By Dr Cesar Chelala
The decision by US District Court Judge Gladys Kessler determining that the US military can force-feed a Syrian detainee at the US prison at Guantanamo Bay, Cuba, is a well intentioned but wrong decision. It allows the US government to continue a criminal practice that has been widely condemned by medical professionals and human rights activists worldwide.
Judge Kessler said that she was faced with an “anguishing” choice: to issue another restraining order that would prevent the military from force-feeding Abu Wa’el Dhiab, a Syrian national, “despite the very real probability” that he would die as a result, or to refuse to extend the order “at the possible cost of great pain and suffering” to the prisoner.
Force-feeding is the practice of feeding a person against their consent. It involves placing the prisoner in a restraining chair, inserting a tube through his nose and down his throat, and pumping a nutritional drink into his stomach. This brief description doesn’t convey the pain and the serious health risks that this practice entails.
In 1914, Emmeline Pankhurst, founder of the Women’s Social and Political Union in the UK, was appalled by the screams of women being forced-fed in HM Prison Holloway during hunger strikes in which she participated. In her autobiography, she wrote: “Holloway became a place of horror and torment. Sickening scenes of violence took place almost every hour of the day, as doctors went from cell to cell performing their hideous office… I shall never while I live forget the suffering I experienced during the days when those cries were ringing in my ears.”
Force-feeding prisoners has been prohibited since 1975 by the Declaration of Tokyo of the World Medical Association. In its guidelines for physicians the declaration states: “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 voluntary refusal or nourishment, he or she shall not be fed artificially.” The UN Human Rights Commission said it regards force-feeding at Guantanamo as a form of torture. The US has repeatedly denied that charge.
Under US jurisdiction, force-feeding is frequently used in the military prison in Guantanamo Bay. In 2004, Muslim prisoners in Abu Ghraib prison described in sworn statements that they were forced to eat pork and drink alcohol, both of which are strictly prohibited in Islam. In other cases, prisoners described being fed from toilets.
In March 2006, 250 doctors wrote an open letter in The Lancet warning that, in their opinion, the participation of any doctor in force-feeding practice is contrary to the rules of the World Medical Association. “We urge the US government to ensure that detainees are assessed by independent physicians and that techniques such as force-feeding and restraint chairs are abandoned,” said the doctors in the letter. The US military started using restraint chairs for feeding hunger-striking prisoners in 2005 to prevent them from vomiting as a result of forced nutrition.
In her ruling Judge Kessler also stated that the US government must release to Dhiab’s lawyers videos of the detainee being removed from his cell and forced-fed. This will be the first time that individuals not affiliated with the US government will see the videos.
Currently, there are 154 detainees at Guantanamo, down from a peak figure of almost 800. It is not known precisely how many among those staging a hunger strike have been videotaped while being forcibly fed or removed from their cells for force-feedings. Release of the videos will probably show the brutality of the practice and be embarrassing for the government.
What makes Dhiab’s case particularly worrisome from the legal point of view is that he was arrested in Pakistan in 2002, and has since been detained without any charges filed against him. Although he was cleared for transfer by the Obama administration in 2009, the government has been unable to repatriate him because of conditions in his home country. Judge Kessler’s decision doesn’t address the root of the problem facing many prisoners at Guantanamo: they have been kept in prison for many years without any charges against them, a situation that contravenes basic legal procedures and principles.
Dhiab is only one among many Guantanamo prisoners who have staged hunger strikes to protest the conditions of their prolonged detention. Although Judge Kessler’s decision to allow the military to continue force-feeding him against his will is based on her humanitarian concern, it is not justified from the medical and the prisoner’s human rights point of view. US government officials have repeatedly stated that the government doesn’t conduct torture on prisoners. Force-feeding prisoners is a barbaric practice that does a disservice to the democratic principles the government insists it respects.
Dr Cesar Chelala is an international public health consultant and a co-winner of an Overseas Press Club of America award.
