Search Results For How Barbaric Is Force-Feeding?

A reader asks a “simple question”:

Is it more humane to let the detainees starve to death?

Obviously, in a perfect world, the situation would resolve itself, GTMO would close, and we would all live happily ever after. Sadly, we don’t live in that world. We live in a much more complicated world where there isn’t a simple or elegant solution to this issue. I’ve been to GTMO as a Judge Advocate working on the military commissions. I, too, would like it to close. I really would. But in the meantime, how many men do you let starve to death?

All who wish to do so. If they believe it is the only way to end their torment, what right do we have to prevent them? One reader’s answer:

Perhaps some fellow Dishheads can shed some light on what the pains are associated with long-term starvation, but I have to assume that’s not exactly a pretty picture. What all of this does for me is just crystallize the giant clusterfuck that is Gitmo. We have a number of humans who are being indefinitely detained with no end in sight, which in and of itself is horrible. And the choices appear to be for us to inflict further pain by forcing them to eat, or for us to let them inflict pain on themselves, possibly to the point of a slow horrible death.

When you frame it this way, I would lean slightly toward saying that in the current circumstances, force-feeding is the better choice of two bad options.

Another:

I have followed this thread with some interest and can’t help but point out: this treatment does not meet the dictionary definition of torture.

Torture, as it is commonly defined, is “the act of inflicting excruciating pain, as punishment or revenge, as a means of getting a confession or information, or for sheer cruelty.” That the procedure is deeply unpleasant I have no doubt in my mind, but let’s be clear: I doubt even the soldiers who perform it enjoy seeing the pain and discomfort in the eyes of these prisoners. Nor is it being done to extract information or as a way to “punish” them.

Plenty of acts done by the U.S. government in the past should be labeled torture, including waterboarding, but force-feeding simply does not meet the definition. It is being done for one simple purpose: to keep them alive – hardly a cruel intention.

And as your readers have pointed out, this is a common medical procedure for people with medical problems or people with mental illnesses. Had your thread been titled, “Is force-feeding just in these circumstances?”, I might refrain from speaking, but you’ve put it in such broad terms I can’t help but find your arguments ludicrous.

Supposing these were genuine al-Qaeda members, and they refused to eat until a fellow murdered was freed: would you still label force-feeding them torture? Would you still think it cruel that instead of quietly sitting on their hands as some men starved in front of them – to stand as martyrs for some horrible cause – they saved their lives by intervening?

They have a right to their own bodies. If they do not even have that right, they are slaves, not prisoners.

Brian Kellett, a paramedic who in “most cases [is] completely against force-feeding,” nevertheless deems the Mos Def video “propaganda”:

I have placed more NG tubes than I can remember and I have never seen a reaction as strong as that shown in the first video. It certainly isn’t very pleasant to have a NG tube inserted as it tickles the back of the throat that makes you want to gag (or swallow), but it is not this apparent torture that is being shown. An NG tube is inserted in hospitals for a number of reasons, sometimes for surgery, sometimes because a patient cannot swallow. In the first video Yasiin Bey [aka Mos Def] isn’t given water to drink during the procedure, but in many of my patient’s I also couldn’t give them anything to drink to ease the passing of the tube as these patients would have no gag reflex and so giving them water could result in them inhaling rather than swallowing the water. Inhaling water can have side effects that include death.

Yasiin Bey is also shown to be resisting, while the person in the [above] video is complying with instructions. Many of the patients that I passed an NG tube into had some form of confusion, either due to a stroke, due to dementia or due to a multitude of other causes . In some cases I would be passing a tube into the stomach of someone against their will because they had tried to commit suicide and were under a Mental Health Section.

Even in these cases I never saw a reaction as strong as that of Yasiin Bey.

A reader has a very different take:

I have a rare condition called Multiple System Atrophy, which involves a number of progressive diseases/conditions. But of all of the painful things I’ve endured, feeding tubes take the prize.

I first encountered NG tubes in 2002, when after a bout of pancreatitis I found my stomach completely without function. After about a week, the decision was made to insert a nasal tube. I can never forget that experience. Two nurses came to insert the tube. They explained what the process would be, telling me it would be mildly uncomfortable. Undersale of the century. They tried inserting it in the right nostril first. Whether I already had a deviated septum or they caused it with poor technique, they couldn’t get the tube to pass. It turns out they also forgot to apply the numbing agent, meaning I felt every bit of the pressure and pain of the first attempt.

