"Force-feeding a competent person is not the practice of medicine; it is aggravated assault," health law, bioethics and human rights Professors George Annas and Leonard Glantz and Associate Professor of Medicine Dr. Sondra Crosby, all from Boston University, wrote in The New England Journal of Medicine.
"Using a physician to assault prisoners no more changes the nature of the act than using physicians to 'monitor' torture makes torture a medical procedure," they wrote in a commentary titled, "Guantanamo Bay: A Medical Ethics-Free Zone?"
"Military physicians are no more entitled to betray medical ethics than military lawyers are to betray the Constitution or military chaplains are to betray their religion," the professors said.
Their article, available online at tinyurl.com/Guantanamo-Ethics, appeared a week before a military tribunal at the detention camp is expected to address the force-feeding issue at a pretrial hearing for Khalid Sheik Mohammed and four other men accused of engineering the Sept. 11, 2001, terrorist attacks.
Mohammed was identified as "the principal architect of the 9/11 attacks" by "The 9/11 Commission Report." He was captured in Pakistan on March 2, 2003.
The Guantanamo prison said Wednesday it was force-feeding 43 of 104 captives it says are hunger-striking among 166 detainees.
The hunger strike began in early February and steadily grew. It started as a protest against a decision by the Guantanamo guard force to search detainees' Korans. The military said detainees used Korans to hide contraband and said the searches were conducted by Muslim cultural advisers, not ordinary guards.
The prisoners said the searches amounted to desecration.
The hunger strike later became a wider protest about what the detainees considered President Barack Obama's abandonment of his policy to close the facility.
Last month, Obama recommitted to closing the prison.
He initially signed an executive order Jan. 22, 2009 -- two days after starting his first term -- to shut down the prison within a year.
But the Senate five months later blocked funds needed to transfer or release Guantanamo prisoners, and lawmakers in both houses have opposed moving prisoners to U.S. prisons for detention or trial.
The force-feeding is ordered by the prison commander, currently Rear Adm. John W. Smith Jr, who is not a doctor. Guards shackle each striking prisoner into a restraint chair and a nurse inserts a tube up his nose, down the back of his throat and into his stomach.
The Pentagon calls it a humane practice that stops prisoners from starving to death. Defense attorneys say their clients consider it torture.
Prison spokesman Navy Capt. Robert Durand told The Miami Herald the prison did not receive an advance copy of the professors' commentary, so he couldn't respond to it directly.
"People follow lawful orders," he said. "It's Department of Defense policy to preserve life through lawful means."
But "this policy mistakenly conflates hunger striking with suicide," the professors said in their commentary.
"Hunger strikers are not attempting to commit suicide. Rather, they are willing to risk death if their demands are not met," they said. "Their goal is not to die but to have perceived injustices addressed.
"The motivation resembles that of a person who finds kidney dialysis intolerable and discontinues it, knowing that he will die," they said. "Refusal of treatment with the awareness that death will soon follow is not suicide, according to both the U.S. Supreme Court and international medical ethics."
The authors said military doctors willing to disobey military orders that violate medical ethics would need support "from their civilian counterparts."
"Professional organizations and medical licensing boards should make it clear that the military should not take disciplinary action against physicians for refusing to perform acts that violate medical ethics," the authors said.
"If the military nonetheless disciplines physicians who refuse to violate ethical norms when ordered to do so, civilian physician organizations, future employers, and licensing boards should make it clear that military discipline action in this context will in no way prejudice the civilian standing of the affected physician," they said.
"Guantanamo has been described as a 'legal black hole,'" the professors said. "As it increasingly also becomes a medical ethics-free zone, we believe it's time for the medical profession to take constructive political action to try to heal the damage and ensure that civilian and military physicians follow the same medical ethics principles."
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