Command's Responsibility: Detainee Deaths in U.S. Custody in Iraq and Afghanistan

Human Rights First:  Press Briefing on
“Command’s Responsibility: Deaths in U.S. Custody in Iraq and Afghanistan”
February 22, 2006

STATEMENT OF BRIGADIER GENERAL STEPHEN XENAKIS (RET., USA)

Brigadier General Stephen N. Xenakis, USA (Ret.) served in the U.S. Army, as well as in academic medicine and clinical practice.  He retired from the Army in 1998 and held many high-level positions, including Commanding General of the Southeast Regional Army Medical Command.  He is currently the Director of Child and Adolescent Psychiatry at the Psychiatric Institute of Washington.

The roles and responsibilities of military medical officers conform to ethics and principles that have been widely recognized throughout the world across all national boundaries and military engagements.  Medical officers enjoy special privileges and status and are expected to abide by and stand up for their professional principles at all times and in all situations.   This operation – the War on Terror – is no different. Medical personnel had a duty to serve as a check to the line command and investigators, and as a constant reminder that all soldiers – even the enemy captured in combat – should be treated with dignity and humanely.

This report sheds light on several important findings.

First, autopsies were not required until after Abu Ghraib, when the Department of Defense clarified policies and guidelines for handling detainees in custody. Nonetheless, the tradition up to that time had been to conduct an autopsy on the death of any soldier or individual in military custody, as a matter of customary practice.  The conduct of the military authorities in Iraq, until the publication of the new guidelines, constituted a serious departure from usual procedures.

Then, there were problems in record keeping…“full and adequate records regarding the capture and treatment of detainees [should have been] kept; …[and that]…a host of Department of Defense and Army regulations codify this requirement… [as an example], Army investigations found that fourteen detainees died of natural causes because of pre-existing conditions, at least five case files [did] not include records documenting these conditions… such record keeping [is a] ‘standard of care throughout the world.’ “What are the implications for the quality and adequacy of medical care provided to the detainees?

Considering the nature of this military operation and the international attention focused on the America military, it is reasonable to expect that a senior military medical officer should have directed that the death of any detainee be thoroughly investigated. Each fatality should have been handled with special attention. The absence of autopsies, body parts, and evidence is astonishing.   Moreover, special effort should have been exercised to ensure the highest quality of care to detainees and any indication of problems in delivering that care or suspicion of maltreatment should have been reported.

As such, there are concerns of commission and omission.  To date, we have no indication that either the Army Medical Department or the Office of the Assistant Secretary of Defense for Health Affairs has conducted a thorough investigation of the medical care provided to detainees and the circumstances surrounding the known deaths.  The only such review has been a functional assessment by MG Lester Martinez-Lopez, which is merely a compilation of reports and interviews and not an investigation that probes directly into the handling of these cases. We have no evidence to show that early in the operation the Defense Department wrote out guidelines for adherence to the traditional policies and practices.  It is important to remember that the burden of leadership is to ensure that high moral and ethical practices are maintained in even the most demanding situations.