for the government has turned over 47.000 pages of medical history to the defendants relating to medical, psychological, dental or therapist visits since their arrival in Guantánamo. The problem is that all of the documents are redacted to some extent and predominantly it is medical personnel identifiers that are removed. With the exception of seven real name examples Government counsel acknowledged as ones he had ‘missed’ in error, all names have been replaced by unique medical identifiers (UMIs) or redacted to obscure the identification. The UMIs include designators such as Dr Shrek, SMO (Senior Medical Officer) and Dr 10. More vexing for defense counsel is the fact that several of the UMIs are not unique at all. As counsel argued before the commission, in the course of their examination of the records provided by the Government, it has become clear that the same UMI was used by different medical professionals in some cases and in others individuals had used different UMIs in a haphazard way. This inconsistency frustrates defense efforts to piece together a clear picture of their clients’ physical and mental states when they arrived fresh from their years on black sites as they are unable to corroborate the information derived from the incomplete reports.

Persistent threats to medical personnel?

The Government contends that these men pose a direct threat to the safety of medical personnel and their families. It is an interesting argument considering the defendants’ long-term address in the top-secret, maximum security Camp 7 where the very limited communication they have with the outside world is subjected to extensive security and classification reviews. Government counsel went as far as to claim that threats against medical personnel are made ‘practically every day, certainly at least once a month’, suggesting that they were made by the men for whom the military medical corps has provided care for roughly 11 years. It is unlikely that evidence of these ‘threats’ will ever be seen by the public. Such evidence, if it exists, may be proffered through ex parte submissions to the judge anytime prosecution invokes the national security privilege. Defense efforts to substantiate claims of the threats have been fruitless and, according to counsel, none of the few medical personnel that have been tracked down have suggested that they were ever threatened in the course of their treatment.

In-court exchanges suggest that all government explanations of medical records are to be taken at face value despite multiple proffers of error by defense counsel. The more bizarre fact is the Government admission in previous commission exchanges that medical records including the names of medical professionals, is not classified material. Even if classified, or marked as sensitive, the legal team members all have the clearance to view the full documents. In a case heavily dependent on classified material, it is not uncommon for the cleared lawyers to access materials for investigation purposes without sharing the information with their clients. It, therefore, boggles the mind that the Government continues to deny defense counsel information necessary to fully investigate each defendant’s case. It seems solely obstructive that defense counsel is forced to argue for access to full medical records bit by bit as the responsive records provided after each successful motion provides only a bit more information than before. Very simply, the Government should provide unclassified information when requested through discovery.

The tussle over complete medical records appears to be a circular exercise. No logic can explain the stalemate in relation to complete medical records for the 9/11 defendants. And with a third judge due to assume control of the case at the 36th round of hearings in June 2019, the issue is likely far from over.

Off the Record: 9/11 Military Commission in its 7th Year

This is the third post in a blog series by Dr Kasey McCall-Smith which examines some of the contentious legal issues raised in the US v. Khalid Shaikh Mohammad, et. al. military commission proceedings against the five men charged with various war crimes and terrorism in relation to the 11 September 2001 attacks on the US. The series is a continuation of her project ‘Torture on Trial’ which was funded by a grant from the Royal Society of Edinburgh and is supported by the Edinburgh Law School.

Whatever Happened to the Alleged 9/11 Terror Plotters? 9/11 Military Commission in its 7th Year

The largest criminal justice trial in US history is currently taking place on Naval Station Guantánamo Bay. For the most part, the general public has no idea. Apart from consistent media coverage by a small handful of journalists, including Carol Rosenberg (formally of The Miami Herald and now with the New York Times) and John Ryan of Lawdragon, the US public and the formerly vocal academy have forgotten that five men, Khalid Shaikh Mohammad, Khallad bin Attash, Ammar al-Baluchi, Ramzi Bin Al-Shibh and Mustafa al-Hawsawi, are charged with conspiracy to commit various war crimes and terrorism in relation to the September 11th attacks under the Military Commissions Act 2009 (MCA) in United States v. Khalid Shaikh Mohammad, et al. (9/11 case). In previous blogs I have explained the choice of venue for the detention facility, law of war detention, details on some of the detainees, and addressed issues relating to torture. This series looks in more detail at specific issues in the trial and why controversial legal stand-offs may not go away.

