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Medical Professionals Condemn Force-Feeding At Guantanamo Bay

A U.S. Navy medical officer at Guantanamo Bay Detention Camp has refused to force-feed prisoners on an extended hunger strike, according to an attorney representing an inmate at the facility [1]. The report was later confirmed by a Pentagon official [1].   

Guantanamo Bay, a U.S. military prison operational since 2002 and located in Cuba, currently holds 149 inmates. Over half of the prisoners have been cleared for release and many have been imprisoned for over a decade. Some prisoners have engaged in prolonged hunger strikes in protest to their imprisonment. If inmates refuse to eat, a group of military officers force them to ingest a nutrition supplement through a feeding tube—a practice widely denounced by the domestic and international medical community.

A number of leading medical societies, including Physicians for Human Rights (PHR), the American Medical Association (AMA) and the World Medical Association (WMA), have clearly defined their stance against force-feeding. According to the WMA’s 1991 Declaration of Malta on Hunger Strikers, “Forcible feeding is never ethically acceptable. Even if intended to benefit, feeding accompanied by threats, coercion, force or use of physical restraints is a form of inhuman and degrading treatment [2, art. 13].”

In 2013, 35 prominent physicians sent a letter to President Obama calling for an end to force-feeding, claiming that it violates medical ethics and compromises the integrity of the medical field [3]. “The essential role of physicians in such cases is to maintain their doctor-patient relationship with the detainee, meet the patient’s medical needs, and counsel the patient. Respect for the patient’s decision-making . . . is essential.”

A 2013 editorial in the New England Journal of Medicine called on military physicians to refuse orders that violate medical and professional ethics [4]. The military justifies medical intervention without consent on the basis of attempted suicide or self-injury; however, the authors point out that according to the U.S. Supreme Court and international medical ethics standards, “the refusal of treatment with the awareness that death will soon follow is not suicide.” In other words, hunger strikes are a form of protest in which individuals willingly neglect their own health in order to accomplish a political goal.                

PHR and other organizations have declared their support for the military official’s refusal to force-feed inmates, reiterating their stance against the general practice of force-feeding. “By becoming a conscientious objector, this nurse is respecting the medical profession’s core ethics, which unequivocally prohibit the inhuman and degrading practice of force-feeding,” said Dr. Vincent Lacopino, senior medical officer at PHR [5]. “This nurse, and any other conscientious objectors, should not be subject to any disciplinary actions for refusing to follow unethical and unlawful orders,” said PHR’s executive director, Donna McKay [5].

PHR also called for more transparency on the Guantanamo Bay prison. Yet after the extensive press coverage of the Navy official’s refusal to follow orders, the military has curtailed public information about hunger strikes in Guantanamo Bay [6]. According to the Pentagon official, the Navy officer has been reassigned to other duties [1]. It is unknown whether he will face disciplinary action.

[1] http://www.cnn.com/2014/07/15/world/americas/guantanamo-forced-feedings-nurse-refuses/index.html

[2] http://www.wma.net/en/30publications/10policies/h31/

[3] https://s3.amazonaws.com/PHR_other/Letter-to-President-Obama-Guantanamo-November-2013.pdf

[4] http://www.nejm.org/doi/full/10.1056/NEJMp1306065

[5] http://physiciansforhumanrights.org/press/press-releases/phr-welcomes-nurses-decision-to-honor-medical-ethics-by-refusing-to-force-feed-guantanamo-detainees.html

[6] http://www.theguardian.com/world/2014/jul/16/guantanamo-nurse-refuses-force-feed-prisoners  


This article is part of the Summer 2014 issue of Professional Ethics Report (PER). PER, which has been in publication since 1988, reports on news and events, programs and activities, and resources related to professional ethics issues, with a particular focus on those professions whose members are engaged in scientific research and its applications.