Physicians speak out on prisoner force-feeding

Doctor participation in the practice is wrong, say the AMA and other physician groups. The Defense Dept. says it is saving lives.

By Kevin B. O'Reilly, AMNews staff. April 3, 2006.

Reports in February that military doctors have force-fed hunger-striking detainees at Guantanamo Bay prompted the AMA and other physician groups to condemn physician participation in a practice they said violates a competent patient's right to refuse medical treatment. Military officials said the practice was humane and intended only to safeguard the life and health of detainees.

In August 2005, 75 of the nearly 500 detainees went on a hunger strike, said a Guantanamo Bay spokesman. That figure jumped to a high of 131 around the anniversary of the 9/11 terrorist attacks. By press time, that number had shrunk to six, as officials concerned that detainees might starve themselves resorted to restraining detainees to prevent them from resisting the administration of artificial nutrition.

In an editorial distributed to various news outlets, Duane M. Cady, MD, chair of the AMA's Board of Trustees, wrote that the AMA endorses the World Medical Assn.'s Declaration of Tokyo guidelines for physicians concerning the humane treatment of prisoners. Dr. Cady wrote that the declaration states that " 'Where a prisoner refuses nourishment and is considered by the physician as capable of forming an unimpaired and rational judgment concerning the consequences of such a voluntary refusal of nourishment, he or she shall not be fed artificially.' "

The AMA has met with the Dept. of Defense over the past year "to voice our concerns, provide them with relevant policies and offer our expertise with the goal of ensuring that U.S. policies on detainee treatment comport with ethical standards of medicine. ... Our physician colleagues in the military, many of whom are placed in difficult, sometimes dangerous situations, deserve nothing less," Dr. Cady wrote.