OPINION OF THE COURT
FUENTES, Circuit Judge, joined by SCIRICA, SLOVITER, BARRY, SMITH, FISHER, CHAGARES, JORDAN, HARDIMAN, and GARTH, Circuit Judges.
We ordered rehearing en banc in this case to determine the level of intent required, under the Convention Against Torture (the “CAT”),1 for an applicant to show that he is more likely than not to be tortured if sent to the proposed country of removal. Paul Pierre, who is restricted to a liquid-only diet because of a self-imposed injury to his esophagus, appeals the decision of the Board of Immigration Appeals (“BIA”) denying him CAT relief, claiming that as an ex-convict he will be imprisoned upon his deportation to Haiti, will not be provided with the necessary medical care and diet he requires, and will likely die as a result. He contends that the prison officials’ knowledge that it is practically [183]*183certain that he will suffer severe pain if imprisoned in Haiti is sufficient for a finding of specific intent to torture under the CAT. The government, on the other hand, argues that the jailer’s knowledge that an action might cause severe pain and suffering is not sufficient for a finding of specific intent. We conclude that Pierre is not entitled to relief under the CAT because he is unable to sustain his burden of proof to show that, by imprisoning him, the Haitian authorities have the specific intent to torture him. Accordingly, we will deny his petition.
I.
Pierre, a Haitian citizen, first entered the United States in 1986 and was granted permanent legal resident status on December 1, 1990. On October 14, 1992, Pierre broke into the home of his ex-girlfriend and stabbed her repeatedly with a meat cleaver. When a neighbor interrupted the attack after hearing the victim’s cries, Pierre drank a container full of battery acid, in an attempt to commit suicide. His suicide attempt was unsuccessful, however, and due to his ingestion of the battery acid, Pierre suffers from a condition called esophageal dysphagia, limiting him to a liquid diet administered through a feeding tube. According to Pierre, the feeding tube must be replaced on a monthly basis and he requires daily medical care.
Following a trial by jury, Pierre was convicted of various crimes for his attack on his ex-girlfriend, including attempted murder, and was subsequently sentenced to 20 years imprisonment with a mandatory minimum of 10 years without parole. After he had served his 10-year minimum, the former Immigration and Naturalization Service filed a Notice to Appear charging Pierre with being deportable under INA § 237(a)(2)(A)(iii), for having been convicted of an aggravated felony.
According to the 2006 State Department Country Report for Haiti (the “Country Report”), Haiti detains its citizens deported by reason of prior convictions in a foreign country. These detentions sometimes last several months and the Haitian government justifies its detention policy on the grounds of public safety. The Country Report indicates that the prisons are overcrowded, poorly maintained, unsanitary, and rodent infested. Prisoners suffer from malnutrition, inadequate health care, and a lack of basic hygiene.
At a hearing before the Immigration Judge (“IJ”), Pierre conceded that he was subject to removal for his conviction,2 but applied for relief under the CAT, asserting that he would not survive in the Haitian prison for more than two or three weeks. In his written CAT application, he explained that he feared that if he was returned to Haiti he would “die for lack of medical care” while in prison because of the Haitian detention policy. (App. 122.) Pierre described the “expected failure of Haitian authorities ... to provide [him with] adequate medical attention” as “tantamount to ... torture.” (App. 123.)3 He did not attribute this expected failure to any ill will on behalf of the Haitian authorities. Rather, Pierre claimed that “Haiti does not have the means ... to care for [his] medical condition.” (App. 123.) He appealed to the IJ to make a legal “exception” in his case, “not[184]*184withstanding any statutory bar to relief, ... for humanitarian reasons.” (App. 127.)
The IJ found that Pierre was seeking relief for humanitarian reasons based on his medical needs. The IJ concluded that under the interpretation of the CAT in Auguste v. Ridge, 395 F.3d 123 (3d Cir.2005), he did not have discretion to grant humanitarian relief. Accordingly, the IJ denied Pierre’s application for deferral of removal. A single member of the BIA affirmed the IJ’s decision without opinion. Pierre appealed the BIA’s decision to this court.
