Have You Ever Tried to Force-Feed a Captured Human?

U.S. Naval medics are forcing tubes down the noses of detainees at Guantánamo Bay in order to feed them against their will. The U.N. has said this violates international law. When does "suicide prevention" become torture?
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Another hunger strike is happening in the detention camp at the Guantánamo Bay U.S. naval base in Cuba. It currently involves around 100 people, 23 of whom are being force-fed by Naval medics as a matter of "suicide prevention." Extra medics were flown in earlier this week for this purpose. 

The hunger strike led President Obama to bring Guantánamo back into the national spotlight at a press conference on Tuesday. He called the current situation at the base "unnecessary and unsustainable," but did not lay out a timetable for definitive action. What's happening now, though, could compel it.

An understanding of what it means to be force-fed is important in the discussion of the morality surrounding this, and why it is unsustainable. Carol Rosenberg at The Miami Herald -- where they have a daily Hunger Strike Tracker -- described the feedings vividly on Morning Edition yesterday: "Twice a day, if you're designated for what they call tube-feeding, you are shackled at the wrists and ankles to a chair, and a corpsman, a Navy medic, snakes a tube up your nose, down the back of your throat, into your stomach, and pumps a can of Ensure [a high-protein nutritional supplement] inside."

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Feeding tubes and high-nutrition shakes used to force-feed detainees on hunger strike at Guantánamo Bay (AP / Brennan Linsley)

In hospitals all over the world, these same tubes are used to feed patients who are unable to eat. It's very common. I've put in hundreds. I've had one put into me. It's uncomfortable while going though the back of your throat and down your esophagus, but tolerable once it's in. Still the process is not something I would wish on anyone, especially twice every day. Sometimes the tube goes down the person's airway instead of their esophagus, which can be dangerous. Sometimes it goes into their nose and comes out their mouth, which, in my experience, is disconcerting to the person.

Nasogastric tubes are an appropriate medical intervention for a consenting patient, or for someone whose power of attorney consents on their behalf. It can also be an appropriate measure when a patient is in an altered mental state, prone to self-harm, where the tube might be a temporizing measure to restore them to good mental and physical health. Once in good health, the person could refuse further use of the tube.

Or, could they? Does refusing to eat, in itself, constitute psychopathology -- suicidality?

That is the question at Guantánamo. So, let's step back on the idea of force-feeding for a minute. 

Sometimes people force-feed animals benevolently.

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Volunteers at the Marine Mammal Care Center force-feed a young California sea lion, too ill to feed itself after being sickened by algae blooms. (AP / Reed Saxon)

Other times, we force-feed animals non-benevolently to make delicious foie gras. People have been doing this to birds for at least 5,000 years.

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Force-feeding a measured dose of corn mush to a Moulard duck in its pen at Sonoma Foie Gras in Farmington, California, 2003 (AP / Eric Risberg)

That provokes responses like this staged protest in London, though.

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PETA founder Ingrid Newkirk poses during a media event outside an London department store, to campaign against sale of foie gras (AP / Alastair Grant)

Presented by

James Hamblin, MD, is a senior editor at The Atlantic. He writes the health column for the monthly magazine and hosts the video series If Our Bodies Could Talk.

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