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Forcefeeding and restraint of Guantanamo Bay hunger strikers
By David J Nicholl, Holly G. Atkinson, John Kalk, William
Hopkins, Elwyn Elias, AdnanSiddiqui, Ronald E. Cranford and
Oliver Sacks on behalf of 255 other doctors
03/10/06 "The
Lancet" -- -- We write regarding the forcefeeding and
restraint of Guantanamo Bay detainees currently on hunger strike.1,2
The World Medical Association specifically prohibits forcefeeding in
the Declarations of Tokyo and Malta, to which the American Medical
Association is a signatory.
Fundamental to doctors' responsibilities in attending a hunger
striker is the recognition that prisoners have a right to refuse
treatment. The UK government has respected this right even under
very difficult circumstances and allowed Irish hunger strikers to
die. Physicians do not have to agree with the prisoner, but they
must respect their informed decision. Those breaching such
guidelines should be held to account by their professional bodies.
John Edmondson (former commander of the hospital at Guantanamo)
instigated this practice, and we have seen no evidence that
procedures have changed under the current physician in charge,
Ronald Sollock.3
Edmondson, in a signed affidavit, stated that ?the involuntary
feeding was authorized through a lawful order of a higher military
authority.?4 This defence, which has previously been described as
the Nuremberg defence,5 is not defensible in law. In a reply to an
earlier draft of this letter, Edmondson said that he was not
forcefeeding but ?providing nutritional supplementation on a
voluntary basis to detainees who wish to protest their confinement
by not taking oral nourishment?.
Recently, it was confirmed that health-care staff are screened to
ensure that they agree with the policy of forcefeeding before
working in Guantanamo Bay.1 On his departure, Edmondson was awarded
a medal for his ?inspiring leadership and exemplary performance
[which] significantly improved the quality of health care for
residents of Guantanamo Bay? and ?scored an unprecedented 100% on
both the Hospital and the Home Health surveys.?3 The New York Times,
however, reports that hunger striking detainees are strapped into
restraint chairs in uncomfortably cold isolation cells to force them
off their hunger strike.2
We urge the US government to ensure that detainees are assessed by
independent physicians and that techniques such as forcefeeding and
restraint chairs are abandoned forthwith in accordance with
internationally agreed standards.
We declare that we have no conflict of interest.
David J Nicholl, Holly G. Atkinson, John Kalk, William Hopkins,
Elwyn Elias, AdnanSiddiqui, Ronald E. Cranford and ? Oliver Sacks on
behalf of 255 other doctors
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