As Hunger Strike Grows, Guantánamo Adds Medical Staff - New York Times
WASHINGTON — “Medical reinforcements” of nearly 40 Navy nurses, corpsmen and specialists have arrived at the military prison at Guantánamo Bay, Cuba, to help carry out the force-feedings of inmates there who are on a hunger strike.
As of Tuesday morning, 100 of the 166 prisoners at Guantánamo were officially deemed by the military to be participating, with 21 “approved” to be fed the nutritional supplement Ensure through tubes inserted through their noses. In a statement released earlier, a military spokesman said the deployment of additional medical personnel had been planned several weeks ago as more detainees joined the strike.
“We will not allow a detainee to starve themselves to death, and we will continue to treat each person humanely,” said Lt. Col. Samuel House, the prison spokesman.
The military’s response to the hunger strike has revived complaints by medical ethics groups that contend that doctors — and nurses under their direction — should not force-feed prisoners who are mentally competent to decide not to eat.
Last week, the president of the American Medical Association, Dr. Jeremy A. Lazarus, wrote a letter to Defense Secretary Chuck Hagel saying that any doctor who participated in forcing a prisoner to eat against his will was violating “core ethical values of the medical profession.”
“Every competent patient has the right to refuse medical intervention, including life-sustaining interventions,” Dr. Lazarus wrote.
He also noted that the A.M.A. endorses the World Medical Association’s Tokyo Declaration, a 1975 statement forbidding doctors to use their medical knowledge to facilitate torture. It says that if a prisoner makes “an unimpaired and rational judgment” to refuse nourishment, “he or she shall not be fed artificially.”
The military’s policy, however, is that it can and should preserve the life of a detainee by forcing him to eat if necessary.
“In the case of a hunger strike, attempted suicide or other attempted serious self-harm, medical treatment or intervention may be directed without the consent of the detainee to prevent death or serious harm,” a military policy directive says. “Such action must be based on a medical determination that immediate treatment or intervention is necessary to prevent death or serious harm and, in addition, must be approved by the commanding officer of the detention facility or other designated senior officer responsible for detainee operations.”
On Monday, Colonel House also said that some detainees on the “enteral feeding” list were drinking the supplement.
“Just because the detainees are approved for enteral feeding does not mean they don’t eat a regular meal,” he said. “Once the detainees leave their cell and are in the presence of medical personnel, most of the detainees who are approved for tube feeding will eat or drink without the peer pressure from inside the cellblock.”
Medical ethicists and the Pentagon also clashed during the Bush administration over hunger strikes at Guantánamo.
The current protest began in February and escalated after a raid this month in which guards confined protesting detainees to their cells. The impetus for it is disputed. The prisoners, through their lawyers, cite a search for contraband on Feb. 6, during which they say Korans were handled in a way they found offensive. The military says the Koran search followed routine procedures.
But both sides agree that the root cause is frustration over the collapse of President Obama’s effort to close the prison, which drew Congressional resistance, and the fact that no prisoners have been transferred because of restrictions on where they can be sent.
Ramzi Kassem, a City University of New York law professor who represents several detainees, said he had talked to a Yemeni client, Moath Hamza Ahmed al-Alwi, who said a guard had shot him with rubber-coated pellets at close range during the raid. Since then, Mr. Kassem was told, the prisoners have been denied soap, toothbrushes, toothpaste and their legal papers.
Mr. Alwi said he had not eaten in 80 days and stopped drinking after the raid, Mr. Kassem said. He also said he was being force-fed twice a day after being tied to a restraint chair.
Mr. Kassem also quoted Mr. Alwi as saying: “I do not want to kill myself. My religion prohibits suicide. But I will not eat or drink until I die, if necessary, to protest the injustice of this place. We want to get out of this place. It is as though this government wishes to smother us in this injustice, to kill us slowly here, indirectly, without trying us or executing us.”
In his statement on Monday, Colonel House said the prisoners would not be allowed to die.
“Detainees have the right to peacefully protest, but we have the responsibility to ensure that they conduct their protest safely and humanely,” he said. “Detainees are given a choice: eat the hot meal, drink the supplement or be enteral fed.”
