C.I.A. Captive Was Too Small for Waterboard, Interrogator Testifies

Carol Rosenberg

The New York Times

Originally posted 3 MAY 22

The psychologist who for the C.I.A. waterboarded a prisoner accused of plotting the U.S.S. Cole bombing testified this week that the Saudi man broke quickly and became so compliant that he would crawl into a cramped crate even before guards ordered him inside.

The psychologist, James E. Mitchell, also told a military judge that the prisoner, Abd al-Rahim al-Nashiri, was so scrawny that Dr. Mitchell and his interrogation partner, [psychologist] John Bruce Jessen, stopped waterboarding him after the third session at a secret site in Thailand in 2002 because they feared he might be hurt.

In that instance, they put him in a neck brace and strapped him to a gurney that served as the board. But when they tilted the board up to let him breathe after a “40-second pour,” the 5-foot-5, 120-pound prisoner nearly slid out of the straps to the floor, Dr. Mitchell said.

“He was snorting and blowing water out of his nose,” Dr. Mitchell testified. 

A former career military psychologist..., Dr. Mitchell said the waterboarding episodes were so long ago that he could not recall whether the prisoner actually cried.

Defense lawyers for Mr. Nashiri questioned Dr. Mitchell on Monday and Tuesday about what went on for several weeks in the black site in November 2002. 

His testimony was meant to offer an account of what may have been on videotapes that senior C.I.A. leaders destroyed at a time when the Senate Intelligence Committee was investigating the black site activities.

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For Mr. Nashiri, it was the fourth stop on what would become a four-year odyssey of C.I.A. detention through 10 secret overseas sites.

The episodes Dr. Mitchell described included:

• A member of an interrogation team used a belt to strap Mr. Nashiri’s arms behind his back and lift him up from behind to “his tiptoes,” Dr. Mitchell said. The prisoner howled, and Dr. Mitchell said he protested, fearing Mr. Nashiri’s shoulders would be dislocated. The treatment continued.

• Guards forced a shackled Mr. Nashiri onto his knees then bent him backward, with a broomstick placed behind the prisoner’s knees.

• The chief interrogator, ostensibly seeking to train Mr. Nashiri to address him as “sir,” used a stiff bristle brush to give Mr. Nashiri a cold-water bath, then scraped the brush from the prisoner’s anus to his face and mouth.

Dr. Mitchell said he learned only in recent days — from case prosecutors — that Mr. Nashiri had been subjected to “rectal feeding,” a procedure he said was mostly handled by C.I.A. doctors for medical reasons, except when the chief interrogator in Afghanistan chose to use it.

The info is here.

MAID Without Borders? Oregon Drops the Residency Requirement

Nancy Berlinger

The Hastings Center: Bioethics

Originally posted 1 APR 22

Oregon, which legalized medical aid-in-dying (MAID) in 1997, has dropped the requirement that had limited MAID access to residents of the state. Under a settlement of a lawsuit filed in federal court by the advocacy group Compassion & Choices, Oregon public health officials will no longer apply or enforce this requirement as part of eligibility criteria for MAID.  The lawsuit was filed on behalf of an Oregon physician who challenged the state’s residency requirement and its consequences for his patients in neighboring Washington State.

In Oregon and in nine other jurisdictions – California, Colorado, the District of Columbia, Hawaii, Maine, New Jersey, New Mexico, Vermont, and Washington – with Oregon-type provisions (Montana has related but distinct case law), MAID eligibility criteria include being an adult with a life expectancy of six months or less; the capacity to make a voluntary medical decision; and the ability to self-administer lethal medication prescribed by a physician for the purpose of ending life. Because hospice eligibility criteria also include a six-month prognosis, all people who are eligible for MAID are already hospice-eligible, and most people who seek to use a provision are enrolled in hospice.

