Medical journal urges military physicians not to cooperate with Guantanamo force-feedings

A recent article in The New England Journal of Medicine urges military physicians at Guantanamo not to cooperate with the force-feeding of prisoners currently on a hunger strike.

Calling the military prison a "medical ethics-free zone," the authors of the article say they believe military doctors should "refuse to participate in any act that unambiguously violates medical ethics."

"Physicians at Guantanamo cannot permit the military to use them and their medical skills for military purposes and still comply with their ethical obligations. Force-feeding a competent person is not the practice of medicine; it is aggravated assault. Using a physician to assault prisoners no more changes the nature of the act than using physicians to 'monitor' torture makes torture a medical procedure. Military physicians are no more entitled to betray medical ethics than military lawyers are to betray the Constitution or military chaplains are to betray their religion," they write.

The prisoners' hunger strike has been going on at the military detention facility in Cuba for almost five months.  According to The Washington Post, more than 100 detainees are refusing food to protest their indefinite detention and the conditions of their confinement. Of these, the Post reports, 41 are subjected daily to force-feedings, a procedure that entails strapping a detainee to a chair, inserting a tube in his nose and flooding his stomach with liquid protein.

In April, President Barack Obama said he did not want any hunger-striker to die. In May, he promised to begin releasing the 86 men his interagency task force cleared to leave the prison in 2010. Weeks have passed, and no detainee has exited Guantanamo.

In fact, the situation there deteriorates. Shaker Aamer, a British resident twice cleared for release from Guantanamo, recently told the head of the British legal charity Reprieve that prison authorities are using increasingly brutal tactics in an attempt to break the strike, making the cells "freezing cold" and employing metal-tipped tubes that cause prisoners to vomit during the twice-daily force-feedings.

In the interview, excerpts of which were published in the The Guardian, Aamer also said nurses are discarding their name tags before entering the camp so prisoners cannot identify and file complaints against them.

The article in The New England Journal of Medicine denounced the co-opting of medical professionals for political purposes.

"It's hardly revolutionary to state that physicians should act only in the best interests of their patients," the authors wrote.

They pointed out that "hunger striking is a peaceful political activity to protest terms of detention or prison conditions" and is not a medical condition that warrants force-feeding to prevent self-harm or save lives, as Guantanamo officials claim.

"Unlike individual medical and psychiatric assessments made in the context of doctor patient-relationship, the decision to force-feed prisoners is made by the base commander," they wrote. "It is a penological decision about how best to run the prison. Physicians who participate in this nonmedical process become weapons for maintaining prison order."

When informed of brutality, a common response for many of us is to abrogate responsibility. The violence is too remote, too complex to tackle. We forget that even the most egregious and seemingly impenetrable system of cruelty is the work of human hands. Let's hope some of the medical hands sustaining operations at Guantanamo read this article and heed its call not to cooperate.

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