I’m sure this is giong to be a really stupid question, but on NPR this morning they mentioned prisoners being tortured via force feeding and I was wondering about it. I’m sure it is unpleasant and you get really full and sick. But how do they keep people from throwing up? How do they force them to keep chewing and/or swallowing food? Do they actually force feed them food? Or is it like cardboard or something? Would some foods make you feel sicker than others? Or are they all equally torturuous after you are full? Sorry for my morbid curiousity.
I doubt it’s force feeding as in shoving actual food in their mouths. I imagine they’re just using a medical feeding tube and whatever nutritional glop goes along with using a feeding tube.
I’ve heard reports that they’ve been doing that to prisoners who try to go on hunger strikes. Dunno if that’s what they were referring to.
Forced feeding generally consists of a nasogastric tube being inserted thru a nostril, down the back of the throat, and into the stomach. Liquid nutrition is then passed thru the tube, and the tube is withdrawn.
If the individual is drinking water, they can generally get enough nutrition from twice a day tube feedings. If they’re refusing all liquids, then liquid nutrition, along with extra fluids, must be given about three times a day.
Nostrils tend to get irritated when these things are inserted repeatedly, but it can be done daily for months.
The nasogastric tube could be left in, but any hunger striker worth his salt would pull it out on his own.
QtM, who unfortunatley knows waaaaaay too damn much about this (but not from working with alleged terrorists, at least).
The only force-feeding-as-torture I’ve ever heard of involved force feeding a prisoner dry rice & then forcing them to drink water. This is, apparently, uncomfortable. But, I don’t remember if it’s something I read in a history book or a Stephen King novel. I’ll look.
I heard that same report this morning. Everyone so far has described forced feeding as I remember it in the hospital (it was very uncomfortable!)
The impression I got from the report was that the forced feeding by itself was not considered torture. Rather, it was a combination of things in addition to the forced feeding that could be considered torture. For example, I recall them mentioning that the person being force fed would be tied to a chair for several hours. I suppose they wanted the subjects to digest what they were being fed, rather than have them stick a finger down their throat.
I seem to recall Hubby telling me that the inmates at his prison were fed intravaneously. Does it vary from insitution to institution, or did I mishear him? (I’d ask him, but he’s not home.)
My sister, who is in touch with a human rights lawyer who defends torture victems at Guantanamo Bay sent me a PDF photocopy of Civil Action 05-0301 (GK), MAJID ABDULLA AL JOUDI, et al., Petitioners/Plaintiffs v. GEORGE W. Bush, et al., Respondents/Defendants submitted to the United States District Court for the District of Columbia (10/13/2005)
Warning: Graphic, TMI, and sorry it’s long, but this is important. People should know exactly what the allegations of torture are. There is more content in the document, but I’ve exerpted the most detailed description of torture:
- When we saw [Yousef Al-Shehri] on Saturday morning, Yousef was emaciated and had lost a disturbing amount of weight (even when compared with our last visit, when he had seen him only the day after he had discontinued his first hunger strike). This twenty-one year-old client was visibly weak and frail, and was seated in a chair behind a walker, on which he frequently leaned for balance during the interview. He had difficulty speaking because of lesions in his throat that were a result of the involuntary force-feeding he had been receiving through his nose and throat. He held the nasal-gastric (“NG”) tube away from his mouth in order to speak, and he winced with pain on more than one occasion as we talked with him. His speech was slow and labored - a drastic difference from the young boy we first met in May of this year.
- Yousef told us that the second hunger strike began on August 8, shortly after we had last seen him. After approximately seven days without any food or water, Yousef and four other prisoners were taken to a special detainee wing at Guantanamo’s military/civilian hospital, away from the detainee camp. At the hospital, he and the other detainees were verbally abused and insulted and were restrained from head to toe. They had shackles or other restraints on their arms, legs, waist, chest, knees and head. With these restraints in place, they were given intravenous medication (often quite painfully as inexperienced medical professionals seemed incapable of locating appropriate veins). Their arms were swollen from the multiple attempts to stick them with IV needles. Yousef told us that if the detainees moved, they were hit in the chest/heart. He said that one detainee fainted after such treatment, and that the doctors gave him a shot and he woke up in an hour.
