Kent Sepkowitz describes the procedure, which many Gitmo prisoners have been subjected to:
During my training, I placed countless feeding tubes (and larger hoses to pump stomachs). Without question, it is the most painful procedure doctors routinely inflict on conscious patients. The nose—as anyone knows who ever has received a stinger from an errant baseball—has countless pain fibers. Some patients may scream and gasp as the tube is introduced; the tear ducts well up and overflow; the urge to sneeze or cough or vomit is often uncontrollable. A paper cup of water with a bent straw is placed before the frantic and miserable patient and all present implore him to Sip! Sip! in hopes of facilitating tube passage past the glottis and into the esophagus and stomach.
The procedure is, in a word, barbaric. And that’s when we are trying to be nice.
It’s a grotesque attack on a human being’s dignity. Here is how it was described by Vladimir Bukovsky in a must-read essay on torture when it was done by the Soviets:
“The feeding pipe was thick, thicker than my nostril, and would not go in. Blood came gushing out of my nose and tears down my cheeks, but they kept pushing until the cartilages cracked. I guess I would have screamed if I could, but I could not with the pipe in my throat. I could breathe neither in nor out at first; I wheezed like a drowning man — my lungs felt ready to burst. The doctor also seemed ready to burst into tears, but she kept shoving the pipe farther and farther down. Only when it reached my stomach could I resume breathing, carefully. Then she poured some slop through a funnel into the pipe that would choke me if it came back up. They held me down for another half-hour so that the liquid was absorbed by my stomach and could not be vomited back, and then began to pull the pipe out bit by bit.”
The method in Gitmo is unlikely to be as severe – but every time I have assumed simple decency from the US government with respect to “enemy combatants,” I have often been wrong. But some forced-feeding is rightly judged to be a form of cruel, inhumane and degrading treatment. The UN Rapporteur on Human Rights issued this statement yesterday:
According to the World Medical Assembly’s Declaration of Malta, in cases involving people on hunger strikes, the duty of medical personnel to act ethically and the principle of respect for individuals’ autonomy, among other principles, must be respected. Under these principles, it is unjustifiable to engage in forced feeding of individuals contrary to their informed and voluntary refusal of such a measure. Moreover, hunger strikers should be protected from all forms of coercion, even more so when this is done through force and in some cases through physical violence. Health care personnel may not apply undue pressure of any sort on individuals who have opted for the extreme recourse of a hunger strike.
You think it isn’t cruel or inhumane? Even in Soviet Russia, the practitioners could break down because doing this to another human being against his or her will is so traumatizing:
There had just been time for everything to start healing during the night when they came back in the morning and did it all over again, for 10 days, when the guards could stand it no longer. As it happened, it was a Sunday and no bosses were around. They surrounded the doctor: “Hey, listen, let him drink it straight from the bowl, let him sip it. It’ll be quicker for you, too, you silly old fool.” The doctor was in tears: “Do you think I want to go to jail because of you lot? No, I can’t do that. . . . ” And so they stood over my body, cursing each other, with bloody bubbles coming out of my nose. On the 12th day, the authorities surrendered; they had run out of time. I had gotten my lawyer, but neither the doctor nor those guards could ever look me in the eye again.
For America to be doing this now is, moreover, a direct result of both Congress’s and Obama’s failure of nerve on this hideous legacy of the dark years of Bush and Cheney. Leith Passmore thinks that the US has no good options:
The U.S. military is understandably wary of the potential fallout over inmate deaths. A member of the Irish Republican Army, Bobby Sands, starved to death in prison in 1981, and his death increased recruitment and sectarian violence. Force-feeding may prevent this type of martyrdom, but it also leaves the United States open to further accusations of state torture.
While Sands was starving himself in Northern Ireland, hunger striking terrorism suspects in West Germany were being forcibly fed. The treatment of Red Army Faction prisoners produced a groundswell of support for the prisoners’ cause and helped to recruit new members. The Red Army Faction survived for decades on the back of force-feeding.
In his recent comments, President Obama has shown an awareness of Guantánamo as a potential recruiting tool for terrorist groups. Neither the ethical nor the unethical treatment of prisoners will reduce that risk.
(Image: a newspaper from the period when activists’ for women’s suffrage were routinely force-fed in hunger strikes.)