George J. Annas, J.D., M.P.H., Sondra S. Crosby, M.D., and Leonard H. Glantz, J.D.
June 12, 2013
DOI: 10.1056/NEJMp1306065
American physicians have not widely criticized medical policies at the Guantanamo Bay detainment camp that violate medical ethics. We believe they should. Actions violating medical ethics, taken on behalf of the government, devalue medical ethics for all physicians. The ongoing hunger strike at Guantanamo by as many as 100 of the 166 remaining prisoners presents a stark challenge to the U.S. Department of Defense (DOD) to resist the temptation to use military physicians to “break” the strike through force-feeding.
President Barack Obama has publicly commented on the hunger strike twice. On April 26, he said, “I don't want these individuals [on hunger strike] to die.” In a May 23 speech on terrorism, the President said, “Look at our current situation, where we are force-feeding detainees who are . . . on a hunger strike. . . . Is this who we are? . . . Is that the America we want to leave our children? Our sense of justice is stronger than that.” How should physicians respond? That force-feeding of mentally competent hunger strikers violates basic medical ethics principles is not in serious dispute. Similarly, the Constitution Project's bipartisan Task Force on Detainee Treatment concluded in April that “forced feeding of detainees [at Guantanamo] is a form of abuse that must end” and urged the government to “adopt standards of care, policies, and procedures regarding detainees engaged in hunger strikes that are in keeping with established medical professional ethical and care standards.” Nevertheless, the DOD has sent about 40 additional medical personnel to help force-feed the hunger strikers.
The ethics standard regarding physician involvement in hunger strikes was probably best articulated by the World Medical Association (WMA) in its Declaration of Malta on Hunger Strikers. Created after World War II, the WMA comprises medical societies from almost 100 countries. Despite its checkered history, its process, transparency, and composition give it credibility regarding international medical ethics, and its statement on hunger strikers is widely considered authoritative.
The entire article is here.
Thanks to Gary Schoener for this lead.
Showing posts with label Hunger Strike. Show all posts
Showing posts with label Hunger Strike. Show all posts
Tuesday, June 25, 2013
Thursday, May 2, 2013
The Role of Medical Professionals Related to Hunger Strikes at Guantanamo
Obama to Seek Closing Amid Hunger Strikes at Guantanamo
By Charlie Savage
The New York Times
Originally published April 30, 2013
Here is a piece of the article:
Last week, the president of the American Medical Association, Dr. Jeremy A. Lazarus, wrote a letter to Defense Secretary Chuck Hagel saying that any doctor who participated in forcing a prisoner to eat against his will was violating “core ethical values of the medical profession.”
“Every competent patient has the right to refuse medical intervention, including life-sustaining interventions,” Dr. Lazarus wrote.
He also noted that the A.M.A. endorses the World Medical Association’s Tokyo Declaration, a 1975 statement forbidding doctors to use their medical knowledge to facilitate torture. It says that if a prisoner makes “an unimpaired and rational judgment” to refuse nourishment, “he or she shall not be fed artificially.”
The military’s policy, however, is that it can and should preserve the life of a detainee by forcing him to eat if necessary.
“In the case of a hunger strike, attempted suicide or other attempted serious self-harm, medical treatment or intervention may be directed without the consent of the detainee to prevent death or serious harm,” a military policy directive says. “Such action must be based on a medical determination that immediate treatment or intervention is necessary to prevent death or serious harm and, in addition, must be approved by the commanding officer of the detention facility or other designated senior officer responsible for detainee operations.”
On Monday, Colonel House also said that some detainees on the “enteral feeding” list were drinking the supplement.
“Just because the detainees are approved for enteral feeding does not mean they don’t eat a regular meal,” he said. “Once the detainees leave their cell and are in the presence of medical personnel, most of the detainees who are approved for tube feeding will eat or drink without the peer pressure from inside the cellblock.”
Medical ethicists and the Pentagon also clashed during the Bush administration over hunger strikes at Guantánamo.
The entire article is here.
By Charlie Savage
The New York Times
Originally published April 30, 2013
Here is a piece of the article:
Last week, the president of the American Medical Association, Dr. Jeremy A. Lazarus, wrote a letter to Defense Secretary Chuck Hagel saying that any doctor who participated in forcing a prisoner to eat against his will was violating “core ethical values of the medical profession.”
“Every competent patient has the right to refuse medical intervention, including life-sustaining interventions,” Dr. Lazarus wrote.
He also noted that the A.M.A. endorses the World Medical Association’s Tokyo Declaration, a 1975 statement forbidding doctors to use their medical knowledge to facilitate torture. It says that if a prisoner makes “an unimpaired and rational judgment” to refuse nourishment, “he or she shall not be fed artificially.”
The military’s policy, however, is that it can and should preserve the life of a detainee by forcing him to eat if necessary.
“In the case of a hunger strike, attempted suicide or other attempted serious self-harm, medical treatment or intervention may be directed without the consent of the detainee to prevent death or serious harm,” a military policy directive says. “Such action must be based on a medical determination that immediate treatment or intervention is necessary to prevent death or serious harm and, in addition, must be approved by the commanding officer of the detention facility or other designated senior officer responsible for detainee operations.”
On Monday, Colonel House also said that some detainees on the “enteral feeding” list were drinking the supplement.
“Just because the detainees are approved for enteral feeding does not mean they don’t eat a regular meal,” he said. “Once the detainees leave their cell and are in the presence of medical personnel, most of the detainees who are approved for tube feeding will eat or drink without the peer pressure from inside the cellblock.”
Medical ethicists and the Pentagon also clashed during the Bush administration over hunger strikes at Guantánamo.
The entire article is here.
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