- After some time in the hospital, a medical team from the United States mainland arrived and informed the detainees they were going to be fed involuntarily. The detainees were told that the Court had ordered such forced feeding [1 Yousef was greatly distrurbed to hear from us that ther was no such court order of which we were aware. While we explained that there may be other orders of which we were unaware, Yousef said that he and the others were only complying with the nasal tube feeding because they believed it had been ordered by this Court…]
- Yousef was the second detainee to have an NG tube inserted into his nose and pushed all the way down his throat and into his stomach, a procedure which caused him great pain. Yousef was given no anesthesia or sedative for the procedure; instead, two soldier [sic] restrained him - one holding his chin while the other held him back by his hair, and a medical staff member forcefully inserted the tube in his nose and down his throat. Much blood came out of his nose. Yousef said he could not speak for two days after the procedure; he said he felt like a piece of metal was inside of him. He said he could not sleep because of the severe pain.
- After two or thre days, Yousef was given large amounts of Ensure (a liquid nutrition supplement) through the tube in his nose. Yousef told the doctors that it was too much food, but the doctors gave it to him anyway, and it made him vomit repeatedly. He and other prisoners were vomiting up substantial amounts of blood. When they vomited up blood, the soldiers mocked and cursed at them, and taunted them with statements like “look what your religion has brought you.”
- After two weeks of this treatment, with little nutrition and virtually no sleep, the prisoners were transfered back to Camp Delta and placed in solitary cells on the [censored] Block. According to Yousef, they stayed there for five days without any food or water, including without any involuntary feeding through the NG tubes. During this time, they were subjected to various forms of psychological torture: soldiers laughed and made fun of them, rattled the metal bars on their cells at all times of the day and night, interrupted their prayers, and refused to allow the ill detainees sleep, all in an effort to get them to stop the hunger strike.
- Finally after five days, the detainees were transfered to a location they described as being for the metally disturbed. In this area, the walls were made of foam, and there were strange lights and a hole in the floor in which to urinate. It was in this location that the guards first began to insert larger, thicker tubes into the detainees’ noses.
- These alrge tubes - the thickness of a finger, he estimated - were viewed by the detainees as objects of torture. They were forcibly shoved up the detainees’ noses and down into their stomachs. Again, no anesthesia or sedative was provided to alleviate the obvious trauma of the procedure. Yousef said that he could not breathe with this thick tube inserted into his nose (which, when inserted, was so large it caused his nostril to distend). When the tube was removed, it was even more painful, and blood came gushing out of him. He fainted, and several of the other detainees also lost consciousness. The detainees were told by the guards: “we did this on purpose to make you stop the hunger strike.” They were told that this tube would be inserted and removed twice a day every day until the hunger strike ended. Yousef described the pain as “unbearable.”
- Yousef explained that doctors were present as the riot guards at Guantanamo (called the Initial Reaction Force (“IRF”)) forcibly removed these NG tubes by placing a foot on one end of the tube and yanking the detainee’s head back by his hair, causing the tube to be painfully ejected from the detainee’s nose. When the detainees saw this happening, they begged to have the tubes remain, but the guards refused and continued to forcimbly remove the tubes.
- Then, in front of the Guantanamo physicians - including the head of the detainee hospital - the guards took NG tubes from one detainee, and with no sanitization whatsoever, re-inserted it into the nose of a different detainee. When these tubes were re-inserted, the detainees could see the blood and stomach bile from other detainees remaining on the tubes. A person the detainees only know as “Dr. [censored]” [2 Yousef described “Dr [censored]” as the “head of the torture team.” He estimated that Dr. [censored] was approximately [censored] tall, with [censored] hair. He said he appeared to be in his [censored], and worse a [censored] and a [censored]. Yousef believed he was a member of the [censored], with a [censored] on his uniform. A similar description of Dr. [censored] was provided by another client.] stood by and watched these procedures, doing nothing to intervene.
And
Sorry for the typos. Only the one marked [sic] isn’t mine.
IV is fine to rehydrate someone who’s sick, or give fluids to someone coming off a fluid refusal strike, but for sustained hunger strikers who would pull out any lines given half the chance, one can’t leave them restrained day after day so they won’t mess with their tubes. And standard IV fluids just supply electrolytes and some sugar. Not the more complex proteins, fats and vitamins needed.
True IV feedings do exist, in the form of hyperalimentation. That generally takes a central line into a very large vein (usually in the neck or upper chest) and very specialized, very expensive food is infused directly into the circulatory system.
Most inmates only get tubed thru the nose once, if that, before calling off their strike. But some very committed individuals can go for months with tube feedings. We only do it if a court has ordered it, and personally I feel an inmate generally has the right to refuse food and drink. But not the right to kill themselves. It’s a tough situation.
I don’t know about anyone else, but my mother used to force me to eat brussel sprouts (torture!). If I didn’t, I was forced to my bedroom (prisoner).
Force-feeding via the tube down the nose was used against woman suffragists who were arrested for demonstrating. Many of them went on hunger strikes in prison, and so they were forcibly fed via tubes, in unsanitary conditions.
