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Israeli doctors are given conflicting advice on treating hunger strikers

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1400 (Published 01 March 2013) Cite this as: BMJ 2013;346:f1400
  1. Judy Siegel-Itzkovich
  1. 1Jerusalem

Israel’s health ministry and the association that represents the country’s doctors have issued contradictory statements on whether prisoners who go on hunger strike should be hospitalised by force.

The ethics bureau of the Israel Medical Association declared that people who have been arrested or imprisoned and are holding a hunger strike—and able to voice their preferences—should not be hospitalised against their will. It also said that hunger strikers should not be tied up as a routine matter or forced to receive medical treatment against their will if they understood the implications of refusing care.

The position paper was signed by the head of the ethics bureau, Avinoam Reches, and the association’s chairman, Leonid Eidelman. It was issued in response to a statement by Israel’s health ministry that it would allow forced treatment of prisoners who were on hunger strike.

The head of the ministry’s general medicine division, Michael Dor, issued a new regulation allowing the authorities “in unusual cases” to force hunger strikers to receive medical care against their will after the 28th day of their refusal to eat solid foods. Dor, who sent the regulation to directors of all Israeli hospitals, said that even those fasting for less than 28 days may be hospitalised if a hunger strike endangered their lives.

In February Arafat Jaradat, a 30 year old Palestinian accused of injuring an Israeli by throwing a rock at him, was arrested and held at Megiddo Prison near Haifa. A few days later he was found dead in his cell. The Israeli authorities said that he seemed to have died of cardiac arrest, but Palestinians maintained that he had been “tortured.” The case triggered a few days of rioting by Palestinians in the West Bank, and a number of prisoners went on hunger strike, which they ended a few days later.

The Israeli authorities scheduled an autopsy by the country’s leading pathologist, with a leading Palestinian pathologist and the head of the health ministry’s medical branch as observers. In a preliminary report the health ministry said that Jaradat’s body showed signs of physical trauma “caused by unsuccessful resuscitation efforts” but that the cause of death could not be determined until laboratory tests were completed. Israel’s public security minister said that he was considering the possibility of adding foreign observers to the investigation of the prisoner’s death, which he insisted was not the result of torture.

Dozens of doctors work for the Israel Prison Service, but the health ministry said that at this stage it was not contemplating the possibility of forcing them to treat hunger strikers who did not want treatment.

Notes

Cite this as: BMJ 2013;346:f1400