The legal and practical implications of this policy change are not yet known and are potentially complex. Advocates have called attention to potential legal risks associated with traveling to Oregon to gain access to MAID. For example, a family member or friend who accompanies a terminally ill person to Oregon could be liable under the laws of their state of residence for “assisting a suicide.”

What are the ethical and social implications of this policy change? Here are some preliminary thoughts:

First, it is unlikely that many people will travel to Oregon from states without MAID provisions. MAID is used by extremely small numbers of terminally ill people, and Oregon’s removal of its residency requirement did not change the multistep evaluation process to determine eligibility. To relocate to another state for the weeks that this process takes would not be practicable or financially feasible for many terminally ill, usually older, adults who are already receiving hospice care.

The info is here.

Mathematical model offers clear-cut answers to how morals will change over time

The Institute for Future Studies

Phys.org

Originally posted 13 APR 2022

Researchers at the Institute for Futures Studies in Stockholm, Sweden, have created a mathematical model to predict changes in moral opinion. It predicts that values about corporal punishment of children, abortion-rights and how parental leave should be shared between parents, will all move in liberal directions in the U.S. Results from a first test of the model using data from large opinion surveys continuously conducted in the U.S. are promising.

Corporal punishment of children, such as spanking or paddling, is still widely accepted in the U.S. But public opinion is changing rapidly, and in the United States and elsewhere around the world, this norm will soon become a marginal position. The right to abortion is currently being threatened through a series of court cases—but though change is slow, the view of abortion as a right will eventually come to dominate. A majority of Americans today reject the claim that parental leave should be equally shared between parents, but within 15 years, public opinion will flip, and a majority will support an equal division.

"Almost all moral issues are moving in the liberal direction. Our model is based on large opinion surveys continuously conducted in the U.S., but our method for analyzing the dynamics of moral arguments to predict changing public opinion on moral issues can be applied anywhere," says social norm researcher Pontus Strimling, a research leader at the Institute for Futures Studies, who together with mathematician Kimmo Eriksson and statistician Irina Vartanova conducted the study that will be published in the journal Royal Society Open Science on Wednesday, April 13th.

The research is here.

From the Discussion

Overall, this study shows that moral opinion change can to some extent be predicted, even under unusually volatile circumstances. Note that the prediction method used in this paper is quite rudimentary. Specifically, the method is only based on a very simple survey measure of each opinion's argument advantage and the use of historical opinion data to calibrate a parameter for converting such measures to predicted change rates. Given that the direction is predicted completely based on surveys about argument advantage it is remarkable that the direction was correctly predicted in two-thirds of the cases (three-quarters if the issues related to singular events were excluded). Even so, the method can probably be improved.

Predicting how the U.S. public opinion on moral issues will change from 2018 to 2020 and beyond, Royal Society Open Science (2022).

Interventions to reduce suicidal thoughts and behaviours among people in contact with the criminal justice system

A. Carter, A. Butler, et al. (2022)

The Lancet, Vol 44, 101266

Summary

Background

People who experience incarceration die by suicide at a higher rate than those who have no prior criminal justice system contact, but little is known about the effectiveness of interventions in other criminal justice settings. We aimed to synthesise evidence regarding the effectiveness of interventions to reduce suicide and suicide-related behaviours among people in contact with the criminal justice system.

Findings

Thirty-eight studies (36 primary research articles, two grey literature reports) met our inclusion criteria, 23 of which were conducted in adult custodial settings in high-income, Western countries. Four studies were randomised controlled trials. Two-thirds of studies (n=26, 68%) were assessed as medium quality, 11 (29%) were assessed as high quality, and one (3%) was assessed as low quality. Most had considerable methodological limitations and very few interventions had been rigorously evaluated; as such, drawing robust conclusions about the efficacy of interventions was difficult.