Subsequent to the initial briefing in this case, we decided Lavira v. Attorney General, 478 F.3d 158 (3d Cir.2007). In Lavi-ra, a panel of our court granted a CAT claim based on evidence that severe pain was the “only plausible consequence” of a petitioner’s imprisonment in a Haitian prison. Id. at 170. In that case, the panel stated that a jailer’s “willful blindness” or “deliberate indifference” might be enough to satisfy the specific intent requirement of the CAT. Id. at 171. The original panel in this case asked for supplemental letter briefs, on the impact of Lavira on Pierre’s case. After receiving the letter briefs and hearing oral argument, we voted to hear the case en banc to resolve any conflict between Auguste and Lavira.
II.
In this matter, Pierre petitions for review of the final order of removal by the BIA. We have jurisdiction pursuant to 8 U.S.C. § 1252(a)(1). Because the basis for removal is Pierre’s conviction for an aggravated felony, our jurisdiction is limited under the REAL ID Act to “constitutional claims or questions of law.” Id. § 1252(a)(2)(C)-(D).
Where, as here, the BIA affirms an IJ’s decision without opinion, we review the IJ’s decision as the final agency determination. Berishaj v. Ashcroft, 378 F.3d 314, 322 (3d Cir.2004). We will review the IJ’s legal determinations de novo, subject to the principles of deference articulated in Chevron v. Natural Resources Defense Council, 467 U.S. 837, 844, 104 S.Ct. 2778, 81 L.Ed.2d 694 (1984). See Briseno-Flores v. Att’y Gen., 492 F.3d 226, 228 (3d Cir.2007); Wang v. Ashcroft, 368 F.3d 347, 349 (3d Cir.2004). Under the REAL ID Act, factual or discretionary determinations are outside of our scope of review. Sukwanputra v. Gonzales, 434 F.3d 627, 634 (3d Cir.2006).
III.
The CAT was designed to acknowledge the obligation of nations under the United Nations Charter to “promote universal respect for, and observance of, human rights and fundamental freedoms.” See Preamble to Convention, S. Treaty Doc. No. 100-20, 1465 U.N.T.S. 85. It was adopted by the United Nations General Assembly on December 10, 1984, and entered into force on June 26, 1987, to “make more effective the struggle against torture and other cruel, inhuman or degrading treatment or punishment throughout the world.” Id. Since opening for signature in December 1984, 145 countries have signed and/or become parties to the CAT. See Office of the High Commissioner for Human Rights Page on the Status of the CAT (visited May 21, 2008) (http://www2.ohchr.org/ english/bodies/ratification/9.htm).
Article 1 of the CAT defines torture as: [A]ny act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a [185]*185third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions.
Art. 1(1), S. Treaty Doc. No. 100-20, 1465 U.N.T.S. 85 (emphasis added). The CAT then commands that: “No State Party shall expel, return (‘refouler’) or extradite a person to another State where there are substantial grounds for believing that he would be in danger of being subjected to torture.” Art. 3(1), S. Treaty Doc. No. 100-20,1465 U.N.T.S. 85.
President Reagan signed the CAT on April 18,1988, in accordance with the power granted to the President in Article II, Section 2 of the United States Constitution, and reserved the United States’ right “to communicate, upon ratification, such reservations, interpretive understandings, or declarations as are deemed necessary.” See Auguste, 395 F.3d at 130 (citation omitted). President Reagan then transmitted the CAT to the Senate for advice and consent on May 20, 1988, proposing a list of reservations, understandings, and declarations, which were revised and resubmitted by President George H.W. Bush in January 1990. See Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, S. Exec. Rep. 101-30, at 2, 7-8 (1990). Included in this list, was an understanding that “in order to constitute torture, an act must be specifically intended to inflict severe physical or mental pain or suffering.” Id. at 9, 36. In addition, President Bush included an understanding that the CAT prohibition on returning a person to a country “where there are substantial grounds for believing that he would be in danger of being subjected to torture,” Art. 3(1), S. Treaty Doc. No. 100-20, 1465 U.N.T.S. 85, would be interpreted to mean “if it is more likely than not that he would be tortured.” See S. Exec. Rep. 101-30, at 10, 16, 36. President Bush also included a declaration that the CAT is not self-executing, to clarify that implementation of the CAT would be through separate legislation. See id. at 12, 37.
