Physicians for Human Rights commends the U.S. Navy’s decision not to discharge the nurse who refused to participate in the force-feeding of Guantánamo detainees. This decision is an important step in recognizing the right of military health professionals to recuse themselves from unethical medical practices. But the Navy’s decision does not squarely address the ongoing problem of medical ethics being subsumed by military objectives and policies, to the detriment of ethical care.
According to the World Medical Association and the American Medical Association, the force-feeding of competent people is a form of inhuman and degrading treatment and is never ethically acceptable, even if intended to benefit.
Force-feeding at Guantánamo has nothing to do with medical necessity or benefit. Instead, it is a military policy that serves to silence detainees from protesting 12 years of indefinite detention without legal charges – what some in the military refer to as “asymmetrical warfare.”
As we speak, the Department of Defense (DoD) instructions for health professionals continue to provide a set of ethical standards that are inconsistent with international norms; they compel DoD health professionals to force-feed detainees against their will and to enable behavioral science consultants to participate in interrogations.
As health professionals, we cannot conduct medical procedures against the will of our patients; we cannot inflict pain for non-clinical purposes, and we have no business assisting in interrogations. Our profession and our ethical duties cannot be subsumed by military and policy imperatives, and health professionals should never be used as a tool to carry out such policies.
Recently, the Defense Health Board provided a series of recommendations to the DoD affirming that a military health professional’s first ethical obligation is to his or her patient. We support the Defense Health Board’s recommendations and we urge the Obama administration to take immediate executive action to stop force-feeding and institute policies and procedures on hunger strikes that are consistent with international standards. We also call upon the DoD to revise its instructions to health professionals to ensure that all medical staff, whether they work in clinical or non-clinical capacities, are able to act independently and according to the ethical obligations of their profession.