Fax to Steve Bradbury, Office of Legal Counsel, DOJ

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Washington, DC 20505
4 Ma 2005
To: I DOJ Command Center
__, ___! Fg_~ Stev_~~EadburL.-.. .. _:___, __· : ___._.
Orgf!.nization: I Office of Legal Counsel ·
U.S. Denartment of Justice
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Comments: (U//FOUO) Steve, Answers to your questions
faxed to me yesterday. L(b)(3) tJAAct
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FOtJO upon removal of attachment
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Trans·mitted .by Secure Facsimile
Steve Bradbury ·
Acting Assistant Attorney General
Off ice of uegal counsel
Departme'nt ·of Justice ·.
Washington, DC 20530
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Dear Mr. ·Bradbury: (b )(3) NatSecAct
4 May 2005
('PS/ A l./N-Fi=:J ·. J?lease find b.elow answers to the
questions you faxed to me yesterday. These answers were
composed l:/Y tbe CIA' s Office of Medical Servic.es· (OMS) after
consideration of the medical journal articles you referenced.
1 .. · Does OMS accept the· findings of the studies that sleep
deprivation can lower the threshold of pain?
Answer: OMS believes tbe studies on sleep deprivation and
pain threshold remain inconsistent in their findings in healthy
subjects, even in the papers cited. Where differences in pain
thre.shold may have· been demonstrated (·i.e. increased sensitivity
to.heat, nonsignificant or no differences in cold,
· nonsignificant changes in perception to pressure) , they are not
geirnane to the techniques used in. the.int~~rogation program.
None of CIA's methods are designed to induce pain. under any
circumstances; to the extent that they might Ci.e. facial slap,
abdominal slap}; they do not involve application .of heat, cold,
pressure, any sharp objects (or indeed any objects at all).
2. If this lowering of the threshold can exist,· has OMS
·evalu~ted how the lowering would affect the use: of other
· interrogatiop techr).ique·s?
,/mswer: See above, which infol'.'llls below comments.
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Steve Bradbury, Esq.
- :: S.tress positions, slaps, walling, cramped
confinement, and water dousing all might cause some pain·. How
wou1d the lowered threshold change the effects of the
techniques?
Answer; We believe ·that because of fatigue (not increased
sensitivity to pain), sleep deprivation would reduce the ability
to maintain a stress position compared to normal subjects, "
leading to sooner release from the position, not greater pain.
In other words, when the individua1·reaches his limit, the
technique ends,· and we would expect him to reach that limit
soo11er under conditions of sleep deprivation. We have no reason
to believe slaps are more painful, and no reason to believe;
based on CIA or SERE experience, that they would induce severe
or pe?.'lllanent injury. The same is true for walling. As for
cramped confinement, ·our limited experience indicates that·
subjects .use the opportunity to sleep, mitigating any concern
about pain. Finally, we a.re aware that the temperature-lowering
effect of sleep· deprivation cre~tes a potential increased risk
of hypothermia with water dousing compared to that in normal
. subjects (and .thus monitor for that effect) i but ·at the.
temperatures of wate.r we have recommended . for the program the
. likelihood of induction of pain by water dousing is very 'low
under·any.circumstances, and not a phenomenon we have seen in
detainees subject to this technique,
-- Standing sleep depriva,tion can lead tc;i e.dema. With
a lowered th~eshold, would the ed~ma become painful?. Would
shackling become painful? ·
Answer: We have not observed this phenomeno·n in the
interrogations performed to dat.e, and have no reason to believe
on.theoretical grounds that edema or shackling would be more
painful, provided (a) shackles are maintained with appropriate
slack; and (b) .interrogators follow medical officers•
.recommendation to end standing sleep deprivation and .use an
aitetnate technique when the medicai officer judges that edema
is significant in any way. Detainees have not complained about
pain from edema, however, an.d we have no information to suggest
otherwise. ,Further, OMS's.experience is that·medical officers•
redommendat:Lons are always followed/ its relationship with the
interrogators, has been one of close and mutual collaboration on
all medical .:reconunendations.
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Steve Bradbury, Esq.
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.4. In the monitoring of .detainees undel'.'going interrogation, is
it possible to tell reliably (e.g. fl'.'om outward physical signs
like grimaces) whether a detainee is experiencing severe pain?
tf so, how?
.l\:nswer: _As th~ memo and all supporting literature notes,
all pain i_s sub1ective, not objective. Medical officers can
monitor for eyidence of condition or injury that most people
would consider painful; and can observe the individual for
outward displays and expressions associated with the experience
of pain. Medical officer can and do.ask th$ subject, after !;:he
interrogation session has concluded, if he is in pain·,· and have
and do provide analgesics, such as Tylenoi and Aleve, to·
detainees who report headache.and other discomforts during their
interrogations. We reiterate, that an interrogation.session
would b.e stopped if, in the judgment of the interrogators or
medical personnel, medical attention was required.
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Steve Bradbury, Esq.
-- If not, are there additional safeguards or limits that
might be appropriate?.
Answer: It is·OMS's view that.based·on our limited
experience. and the extensive experience of the military with
these technii;rues, the program in place has effectively avoided
severe physical pain and suffering, and should continue to do
so. Application of the thirteen techniq\lea has not to date
resulted in any severe or permanent physical injury (or any
injury other than transient bruising), and we do not expect this
to change.
(U/fPS'Effi) If you have any additional questions, 'please
give me a call.
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