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.

The Erosion of the Civilian

A guest post by Nicola Perugini and Neve Gordon. 

On the 16th of November 2018, speakers from different parts of the world and different backgrounds—academics, human rights and humanitarian practitioners, policy makers, and investigative journalists—interrogated and debated the status of civilians in armed conflicts.The Erosion of the Civilian was the first of two events that Neve Gordon, Professor of International Law at Queen Mary, Jonathan Whittall, Director of the Analysis Department at MSF in Brussels, and Nicola Perugini are organizing. The second workshop will take place in London at Queen Mary on the 14th of December. The aim of these two workshops is to create a dialogue across different disciplines and areas of expertise and to try to establish a thinking group on the topic of civilian protections and erosions.

The Edinburgh workshop was organized through collaboration between the University of Edinburgh, the School of Law at Queen Mary University of London, and the Médecins Sans Frontières (MSF) Analysis Department in the Operational Centre in Brussels, and was sponsored by the College of Arts, Humanities and Social Sciences, the Global Justice Academy, the Global Development Academy; the Centre for Security Research (CeSeR); Politics and International Relations at the University of Edinburgh; and Marie Sklodowska-Curie Action 703225 “On Human Shielding” for funding this event. What follow are the introductory notes to the Edinburgh workshop.

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Off the Record: Unlawful Influence on the War Crimes Proceedings

This is the second post in a blog series by Dr Kasey McCall-Smith examines some of the crucial legal issues and broader public questions raised regarding 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 part of her project ‘Torture on Trial’ and funded by a grant from the Royal Society of Edinburgh.

In the 9/11 war crimes trial taking place in Guantánamo, an array of motions have been filed regarding unlawful influence on the US v. Khalid Shaikh Mohammad, et. al.(9/11 case) proceedings. They began with complaints regarding statements by then-President Obama and continue to the present with complaints regarding President Trump, Secretary of Defense Mattis, former Attorneys General Sessions and Holder and CIA Director Gina Haspel. These motions, all based on section 949b of the 2009 Military Commissions Act, cover a range of statements and actions.

During the April-May 2018 proceedings, the influence of current US President Trump was raised as lawyers debated the influence of statements made by Trump as the commander in chief of the US military. The relevant statements focused on the president’s response to the Bowe Bergdahl v. US courts martialand also the 31 October 2017 New York incident where an alleged terrorist drove a van onto a bike path killing eight people. Trump’s statements on the campaign trail and after his election were also potentially problematic for the 9/11case and attacked the integrity of the military justice system. His statements and twitter posts explicitly called into question the administration of justice and constitutional protections in the US. Defence counsel in the 9/11 war crimes tribunal argue that collectively these successive statements by US presidents and other government officials equate to unlawful influence (UI), a concept drawn from provisions in the US Uniform Code of Military Justice prohibiting Unlawful Command Influence (UCI). UI is a concept set out in 10 USC §837 and article 37 of the UCMJ and is deemed the ‘mortal enemy’ of military justice and also violates due process as guaranteed by the US Constitution and the right to a fair trial under Article 14 of the International Covenant on Civil and Political Rights (ICCPR). The concept applies here as the governing law of the trial is the Military Commissions Act 2009 (MCA 2009) – combining rules of military, domestic and international law – and the president is the constitutional Commander-in-Chief of the US military.

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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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The Shadows of Torture: Reporting from Guantánamo

This series of blogs presents a number of the legal issues raised at the April – May 2018 military commission proceedings against the alleged plotters of the 11 September 2001 (9/11) terror attacks against the US in the case of US v. Khalid Shaikh Mohammad, et. al. taking place at Camp Justice, Guantánamo Bay Naval Station, Cuba.

The author, Dr Kasey McCall-Smith, is conducting a research project entitled Torture on Trial, which is funded by the Royal Society of Edinburgh.

1. The Shadows of Torture

When people speak about torture and the war on terror, the most egregious and publicly decried acts generally pop to mind: waterboarding, walling, sleep deprivation, and so on. As the military commission proceedings in case of US v. Khalid Shaikh Mohammad, et. al. (KSM case) unfold, less examined examples aspects of torture reveal the irreversible physical and mental impacts on victims of such abuse.

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Personality and Procedure: Judges and UNCLOS adjudication

In his first post as GJA Student Ambassador, Connor Hounslow reports from the 2017 Scottish Centre for International Law‘s Annual Lecture. This year’s lecture was delivered by Natalie Klein, Professor and Dean of Macquarie Law School.

 

Last Tuesday, Professor Klein delivered the Scottish Center for International Law Annual lecture on the role of the judge in developing international law, especially within the context of the Law of the Sea. As described by Professor Klein, her body of research on this topic represents a microcosm of the international legal system. Nonetheless, Professor Klein’s explorations in this lecture posited an understanding of the judge which applies to the broader international legal universe.