WASHINGTON — “Medical reinforcements” of nearly 40 Navy nurses, corpsmen and specialists have arrived at the military prison at Guantánamo Bay, Cuba, to help carry out the force-feedings of inmates there who are on a hunger strike.
As of Tuesday morning, 100 of the 166 prisoners at Guantánamo were officially deemed by the military to be participating, with 21 “approved” to be fed the nutritional supplement Ensure through tubes inserted through their noses. In a statement released earlier, a military spokesman said the deployment of additional medical personnel had been planned several weeks ago as more detainees joined the strike.
“We will not allow a detainee to starve themselves to death, and we will continue to treat each person humanely,” said Lt. Col. Samuel House, the prison spokesman.
The military’s response to the hunger strike has revived complaints by medical ethics groups that contend that doctors — and nurses under their direction — should not force-feed prisoners who are mentally competent to decide not to eat.
Last week, the president of the American Medical Association, Dr. Jeremy A. Lazarus, wrote a letter to Defense Secretary Chuck Hagel saying that any doctor who participated in forcing a prisoner to eat against his will was violating “core ethical values of the medical profession.”
“Every competent patient has the right to refuse medical intervention, including life-sustaining interventions,” Dr. Lazarus wrote.
He also noted that the A.M.A. endorses the World Medical Association’s Tokyo Declaration, a 1975 statement forbidding doctors to use their medical knowledge to facilitate torture. It says that if a prisoner makes “an unimpaired and rational judgment” to refuse nourishment, “he or she shall not be fed artificially.”
The military’s policy, however, is that it can and should preserve the life of a detainee by forcing him to eat if necessary.
“In the case of a hunger strike, attempted suicide or other attempted serious self-harm, medical treatment or intervention may be directed without the consent of the detainee to prevent death or serious harm,” a military policy directive says. “Such action must be based on a medical determination that immediate treatment or intervention is necessary to prevent death or serious harm and, in addition, must be approved by the commanding officer of the detention facility or other designated senior officer responsible for detainee operations.”
On Monday, Colonel House also said that some detainees on the “enteral feeding” list were drinking the supplement.
“Just because the detainees are approved for enteral feeding does not mean they don’t eat a regular meal,” he said. “Once the detainees leave their cell and are in the presence of medical personnel, most of the detainees who are approved for tube feeding will eat or drink without the peer pressure from inside the cellblock.”
Medical ethicists and the Pentagon also clashed during the Bush administration over hunger strikes at Guantánamo.
The current protest began in February and escalated after a raid this month in which guards confined protesting detainees to their cells. The impetus for it is disputed. The prisoners, through their lawyers, cite a search for contraband on Feb. 6, during which they say Korans were handled in a way they found offensive. The military says the Koran search followed routine procedures.
But both sides agree that the root cause is frustration over the collapse of President Obama’s effort to close the prison, which drew Congressional resistance, and the fact that no prisoners have been transferred because of restrictions on where they can be sent.
Ramzi Kassem, a City University of New York law professor who represents several detainees, said he had talked to a Yemeni client, Moath Hamza Ahmed al-Alwi, who said a guard had shot him with rubber-coated pellets at close range during the raid. Since then, Mr. Kassem was told, the prisoners have been denied soap, toothbrushes, toothpaste and their legal papers.
Mr. Alwi said he had not eaten in 80 days and stopped drinking after the raid, Mr. Kassem said. He also said he was being force-fed twice a day after being tied to a restraint chair.
Mr. Kassem also quoted Mr. Alwi as saying: “I do not want to kill myself. My religion prohibits suicide. But I will not eat or drink until I die, if necessary, to protest the injustice of this place. We want to get out of this place. It is as though this government wishes to smother us in this injustice, to kill us slowly here, indirectly, without trying us or executing us.”
In his statement on Monday, Colonel House said the prisoners would not be allowed to die.
“Detainees have the right to peacefully protest, but we have the responsibility to ensure that they conduct their protest safely and humanely,” he said. “Detainees are given a choice: eat the hot meal, drink the supplement or be enteral fed.”