The first incarnation of the military commissions were replaced by the MCA following the US Supreme Court decisions in Hamdan v. Rumsfeld and Boumediene v. Bush. The MCA applies to alien terrorist suspects and members of al Qaida, defined as alien ‘unprivileged enemy belligerents’, rounded up from 2002-2008, though recently there has been talk of the potential use of the statute to detained ISIS fighters.

 

The MCA sets out its applicability to offences before, on and after 11 September 2001 and raises questions about the long-standing principle of no ex post facto laws and the creative addition of ‘conspiracy’ to accepted war crimes definitions. The statute combines different and overlapping issues of military law, constitutional law and international law. Observing the 9/11 hearings, the failure to thoroughly evaluate the relationship between these different legal systems is proving problematic in every aspect of the trial’s slow progress. The only clarity lies in the fact that legislative responses to 9/11 were walled off from the realities of the outrageous conduct of the CIA during its Rendition, Detention and Interrogation programme.

According to the Senate Intelligence Committee Study on CIA Detention and Interrogation Program (SSCI Report), it is well documented that Khalid Shaikh Mohammad was subjected to combinations of ‘enhanced interrogation techniques’, so-called EITs, equating to torture designed to exercise total control over the victim. Notably, he suffered periods of sleep deprivation lasting up to 180 hours and was ultimately waterboarded 183 times. The other four defendants were similarly treated. Bin Al-Shibh was subjected to EITs for approximately 34 days and kept in social isolation for almost 2.5 years. Bin Attash and al-Baluchi were subjected to EITs over a period of months. The CIA waterboarded al-Hawsawi and further subjected him to such brutal bodily treatment that he suffers irreparable physical damage. In short, US agents subjected each of them to a sustained and systematic programme of torture in direct violation of US and international law.

The illegal actions by the US were defended by the then Bush Administration as necessary to national security. When rumours and then evidence of ill-treatment began to leak out of US military bases abroad, international civil society and US civil rights groups called for the US, as well States working in concert with the US, to maintain detention and treatment standards demanded by the law. In particular, the customary Law of War and standards outlined in the Geneva Conventions as well as the Convention Against Torture were frequently invoked. Yet as the first detainees arrived in Guantánamo on 11 January 2002 these well-established rules appeared to be the furthest thing from the US government’s mind. For anyone watching as the first goggled and shackled jumpsuit-clad men dropped to their knees in the Cuban heat it was clear that this would be a long game. Of the approximately 780 men that were detained in Guantánamo since it opened the doors to the now defunct Camp X-Ray (pictured below), only 40 remain. One man (Balhul) is serving his sentence following conviction by military commission, 26 are known as ‘forever prisoners’ and eight are currently under charge, including the 9/11 defendants. The 9/11 charge sheet alleges that the defendants committed conspiracy, attacked civilians, and committed murder in violation of the Law of War, intentionally caused serious bodily harm, hijacked an aircraft, and committed acts of terrorism resulting in the deaths of 2.976 along with countless injuries. Following their arraignment on 5 May 2012, intentionally causing serious bodily injury was struck from the charges in the early months of the case. From the outset, issues regarding public access to the trial were raised. Limited public access to close circuit broadcast sites was offered to families soon after the litigation commenced. Though now only a trickle of viewers attend the 40 second delayed live-streams at Fort Meade, Fort Devens and Fort Hamilton. The roster of media and civil society observers at Camp Justice, too, can only be described as small when compared to the original outpouring of attention on the detention activities in Guantánamo.

In its 7th year of pre-trial proceedings, the 9/11 case is bogged down in a range of issues (see subsequent posts) that challenge the rule of law to its very core. How to reconcile the defendants’ status as both alleged terrorist war criminals and torture victims? Does US ‘reinterpretation’ of war crimes definitions square with the law of war? Can an appropriate balance between the alleged crimes and victimhood be achieved? Will the victims of 9/11 ever get the justice they deserve and, if so, at what cost? Seventeen years after the horrendous acts that markedly shifted western governments into a new era of aggressive national security pursuits, it seems that only time will tell. At the conclusion of the 35th round of hearings, we are left only with questions. 

