10 March 2006

Doctors object to force-feeding at Guantanamo

KRT Wire

Knight Ridder Newspapers

MIAMI - More than 250 physicians from around the world are condemning the Pentagon's practice of force-feeding suspected terrorists at Guantanamo Bay, Cuba, in a letter in Friday's edition of the British medical journal Lancet.

"Fundamental to doctors' responsibilities in attending a hunger striker is the recognition that prisoners have a right to refuse treatment," says the letter, which accuses the U.S. military of violating medical ethics.

Physicians who signed the letter include former military doctors, psychiatrists, gastroenterologists, pathologists and general practitioners from Britain, the United States, South Africa, Germany, Australia and the Netherlands. They included South African physician John Kalk, who refused to force-feed hunger strikers in Johannesburg during apartheid.

The protest in the prestigious journal comes on the heels of a New York Times report that U.S. military medical personnel at the base have been overseeing force-feedings of hunger strikers. The captives have been strapped into restraint chairs in cold cells to get them to eat on their own, the Times said.

"We urge the U.S. government to ensure that detainees are assessed by independent physicians and that techniques such as force-feeding and restraint chairs are abandoned, forthwith in accordance with internationally agreed standards," the letter said.

The Pentagon said in a statement Thursday night that Guantanamo detainees are "treated humanely and are being provided with excellent medical care." It added that doctors follow federal prison guidelines for feeding prisoners with tubes.

"These dangerous men are held in an environment that is stable, secure, safe, and humane," the Pentagon said.

U.S. commanders at the Guantanamo Bay Navy Base have been struggling for nearly four years to cope with the consequences of hunger-striking protests by some of the nearly 500 captives. They argue that they cannot allow a captive to starve himself.

After a detainee refuses nine consecutive meals, according to Guantanamo procedures, he is fed liquids through a tube that is snaked down his nose and into his stomach.

Guantanamo officials defend the practice as humane in court filings.

"This is not a no-risk procedure. Eventually someone is going to die," said David Nicholl, a neurologist at Queen Elizabeth Hospital in Birmingham, England, who organized the letter-writing campaign in Europe.

He listed potential life-threatening complications of force-feedings: a collapsed lung, if the tube is inserted improperly; pneumonia; chest infection; and injuring a captive struggling against straps and restraints.

The physicians assert U.S. military medicine is being unethical by engaging in the practice - and that even U.S. Navy doctors should comply with a hunger striker's wish, because he is a patient first, a prisoner second.

The letter writers say the World Medical Association specifically prohibits force-feeding in the Declaration of Tokyo and Malta, which the American Medical Association has signed.

Nicholl, who was born in Belfast, drew notice last year by running the London Marathon in the garb of a Guantanamo detainee - wearing an orange jumpsuit and chains.

Nicholl said he became aware of Guantanamo's force-feeding practices through a Navy doctor's affidavit attached to a habeas-corpus petition in a U.S. civilian court.

He has since written the Navy doctor's medical association seeking to have him stripped of his license.

Both sides there, he said, are engaging in a form of "mutual Russian Roulette."

"If they choose of their own free will to starve themselves to death, the argument that you're saving their lives just doesn't hold water. You are reviving them in effect through torture."

In the case of Northern Ireland, Nicholls said, the authorities allowed Irish Republican prisoner Bobby Sands to starve himself to death in 1981, rather than force-feed him.

The English did force-feed some Irish prisoners, he said, but only after family went to court and the prisoners were declared mentally unfit.

Nicholls dismissed such an alternative at Guantanamo. "It begs the question, if you've got somebody who is mentally ill, is Guantanamo the right place for them?"

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