That little newspaper they hand out on airplanes, the International Herald Tribune, has taken the NY Times piece from bioethicist Marks and Bloche’s work, this segment being about the use of leashes on prisoners in Abu Ghraib who were purportedly psychotic. Yes, those leashes … the ones you saw in the pictures being used for decidedly different ends. And as a result of this story’s wider global dissemination, apparently the question has arisen as to how triage should be conducted in a harsh military prison.
Major David Auch told us that some of the prisoners at Abu Ghraib were psychotic and out of control. One, he said, would repeatedly strip off his clothes and smash his head against the wall. After handcuffs and a helmet failed to stop him and with straitjackets unavailable, some soldiers suggested the leash. Auch granted their request. “My concern was whatever it took to keep him from getting hurt,” he said.
It is easy to criticize Auch for allowing military police officers to use a leash, but it is difficult to say what he should have done instead. He had antipsychotic drugs on hand but no psychiatrists to prescribe them, and he lacked the experience to give these powerful drugs himself.
So the leashed detainee went untreated, as did hundreds of others with mental disorders. The lone psychologist who accompanied Auch, Lieutenant Joseph Wehrman, was troubled by what he found on their weekly visits. Up to 5 percent of the detainee population (which averaged 2,000 in late 2003 and early 2004) was mentally ill, Wehrman told us, but to his knowledge, none of the prisoners received medication.
The atmosphere at Abu Ghraib hardly promoted sanity. Mortar shells landed almost daily, according to military personnel we interviewed, and prisoners often rioted, sometimes using smuggled weapons, with deadly effect. In late 2003, Auch’s unit set up a field hospital, bringing a full-time medical presence to the prison for the first time. For the dozen or so clinicians assigned to the hospital, the daily routine was surreal.