Philippe Sands on the Making of Modern Human Rights

Guncha Sharma is a candidate for the Global Justice Academy’s LLM in Human Rights, and a GJA Student Ambassador for 2018-19. From India, she is also one of three recipientsof the GJA’s LLM Human Rights scholarship awards for this year, and has a keen interest in gender issues, the rights of children and other vulnerable groups, and public health. In this post, Guncha reflects on the recent Ruth Adler Memorial Lecture, which was delivered by Philippe Sands QC, with a response from Scotland’s Lord Advocate James Wolffe QC.

On October 24 2018, Philippe Sands delivered the Ruth Adler Memorial Lecture with a talk based on his bestselling book East-West Street and the Making of Modern Human Rights. Phillippe Sands is one of the most successful British lawyers working in the field of International Law. He has argued many high-profile cases before International courts and tribunals, and currently directs the Project on International Courts and Tribunals from his position as Professor of Laws at UCL.

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Inspiring Action in these Challenging Times

The Global Justice Academy (GJA) and Edinburgh Law School welcomed over 200 human rights academics and practitioners to the University of Edinburgh for the 2018 Association of Human Rights Institutes  (AHRI) Annual Conference on the 6-8 September 2018. The GJA holds the current Secretariat of AHRI in conjunction with the Centre for the Study of Human Rights Law (CSHRL) at the University of Strathclyde. In this post, AHRI Chair and GJA Management Group member, Dr Kasey McCall-Smith, reflects on the three days.

The theme of this year’s conference was ‘Renewing Rights in Times of Transition: 70 Years of the Universal Declaration of Human Rights’. The conference began with Works in Progress sessions on 6 September followed by the launch of the Political Settlements Research Programme’s PA-X Peace Agreements database (PA-X). Professor Christine Bell delivered a public lecture entitled The Inclusion Project: Human Rights Dilemmas in the Negotiation of Peace Agreements, with a response from the UN’s Ian Martin, entitled A UN ‘Surge in Diplomacy’ in a World in Transition

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Why torture? Exploring our Perceptions of Torture, and What Causes It

In this post, our Communications Intern, Jee-Young Song, reports from the second day of the recent GJA-sponsored GREYZONE summer school.

26 June 2018 was the second day of the GREYZONE Summer School, and starting the day’s session was Danielle Celemajer, Professor of Sociology and Social Anthropology at the University of Sydney. Titled ‘The worlds that produce torture’, the main question put to us was:

“What causes torture?”

The straightforward answer to this would of course be obvious: doesn’t torture occur because a malignant perpetrator decided to inflict such an act on the victim?

However, this is an over-simplistic approach, as Professor Celemajer professed her view that there is in fact a complex map of causality for torture, with many contributory factors which extend beyond the scope of the individual perpetrator.

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Complicity, Elitism and Storytelling: Exploring Moral Ambiguity in Times of Injustice

In her second post for this blog, GJA Communications Intern, Jee-Young Song, reflects on the recent GJA GREYZONE Summer School keynote session on ‘Conceptual Perspectives’.

The Summer School kick-started on Monday the 25 June, the theme this year being ‘Navigating the Grey Zone: Complicity, Resistance and Solidarity’.The following is from the ‘Conceptual Perspectives’ talks, where expert speakers from the fields of human rights, philosophy, and political theory (Ruth Kelly, Charlotte Knowles and Lukas Slothuus, pictured above) each gave their unique insight on the key issues.

Storytelling as a way to reinforce human rights

First to speak was Ruth Kelly, who focused on the potential for narrative to help communities articulate approaches to the development of human rights. To give an example of such artistic intervention, she showed footage taken at a poetry workshop in Uganda, where a woman recites a poem about struggling to choose between action and complicity, entitled ‘Should I stay? Should I go?’.