Natalie Klein, Professor and Dean of Macquarie Law School, giving the Scottish Center for International Law Annual Lecture on ‘The Role of Judges in Developing the Law of the Sea’.

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Talking Human Trafficking and Modern Slavery in the Context of Migration Negotiations

Dr Kasey McCall-Smith, Chair of the Association of Human Rights Institutes and member of the Global Justice Academy, discusses Human Trafficking and Modern Slavery in the context of the UN Global Compact for Migration.

In a previous post, I gave general overview of the UN Global Compact for Migration and a brief analysis of the Migration Compact thematic discussions on the distinctions between human smuggling and human trafficking. This note considers modern slavery, a topic with which the University of Edinburgh is highly engaged through both academic projects as well as its Modern Slavery initiatives. Following on from the distinction between migrants smuggled into a state for the sole purpose of evading legal migration and individuals trafficked into (or within) a state for purposes of exploitation, the following will present key debates about modern slavery and human trafficking that are highly relevant to the conclusion of a comprehensive Migration Compact.

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Smuggling or Trafficking? Defining the Terms in the UN Migration Compact

Dr Kasey McCall-Smith, Chair of the Association of Human Rights Institutes and member of the Global Justice Academy, discusses recent steps towards a UN Global Compact for Migration. This is the first of two blogs from Dr McCall-Smith on the Migration Compact negotiations.

The next steps toward a UN Global Compact for Migration to combat the ever-growing legal and policy issues associated with mass and irregular migration were taken at the UN headquarters in Vienna, Austria, 4-5 September 2017. The Compact aims to deliver a comprehensive approach to human mobility as well as further clarification of and support for existing international frameworks addressing migration, refugees and trafficking, including the Refugee Convention and its Protocol, the UN Convention against Transnational Organized Crime (UNTOC), the UN Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children (Trafficking in Persons Protocol) and the Protocol against the Smuggling of Migrants by Land, Sea and Air (Smuggling of Migrants Protocol), as well as a number of human rights instruments such as the Convention on the Elimination of all forms of Discrimination against Women (CEDAW) the Convention on the Rights of the Child (CRC), among many others.

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Specifying and Securing a Social Minimum

Dr Dimitrios Kagiaros (Edinburgh Law School) reports on a recent workshop, ‘Specifying and Securing a Social Minimum’, held at the International Institute for the Sociology of Law in Oñati, Spain with support from the Global Justice Academy.

Organised by Professors Mike Adler (University of Edinburgh), Sara Stendahl (University of Gothenburg) and Jeff King (UCL), the purpose of the workshop was to bring together international experts from a variety of research backgrounds to discuss the theme of ‘Specifying and Securing a Social Minimum’. The overarching issue that was examined related to the difficulties in determining how poor and vulnerable people can achieve basic minimum standards of nutrition, health care, housing, income, employment and education.

Drawing from a variety of disciplines, including legal theory, human rights law, constitutional and administrative law and social policy, the invited academic speakers were asked to submit research papers illustrating recent developments and new challenges in this field. The workshop followed a particularly innovative approach in generating discussion. Commentators were assigned to each paper and were responsible for presenting its content while also acting as discussants, providing feedback and identifying points for further discussion. This facilitated in-depth consideration of each paper and multiple opportunities for exchange of ideas across disciplines.

The conference theme generated debate on two controversial issues. Firstly, the workshop addressed different approaches and obstacles to defining a social minimum. This included discussion on the concept of poverty, the legal position of social assistance recipients, the concepts of social rights and social responsibilities, and the relationship between resources and the concept of a ‘minimally decent life’.
Secondly, the workshop aimed to bring further clarity to the thorny issue of how such a minimum can be achieved. More specifically, participants critically assessed the contribution of national policies, international conventions, targets and development goals, bills of rights or other forms of constitutional protection to securing this social minimum. Special emphasis was placed on the role of courts. Participants presented judicial approaches to securing a social minimum from India, South Africa, Brazil, and at the international level, the UN Committee on Economic, Social and Cultural Rights and the European Court of Human Rights.

Dr Kagiaros’ paper focused on the role of the European Court of Human Rights in this debate. The paper relied on recent admissibility decisions where applicants unsuccessfully challenged austerity measures adopted to give effect to conditionality agreements in states in the midst of a debt crisis. While ultimately the applications failed at the admissibility stage, the Court in obiter statements alluded to the possibility that a wholly insufficient amount of pensions and other benefits would, in principle, violate the Convention. The paper explored these statements in detail to decipher whether in fact the Court would be willing to set a social minimum standard of protection. The paper argued, that although a duty not to target specific individuals with harsh austerity measures while leaving others unaffected has been read into the ECHR, it is unlikely that with this statement on insufficiency of benefits the Court intends to create a social minimum.

Overall, this was a particularly enriching experience for all involved and hopefully more similar opportunities will arise to discuss these issues in even greater depth.

