The Ethical Application of Force-Feeding: a Closer Look at Medical Policy Involving the Treatment of Hunger-Striking POWs and Detainees

Abstract

Hunger strikes are used as a method of protest to call attention to grievances or political positions and galvanize support for a cause. Historical examples from pre-Christian Europe through Guantanamo Bay have demonstrated various motives, interventions, and outcomes to this unique form of protest. Starvation causes life-threatening damage to the body, and to intervene on an unwilling subject involves invasive medical procedures. As scholars have debated how to approach this medical-ethical dilemma, a tug-of-war exists between autonomy, beneficence, and social justice with regard to the rights of prisoners of war (POWs) and detainees. International documents, legislation, and case law demonstrate vast support for and place precedence on the prisoners right to make their own autonomous, informed medical decisions, and many in the international community lean towards abstaining from intervention on hunger strikes on the basis of patient autonomy. However, there are notable arguments both for and against force-feeding that have been well documented. Despite the vast international dialogue, there is a key component that seems to have been forgotten—the environment within which the prisoner or detainee resides is immersed with coercive and manipulative activity and interrogation on a regular basis. This environment may impede the ability for the POW or detainee to make an autonomous decision and then leads to the refusal of life-saving, medical intervention on the basis of a decision that is markedly coerced or manipulated. It is therefore noted that a different lens must be used to analyze hunger strike situations for this specific population.