In October 1990, the Senate adopted a resolution of advice and consent that incorporated the understandings and declaration discussed above. See 136 Cong. Rec. S 17486-01, S 17491-92 (Oct. 27, 1990) (“Senate Resolution”). Next, as required by Article 26 of the CAT, President Clinton deposited the instrument of ratification with the United Nations on October 21, 1994, and the CAT became enforceable in the United States 30 days later.4 See Regulations Concerning the Convention Against Torture, 64 Fed.Reg. 8478, 8478 (Feb. 19, 1999). President Clinton included the reservations, understandings, and declarations from the Senate Resolution in the instrument of ratification. See 1830 U.N.T.S. 320, 320-22 (1994).
Because the CAT did not self-execute, it needed to be “implemented by legislation before [giving] rise to a private cause of action.” . Ogbudimkpa v. Ashcroft, 342 F.3d 207, 218 (3d Cir.2003) (quoting Man-nington Mills, Inc. v. Congoleum Corp., 595 F.2d 1287, 1298 (3d Cir.1979)); see also Auguste, 395 F.3d at 133 n. 7. Accordingly, in 1998, Congress passed legislation [186]*186to implement the United States’ obligations under the CAT: the Foreign Affairs Reform and Restructuring Act (“FARRA”). See Pub.L. No. 105-227, Div. G, Tit. XXII, § 2242, 112 Stat. 2681, 2681-761, 2681-822 (codified as a note to 8 U.S.C. § 1231).5
The first section of FARRA, § 2242(a), announces that “[i]t shall be the policy of the United States not to expel, extradite, or otherwise effect the involuntary return of any person to a country in which there are substantial grounds for believing the person would be in danger of being subjected to torture,” thereby adopting the obligation in Article 3 of the CAT. See id. Next, § 2242(b) directed “the appropriate agencies” to “prescribe regulations to implement the obligations of the United States under Article 3 of [the CAT], subject to any reservations, understandings, declarations, and provisos contained in the United States Senate resolution of ratification of [the CAT].” Id.
In accordance with § 2242(b) of FAR-RA, the Department of Justice (“DOJ”) promulgated regulations setting forth the procedures by which individuals could seek relief under the CAT. See 64 Fed.Reg. 8478 (Feb. 19, 1999), codified at 8 C.F.R. §§ 208.16(c), .17, & .18(a) (2004). In § 208.18(a), the DOJ provided a definition of torture, incorporating “the definition of torture contained in Article 1 of [the CAT], subject to the reservations, understandings, declarations, and provisos contained in the [Senate] resolution of ratification of the Convention.” Section 208.18(a)(1) provides a definition of torture which mirrors Article 1 of the CAT. In addition, the DOJ included six additional provisions, one of which is relevant to this case: “In order to constitute torture, an act must be specifi-catty intended to inflict severe physical or mental pain or suffering. An act that results in unanticipated or unintended severity of pain and suffering is not torture.” Id. § 208.18(a)(5) (emphasis added). If a petitioner is able to show that it is “more likely than not” that he or she will be tortured, deferral of removal is mandatory. Id. § 208.17(a).
IV.
This Circuit has previously addressed whether Haiti’s policy of indefinitely imprisoning deportees who have been convicted in other countries violates the CAT. We review that history now.