Research in context

Evidence before this study

One previous review had synthesised the literature regarding the effectiveness of interventions during incarceration, but no studies had investigated the effectiveness of interventions to prevent suicidal thoughts and/or behaviours among people in contact with the multiple other settings in the criminal justice system. We searched Embase, PsycINFO, and MEDLINE on 1 June 2021 using variants and combinations of search terms relating to suicide, self-harm, prevention, and criminal justice system involvement (suicide, self-injury, ideation, intervention, trial, prison, probation, criminal justice).

 Added value of this study

Our review identified gaps in the evidence base, including a dearth of robust evidence regarding the effectiveness of interventions across non-custodial criminal justice settings and from low- and middle-income countries. We identified the need for studies examining suicide prevention initiatives for people who were detained in police custody, on bail, or on parole/license, those serving non-custodial sentences, and those after release from incarceration. Furthermore, our findings suggested an absence of interventions which considered specific population groups with diverse needs, such as women, First Nations people, and young people.

The research is here.

USS George Washington sailors detail difficult working conditions after string of suicides

Melissa Chan

NBCNews.com

Originally posted 28 APR 22

Here are two excerpts:

Crisostomo and several other George Washington sailors said their struggles were directly related to a culture where seeking help is not met with the necessary resources, as well as nearly uninhabitable living conditions aboard the ship, including constant construction noise that made sleeping impossible and a lack of hot water and electricity. 

Since Crisostomo’s attempt, at least five of her shipmates on the George Washington have died by suicide, including three within a span of a week this April, military officials said. The latest cluster of suicides is under investigation by the Navy and has drawn concern from the Pentagon and Rep. Elaine Luria, D-Va., who served in the Navy for two decades.

On April 15, Master-at-Arms Seaman Recruit Xavier Hunter Sandor died by suicide onboard the George Washington, according to the Navy and the state chief medical examiner’s office. He had been working on the warship for about three months, his family said.

His death came five days after Natasha Huffman, an interior communications electrician, died by suicide off-base in Hampton, officials said.

The day before, Retail Services Specialist 3rd Class Mika’il Rayshawn Sharp also died by suicide off-base in Portsmouth, said his mother, Natalie Jefferson. 

“Three people don’t just decide to kill themselves in a span of days for nothing,” said Crisostomo, who left the Navy in October 2021, on an honorable discharge with a medical condition following her suicide attempt.

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When asked about mental-health resources, Smith told sailors that the Navy would put more chaplains on smaller ships for the first time, but that it’s not easy to hire more psychologists, psychiatrists, and other mental health care workers, because they’re not “out there in abundance.”

“You can’t just snap your fingers and grow a psychiatrist,” he said, adding that the sailors should be “each other’s counselors.”

Myers said a larger Navy team is being built to assess quality-of-life conditions on aircraft carriers undergoing overhauls. 

“Their recommendations will inform potential future action, identify areas for improvements, and propose mitigation strategies to optimize [quality of life],” he said.

In 2020, the most recent year for which full data is available, 580 military members died by suicide, a 16 percent increase from 2019, when 498 died by suicide, according to the Defense Department. Nineteen out of every 100,000 sailors died by suicide in 2020, compared to members of the Army, which had the highest rate, at about 36 per 100,000, Pentagon statistics show.

The info is here.

Why nurses are raging and quitting after the RaDonda Vaught verdict

B. Kelman & H. Norman

www.npr.org

Originally published 5 APR 22

Emma Moore felt cornered. At a community health clinic in Portland, Ore., the 29-year-old nurse practitioner said she felt overwhelmed and undertrained. Coronavirus patients flooded the clinic for two years, and Moore struggled to keep up.

Then the stakes became clear. On March 25, about 2,400 miles away in a Tennessee courtroom, former nurse RaDonda Vaught was convicted of two felonies and now faces eight years in prison for a fatal medication mistake.

Like many nurses, Moore wondered if that could be her. She'd made medication errors before, although none so grievous. But what about the next one? In the pressure cooker of pandemic-era health care, another mistake felt inevitable.

