Wednesday, July 23, 2014


"Refusing to force-feed us was a historical act and a strong statement.
We were all amazed."

I would like to take a moment to thank an unknmown US Navy  nurse for risking much and taking a stand for humanity.  I am a week late, but better late then never.

The nurse has refused to participate in the force feeding of hunger striking inmates at the gulag known as Guantanamo.

Attorney Cori Crider wrote in the Guardian last Friday that she

...was on the phone with my client, Abu Wa’el Dhiab – a detainee of the US government at Guantánamo Bay who has been cleared of any involvement in terrorism – discussing our litigation and whether he had reason to believe he might one day be released. He has been on a hunger strike for over a year and is fighting in court to stop the government from abusively force-feeding him, so he was listless, as is typical. But then he perked up. "I have great news", he said. "Someone at Guantánamo has made a historic stand."

One Navy nurse at Guantánamo had refused to force-feed detainees anymore and declared the practice unethical: I have come to the decision that I refuse to participate in this criminal act, Dhiab told me the nurse said.

The nurse, Dhiab tells me, is the first staffer at Guantánamo to choose medical ethics over military logic. Like all staff assigned to force-feed detainees, this Navy nurse was initially a volunteer. But when he arrived on base this spring, he told Dhiab, he encountered something different from what he expected: The story we were told was completely the opposite of what I saw.

We don't yet know what will happen to this nurse, who is described by Dhiab as an approximately 40 year-old Latino man.

 It is the first time a nurse or doctor is known to have refused to tube-feed a prisoner, said Col Greg Julian, a spokesman for southern command, which oversees Guantánamo. He said in a phone interview with the Guardian that the nurse was a lieutenant and had been assigned other duties at Guantánamo.  "It's being handled administratively," he said.

The Guantánamo spokesman, Capt Tom Gresback, did not respond to messages seeking comment.
The American Medical Association's president has said that force-feeding hunger strikers violates core ethical values.  Great, but  Steven Miles, professor of medicine at the University of Minnesota Medical School and a member of its Center for Bioethics, told TheBritish Medical Journal that the American Medical Association’s stand against force feedings was “toothless” because it failed to hold doctors to account for participating in the practice.

The World Medical Association insists that, "Forcible feeding is never ethically acceptable. Even if intended to benefit, feeding accompanied by threats, coercion, force or use of physical restraints is a form of inhuman and degrading treatment." (WMA Declaration of Malta on Hunger Strikers, 2006).

Asked about its position on nurses cooperating with force feedings, the American Nurses Association told The British Medical Jouranl that it “cannot find an ANA official position directly related to this issue.”

Kinda sad, ANA.  I expect more.  Actually there is more.  The professional code of ethics directs all nurses to "practice with compassion and respect for the inherent dignity, worth and uniqueness of every individual" and "protect the health, safety, and rights of the patient." (American Nurses Association Code of Ethics, 2001) 

What does force feeding of a hunger striker actually ential.  According to Palina Prasasouk writing at OpEd News:

As described in letters from detainee Emad Hassan, the hunger striker is strapped into a restraining chair, often tightly around the abdomen. A tube larger than one used for standard nasogastric tube-feeding is forced through delicate nasal passages, down the throat, and into the victim's stomach. Nutritional supplement, at times containing medication or water, is injected rapidly in large quantities into the stomach, sometimes causing nausea, vomiting, and abdominal pain. The tube is then removed -- and is sometimes yanked quickly from the nose, causing trauma in the nasal passages.

Sound compassionate, respectful of the dignity, worth and uniqeness of every individual? Sound like this protects the health, safety and rights of the patient?


The nurse was not the only medical staff against the force-feeding. Several other medial officers had told prisoners they did not like the operation.

"But this one soldier stood up and refused to do it. This takes real courage," Dhiab said,. "Refusing to force-feed us was a historical act and a strong statement. We were all amazed."

Prasasouk writes:

Dhiab's lawyers are challenging his forced-feeding in federal court. In a related lawsuit, Judge Gladys Kessler granted the disclosure of videotapes of forced-feeding sessions to attorneys. One attorney described the footage as "so 'grim' that I had trouble sleeping." Media groups are asking a judge to release the videos to the public, which absolutely should happen. Regardless of the ruling on the tapes, President Obama should view them and ask himself if forced-feeding is something he or the United States can condone.

The nurse refusing to obey the order to force-feed prisoners displayed great courage and integrity. Nonetheless, it is astounding that it has taken until now for a medical professional to refuse to engage in forced-feeding.

An undisclosed number of the 149 prisoners at Camp Delta at the Naval Base, located on occupied Cuban territory, have been on a hunger strike for the last year and a half, to protest their indefinite detention without trial.

The following is from Physicians for Human Rights.

PHR Welcomes Nurse’s Decision to Honor Medical Ethics by Refusing to Force-Feed Guantánamo Detainees

Physicians for Human Rights (PHR) said today it supports the refusal of a U.S. Navy nurse to continue force-feeding Guantánamo Bay prisoners, who are engaged in hunger strikes as a legitimate form of protest against indefinite detention.
"By becoming a conscientious objector, this nurse is respecting the medical profession’s core ethics, which unequivocally prohibit the inhuman and degrading practice of force-feeding," said Dr. Vincent Iacopino, PHR’s senior medical advisor. "His refusal to participate demonstrates an understanding that force-feeding is being used to punish detainees protesting torture and years of indefinite detention without any legal charges. Medical professionals should have no role in the unlawful practice of force-feeding, and we commend this nurse for honoring that professional obligation."
The nurse’s decision is reportedly the first time a medical officer at Guantánamo has refused to participate in force-feeding. News outlets report that the nurse has since been reassigned to other duties at the prison camp.
Leading medical professionals and associations have condemned the use of force-feeding of mentally competent individuals, including the American Medical Association and the World Medical Association (WMA). The practice at Guantánamo involves shackling detainees to a restraint chair and administering nutrition through a nasogastric tube. Detainees are often immobilized and transported to and from the feedings by "forced cell extraction" teams – military police in riot gear. PHR has consistently criticized force-feeding for violating not only medical ethics, but also individuals’ fundamental right to make decisions about their own health.
U.S. government officials have stopped releasing information about the hunger strike and the number of detainees being force-fed. The practice of force-feeding is taking place in the context of prolonged, arbitrary, and unlawful detention. Of the 149 remaining detainees, over half have been cleared for release. Most have been held there without charge for over a decade.
PHR reiterated its call for President Barack Obama to end force-feeding immediately and institute policies consistent with the WMA’s Declaration of Malta on Hunger Strikers. PHR has also called for greater transparency around the hunger strikes, including information about how many detainees remain on strike, how many are being force-fed, and how many are being subjected to forced cell extractions. PHR is also calling on other medical personnel at the prison to act on their conscience and follow ethical duties by refusing to participate in force-feeding.
"This nurse, and any other conscientious objectors, should not be subject to any disciplinary actions for refusing to follow unethical and unlawful orders," said Donna McKay, PHR’s executive director.
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