Physicians Roles at Guantanamo Bay
Hundreds of prisoners at Guantanamo Bay, Cuba have gone on hunger strikes to protest their indefinite detention without legal process and inhumane treatment. When this happens, 6-point restraints have been and are still being used to immobilize prisoners and nasogastric tubes are inserted for force feedings.
Force feeding of competent prisoners who have refused food is a violation of the Geneva Conventions, International human rights law and medical ethics. The World Medical Association has recently updated the Declaration of Malta with guidelines on care of hunger strikers. They have stated that if the hunger striker is not being coerced, either by other prisoners, officials or outside influences, forcing treatment on competent people is wrong.
"Forced feeding contrary to an informed and voluntary refusal is unjustified...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."
The International Tribunal for the former Yugoslavia ruled in 2006 that force feeding of a prisoner in handcuffs with a rubber tube "constituted treatment of such a severe character warranting the characterization of torture".
A Physician's duty to the patient is always the highest priority. Because all ethical rules for treating hunger strikers require the cooperation of physicians, physicians should prevent the force-feeding of competent prisoners by refusing to approve or participate in these activities.