The HBO movie Iron Jawed Angles showed the character being strapped to a chair and a hose put down her throat.
When I first heard the story on NPR, I was completely confused. How is it torture to feed someone to keep them alive? But after reading this stuff, it sounds like the METHODS that end up getting used are pretty horrific. Or at least can be painful.
It’s unpleasant, just like having to have a catheter inserted into the bladder to empty it is unpleasant. But thousands of people catheterize themselves every day when they have conditions which make bladder emptying difficult.
Me, I’d rather these folks just decide to eat and drink on their own. But when they don’t, and the State decides to not let them harm or kill themselves, there aren’t a lot of other options.
The force-feeding is just one aspect of the torture. Imagine the mental state of these people who
A) Feel that they must go on a hunger strike.
B) Are constantly sleep, food, and water deprived.
C) Are continuously berated, and insulted by guards
D) Are insulted and treated callously by people violating their throat with plastic tubing. This kind of treatment is unbearable. I had an endoscope inserted down my throat a few times. Thankfully I was under general anesthesia. But one of those times, the anesthesia was a little light, and I became conscious during the procedure. I was gagging continuously until they removed it. It was less than a minute, but it was terrifying and excruciatingly uncomfortable. And I was very sedated, and surrounded by professionals taking the utmost care to insure my comfort. I shutter to think of what these prisoners had to endure: people performing a similar procedure without anesthesia, and without any attempt to make it more comfortable, if not actually deliberately making it more torturous.
Another quote from the document I quoted yesterday (again, graphic TMI):
[Abdul-Rahman Shalabi, another captive who reported the same conditions as Yousef Al-Shehri]
28. In addition, Abdul-Rahman told us that one Navy doctor came and put the tube in his nose and down his throat and then just kept moving the tube up and down, until finally Abdul-Rahman starting [sic] violently throwing up blood. Abdul-Rahman tried to resist the “torture” from this physician, but he could not breathe. He was suffocating, and when the tube that had been jabbing him internally was finally removed, it was full of blood. The guards told Abdul-Rahman to rest for two minutes, and then a female nurse was brought in to re-insert the tube. The next day, the guards brought tubes that clearly had been used, and were filled with blood and bile. According to Abdul-Rahman, the guards laughed at their horror and said simply “it’s your stomach.”
This part I can leave out of the spoiler quotes:
My sister explained this to me (and an associate who is a psychologist specializing in torture explained it to her): The force-feeding can only occur because the captives have been broken down to the point where they believe that a hunger strike is their only recourse in an unjust situation. This in itself is part of the torture. Not only are they enduring excuciating pain, but in some part they believe that it is because of their own doing. I of sound mind, see plainly that they should not have even been put in a situation so drastic and terrible that a hunger strike should be their best recourse, but these captives are already broken down. They have no other recourse – they are psychologically trapped between agony, morality, and victimization. Every day that this continues, they get more mentally ruined. Even if these people survived these circumstances, they would never recover psychologically. That is torture.
Sorry, I meant “psychologist specializing in aiding torture victims”
What do you suggest for a (semi) hypothetical inmate who is refusing all food and drink unless he dies or he is released from prison? Keep in mind he was convicted of assault and battery, and did great physical harm to his victim.
Both psychiatric and psychologic evaluation find no mental illness, only extreme stubbornness.
Anesthesia, respect, every effort made to make insertion an removal as painless, comfortable and as infrequent as possible. Keeping someone alive should never be confused with punishment.
According to the document I’ve quoted above, inmates asked for anesthetic, and their request was denied. That and the lack of sanitation are completely inconsistent with professional medical care.
And in the case of Guantanamo Bay captives, there isn’t even any punishment taking place, because there was never a trial, and they don’t have access to representation (now explicitly in law thanks to GWB et. al.!). So what’s the confusion? These people don’t have information after four years. That is ancient history by military standards. These people were just being tortured, pure and simple.
Anesthesia has associated risks, even topical anesthesia. Most experts feel that the risks of anesthesia outweigh the benefits from it if the procedure needs doing over and over and over. Frankly, the greatest discomfort tends to be from the first few times the tube passes thru the nasal passages, and from the gag reflex. Repeated nasal intubations tend to be associated with far less discomfort and gagging. If done properly, that is.
In my experience, adequate lubrication on the tube is the most vital component in making the procedure more tolerable. And the procedure should be done under clean (not sterile) conditions by trained personnel. And always offer the patient the opportunity to eat and drink voluntarily before proceeding.
And, IMHO it should only be done on those who are wards of the state, with proper court oversight, when all other less intrusive avenues (including limited fasting with medical monitoring) have already been tried without success.