Advancing health, dignity and justice
June 9, 2010
A. Frank Donaghue
Chief Executive Officer
BOARD OF DIRECTORS
Robert S. Lawrence, MD
Johns Hopkins University
Chair
Frank Davidoff, MD
Institute for Healthcare Improvement
Vice Chair
Eli Adashi, MD
Brown University
Deborah Ascheim, MD
Mt. Sinai School of Medicine
Columbia University
Holly G. Atkinson, MD
Mt. Sinai School of Medicine
Immediate Past Chair
Marion J. Bergman, MD, MPA
Miracle Corners of the World, Inc.
Donald Berwick, MD, MPP
Institute for Healthcare Improvement
Greg C. Carr
Carr Foundation
Carola Eisenberg, MD
Harvard Medical School
H. Jack Geiger, MD, MSci
City University of New York
Medical School
Justice Richard J. Goldstone
Justice of the South African
Constitutional Court, Retired
Ali Khan
Medical College of Virginia
Joel Lamstein
President, John Snow, Inc. (JSI)
President, World Education, Inc.
Adam Richards, MD
Robert Wood Johnson Clinical Scholar,
UCLA
Anne Stetson, JD, MIA
Lighthouse Consulting
Kerry Sulkowicz, MD
Boswell Group LLC
Gerald E. Thomson, MD
Professor of Medicine Emeritus
Columbia University
2 Arrow Street, Suite 301
The Honorable Kathleen Sebelius
Secretary of Health and Human Services
200 Independence Ave., SW
Washington, DC 20201
Dear Secretary Sebelius:
Physicians for Human Rights has released a new report “Experiments in
Torture: Evidence of Human Subject Research and Experimentation in the
“Enhanced” Interrogation Program,” which provides evidence indicating that
the “enhanced interrogation” program carried out after September 11, 2001
involved physicians, psychologists, and other health professionals in conducting
apparently unethical research and experimentation using detainees as human
subjects.
We are writing to urge that the Department of Health and Human Services take
immediate action to fully investigate these allegations and restore the damaged
regime of US human subject research protections, as outlined below. Our report
raises concerns that the CIA’s Office of Medical Services (OMS) conducted
research and experimentation on detainees in US custody and, in the process,
likely violated federal regulations known as The Common Rule (45 CFR 46)
governing human subject research carried out by United States Government
entities. The CIA is one of seventeen federal agencies required by law to adhere
to The Common Rule when conducting federally funded research on human
beings. It is imperative that you instruct the Office for Human Research
Protections (OHRP) to begin an investigation of alleged violations of the
Common Rule by the CIA and other government agencies as part of the
“enhanced” interrogation program.
OHRP should initiate immediately its investigation into experimentation by the
CIA on detainees in its custody based upon the following evidence of
wrongdoing detailed in declassified government documents:
• The collection by OMS health professionals of data from detainees in
order to derive generalizable knowledge of the effects on detainee
subjects of “enhanced interrogation” techniques. These techniques,
which have serious potential to cause harm, included sleep deprivation,
waterboarding, sensory deprivation and overload. It appears that data
also was collected on the impact of techniques both when used
individually and when applied in combination;
• The collection of data from detainees subjected to the technique of the
waterboard in order to develop new methods and procedures for its
application, including the experimental use of potable saline in place of
water to reduce the risk of hyponatremia;
• The CIA’s apparent failure to comply with The Common Rule’s
regulations (a) requiring all human research subjects to provide informed
consent, (b) assuring that subjects of research have the right and ability
• Cambridge, MA 02138 • T: 617.301.4200 • F: 617.301.4250 • physiciansforhumanrights.org
 To: Secretary of Health and Human Services Kathleen Sebelius, con’t page 2

to stop their participation in the research at any time, and (c) requiring the conduct of prior
review of the proposed human subject research by an Institutional Review Board.
If the OHRP concludes that OMS research on detainees subjected to “enhanced interrogation”
techniques commonly viewed as torture violated The Common Rule and internationally
accepted standards of health professional ethics, the CIA must be immediately sanctioned by the
Department of Health and Human Services. Any personnel found to have violated the law
should be referred to the Department of Justice for prosecution. Professionals determined to be
in violation of their ethically mandated responsibilities should be referred to state licensing
bodies and professional associations for appropriate professional sanctions.
The essence of the extensive ethical and legal protections for human subjects is that the subjects,
especially vulnerable populations such as prisoners, be treated with the dignity befitting a human
being and not simply as an experimental guinea pig. The Nuremberg code and other guidance
also call on the medical professional to treat persons with their best interests in mind and not to
cause them pain in the service of a research goal. Doctors are required to use treatments that are
expected to be effective and not to engage in speculative medicine at the expense of a human
research subject. Further, research with any potential for harm should not be conducted without
the fully informed consent of those studied, and the ability to withdraw that consent at any time.
The use of doctors to monitor intentionally harmful interrogation techniques places them in the
service of national security objectives which are in conflict with both their ethical obligations as
researchers and the best therapeutic interest of those they are monitoring. The result has been a
cooptation of health professionals by the national security apparatus and a violation of the
highest medical admonition to “do no harm.” The misuse of scientific expertise for expedient
and exploratory goals leads to a corrosion of the high standards of the profession.
We respectfully urge you to make the investigation of these alleged crimes and unethical
activities and the restoration of a fully enforced regime of human subject research a top priority
for your Department. Until these actions are taken, the medical professionals and scientists
working for the US government in the national security apparatus will remain under a cloud of
ethical and legal questions which will further compromise US standing as nation that adheres to
high ethical standards and the rule of law.

Sincerely,

Frank Donaghue
Chief Executive Officer

2 Arrow Street, Suite 301 • Cambridge, MA 02138 • T: 617.301.4200 • F: 617.301.4250 • physiciansforhumanrights.org