Before we ever addressed this issue, in 2002, the BIA considered whether indefinite detention, inhuman prison conditions, and police mistreatment constitute torture under 8 C.F.R. § 208.18(a). Matter of JE-, 23 I. & N. Dec. 291 (B.I.A.2002). Relying on the understanding contained in the Senate Resolution, the BIA determined that in order to obtain relief under the CAT, a petitioner must show that the alleged torturous acts by the government will be “specifically intended to inflict severe physical or mental pain or suffering.” Id. at 298. Considering Haiti’s policy of indefinitely detaining deportees who have been convicted of crimes abroad, the BIA found that “there is no evidence that Haitian authorities are detaining criminal deportees with the specific intent to inflict severe physical or mental pain or suffering.” Id. at 300. Rather, the BIA concluded that the “Haitian prison conditions are the result of budgetary and management problems as well as the country’s severe economic difficulties.” Id. at 301. Thus, the BIA concluded that the Haitian [187]*187detention policy did not constitute torture for purposes of the CAT.6
Subsequently, in Zubeda v. Ashcroft, 333 F.3d 463 (3d Cir.2003), our Court considered the CAT claim of an immigrant ordered removed to the Democratic Republic of the Congo (“DNC”). In the context of Zubeda’s claim, we stated that the “intentionally inflicted” language in the regulations did not impose a “specific intent” requirement, but simply “exclude[d] severe pain or suffering that is the unintended consequence of an intentional act.” Id. at 473. However, the decision in Zubeda did not turn on whether there is a specific intent requirement in the CAT; instead, the court remanded the case primarily for a clarification of the IJ’s basis for determining that Zubeda would be detained upon her return to the DNC.
The following year, in Auguste, we considered the CAT claim of a Haitian citizen who had been imprisoned in the United States. In Auguste, the petitioner “claim[ed] that he w[ould] be indefinitely detained upon his arrival in Haiti in prisons that are notorious for their brutal and deplorable conditions.” 395 F.3d at 128. We found the language from Ztfbeda discussed above to be dicta, and followed Matter of J-E-, holding that Auguste was unable to show the specific intent to torture required for relief under the CAT. We determined that the definition of torture under the CAT included a specific intent requirement as the court was obligated to “apply the standard clearly stated in the ratification record.” Id. at 140. We rejected Auguste’s argument that the specific intent requirement could not be incorporated into United States law because it was inconsistent with the accepted international interpretation of the CAT. We clarified that “[a] treaty that is ratified ... with a statement of understanding becomes effective in the domestic law subject to that understanding.” Id. at 142 (quoting Restatement (Third) of the Foreign Relations Law of the United States § 314, cmt. d (2004)). Both the President and the Senate indicated their understanding that Article 1 of the CAT contains a specific intent requirement and that understanding has domestic legal effect.
Next, in Auguste we reviewed, with Chevron deference, the BIA’s decision that specific intent should be interpreted with reference to its ordinary meaning in American criminal law and we determined that the BIA did not err in this determination. Citing to Carter v. United States, 530 U.S. 255, 269, 120 S.Ct. 2159, 147 L.Ed.2d 203 (2000), we held that, in order to act with specific intent, an individual “must expressly intend to achieve the forbidden act.” Id. at 145. More specifically, we found that “for an act to constitute torture, there must be a showing that the actor had the intent to commit the act as well as the intent to achieve the consequences of the act, namely the infliction of the severe pain and suffering.” Id. at 145-46. Where the “severe pain and suffering” is merely a “foreseeable consequence” of the act, “the specific intent standard would not be satisfied.” Id. at 146.
Thus, where Auguste complained of the conditions in the Haitian prison but not his particular vulnerability to them, we determined that the BIA did not err by concluding that the Haitian authorities would lack [188]*188the requisite specific intent to inflict severe pain and suffering on Auguste, as the prison conditions were the result of “Haiti’s economic and social ills,” and did not derive from any intent to torture detainees. Id. at 153. Nevertheless, we cautioned that there is no “per se rule that brutal and deplorable prison conditions can never constitute torture.... [I]f there is evidence that authorities are placing an individual in such conditions with the intent to inflict severe pain and suffering on that individual, such an act may rise to the level of torture.” Id. at 154.
In our most recent case to address whether the deportation of a Haitian ex-convict constitutes torture under the CAT, Lavira, we granted the petition of an HIV positive, “above-the-knee amputee with a lifelong political affiliation with exiled former President Jean-Bertrand Aristide.” 478 F.3d at 159. Lavira interpreted Au-guste as prohibiting relief “where the petitioner relied only on the general conditions of the Haitian detention facility.” Id. at 167. In contrast, Lavira’s condition “set him apart from the petitioner in Matter of J-E- [and] the general population incarcerated at the facility.” Id. at 168. We held that Lavira had a valid claim because he presented evidence that showed that he would be targeted, such as being singled out by the guards because of his HIV-positive status. Noting that “demonstrating proof of intent is necessarily an inferential endeavor,” we concluded that “Au-guste demands no more.” Id. at 171.
