Physicians’ ethical obligations to hunger strikers

Hunger strikes have been a fact of life at the US Naval Base at Guantanamo Bay, Cuba almost from the moment the first detainees of the “war on terror” arrived at the facility in January 2002. In the decade and more since, detainees have used refusal of food to protest inhumane conditions, religious abuses, and indefinite detention without legal process.1 Over time, military personnel have reportedly used a variety of tactics to try to dissuade hunger strikes,2 up to and including the use of restraint and forced feeding.3 4

The International Committee of the Red Cross (ICRC) defines a hunger strike as voluntary fasting pursued for a specific purpose.5 A hunger striker is willing to die to achieve a political goal, but does not seek death.

The ICRC observes that “Fasting prisoners who are mentally ill or otherwise incapable of unimpaired rational judgment and decision-making cannot be considered real …