Medical Associations Push to Stop Force-Feeding of Hunger Strikers at Guantanamo

The entrancer to Camp Justice at the Guantanamo Bay Naval Base is seen on October 24, 2013, in Guantanamo Bay, Cuba. The tents at Camp Justice house media, lawyers, human rights observers, and military personnel and they are near the Guantanamo military commissions, the military tribunals created by the Military Commissions Act of 2006 for prosecuting detainees.
National Journal
Clara Ritger
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Clara Ritger
Dec. 2, 2013, 1:46 p.m.

Ex­ec­ut­ives from lead­ing U.S. med­ic­al as­so­ci­ations craf­ted more than a dozen re­com­mend­a­tions Monday re­gard­ing doc­tors’ treat­ment of de­tain­ees at Guantanamo Bay.

Con­fer­ees fo­cused on the need for the U.S. to ad­opt the De­clar­a­tion of Malta, a 1991 ac­cord that pro­tects hun­ger strikers from force-feed­ing and calls on doc­tors to re­spect the autonomy of the pa­tient.

“Force-feed­ing is equi­val­ent to tor­ture,” said Vir­gin­ia Hood, a med­ic­al pro­fess­or at the Uni­versity of Ver­mont. “Even if it is not con­sidered so in the United States, it should be.”

Pentagon spokes­man Lt. Col. Todd Breas­seale de­fen­ded the De­part­ment of De­fense prac­tice of feed­ing hun­ger strikers. He said the DoD be­lieves “the pre­ser­va­tion of life” su­per­sedes a pa­tient’s right to de­cline treat­ment.

“Every time that chal­lenge has been brought up, the courts have ruled in fa­vor of the prac­ti­tion­ers who have fed people who are try­ing to starve them­selves to death,” Breas­seale said.

Though the De­clar­a­tion of Malta would have to be taken up by Con­gress, the DoD could make some of the struc­tur­al changes the as­so­ci­ation ex­ec­ut­ives called for at the con­fer­ence. The as­so­ci­ations want more trans­par­ency and ac­count­ab­il­ity of med­ic­al prac­tice in Guantanamo, but they also be­lieve the re­la­tion­ship between the mil­it­ary com­mand­er and the mil­it­ary phys­i­cian should not re­quire the doc­tor to put mil­it­ary goals ahead of pa­tient needs.

“The com­mand­er should no more be able to tell a doc­tor how to prac­tice medi­cine than he can tell a JAG [Judge Ad­voc­ate Gen­er­al] of­ficer how to prac­tice law,” said George An­nas, an eth­ics and health law pro­fess­or at Bo­ston Uni­versity in­volved in or­gan­iz­ing the con­fer­ence.

The as­so­ci­ations con­sidered such ideas as form­ing a med­ic­al eth­ics com­mit­tee to re­view phys­i­cians’ prac­tices in the mil­it­ary and set­ting up a hot­line for phys­i­cians to call if they are un­com­fort­able with or­ders and worry about risk­ing their prac­ti­cing li­cense.

“We have to ask the ques­tion of why did [the phys­i­cians] not protest?” said Vivi­enne Nath­an­son, dir­ect­or of pro­fes­sion­al activ­it­ies in the Brit­ish Med­ic­al As­so­ci­ation. “We have to make sure that they un­der­stand it is their role and duty to protest.”

Ac­cess to in­form­a­tion about mil­it­ary prac­tice in Guantanamo hinders the as­so­ci­ations’ case for re­form and their ef­forts to in­sti­tute re­view boards for the phys­i­cians in the field. But they plan to move for­ward in im­ple­ment­ing their re­com­mend­a­tions, put­ting pres­sure on Con­gress and the Pentagon to shift mil­it­ary policy to­ward what the as­so­ci­ations called an in­ter­na­tion­al con­sensus about the defin­i­tion of med­ic­al eth­ics.

“All it takes for the con­tinu­ation of evil is for us to do noth­ing,” said Steph­en Xena­kis, re­tired bri­gadier gen­er­al in the U.S. Army.

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