Four days after Vaught's verdict, Moore quit. She said the verdict contributed to her decision.

"It's not worth the possibility or the likelihood that this will happen," Moore said, "if I'm in a situation where I'm set up to fail." In the wake of Vaught's trial ― an extremely rare case of a health care worker being criminally prosecuted for a medical error ― nurses and nursing organizations have condemned the verdict through tens of thousands of social media posts, shares, comments and videos. They warn that the fallout will ripple through their profession, demoralizing and depleting the ranks of nurses already stretched thin by the pandemic. Ultimately, they say, it will worsen health care for all.

Statements from the American Nurses Association, the American Association of Critical-Care Nurses, and the National Medical Association each said Vaught's conviction set a "dangerous precedent." Linda Aiken, a nursing and sociology professor at the University of Pennsylvania, said that although Vaught's case is an "outlier," it will make nurses less forthcoming about mistakes.

"One thing that everybody agrees on is it's going to have a dampening effect on the reporting of errors or near misses, which then has a detrimental effect on safety," Aiken said. "The only way you can really learn about errors in these complicated systems is to have people say, 'Oh, I almost gave the wrong drug because ...'"

"Well, nobody is going to say that now."

The info is here.

The Mystifying Rise of Child Suicide

Andrew Solomon

The New Yorker

Originally posted 4 APR 22

Here are two excerpts:

Every suicide creates a vacuum. Those left behind fill it with stories that aspire to rationalize their ultimately unfathomable plight. People may blame themselves or others, cling to small crumbs of comfort, or engage in pitiless self-laceration; many do all this and more. In a year of interviewing the people closest to Trevor, I saw all of these reactions and experienced some of them myself. I came to feel a love for Trevor, which I hadn’t felt when he was alive. The more I understood the depths of his vulnerability, the more I wished that I had encouraged my son, whose relationship with Trevor was often antagonistic, to befriend him. As I interviewed Trevor’s parents, my relationship with them changed. The need to write objectively without increasing their suffering made it more fraught—but it also became deeper and more loving. As the April 6th anniversary of Trevor’s death approached, I started to share their hope that this article would be a kind of memorial to him.

Angela was right that a larger issue is at stake. The average age of suicides has been falling for a long time while the rate of youth suicide has been rising. Between 1950 and 1988, the proportion of adolescents aged between fifteen and nineteen who killed themselves quadrupled. Between 2007 and 2017, the number of children aged ten to fourteen who did so more than doubled. It is extremely difficult to generalize about youth suicide, because the available data are so much sparser and more fragmentary than for adult mental illness, let alone in the broader field of developmental psychology. What studies there are have such varied parameters—of age range, sample size, and a host of demographic factors—as to make collating the information all but impossible. The blizzard of conflicting statistics points to our collective ignorance about an area in which more and better studies are urgently needed. Still, in 2020, according to the Centers for Disease Control and Prevention, in the United States suicide claimed the lives of more than five hundred children between the ages of ten and fourteen, and of six thousand young adults between fifteen and twenty-four. In the former group, it was the second leading cause of death (behind unintentional injury). This makes it as common a cause of death as car crashes.

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Perhaps the most unsettling aspect of child suicide is its unpredictability. A recent study published in the Journal of Affective Disorders found that about a third of child suicides occur seemingly without warning and without any predictive signs, such as a mental-health diagnosis, though sometimes a retrospective analysis points to signs that were simply missed. Jimmy Potash, the chair of the psychiatry department at Johns Hopkins, told me that a boy who survived a suicide attempt described the suddenness of the impulse: seeing a knife in the kitchen, he thought, I could stab myself with that, and had done so before he had time to think about it. When I spoke to Christine Yu Moutier, who is the chief medical officer at the American Foundation for Suicide Prevention, she told me that, in children, “the moment of acute suicidal urge is very short-lived. It’s almost like the brain can’t keep up that rigid state of narrowed cognition for long.” This may explain why access to means is so important; children living in homes with guns have suicide rates more than four times higher than those of other children.

