Hunger striking prisoners: the doctors' dilemma

News of further hunger strikes and force feeding at Camp X-Ray, the temporary US detention centre at Guantanamo Bay, Cuba, again brings into sharp relief the ethical debate on the position of doctors in a hunger strike by prisoners. A series of hunger strikes has occurred at the camp since it was opened, but they have gone largely unnoticed. What little coverage the media have given them seems to accept without question the right of prison authorities to force feed hunger striking prisoners against their will.

The World Medical Association, in its 1975 Declaration of Tokyo and again in the 1991 Declaration of Malta, prohibits the use of force feeding of hunger strikers. Details at Guantanamo Bay are predictably sketchy, but prison authorities seem to justify force feeding on the basis of preventing suicide. Any justification that is based on an assumption that a hunger strike is a form of prolonged suicide has been almost universally rejected. The aim of suicide is death. Hunger strikers do not …