The ethics of force-feeding are not straightforward

Whether or not to force-feed prisoner Mohammed Allaan, the alleged Islamic Jihad* activist, creates a serious dilemma for every humane thinking person who takes into account our duty to save life and to prevent suicide, balanced by our obligation to respect an individual’s will. As these values should be applied equally to all hunger strikers, care must be taken to separate the force-feeding issue from the thorny question of detention without trial, which, understandably, is a factor in this particular case.

Objections to detention without trial should be subject to serious questioning, separate from the issue of force-feeding. Detention without trial is used not only in Israel, but in many democracies. In December 2013, President Obama signed into law the National Defense Authorization Act, permitting indefinite detention without trial. In Switzerland, Egyptian refugee Dr. Mohamed El Ghanem was detained without charge for seven years and released in October 2013, after the Swiss Supreme Court ruled his detention wrongful. In Singapore, the Internal Security Act allows the government to arrest and indefinitely detain individuals who pose a threat to national security. In Australia, indefinite detention of violent or sexual offenders who are considered unacceptably likely to re-offend may be detained indefinitely. And in 2006, the UK government passed a law allowing for indefinite detention.

In Allaan’s case, it is important to ask whether those who protest against force-feeding are saying, “let the prisoner die,” which would be unconscionable in the eyes of many, or whether they are calling for his release. If the latter alternative is adopted, it should apply not only to political detainees, but to all prisoners. Of course, this would alter the entire judicial system, enabling any prisoner to obtain early release merely by going on a hunger strike, without suffering the discomfort of force-feeding. Prisons everywhere would soon be emptied, and law abiding people would be threatened by rapists, murderers, terrorists and even common robbers who have been released.

Generally, the ethical aspect of force-feeding (apart from considerations of detention without trial) is far from simple. The main objection is that it is done against the will of the prisoner. Assume for a moment that you see a person put a gun to his head with the intention of committing suicide. Would it be wrong to grapple with him and remove the gun against his will?

And what if a prison warder sees a prisoner about to hang himself and does nothing to prevent it? By all civilized standards, that warder would be guilty of a crime. A 2007 World Health Organization publication co-produced with the International Association for Suicide Prevention states significantly:

Jails, prisons and penitentiaries are responsible for protecting the health and safety of their inmate populations, and the failure to do so can be open to legal challenge.

This gives rise to the question whether failure to force-feed a hunger striker is open to legal challenge.

Force-feeding is not new. In 1909, prison doctors began to force-feed imprisoned suffragettes, World War I conscientious objectors used hunger strikes in their protests, and force-feeding has been used extensively in many countries since then. Recent research disclosed 7,734 occurrences of force-feedings in English prisons between 1913 and 1940.

More recently, the force-feeding of detainees in Guantánamo Bay and of African-American prisoners in California have achieved prominence, though not as vociferously as the current world protests about the Israeli prisoner Allhhan

As recently as February 2014, reports of forced-feeding at the ADX prison in Florence, Colorado emerged, where inmates are held in solitary confinement for 22 to 24 hours per day. Federal judges have turned down bids by the Guantánamo inmates to stop the force-feeding. US District Judge Rosemary M Collyer said in a ruling last month that numerous courts had deemed it the government’s duty to prevent suicide and to provide lifesaving nutritional and medical care to people in custody.

In 2013, jailers in California were given permission to force-feed about 136 hunger strikers who were entering their seventh week. US District Court Judge Thelton E Henderson ruled that prison doctors may force-feed selected inmates who are near death, even if they had previously signed orders asking not to be resuscitated

The courts and governments are not unanimous on the issue. The US Department of Defense permits forced-feeding under defined conditions.

The issue was addressed by the Connecticut US Superior Court case, Lantz v. Coleman. Coleman was sentenced to eight years in prison in 2005, for sexually assaulting his wife. In September 2007, he went on a hunger strike and in 2009, the court allowed the prison to force-feed him. The decision did not go uncontested. Arthur Caplan, who testified for Coleman at the trial, wrote in the Harford Courant:

Prisoners do not have many rights while in jail. But one right they do have is the right to protest including the decision not to eat or drink. As horrible as it is to watch someone starve when they need not do so, the state of Connecticut should accept that a competent prisoner may make that choice. I hope that Coleman decides that he has made his point and ends his hunger-strike. But it is not right to use medical treatment to force him not to do so.

On an international level, it is notable that in December 2006, the UN War Crimes Tribunal at The Hague approved the force-feeding of Serbian politician Vojislav Šešelj.

And in relation to terrorists, the “shoe bomber” terrorist, Richard Reid, was force-fed while on a hunger strike in 2009.

Endnote

*The Islamic Jihad is a radical Muslim terror organization financed mainly by Iran which funnels several million dollars a year, mostly going directly to terror activities. Its leadership is located in Syria.

Its charter calls for the establishment of an Islamic state from sea to sea and the destruction of Israel. Its principles derive from the Muslim Brotherhood with main focus on guerrilla warfare and terror. Though operating mainly in the West Bank and Gaza Strip it has also carried out attacks in Jordan and Lebanon