June 20, 2013

Force-feeding people during a voluntary hunger strike is considered an abuse of the Hippocratic Oath, and medical personnel at Gitmo should not follow orders that violate their ethical principles, psychiatrist Terry Kupers told RT.

If the hunger strike continues in Guantanamo, inmates will most likely face irreversible organ damage and eventually death, Terry Kupers, psychiatrist and consultant for Human Rights Watch says. But force-feeding the prisoners also contradicts medical ethics and this aggravated assault alongside other abuses, psychiatrist argues, will result in “permanent psychological damage.” 
Over 150 medical professionals have signed an open letter calling on US President Barack Obama to allow prisoners at the Guantanamo Bay detention center to receive independent medical care. 
RT: How likely is it that there will be a response to the doctors' petition and that they will actually be allowed to examine Guantanamo detainees? 
Terry Kupers: I’m pessimistic that they will be allowed in. If they are allowed in, they will act in an ethical fashion and the situation of the prisoners will improve greatly. 
RT: If the doctors receive the green light, will anything change in the way detainees are treated? 
TC: There are these clear ethical standards in medicine and first is – due no harm. That is the first principle of the Hippocratic Oath. To force-feed people during a voluntary hunger strike is considered an abuse of that ethical standard. 

In this photo reviewed by US military officials, detainees using towels as head dress are seen inside Camp VI as they gather at a cart rolled into the communal area with their noon meal inside the US Detention Center in Guantanamo Bay, Cuba, March 30, 2010. (AFP Photo / Paul J. Richards)

In the New England journal of medicine an article recently doctors called it ‘aggravated assault’, and I agree. Doctors should not be following orders from commanders to do things that violate their ethical principles. Rather they should be taking care of their patient. If their patient, with informed consent decides as an expression of free speech to stop eating then the doctor’s job is to offer the best education to that patient about potential bodily harm and also to provide care when necessary.
RT: The Chair of the US Senate Intelligence Committee has joined the line of Human rights groups and the UN in calling for an end to force feeding detainees as a method to keep hunger strikers alive. How will this affect the current situation? 
TC: The important point to notice is that there is public recognition of what is going on. As happened when the torture that occurred in Abu Ghraib prison was exposed. The military of the United States operates in secret and does not want the world to know what is going on. 

The public attention there is for the actual practice; the more it is called into question. Doctors need to be at the forefront and the entire medical profession needs to step into this. The World Medical Association has provided a statement that is very strong- this is unethical to participate in force-feeding of people on a voluntary hunger strike and all physicians should join that call. 
RT: Significant damage is done to the human brain and body after 90 days of starvation. Could the hunger strikers' health be dire after over 4 months of starvation? 
TC: It is potentially lethal for sure and after a month or two there is deterioration of organs. For different people, it means different organs and different rate of deterioration.  But yes, in the length of time these individuals have been on a hunger strike that is something one might expect to see, and that is a great tragedy. 
RT: Could you explain some of the effects on their long-term mental health if the prisoners are to continue their protest? 
TC: As I read more and more about what is going on, it has been secret mostly, so we’re only recently hearing much about what is going on. The force-feeding is an entirely toxic situation where the individual is tied/strapped to a restraint chair. The tube is forced down their throat. They tend to vomit in that situation when food is forced into their body. They are being involuntarily medicated with medications that have very dangerous side effects. 

A Guantanamo detainee runs inside an exercise area at the detention facility at Guantanamo Bay US Naval Base, Cuba.(AFP Photo / Michelle Shephard)

All of this abuses medical ethics and doctors should not participate; the US military should not be doing it. One of the purposes of torture is to cause permanent damage. So again reference to Abu Ghraib, the humiliation of prisoners, stripping them naked, putting them on top of each other, mocking their genitals, mocking their religious belief – that is purposely meant to cause permanent damage, for instance in their intimate life, in their religious life. 
Well the same thing is true for the hunger strike. For instance, there are also at the same time extremely invasive searches going on of the genitals, of the anus and the searches of the Korans of the prisoners who are Muslims. And this has very serious implications in terms of their integrity as human beings with the capacity for intimacy, as a religious being and certainly there will be permanent psychological damage from that type of severe trauma. 

http://rt.com/op-edge/gitmo-force-feeding-medical-ethics-969/