Monday, August 13, 2007

Another Travesty at Guantanamo

A group of doctors have expressed outrage over the force-feeding of prisoners at the U.S. prison camp in Guantanamo Bay, Cuba. In commentary published in the Journal of the American Medical Association (JAMA), the physicians expressed concern that doctors were violating medical ethics at the behest of the military.
"In medicine, you can't force treatment on a person who doesn't give their voluntary informed consent," said Dr. Sondra Crosby of Boston University, one of the authors. "A military physician needs to be a physician first and a military officer second, in my opinion."
According to CNN, 20 of 23 detainees on a hunger strike were being forcibly fed by nasogastric tubes. The tubes (pictured above) are typically inserted into the nasal cavity and run down the esophagus, terminating just above the stomach. They are used routinely in hospitals to allow liquid feeds to be given to patients who cannot safely feed themselves (due to level of consciousness, mechanical swallowing difficulties etc.). How does the military prevent patients at Guantanamo from simply removing the tubes?
Last year, the military started strapping detainees in restraint chairs during tube feedings to prevent the prisoners from resisting or making themselves vomit.
This may be seen by some as a contentious issue, but in this country (and presumably in the US), the law is quite clear. Any patient who is deemed capable of understanding the consequences of their decision, has the right to refuse medical treatment of any kind - even if that treatment if life saving in nature. Presuming a patient is deemed competent to understand the issue, any physician who administers treatment to a patient against his or her will is guilty of assault, and can be prosecuted in that regard.
The inmates at Guantanamo may be prisoners (or "detainees"), but to their doctors they are patients just like anyone else, and should be accorded the same standard of care. Pressure from the military is no excuse for a breach in medical ethics.