We also stated in Lavira, in dicta, that we could not “rule out” that specific intent could be proven through “evidence of willful blindness.” Id. As discussed below, we now rule out that possibility.
After Lavira was decided, the Second Circuit decided Pierre v. Gonzales, 502 F.3d 109 (2d Cir.2007). There, the government sought to remove Franck Pierre, a Haitian citizen, because of his aggravated felony and firearms convictions. Pierre sought relief under the CAT, presenting evidence regarding Haiti’s prison conditions and detention policies, and his diabetes, which could lead to his death if he went without medication and a proper diet. The IJ denied him relief, concluding that there was no evidence that the Haitian authorities would detain him with the specific intent to inflict severe pain and that his relatives would be able to provide him with his medications while he was in detention. The BIA affirmed and Pierre sought review from the Second Circuit. The Second Circuit denied his petition, concluding that the CAT has a specific intent requirement and that Pierre failed to meet that standard. Calling Lavira a “wrinkle[],” the Second Circuit took issue with our language in Lavira that suggests that a government official’s “willful blindness” or “deliberate indifference,” which bear on the official’s knowledge, could suffice to fulfill the specific intent requirement, which requires an official to “intend the actual consequences of his conduct.” Id. at 118. In the specific case before it, the Second Circuit found that the petitioner’s diabetic condition did not “remove his case from the ambit of In re J-E-” and, accordingly, denied his petition. Id. at 111. In order to obtain relief based on individual circumstances, the petitioner would need to be able to show that “petitioners with certain histories, characteristics, or medical conditions are more likely to be targeted.” Id. at 122.
V.
The specific issue on appeal concerns what degree of intent Pierre must establish in order to obtain relief under the CAT. To inform our analysis, we consider first the definition of torture in 8 [189]*189C.F.R. § 208.18(a)(1). The regulation provides that an act is torture only if it is:
intentionally inflicted on a person for such purposes as obtaining from him or her or a third person information or a confession, punishing him or her for an act he or she or a third person has committed or is suspected of having committed, or intimidating or coercing him or her or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity.
Id. Here, Pierre will not be imprisoned 1) to obtain information or a confession from him, 2) to punish him for an act he committed or is suspected of having committed, 3) to intimidate or coerce him or someone else, or 4) for any discriminatory reason. Rather, Pierre will be imprisoned because the Haitian government has a blanket policy of imprisoning ex-convicts who are deported to Haiti in order to reduce crime. The lack of medical care and likely pain that Pierre will experience is an unfortunate but unintended consequence of the poor conditions in the Haitian prisons, which exist because of Haiti’s extreme poverty. We find that this unintended consequence is not the type of proscribed purpose contemplated by the CAT. To the extent Lavira suggests that the intentional infliction of severe pain need not be to accomplish one of the proscribed purposes, Lavira is overruled.
Given the ratification history of the CAT, we conclude that the CAT requires a showing of specific intent before the court can make a finding that a petitioner will be tortured. In this vein, we note that Pierre does not dispute that the CAT includes a specific intent requirement. Rather, Pierre argues that the specific intent requirement can be satisfied by a showing that the Haitian officials have knowledge that severe pain or suffering is the practically certain outcome of his imprisonment. We disagree that proof of knowledge on the part of government officials that severe pain or suffering will be the practically certain result of Pierre’s detention satisfies the specific intent requirement in the CAT. Rather, we are persuaded by the discussion in Auguste that the specific intent requirement, included in the ratification history of the CAT, requires a petitioner to show that his prospective torturer will have the motive or purpose to cause him pain or suffering. As in Auguste, we hold that “for an act to constitute torture, there must be a showing that the actor had the intent to commit the act as well as the intent to achieve the consequences of the act.” Auguste, 395 F.3d at 145-46. Specific intent requires not simply the general intent to accomplish an act with no particular end in mind, but the additional deliberate and conscious purpose of accomplishing a specific and prohibited result. Mere knowledge that a result is substantially certain to follow from one’s actions is not sufficient to form the specific intent to torture. Knowledge that pain and suffering will be the certain outcome of conduct may be sufficient for a finding of general intent but it is not enough for a finding of specific intent.
