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13 Jun, 2013 09:19

‘Medical ethics-free zone’: US doctors call to stop force feeding in Gitmo

‘Medical ethics-free zone’: US doctors call to stop force feeding in Gitmo

Doctors at the Guantanamo Bay detention camp should refuse participation in the force-feeding of hunger strikers since such an activity is a political statement, not a medical condition argues three senior medical professors.

“Hunger striking is a peaceful political activity to protest terms of detention or prison conditions; it is not a medical condition, and the fact that hunger strikers have medical problems that need attention and can worsen does not make hunger striking itself a medical problem,” wrote Drs. George Annas, Sondra Crosby and Leonard Glantz in the prestigious New England Journal of Medicine.

Physicians stationed at Guantanamo Bay, the authors write, are sacrificing their ethical obligations by permitting the military to “use them and their medical skills for political purposes.”

The article then mentioned the participation of military doctors who are used to ‘monitor’ the torture of detainees.

“Force-feeding a competent person is not the practice of medicine; it is aggravated assault,” the senior professors wrote. “Using a physician to assault prisoners no more changes the nature of the act than using physicians to ‘monitor’ torture makes torture a medical procedure.”

“Military physicians are no more entitled to betray medical ethics than military lawyers are to betray the Constitution or military chaplains are to betray their religion,” they added.

Of the 166 detainees in Guantanamo, at least 104 of them are participating in a hunger strike to protest their indefinite detention without the benefit of a fair trial. Of the hunger strikers, 43 have lost enough weight that military doctors are feeding them through tubes inserted in their noses and down into their stomachs, a military spokesman said.

The procedure has been described as very painful. Prisoners who refuse are strapped into restraining chairs to immobilize them during the process.

In order to combat what has been described as unethical treatment of detainees, the professors from Boston University said “individual physicians and professional groups should use their political power to stop the force-feeding, primarily for the prisoners' sake, but also for that of their colleagues.”

Nasal feeding tubes.(AFP Photo / John Moore)

The medical community’s position on the issue, however, does not flush with that of the military.

Navy Captain Robert Durand, a spokesman for Guantanamo, said the tube-feeding procedure of detainees is court-approved and medically sound.

"It is the policy of the Department of Defense to protect the life and health of detainees by humane and appropriate clinical means, and in accordance with all applicable law and policy," Durand said, as quoted by Reuters.

"The policy on treatment of hunger strikers is focused solely on preserving the life and health of detainees in Department of Defense custody, and is consistent with treatment that would be provided for US military personnel under similar circumstances."

The journal contributors refuted the US military’s position on the issue, arguing that force-feeding hunger strikers is wrongly connected to suicide prevention.

"Hunger strikers are not attempting to commit suicide. Rather, they are willing to risk death if their demands are not met. Their goal is not to die but to have perceived injustices addressed," they wrote.

The authors offered their recommendations as to how military physicians stationed at Guantanamo may preserve their ethical standards in the face of military coercion.

“They should approach congressional leaders, petition the DoD to rescind its 2006 instruction permitting force-feeding, and state clearly that no military physician should ever be required to violate medical ethics. We further believe that military physicians should refuse to participate in any act that unambiguously violates medical ethics,” they recommended.

The doctors reminded that the American Medical Association and the World Medical Association, which represents the medical affiliations of about 100 countries, are of the position that force-feeding mentally competent adults is a violation of medical ethics.

In April the American Medical Association wrote the secretary of defense that “forced feeding of [competent] detainees violates core ethical values of the medical profession.”

On May 23, President Barack Obama pledged to restart the repatriation process for about 86 detainees at Guantanamo Bay who were cleared of the charges brought against them. The process has bogged down, however, as Congress continues to debate whether releasing a portion of the detainees will present a security risk for the United States.

Meanwhile, the ongoing hunger strike only serves to remind the world of President Obama’s failed promise, made on the campaign trail in 2008, to shutter the Guantanamo detention center, which has been described by Human Rights Watch as “the Gulag of our times.” 

Robert Bridge is the author of the book, "Midnight in the American Empire," which discusses the dangerous consequences of excessive corporate power in the United States.