They moved to the left nostril. This time, they remembered the xylocaine or lidocaine, but it really made no difference. It was mildly uncomfortable in the way that the New York Yankees are a recreational baseball team. I have never felt such pain – not even in proctological or urological procedures. Well, maybe it is similar to the urological ones. I felt as if I was drowning as the burning hot sensation passed from my nasal cavity to my throat. I began dry heaving, with the most intense gagging sensation I’d ever felt. The hose didn’t move easily, and the nurses were literally pushing against the resistance with jabbing movements.

Once it was in, it felt like there was a knife in my throat. For days, I was gargling liquid lidocaine to dull the stabbing sensation. The pain was constant and would keep me awake. As my tube was more permanent than the ones being used at Gitmo, I had more issues than are relevant to the discussion. But suffice it to say, there were more issues caused by the tube than I care to remember, and they ultimately had to move me to a surgical feeding tube because of the issues with the NG.

I am in a place right now where I am wasting away. My stomach has no peristaltic function. Two years ago, I weighed 215 pounds. Today, I tip the scales at 125. A 5’10” man in his late thirties, I have the build of a prepubescent boy. My biceps are now smaller than my wrists used to be. But I cannot bring myself to being fed by a tube again, either temporary or permanent. I love my family, and want to spend as much time with them as I’m given, but my wife and I agree that when I was living with a tube, I was not really living; I just wasn’t dead.

I have extremely mixed feelings when it comes to Guantanamo Bay and the hunger strikes. On one hand, Congress has made it almost impossible for the Administration to return those prisoners who are cleared, as the requirement of absolute certainty that those released won’t engage in terrorist acts is not something that can ever be 100% fulfilled. And letting prisoners die would be an absolute disaster, both politically and on a human level. But I also know that forcing a plastic tube up the noses and down the throats of human beings is torturous, if not outright torture. Every politician and military leader who has caused or supports this situation should be forced to endure just one session of restraint and insertion. Until then, it will be seen as just another process issue by the game players in Washington, who are more interested in scoring political points than ending the very real humanitarian crisis that we have created in Cuba.

Update from a reader:

I’ve had a naso-gastric tube inserted twice, each time as part of the treatment for a bowel obstruction. I can confirm what others have said: it ranks up there with the worst things I’ve ever experienced. That said, my reaction was nothing like Yasiin Bey, in no small part because the thing I was being treated for was a bowel obstruction (and its subsequent complication, pancreatitis), which is also on the list of the worst things I’ve ever experienced, and which I was willing to endure almost anything to alleviate, up until the tube went in and the gag reflexes and pain from the plastic tube chafing against my nasal passage and throat started. Yasiin Bey seemed to exhibit none of the gag reflexes and dry heaving that I experienced every time, which really made me wonder if the tube was really being fully inserted. The only time I’ve ever seen an NG tube inserted was when it was going into my own nose, so I really can’t say if my experience was typical or not. I can say two things for sure: first, I think Yasiin got off easy. Second, the “paramedic” who claims the tube “tickles the back of the throat” is correct in the same way, to quote one of your earlier correspondents, that the Yankees are a recreational baseball team.

Fortunately, one of my NG tube insertions was in California, where we don’t have strong strictures against pain killers. Dilauded, a wonderfully potent opiate, made me unable to concentrate on anything for even sixty seconds, but also numbed the pain in my nasal passage, throat, and stomach, where the end of the tube was constantly poking into my stomach wall, enough that I could manage to sleep at night. The other time I had an NG tube inserted was in Arizona, where they felt that miniscule amounts of morphine were more than adequate to kill pain. They weren’t. The pain was constant, twenty-four hours a day, and was only tolerable if I didn’t move. Sleep was nearly impossible: moving my head in any way pulled on that tube, increasing the pain and scratching more tissue off my already raw throat.

Yasiin also missed out on the best part of the entire experience. His tube was in for only a few minutes before being removed. There is nothing – absolutely nothing – like having a tube in for days before it’s pulled out. Even though every nurse that extracted my tubes pulled them out slowly and carefully, extraction is also painful, as the tube rubs for its entire length against the now raw surface of your throat and nasal passages. When the tube finally rounds the last turn and pulls free, the sudden feeling of relief is indescribable.

Readers voice skepticism over this disturbing video:

I feel churlish for pointing this out, since I, too, want to see the forcefeeding of Gitmo detainees stopped, but since this undercuts the strength of the argument, it’s worth point out that Mos Def is an actor. Moreover, he’s a very good actor, having been nominated both for an Emmy and a Golden Globe for a powerful performance in this movie.  Which means that he (unlike Hitchens) may not have been the best person to do this. I fear there are going to be no shortage of neo-cons who will say he was exaggerating very convincingly (though you could always challenge one of the doubters by telling them to try it for themselves).