As we discussed in Auguste, the BIA’s decision in Matter of J-E- that specific intent means “the intent to accomplish the precise criminal act that one is later charged with” is entitled to Chevron deference. Id. at 144. Applying that deference, we concluded in Auguste that the BIA had not erred. Id. at 145. Fleshing out the definition of specific intent as it is used within American criminal law, Au-guste relied on Carter v. United States, 530 U.S. at 269, 120 S.Ct. 2159, in which the Supreme Court discussed the differ[190]*190ence between specific intent and general intent. In Carter, the Supreme Court explained that an actor who knowingly commits an act but does not intend the illegal outcome of that act, can only be held hable for a general, not specific, intent crime.
In addition, the Supreme Court discussed the concept of specific intent in United States v. Bailey, 444 U.S. 394, 405, 100 S.Ct. 624, 62 L.Ed.2d 575 (1980), finding that “ ‘purpose’ corresponds loosely with the common-law concept of specific intent, while ‘knowledge’ corresponds loosely with the concept of general intent.” This formulation of specific intent is found repeatedly in United States law. See, e.g., 31 U.S.C. § 3729(b) (knowledge is sufficient for liability under the False Claims Act, and “no proof of specific intent to defraud is required”); Babbitt v. Sweet Home Chapter of Cmtys. for a Great Oregon, 515 U.S. 687, 697 n. 9, 115 S.Ct. 2407, 132 L.Ed.2d 597 (1995) (Congress’s amendment to a criminal statute outlawing certain activities related to endangered species, in which “willfully” was replaced by “knowingly,” was done in order “to make criminal violations of the act a general rather than a specific intent crime”) (quoting H.R. Conf. Rep. No. 95-1804, p. 26 (1978), U.S.Code Cong. & Admin.News 1978, pp. 9484, 9493-94); Callahan v. A.E.V., Inc., 182 F.3d 237, 261 n. 15 (3d Cir.1999) (stating that “[a]lthough harm to the plaintiffs may have been a probable ultimate consequence of the defendants’ actions, we do not think they specifically intended to cause such harm”); United States v. Blair, 54 F.3d 639, 642 (10th Cir.1995) (holding that “a specific intent crime is one in which the defendant acts not only with knowledge of what he is doing, but does so with the objective of completing some unlawful act”).
In our view, a petitioner cannot obtain relief under the CAT unless he can show that his prospective torturer will have the goal or purpose of inflicting severe pain or suffering.7 Under this standard, Pierre has failed to qualify for relief under the CAT because he has failed to show that Haitian officials will have the purpose of inflicting severe pain or suffering by placing him in detention upon his removal from the United States.
Finally, we reject Lavira’s discussion of willful blindness. Willful blindness can be used to establish knowledge but it does not satisfy the specific intent requirement in the CAT. See United States v. Wasserson, 418 F.3d 225, 237 (3d Cir.2005) (stating that evidence of willful blindness satisfies the mental state of knowledge). Moreover, to the extent that Lavira suggests that mere knowledge is sufficient for a showing of specific intent, we overrule that suggestion. In sum, because we have rejected the knowledge standard discussed in Lavira, and because Lavira contained no discussion of the illicit purpose requirement in the CAT, Lavira’s CAT analysis is overruled.
VI.
In conclusion, we will deny Pierre’s petition. As the courts in Matter of J-E- and [191]*191Auguste found, there is no evidence that Haitian authorities imprison ex-convicts upon their deportation to Haiti in order to cause them severe pain or suffering. Rather, the conditions prevalent in the Haitian prison are due to “Haiti’s economic and social ills.” Auguste, 395 F.3d at 153. As Pierre is unable to show that the Haitian authorities specifically intend to cause him severe pain or suffering, he cannot fulfill the specific intent requirement of the CAT.8