Officials from the Israeli Medical Association have been invited to the U.S. to present policy makers there with their methods of handling hunger strikers, as the U.S. administration comes under fire for its own practice of force-feeding of Guantanamo Bay detention camp prisoners who refuse to eat.
The invitation followed the officials remarks on the matter at a convention at Johns Hopkins’ Bloomberg School of Public Health, one of the most prestigious medical faculties.
Israeli policies regarding hunger strikers were formulated in a position paper of the IMA in February 2005. The guidelines were written following hunger strikes by Palestinian prisoners in Israeli prisons a year earlier, and are based on the 1975 Tokyo Declaration of the World Medical Association, and the WMA’s Declaration of Malta on Hunger Strikers. The policy determines that hunger strikers will not be force-fed with liquids or food against their will.
In recent weeks, photos taken in the U.S.' detention center in Guantanamo depicting Muslim prisoners being force-fed during Ramadan have embarrassed the administration. During the month of Ramadan, Muslims fast from dawn to sunset.
U.S. officials have declared in court that they do not force-feed the prisoners during daylight, but only after nightfall. The decision has caused controversy in the United States as it is opposed to international conventions.
At the Johns Hopkins convention, Dr. Tami Karni, deputy chairperson of the IMA ethics committee, told of two cases in the past year when two prisoners on hunger strike were hospitalized at Assaf Harofeh Hospital in serious condition. Both refused liquids or food, and doctors feared for their lives.
In such cases the ethics committee of the hospital is called, together with a senior official of the Health Ministry. One of the prisoners was taken to intensive care due to a serious disruption in his heart functioning, and was convinced by the committee to accept medication. The other prisoner was hospitalized in serious condition, but in a varying state of consciousness due to lack of vitamin B1. The committee decided, against his will, to administer the vitamin so that he could consciously decide how he would be treated.
Several hours later he agreed of his own will to take the vitamin. Karni said that “all this was done gently and quietly, without any violence or coercion by the doctors. Hunger strikes are delicate situations, necessitating doctors to enable non-violent protest without force-feeding the prisoner.”
Following the convention, IMA officials received requests to return to the United States and explain Israeli policies to administration officials.
Still, Israeli policies regarding hunger strikes were criticized this year by various organizations, including Physicians for Human Rights, which presented a report on the matter in April. The report revealed cases in which ethical regulations were not implemented, and cases where independent doctors were prevented from treating prisoners. The report further criticized the Israeli system under which Israel Prison Service doctors are subordinate to prison authorities, and find themselves in a position of “dual loyalty” − to the patient and to the Prison Service.
Procedures preventing such conflicts have already been implemented in several Western countries, including Britain. Karni says that “in light of the possible conflict of interests, the Ethics Department has declared that independent doctors [unaffiliated with the prisons] must be allowed to be in daily contact with hunger strikers.”
Last April, after the hunger strike that broke out following the death of Palestinian detainee Arafat Jaradat, the Health Ministry published new directives allowing forced hospitalization of hunger strikers in cases when the strike has gone beyond 28 days. The directives allowed forced hospitalization of prisoners who hadn’t eaten for less than 28 days, in cases that their life was in danger. In response IMA officials stated that the organization believes that “hospitalization of prisoners or detainees should be carried out only on medical grounds. This principle is true also when it comes to hunger strikers.”