Another:

Call me cynical, but isn’t it strange that Yasiin is literally begging the people doing the procedure to stop? The whole project is voluntary, right? Why wouldn’t they stop when he first asked them to? I’d wager it’s because they knew that having Mos beg for a bit would better persuade the viewer of the horrors of forced feeding. I don’t mind that so much as a cause marketing idea, except that it presents an inaccurate picture.

Undergoing NTF in and of itself, one time, is not actually such a debilitating or psychologically damaging thing. In fact, it’s pretty commonly done in hospitals and at home, even for children, who presumably have a lower tolerance for pain than a grown adult. I agree that subjecting Guantanamo prisoners to this twice a day, against their will, constitutes torture, but I think it’s patently obvious that Yasiin was doing a bit of acting here. Which is a shame, because it cheapens what is otherwise a correct and important message.

Another speaks from experience:

This past January, I began tube-feeding – or “force feeding” – my son, who is just under two years old.

He had become dangerously underweight due to a medical condition, and could not take food by mouth, so this was the safest way to feed him. The tube, called an NG tube, is not dissimilar to the one in the Mos Def video.  It’s just smaller – more appropriate for a child.  To insert it, I hold his head still (I have to use a strong grip) while my husband measures an appropriate length of tube out, and then pushes it through his nostril and into his stomach  My son struggles, cries, and yells, and we have to swaddle him to keep him from using his arms to block us.  He’s usually gagging as it goes down his throat.  Sometimes he vomits while we’re placing the tube, and we have to stop and wait 5-10 minutes before beginning the process again.

The first time we did it was the worst.  He screamed, and, really did look like he was being tortured.  We’ve had to do it 8-10 times since then, and it’s gotten easier. Nowadays, he no longer looks frightened, but is clearly deeply uncomfortable during the insertion. Once it’s in, he’s fine.  Food is pumped into his stomach 2-3 times a day; he’s usually watching television or peacefully sleeping when he’s being fed.  No discomfort whatsoever.

My son is one of many.  Hundreds of children are either born or later develop conditions that make tube-feeding a necessity for some amount of time.  I learned about them at this website.

Like you, I find the situation at Gitmo an abomination.  And I loathe how this practice refuses these men the right to their own bodies (and I agree with Steve Chapman).   Still, every time you or someone else writes that force-feeding is “barbaric” or “grotesquely inhumane” (and especially when they compare it to water-boarding) I cringe, as I’m sure many other parents of NG tube-fed children do.

Another notes:

For what it’s worth, efforts have been made to categorize the pain associated with common medical procedures.  Insertion of a nasogastric (NG) tube is considered among the most painful of common procedures, according to surveys of patients.  This procedure ranks ABOVE reduction (re-alignment) of a fractured bone.  To do this to people against their will, repeatedly, is beyond inhumane.  One of the lessons I take from these studies is that I owe my patients a bit of IV opiate painkiller (fentanyl, morphine) before proceeding to place the tube; I doubt the prisoners at Gitmo are accorded such compassion.

You be the judge. Yasiin Bey (aka Mos Def) demonstrates the force-feeding procedure used on Gitmo hunger strikers:

Conor watched the video (I actually found it too painful after a while):

[W]hile I don’t know whether or not forced feeding crosses the line of torture, the exercise reminded me of the late Christopher Hitchens volunteering to be waterboarded.

The Obama Administration is force-feeding numerous Gitmo prisoners twice daily as a response to a hunger strike they launched to protest being held indefinitely without charges or trial.

The standard procedures used include “strapping detainees to a chair, forcing a tube down their throats, feeding them large quantities of liquid nutrients and water, and leaving them in the chair for as long as two hours to keep them from purging the food,” The Washington Post has reported. Detainees say the procedures are abusive, verge on torture, and have “caused them to urinate and defecate on themselves and that the insertion and removal of the feeding tube was painful.”

It’s definitely grotesquely inhumane. Seizing control of a human being’s internal body and organs, painfully forcing instruments inside his sinuses and stomach twice daily to keep him under the total control of the authorities is horrifying enough. But when you consider that, unlike Mos Def, these prisoners, many innocent or falsely charged, have no way to challenge their indefinite detention, and are stuck in an endless purgatory of nothingness, the barbarism is obvious. As is the sadism and “globalized indifference” of the American public and their craven Congress. Steve Chapman wants the force-feedings to stop:

It would be unpleasant for the administration to accept the possibility that these detainees will die by starvation. But it might also force the American public and its elected representatives to wake up to the needless, open-ended suffering that is being inflicted on innocent people. It might induce other nations to accept freed inmates.

