Force Feeding

‫פרופ' מיכאל גרוס‬
‫ראש בית הספר למדעי המדינה‪ ,‬אוניברסיטת חיפה‬

“Forcible feeding is never ethically
acceptable. Feeding accompanied by
force or use of physical restraints is a
form of inhuman and degrading
treatment.”
 “The ICRC is opposed to forced
feeding or forced treatment; it is
essential that the detainees' choices
be respected and their human dignity
preserved.”
 http://www.icrc.org/eng/resources/documents/faq/hunger-strike-icrcposition.htm 31.1.13
Sanctity of life
Custodial Responsibility toward Inmates
Security Interests
Limited Medical Rights of Combatants
1.
2.
3.
4.
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Treatment according to need: Battlefield Triage
Right to Refuse Treatment
Confidentiality
Truth telling
Placebos for Malingers
MILITARY MEDICAL
ETHICS
Textbooks of Military Medicine
US Department of the Army
2004
July 8 2013 - ?
Permissible to feed if…
1. a hunger striker is at risk of near-term death
or great bodily injury
2. OR has become incompetent to give consent
3. AND has not previously executed a valid
“DNR” order or the DNR order was the result
of coercion.
Plata v Brown, US District Ct, 19-Aug-13
“Governor Jerry Brown is preparing
to force-feed scores of inmates…”
The Nation, 27-8-13
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Dr. Steven Tharratt, (director of medical
services) said “if the state employs forcefeeding, it's most likely to be done by
pumping nutrient-enriched fluids into the
bloodstreams of unconscious inmates.”
"It's not really a forced re-feeding at that
point," Tharratt said. "It doesn't evoke images
of Guantanamo Bay or anything like that. It's
actually a totally different setting."
Our most significant finding was that the effect of
hunger was more prominent on the central nervous
system than on the neuromuscular system, despite
the fact that all patients were taking thiamine. In
our opinion, partial recovery of neurological, and
neurocognitive signs in prolonged hunger could be a
result of permanent neurological injury.
Neurological complications of prolonged hunger strike
Başoğlu, M., Yetimalar, Y., Gürgör, N., Büyükçatalbaş, S., Kurt, T., Seçil, Y., & Yeniocak, A. (2006)..
European journal of neurology, 13(10), 1089-1097.
Persons taking no active part in the hostilities, shall in all
circumstances be treated humanely,
To this end, the following acts are and shall remain
prohibited:
1. violence to life and person, in particular murder of all
kinds, mutilation, cruel treatment and torture;
2. outrages upon personal dignity, in particular
humiliating and degrading treatment;

Forcible feeding is never ethically acceptable.
Feeding accompanied by force or use of
physical restraints is a form of inhuman and
degrading treatment

Artificial feeding can be ethically appropriate if competent
hunger strikers agree to it. It can also be acceptable if
incompetent individuals have left no unpressured advance
instructions refusing it.

The ICRC is opposed to forced feeding or
forced treatment; it is essential that the
detainees' choices be respected and their
human dignity preserved. The ICRC's position
on this issue closely corresponds to that
expressed by the World Medical Association.

"Where a prisoner refuses nourishment and is considered by
the physician as capable of forming an unimpaired and
rational judgment …, he or she shall not be fed artificially.
The decision as to the capacity of the prisoner to form such a
judgment should be confirmed by at least one other
independent physician."
 http://www.icrc.org/eng/resources/documents/faq/hunger-strike-icrc-position.htm 31.1.13
“Governor Jerry Brown is preparing
to force-feed scores of inmates…”
The Nation, 27-8-13
“As the hunger strike against solitary confinement
in California prisons enters a critical sixth week,
Governor Jerry Brown is preparing to force-feed
scores of inmates rather than meet any of their
demands for improved conditions.”