Although they are generally debated by historians in terms of their political implications, prison hunger strikes are undoubtedly a medical problem. Hunger strikes are essentially about the body, emotions and ethics. Since 1909, prison doctors have been required to treat starving prisoners, whether by using gastric tubes or by monitoring the health of starving prisoners. Many have been portrayed as aggressive individuals willing to work with government programs to crack down on recalcitrant politicized prisoners. But the reality is arguably more complex. Physicians such as Raymond Dowdall seem to have used the gastric tube with remarkable force; his attitude towards prisoners was influenced by the wider contexts of the Easter Rising and the Anglo-Irish conflict. But it is reasonable to assume that many doctors truly believed that they had a medical-ethical duty to save the lives of prisoners who might otherwise starve. Force-feeding was certainly an unpleasant task, but was it really less pleasant than watching bodies decompose and die? Others may have had mixed feelings; Personal considerations, such as avoiding lawsuits, undoubtedly influenced food decisions. Today, doctors who force-feed at Guantánamo are often accused of complicity with government plans related to the “war on terror.” But historical analysis shows a diversity of opinions and a desire for force-feeding. In public statements issued both during the initial release of the report and after, the U.S. government defended force-feeding as a humane and therefore legal alternative to allowing detainees to starve.
At the very least, there seems to be real disagreement about whether international law prohibits force-feeding prisoners on hunger strike. Force-feeding is the practice of feeding a human or animal against their will. The term force-feeding (UK: /ˈɡævɑːʒ, ɡæˈvɑːʒ/,[2][3] US: /ɡəˈvɑːʒ/,[3][4] French: [ɡavaʒ]) refers to the administration of a substance through a small plastic feeding tube that passes through the nose (nasogastric) or mouth (orogastric) into the stomach. Although the World Medical Association officially declared force-feeding unethical in 1975, the same questions resurfaced during the so-called “war on terror.” Guantánamo Bay is the latest place where governments decided to use the gastric tube to tackle the problem of hunger strikers in prisons. Many critics have rallied to denounce the resurgence of forced feeding, placing the practice within broader institutional issues, such as the loss of basic human rights and dignity. Given the extent of the pain and the possibility of death and irreversible physical damage resulting from force-feeding, the practice may amount to torture. Accordingly, the use of force-feeding against Palestinian hunger strikers constitutes a violation of the Geneva Conventions, in particular Article 32 of the Fourth Convention and Article 75(2)(a) of the First Additional Protocol to the Conventions. In the same context, force-feeding as an act of torture qualifies as a crime against humanity and a war crime within the meaning of articles 7 and 8 of the Rome Statute. On the other hand, the principles of medical ethics set forth in Principle No.
5 emphasize the obligation of doctors not to participate in the detention of detainees unless it is medically necessary and does not pose a danger to the physical and mental health of the detainee. Such a principle should not be considered separately from the criteria of “doctor” and “hospital” as contained in the recent amendment to the Prisons Act, as it removed the restriction of these procedures on medical institutions and State personnel. Thus, it has further complicated the link between human rights violations committed by the Israeli Ministry of Health. Moreover, this commitment is particularly important in the case of Palestinian hunger strikers. Previous force-feeding procedures to prevent the death of Palestinian hunger strikers have resulted in the deaths of four Palestinian prisoners, as already mentioned. The 1991 version of the Malta Declaration took all these factors into account, stressing in particular that doctors should ensure that each hunger striker fasts voluntarily and is not coerced by other prisoners or an outside party, including the family. However, Malta did not explicitly ban force-feeding, as force-feeding had not yet emerged as a major problem at the time. After an unfortunate accident in the Middle East in the early 1980s, which killed two prisoners who had been inadvertently introduced into liquid nutrients into the trachea instead of the esophagus, force-feeding had all but disappeared from the political scene. Resuscitation of a patient was considered, whereby the doctor could intervene and “artificially feed” a hunger striker who had fallen into a semi-comatose state [8] if the doctor was convinced that the hunger striker really did not want to die. In such a case, this would obviously constitute an “artificial” and not a “force-feeding”, since the active resistance of the hunger striker was excluded by his incompetence or unconscious. In the exercise of its judicial functions, the European Court of Human Rights (ECHR) has examined several cases involving prisoners on hunger strike. Some of these cases involved force-feeding to end hunger strikes.
Since force-feeding was not specifically addressed in international and regional instruments, the Court based its decisions on Article 3 of the European Convention on Human Rights, which prohibits the use of torture. Since 1909, force-feeding has proven ethically controversial. Discussions on the issue overlapped at various historical moments with broader conversations about prisoner welfare, medical ethics, human rights and civil liberties. These discussions were conducted in the context of historical contexts, including women`s suffrage, the Irish War of Independence, the Irish Civil War, the Cold War and the riots in Northern Ireland. Public opinion on force-feeding has been shaped by the needs of each of these particular contexts. But whatever the historical context, similar ethical debates have largely taken place. These focused on whether: If prisoners can successfully prove that the authorities are forcibly feeding them in retaliation for their protest, they may be able to win their right to freedom of expression.