It might do none of these things. Then maybe the hunger strikers will conclude they are better off dead. If that choice reflects badly on us, it should.

Amen. Life-long confinement without even due process of any meaningful sort, is so alien to democratic principles and Western jurisprudence, it remains a rebuke to everything America claims to stand for.

Earlier Dish on force-feeding here.

gitmo-feeding-chair630

Dave Gilson describes a series of government photos from the Gitmo hunger strike:

Though they do not show any of these frantic scenes, recently released military photos offer a window onto how Guantanamo has been dealing with the unprecedented protest: A “feeding chair” where detainees are force-fed sits next to a tray of feeding tubes and a bottle of butter pecan Ensure; guards deliver meals through “bean holes” in detainees’ cells, only to throw away the uneaten food; hospital beds behind chain-link fences with rings for shackles beside them. Other images in the series, taken in early April by Sgt. Brian Godette of the Army 138th Public Affairs Detachment, depict scenes from Camps V and VI, where most prisoners are held: a sign asking soldiers to respect praying detainees, a stuffed recliner in the “media room” that looks almost normal until you notice the ankle restraints.

A professor from the Naval Academy Anne-Marie Drew visited and penned her reflections in the Jesuit magazine, America. What struck her most was the epistemic closure of the guards there:

The staff is not sadistic. They are not Nurse Ratched. Rather they fiercely believe in the American ideals of 450x299_q75justice and fairness and decent treatment of those in our custody. They want to change the public view of the camps, a view the staff believes is distorted.

Nowhere was this belief more apparent than outside the medical bay when a medical staffer explained force-feedings. With professional calm and compassion, she explained that when we force-feed the detainees, we are taking care of them. We cannot let them starve. The tacit subtext was clear: we are, after all, the United States of America, founded on a Judeo-Christian culture. Inmates are not being mistreated during the procedure, for we are not a country that mistreats others.

She gets to the core of the problem in America, as the country still refuses to look what it is doing and has done clearly in the eye:

Because we think of ourselves as benevolent, as Christian, we cannot conceive of ourselves as cruel. As individuals, we make up stories we can live with. As a nation, we do the same. Thus, we try to convince ourselves that force-feeding reflects benevolence and our role as caretakers. We think of force-feeding as one more safeguard for the detainees… But force-feeding is not such a safeguard. It is a violation of a fundamental human dignity, a dignity these detainees do not abdicate when we incarcerate them.

It’s the same mindset that believes that when Americans torture prisoners, it somehow isn’t torture. Because we have internalized our moral superiority – indeed all but turned it into a national religion – we can do no wrong. What would be torture if authorized by Khamenei is somehow not torture if authorized by Cheney. As Rudy Giuliani – perhaps the most unreflective of all American exceptionalists – put it, waterboarding isn’t always torture, even though it has been designated such by every legal ruling ever made on it. Why? Because

It depends on who does it.

As a Catholic, Giuliani should know that it doesn’t. Evil knows no geographic boundaries. And Americans are not somehow super-humans. So where are the bishops? Michael Shaw reflects on the photos:

Although photos from Gitmo have typically excluded the prisoners themselves, not seeing them and knowing they are wasting away makes their absence here that much more palpable. …

Scenes of olives being delivered that will never be eaten, or full Styrofoam containers getting chucked in the trash, or bottles of Ensure on patient trays next to surgical tubes (to make sure you don’t die on us while the world is watching) can’t help but prompt us to see the prisoners in our own minds (or even imagine we’re getting the treatment).

While the government and the military pretend these photos maintain an adequate level of abstraction, however,  to me they do the opposite. In waging a war of wills at the most primitive level, these photos, if highly institutional, somehow take me back to Abu Ghraib. Torturing a man for information, or out of sadism or to keep him alive, is still torture. And as for breaking the will, well, martyrdom is martyrdom, whether it’s by jetliner or by leaving us with rotting containers full of bananas.

My take on the morality of force-feeding here.

(Photos by Sgt. Brian Godette, Army 138th Public Affairs Detachment)

How Barbaric Is Force-Feeding?

Andrew Sullivan —  May 2 2013 @ 12:17pm

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 trsuffragetteschquestion, 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.)