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Global Justice Academy Spring School: Using Critical Discourse Analysis in Community Settings

In April 2018, the GJA sponsored its first ‘Spring School’ in a collaboration with Moray House School of Education. In this post, Spring School Co-organiser and GJA Management Group member, Dr Callum McGregor, reflects on the Spring School’s innovative community-university partnership, which fostered strong links with local organisations and social justice practitioners. It is hoped that a similar Spring School will run again next year. Callum is also the programme director for the online MSc in Social Justice and Community Action, which is sponsored by the Global Justice Academy.

The Global Justice Academy (GJA) is an institutional forum for dialogue with practitioners engaged in justice issues locally and globally. This short blog highlights one such example of local dialogue, in the form of a series of community-university workshops on Critical Discourse Analysis (CDA). CDA is a form of critical social research, whose purpose is to analyse the ways in which language can be used to both reproduce and challenge social injustice. Discourses can be thought of as representationsof various aspects of our social lives. These representations are made up sets of rules and statements that determine whatcan be expressed within a particular context, howit can be expressed, by whom and under what conditions. Discourses are important because they have real material effects on the distribution of burdens and benefits along different axes of inequality.

Between April and May 2018, three workshops were held, with the purpose of bringing together community practitioners, community-based adult learners, activists, students and academics to learn together about CDA. Specifically, the workshops focused on how CDA can be used creatively to link education to social action, through addressing the interests and struggles of ordinary people in communities.

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‘Hungry?’: Introducing Keris Heading’s Photography

Each year, the Global Justice Academy runs a photography competition as part of Edinburgh College of Art’s MA Photography degree programme. The 2018 competition was run in conjunction with the ERC Greyzone Project and its Summer School, ‘Navigating the Grey Zone: Complicity, Resistance, and Solidarity’. This post is the first in a short series of three, where we introduce this year’s winners, their images, and the stories behind their submissions

Series Winner: Keris Heading, ‘Hungry?’.

Q: What inspired your competition entry?

Working in a supermarket, I noticed the vast amounts of food that is wasted and thrown away, which encouraged me to research more about the exact figures of food wastage in large countries like the UK and US. The figures were astonishing. World hunger is a concept many people, or perhaps everyone, is familiar with, but perhaps it is the injustice in the distribution and usage of food that needs more attention.

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‘The Coming Soon Land’: Introducing Amber Brown’s Photography

Each year, the Global Justice Academy runs a photography competition as part of Edinburgh College of Art’s MA Photography degree programme. The 2018 competition was run in conjunction with the ERC Greyzone Project and its Summer School, ‘Navigating the Grey Zone: Complicity, Resistance, and Solidarity’. This post is the first in a short series of three, where we introduce this year’s winners, their images, and the stories behind their submissions

Single Image Winner: Amber Brown, ‘The Coming Soon Land’.

Q: What inspired your competition entry?

My concept of ‘The Coming Soon Land’ sprouted from the emotional disarray I found in observing a town undergoing change within development. Whilst the project grows from a frustration, the landscapes are in some sort of structural purgatory which I find aesthetically interesting, a grey zone that is not quite one nor the other, plans proposed but stuck in quicksand amidst a crisis concerning social and urban justice. Solidarity in this, comes from an accumulation of observed opinions which have been illustrated through my imagery. It feels a complex situation, one that is constantly progressing.

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‘Bridges Not Walls’: Introducing Isobel Budler’s Photography Series

Each year, the Global Justice Academy runs a photography competition as part of Edinburgh College of Art’s MA Photography degree programme. The 2018 competition was run in conjunction with the ERC Greyzone Project and its Summer School, ‘Navigating the Grey Zone: Complicity, Resistance, and Solidarity’. This post is the first in a short series of three, where we introduce this year’s winners, their images, and the stories behind their submissions

Commended Series: Isobel Budler, ‘Bridges Not Walls’.

Q: What inspired your competition entry?

I came across the ‘Bridges Not Walls’ conference through the organiser Nancy, who I knew prior to the project. She spoke to me candidly about the work they do within the school they are employed by, challenging stereotypes and educating young people on a range of topics.

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