In the latest incident in the rapid deterioration of the US-Pakistani relationship, the ISI have picked up a Pakistani doctor that it claims, and the Guardian reports, was involved in a horrifying breach of medical ethics. According to the Guardian’s sources, the CIA recruited this doctor to conduct a fake vaccination drive in Abbottabad, hoping to corroborate bin Laden’s sister’s DNA with residents of the mysterious compound where US operators would later terminate the al Qaeda head. Chris Albon is dead on about the disastrous medical and public health implications of this story, which will seriously endanger health workers even if the story was a complete fabrication:
If true, the CIA’s actions are irresponsible and utterly reprehensible. The quote above implies that the patients never received their second or third doses of the hepatitis B vaccine. And even if they did, there is absolutely no guarantee that the vaccines were real. The simple fact is that the health of the children of Abbottabad has been put at risk through a deceptive medical operations by the Central Intelligence Agency. Furthermore, the operation undermines future vaccination campaigns and Pakistani health workers by fueling conspiracy theories about their true purpose.
Let us be clear about one thing: health care is not a weapon and any use of it as such deserves full-throated condemnation.
All that said, one can feel many things about this story, but one thing I do not feel is surprised – not at all. The CIA and clandestine organizations like it do not subscribe to the same ethical standards as many professions they come in contact with. They are neither doctors, lawyers, police, nor even soldiers. The point of the CIA is not to do legal things quietly, it is to do what the government of the United States believes must be done quietly. We pay clandestine organizations to do things nobody else can or will, and if we pay them more, we pay them to do it without anyone else – or the American public – finding out. The ability of the CIA to accomplish its objectives without needing to care for the standards of other professions, laws, or codes of ethics is a feature, not a bug.
If the President of the United States tells the relevant organs of national security that his top priority is destroying, disrupting, and dismantling al Qaeda, after a campaign trail legacy of notably calling for throwing Pakistani sovereignty to the wind to do so, and tasks his clandestine service in the lead role, then that agency is going to do so, and they will cut ethical corners in the process – on issues that might be sacred to other instruments of state power. You do not task such an organization with eliminating by any means necessary a high value target because of their sensitivity. You do so because you know that somewhere along the line, they are going to do things that are illegal, unethical, or downright evil in pursuit of your goals, and they will have the sense and ability to cover them up for the sake of the nation’s interests, reputations, and self-conscience. Like the American expatriate in Roberto Bolano’s By Night in Chile, clandestine organizations can do horrible things in the basement without alerting the literati at the dinner party upstairs – if the President bid so.
There is a clean, sanitized vision of covert warfare that seems to have taken root amidst the rising bodycounts, extended wars of occupation, highly public instances of collateral damage, and enormous amounts of treasure that have been the most prominent features of the global war on terror. This is somewhat odd, considering the scandals which routinely erupted over Camp X-Ray or overseas black sites. Nevertheless the vision of ultra-efficient drones, special forces teams, and the “good” kind of intelligence much more easily captures the national imagination. The bin Laden raid, superficially, was the epitome of such efforts. No collateral damage, no friendly casualties. Instead of stories of torture, early reports emphasized whiz-bang technology, like NGIA satellites trying to estimate the height of the pacing man in an Abbottabad courtyard. DNA tests to confirm the kill so that the US could be in and out before Pakistan could scramble adequate response. Now we may know how some of that DNA testing was expedited.
In the Bourne film trilogy, it’s darkly amusing to note that one of the eponymous assassin’s critical ethical dilemmas was whether or not to shoot his target in front of his children. Besides the dehumanization and de-personalization, the big ethical issue in the Bourne movies is killing. All the ugliness that goes into enabling that killing receives barely any treatment. At some point, though, that covert killing – slick, quiet, efficient – became immensely preferable to the American public when compared to the wars of occupation and nation-building it was waging in the name of defeating terrorism. After some initial hand-wringing, not many Americans seem to be bothered about whether or not bin Laden was shot in cold blood in front of his family. The aesthetic and moral appeal of these sorts of operations becomes their speed and cleanliness. Unfortunately, the tempo of the execution, rather than the long, dark, and messy process of finding the intelligence to enable it, as well as the bloody and questionably legal act of assassination itself , captures our imagination. Incredulously, Americans sick of the routine war on terror turned to the CIA, with its drones and clandestine operatives, to fight the good fight. Mencken’s admonition that in democracies, citizens get what they want – good and hard – remains appropriate.
While in theory intelligence agencies are bound to uphold the rule of law like every other instrument of state power, they are far from an ethically scrupulous body, as we know from history. Nor do they have as much incentive to be. On the issue of torture, law enforcement officers used to dealing with criminals in courts of law, where everybody has the same rights, had an a priori moral obligation not to torture, as well as a practical consideration, considering the potential for the defendant’s lawyers to use such methods to sink the prosecution’s case, whether through “lawfare” or otherwise. Military officers had the UCMJ and the Geneva conventions and a moral code which required some acts be beyond the pale to make the otherwise hellish undertaking of warfare morally possible. Alongside that they had a very obvious practical obligation not to torture, lest they erode the international humanitarian standards which might protect them should they fall into enemy hands in another conflict. As for the intelligence agencies? While torture is surely evil, it is hard to think that were it actually a superbly effective technique of information gathering (which it is not), it is hard to imagine they would not use it if they felt need to.
So when we task these organizations – which by their nature are less accountable to the public – with fighting the good war, we should naturally expect these sorts of ethical outrages. We will push back, but only after the fact. Yes, this decision may have had enormously terrible consequences for public health efforts, but it was clear this nation and its leadership were not going to put the prerogatives of public health ahead of the clandestine services or anything else involved with killing bin Laden. If you want something done in a clean, transparent way that take a holistic approach, do not frame it as a counter-terror and assassination mission and assign it foremost to the CIA and its most clandestine counterparts in the military, because vaccinations are not going to kill al Qaeda members and the organizations which do are not trained or known for their sensitivity to the whole-of-government approach or balancing the 3Ds.
Of course, what do you expect from a country that sends Google when it wants regime change in the Middle East? What was once spook turf is now the province of public diplomats, NGOs, and a corporation whose prime moral maxim is “don’t be evil.” Lo and behold, Egypt is not quite a democracy and social media has failed to achieve or provide the decisive effect in Libya, Bahrain, Yemen, or Syria. That is because this country did not make regime change in these states a national priority. If it did, and the CIA was in charge, well, you only need to know a little bit of Cold War history to know how that turned out. Clandestine agencies moral maxims are probably somewhere between “don’t come home until it’s done” and “don’t get caught.” Unfortunately, we too often seem to expect the fancy, 21st century high-tech bloodless efficiency of Google from the cloak and dagger folks of Top Secret America. If Americans are really serious about these kinds of efforts, they need to understand that a low footprint approach does not always mean a light touch.