There are good reasons that international standards of medical ethics disavow force-feeding. As such, news this week that the US military allegedly manipulated data about how many Guantanamo Bay detainees were punishingly force fed during their widespread and ongoing hunger strike is especially troubling.
The fact of force feeding a hunger striker at all is barbarism enough. The Guardian reported on the claims of manipulated force-feeding data, noting that detainees believe that the US military is purposefully trying to underplay the strength of the hunger strike, while avoiding international censure over force-feeding practices:
Letters from a Yemeni detainee, Emad Hassan, and a Saudi former resident of the UK, Shaker Aamer, describe a core of “around 17” hunger strikers, down from a peak of 106 last spring. But the letters allege that the number is kept artificially low by a “new strategy” of only force-feeding detainees when their weight reaches dangerous levels, which the US military denied.
Testaments from force-fed Guantanamo Bay detainees attest to the pain of unwillingly having a two foot-long plastic tube snaked through one's nostril to one's stomach. Their claims have been backed up by medical professionals. Infectious disease specialist Kent Septowitz wrote in The Daily Beast:
Without question, it is the most painful procedure doctors routinely inflict on conscious patients. The nose—as anyone knows who ever has received a stinger from an errant baseball — has countless pain fibers. Some patients may scream and gasp as the tube is introduced; the tear ducts well up and overflow; the urge to sneeze or cough or vomit is often uncontrollable. A paper cup of water with a bent straw is placed before the frantic and miserable patient and all present implore him to sip! sip! in hopes of facilitating tube passage past the glottis and into the esophagus and stomach. The procedure is, in a word, barbaric.
The ethics surrounding force-feeding of hunger strikers concern much more than whether the procedure is itself torturous. Indeed, in many circumstances, the pain of force-feeding is preferable for patients with conditions preventing them from eating, but who still wish to survive and receive nutrients.
Force-feeding hunger strikers, however, delivers a clear cruel message. Reduced as they have been to a state of bare life at Gitmo, indefinitely held without charge for over a decade, striking prisoners are denied even the most basic autonomy over their own bodies.
The World Medical Association recognized the ethical abrogation therein, stating in 2006, "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 a voluntary refusal of nourishment, he or she shall not be fed artificially."
Traditionally, sovereign power was that which could take away life. The sovereign was that entity with sanctified determinations over who could be killed. Sovereignty, as philosopher Michel Foucault traced, has shifted in its form and application. The management over lives (bio power), and not just rulings over death, has for some time become the new operation of government and expression, over and through bodies, of political power. We see it at its starkest with the force-feeding of prisoners, and in the fact of the existence of prisons at all, in many ways: Lives are viscously managed with bars, constraints, and plastic feeding tubes.
The latest letters from remaining core Gitmo hunger strikers — reportedly around 17 inmates — reveal how inmate’s bodies are the site of violent medical calculations. A letter from Hassan claimed that if a hunger striker declines what the military describes as an enteral feeding — that tube fed into a detainee’s stomach through the nose — the detainee will not be forcibly fed “until it’s a critical situation” — meaning the detainee’s weight has dropped substantially.
Such an approach enables the military to manipulate data about how many inmates are being force-fed at a given time, as strikers are moved back and forth from force-feeding schedules. The claim from detainees is, at base, that the US military is force-feeding hunger strikers to maximize punishment and minimize accountability.
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