More about the author:

Dr. Dimitrios Kagiaros is a Teaching Fellow in Public Law and Human Rights at the University of Edinburgh and a member of the Edinburgh Centre for Constitutional Law. He has taught on constitutional law, administrative law and human rights law courses at the University of Edinburgh and the University of Hull. His research interests include whistle-blower protection, the impact of European sovereign debt crisis on human rights and the case law of the European Court of Human Rights in relation to freedom of expression.

 

 

The United Nations Treaty on the Prohibition of Nuclear Weapons

Dagmar Topf Aguiar de Medeiros is reading for a PhD in Law at the University of Edinburgh, and is an intern at UN House Scotland. As a member of a delegation from Scottish civil society, she recently attended negotiations in New York on the Treaty on the Prohibition of Nuclear Weapons, which was adopted 7 July 2017, at the United Nations.

The United Nations has aimed to ban nuclear weapons since it was established in 1945.[1] In fact, the very first UN General Assembly resolution established a Commission to set in motion measures towards nuclear disarmament.[2] Until recently, the most important instrument to this end was the Treaty on the Non-Proliferation of Nuclear Weapons (NPT).[3] Recent years have seen growing discontent with the discriminatory nature of the NPT, which distinguishes between nuclear weapon states and non-nuclear weapon states. Additionally, the NPT faces criticism with regard to the stagnation of nuclear disarmament. Although the treaty includes an obligation to work towards nuclear disarmament, Article 6 has not, as of late, provided sufficient incentive for nuclear weapon states to act.

With an aim to finally move forwards, in October 2016 the UN disarmament and international security committee saw 123 nations voting in favour of meeting to negotiate a legally binding instrument to prohibit nuclear weapons, leading to their total elimination. These negotiations have taken place throughout spring and summer 2017 and have culminated in the adoption of the Treaty on the Prohibition of Nuclear Weapons on the 7th July this year.

The treaty prohibits member states from developing, testing, producing, manufacturing, transferring, possessing, stockpiling, using or threatening to use nuclear weapons, and disallows them from assisting, encouraging or inducing anyone to participate in such activities. Furthermore, it has become forbidden to allow nuclear weapons to be stationed or deployed on member states’ territory. Of equal importance are the positive obligations in the treaty to provide adequate victim assistance and to take measures towards the remediation of environments contaminated as a result of the use or testing of nuclear weapons. Although not explicitly mentioned, there is a growing understanding that financing constitutes ‘assistance’ with prohibited acts.

The text and preamble of the ban treaty reflect the efforts of civil society by emphasising the humanitarian and environmental impact of any nuclear detonation, be it accidental or intentional. The humanitarian initiative proved successful in shifting the debate out of the security argument stalemate states had become entrenched in. At the negotiations, civil society had the opportunity to share the experiences of victims of nuclear weapons and nuclear testing, and to highlight the devastating impact of any detonation and the lack of adequate emergency-response capacity.

By placing human welfare and safety at the centre of the treaty, it is hoped that the ban treaty will have a ripple effect similar to that of the Conventions prohibiting Biological and Chemical weapons. Therefore, even though none of the nuclear weapons states have expressed any interest in joining the negotiations or the treaty, it is hoped the legal norm combined with continued pressure from civil society will eventually convince governments to discontinue nuclear deterrence policies.

The ban treaty is of particular interest to Scotland because of the country’s unique position of having to facilitate nuclear weapons without having any say in the decisions involving them. This is because nuclear weapons are considered a matter of national security and as such fall outside the scope of Scotland’s devolved powers.

[1] https://www.un.org/disarmament/wmd/nuclear/ (last visited 9 July 2017).

[2] General Assembly Resolution VIII, Establishment of a commission to deal with the problem raised by the discovery of atomic energy (24 January 1946), available from http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/1(I) (last visited 9 July 2017).

[3] Treaty on the Non-Proliferation of Nuclear Weapons (5 March 1970) 729 U.N.T.S. 161.

If you are interested in reading more about the negotiations on the ban treaty, including daily reports from the Scottish civil society delegation to New York, visit http://www.nuclearban.scot/ and http://www.icanw.org/

If you want to find out more about civil society engagement surrounding nuclear disarmament, please visit:

http://www.banthebomb.org/

http://www.nukewatch.org.uk/

http://www.article36.org/

If you’re interested in reading twitter updates, the handle to follow is #nuclearban

More about the author:

Dagmar Topf Aguiar de Medeiros is reading for a PhD in Law at the University of Edinburgh. She holds an LLM in Private Law from the University of Leiden and an LLB from the Utrecht Law College of Utrecht University in the Netherlands. Dagmar’s research interests span public international law, specifically environmental law, climate change law and human rights. Her current research relates to the international constitutionalism in the context of the United Nations Framework Convention on Climate Change.