The info is here.

Mormon Leader Reaffirms Faith's Stance on Same-Sex Marriage

Sam Metz

Associated Press

Originally published 3 APR 22

A top leader in The Church of Jesus Christ of Latter-day Saints reaffirmed the faith’s opposition to same-sex marriage and “changes that confuse or alter gender” as debates over gender and sexuality reemerge throughout the United States.

Dallin H. Oaks, the second-highest-ranking leader of the faith known widely as the Mormon Church, told thousands of listeners gathered at a conference center at the church’s Salt Lake City headquarters that what he called “social and legal pressures” wouldn’t compel the church to alter its stances on same-sex marriage or matters of gender identity that he did not specify.

The highest level of salvation, Oaks said, “can only be attained through faithfulness to the covenants of an eternal marriage between a man and a woman. That divine doctrine is why we teach that gender is an essential characteristic of individual pre-mortal, mortal, and eternal identity and purpose.”

Oaks also said church doctrine “opposed changes that confuse or alter gender or homogenize the differences between men and women” and warned that “confusing gender, distorting marriage, and discouraging childbearing” was the devil’s work.

He also implored members of the faith to live peacefully and respect those with beliefs different than their own.

Oaks’ remarks reaffirm the faith’s long-held position on same-sex marriage that it has held to steadfastly even as its softened its policies on other LGTBQ matters, including allowing the children of same-sex couples to be baptized.

The Latter-day Saints’ reaffirmation of their stances comes as debates rage throughout the nation over transgender youth and what kids should learn about gender and sexuality. Officials in Texas have fought to classify gender confirmation surgeries as child abuse and Florida has outlawed instruction on sexual orientation and gender identity in kindergarten through third grade.

The info is here.

Why So Many Middle-Aged Women Are on Antidepressants—Scientists are gaining a better understanding of women’s midlife depression

Andrea Petersen

The Wall Street Journal

Originally posted 2 APR 22

For years, middle-aged women have had some of the country’s highest rates of antidepressant use. Now, scientists are starting to better understand why—and to develop more targeted treatments for women’s midlife depression.

About one in five women ages 40 to 59 and nearly one in four women ages 60 and over used antidepressants in the last 30 days during 2015 to 2018, according to the latest data from the National Center for Health Statistics. 

Among women ages 18 to 39, the figure was about one in 10. 

Among men, 8.4% of those ages 40 to 59 and 12.8% of those 60 and older used antidepressants in the last 30 days, according to the NCHS data.

The figures are drawing increasing attention from scientists and doctors. Many are alarmed at how high depression rates were among midlife women even before the pandemic, now that the past two years have exacerbated mental-health issues for many Americans. 

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Researchers at NIMH who have been following 90 women since 1988 have found that the incidence of women’s midlife depression is concentrated in the two years before and after the last menstrual period, says Dr. Schmidt. 

The quality of women’s midlife depression is distinct, too, Dr. Schmidt says, in that it often involves intense anxiety, irritability and sleep problems along with the more typical sadness and loss of pleasure in once-enjoyed activities.

Doctors speculate that antidepressant use among middle-aged women is being driven in part by the reluctance of women—and many of their physicians—in recent decades to use hormone-replacement therapy for menopausal symptoms. In 2002, a large study, the Women’s Health Initiative, was stopped after women taking hormone therapy had an increased risk of breast cancer, heart attacks and strokes. 

Later analyses found that the risks were largely concentrated among women who were older when they started hormone therapy. For women in their 50s, hormone therapy actually reduced the risk of heart disease and death from any cause. 

Hormone therapy, either estrogen alone or combined with a progestogen, is the most effective treatment for hot flashes and night sweats, according to the North American Menopause Society and the American College of Obstetricians and Gynecologists. 

Some research has found that it can also improve mood.

The info is here, behind a paywall.