PHR Library

March 10, 2006

FOR IMMEDIATE RELEASE

Over 250 Medical Leaders Condemn Brutal Force-Feeding Methods at Guantánamo

Physicians for Human Rights calls for an end to cruel, inhuman and degrading tactics designed to break detainees' hunger strike.

Physicians for Human Rights (PHR) today endorsed the statement of over 250 medical leaders calling on US authorities to cease brutal and inhumane force-feeding tactics against hunger striking detainees at Guantánamo Bay, Cuba. In a letter published in the March 11 issue of the British medical journal, The Lancet, the medical leaders condemn the practice of force-feeding detainees "strapped into restraint chairs in uncomfortably cold isolation cells to force them off their hunger strike."

Attorneys for Guantánamo detainees have reported extreme suffering among their clients as a result of painful force-feeding methods via nasal tubes and prolonged shackling in the restraint chairs. US military officials have acknowledged the use of such aggressive tactics in order to break hunger strikes at the detention facility.

"The Lancet letter reflects an emphatic response by the international medical community against this abusive treatment," said PHR President Holly G. Atkinson, MD, one of the lead signers of the letter. "The infliction of pain and suffering to discourage a hunger strike violates US law and basic principles of human rights." The letter is signed by distinguished medical figures from the United States, the United Kingdom, Ireland, Germany, the Netherlands, Italy, and Australia.

The letter also says that the participation of physicians in force-feeding is unethical. "Physicians and other health personnel never should be used as instruments of the government to exert control over detainees through such infliction of pain and suffering," said Dr. Atkinson.

In a letter to one of the Lancet letter signers, Dr. David Nicholl, the former commander of the hospital at Guantánamo, Dr. John Edmondson, said with regard to the force-feeding that he was "justifying [his] actions by deferring to a higher military authority" and not force-feeding but "providing nutritional supplementation on a voluntary basis to detainees who wish to protest their confinement by not taking oral nourishment."

International medical ethics, endorsed by the World Medical Association and the American Medical Association (AMA), require physicians to respect the autonomy of a prisoner or detainee who makes an unimpaired decision to refuse nourishment after being fully informed of the consequences of that decision in consultation with a physician, allowing for adequate and independent medical evaluation and advice. This ethical standard presumes the existence of a confidential and trusting relationship between the health professional and the patient, a relationship made virtually impossible by the history and circumstances of Guantánamo, where detainees have long been subjected to abusive conditions, ill-treatment, indefinite detention, and denial of access to an independent physician and due process.

PHR renews its call on the US government to:

• Permit an independent delegation of qualified physicians to investigate the conditions and circumstances of the hunger strikers in order to help attending military physicians clarify and fulfill their ethical duties to patients who refuse nourishment;
• Assure that any intervention with regard to hunger strikers is consistent with international standards of medical ethics, as endorsed by the AMA, and that no health personnel are compelled to engage in force-feeding. It is imperative that physicians should be allowed to meet privately and confidentially with prisoners to assess the voluntary nature of their strike, as well as to ascertain how and when they have been artificially or force-fed; and
• Take immediate steps to remedy the conditions of confinement that may lead to an informed, unimpaired decision to refuse nourishment, including assurance of due process, prompt release of detainees determined through that process to be inappropriately detained, and humane treatment in accordance with the Geneva Conventions and other US and international law and principles.

For commentary from UK physicians, including Dr. David Nicholl, contact: Neil Durkin, Amnesty International UK media unit: 020 7033 1547/ outside office hours: 07721 398984, www.amnesty.org.uk.

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Physicians for Human Rights (PHR) mobilizes the health professions to advance the health and dignity of all people by protecting human rights. As a founding member of the International Campaign to Ban Landmines, PHR shared the 1997 Nobel Peace Prize.