Saddam on a hunger strike?

I see where Saddam Hussein is going on a hunger strike! (Will Ramsey Clark join him?) Will Saddam be getting his just desserts?

Hell with them! A pox on both their houses!!!

My initial reaction was “Go for it!”, maybe he will discover that nobody cares.

I don’t understand why the court puts up with his antics. Maybe I’m too used to American courts, where most judges seem to have little tolerance for disruptive behavior.

Prisons (almost certainly including the one in which Saddam is housed) have a duty to keep their prisoners alive-- a duty to prevent suicide, in other words. If he continues to refuse food, they’ll strap him down and feed him intravaneously.

No, prisons do not necesarily have the duty to keep prisoners alive. It depends on the jurisdiction. In the UK, hunger strikes are accepted as a form of protest so long as the person is not lacking in capacity.

Any doctor assisting in force feeding is putting him/herself at risk of a challenge to their registration (see the declarations made by the World Medical Association.

The ICRC considers unjustified force-feeding as tantamount to torture.

Wow-- it’s quite different here in the US. Prisoners are considered wards of the state, and the state is ultimately responsible for their safety and well-being-- all measures must be taken to prevent suicide (including hunger strikes.)

It’s doubtful the prison in which Saddam is being held follows these guidelines.

In fact I’m surprised that any prison would allow the suicide of their prisoners, and as far as I know the World Medical Association is not a licensing body, and losing registration with them has no practical effect on your authority or legal entitlement to practice medicine in any country.

Note that I phrased it as putting themselves at risk of a challenge. Any US doctor who was shown to have taken part in force feeding would probably find it difficult to practice in the UK if a challenge were made as the licensing authority here accepts the Declarations of the WMA on force feeding. They would certainly need to have their excuses ready. :smiley: Similarly, I would suspect that any medical personnel working in Guantanamo would have problems subsequently registering in the UK.

There are different moral standards in different countries.

"Yet international ethical guidelines are unequivocal in their directives to practitioners managing hunger strikers. According to the WMA’s Declaration of Tokyo (1975):

Where a prisoner refuses nourishment and is considered by the doctor as capable of forming an unimpaired and rational judgement concerning the consequences of such a voluntary refusal of nourishment, he or she shall not be fed artificially. The decision as to the capacity of the prisoner to form such a judgement should be confirmed by at least one other independent doctor. The consequences of the refusal of nourishment shall be explained by the doctor to the prisoner.19

The principles of the Tokyo Declaration were endorsed by a position statement of the Royal Australasian College of Physicians in July 1993.20

The preamble to the Declaration of Malta (1991) (revised in 1992) underlines the ethical risks facing doctors working with government agencies:

The ultimate decision on intervention or non-intervention should be left with the individual doctor without the intervention of third parties whose primary interest is not the patient’s welfare.5

At the same time, this provision does not allow a physician acting alone to compel treatment, as the Declaration makes it clear that if a physician tends towards compulsory intervention the “patient would then be entitled to be attended by another doctor”. However, the Declaration of Malta does provide that a doctor may make his or her own decision regarding treatment if hunger strikers are in a state in which they “become confused and [are] therefore unable to make an unimpaired decision or [have] lapsed into a coma”."

http://www.dundee.ac.uk/med&humanrights/SSM/torture/answer7.html

"guidance from the Home Secretary of the United Kingdom in the House of Commons on 17 July 1974 …:

" … the future practice should, in my view, be that if a prisoner persists in refusing to accept any form of nourishment, the medical officer should first satisfy himself that the prisoner’s capacity for rational judgement is unimpaired by illness, mental or phy sical.
If the medical officer is so satisfied he should seek confirmation of his opinion from an outside consultant.
If the consultant confirms the opinion of the prison medical officer, the prisoner should be told that he will continue to recei ve medical supervision and advice and that food will be made available for him. He should be informed that he will be removed to the prison hospital if and when this is considered appropriate. But it should be made clear to him that there is no rule of pr ison practice which requires the prison medical officer to resort to artificial feeding (whether by tube or intravenously).
Finally, he should be plainly and categorically warned that the consequent and inevitable deterioration in his health may be a llowed to continue without medical intervention, unless he specifically requests it""

There was a recent news story that brought this up in the context of the detention camp at Guantanamo Bay.

http://news.bbc.co.uk/1/hi/world/americas/4718724.stm

The UN appears to consider force-feeding to be torture.

Don’t say moral standards like allowing force feeding is morally superior to disallowing it.

Furthermore, the British Medical Association supports the WMA’s stand on force feeding. However, the British Medical Association is also not a licensing agency, they don’t have the authority to license or revoke the license of doctors anymore than the AMA does.

I have no idea if the General Medical Council requires doctors to allow prisoners to starve themselves in the UK, in searching their website I could find nothing definitive on the matter.

There has been spurious claims that American doctors are not allowed to force-feed prisoners because the AMA has accepted the WMA’s position on the matter, and that the doctors are legally bound to follow that. This is not true, the AMA is a voluntary organization and does not have that sort of power over doctors.

Once again you attribute more than I meant. I merely said that there were different moral standards.

It so happens that I believe the UK law is more acceptable to my own set of ethics than the US one.

I do know that. I didn’t mention the BMA.

The GMC certainly does allow this. If they did not do so they would be breaking UK law. It is only permissable to force feed someone if they lack capacity. Under British law, force feeding is assault unless justified by a protective court order or a claim of incapacity together with the need to act in an emergency.

I did not make such a claim.

Cite? I’ve seen no such evidence.

Are you actually reading what I post? See Post 8 in this thread.
http://www.dundee.ac.uk/med&humanri...re/answer7.html

"guidance from the Home Secretary of the United Kingdom in the House of Commons on 17 July 1974 …:

" … the future practice should, in my view, be that if a prisoner persists in refusing to accept any form of nourishment, the medical officer should first satisfy himself that the prisoner’s capacity for rational judgement is unimpaired by illness, mental or phy sical.
If the medical officer is so satisfied he should seek confirmation of his opinion from an outside consultant.
If the consultant confirms the opinion of the prison medical officer, the prisoner should be told that he will continue to recei ve medical supervision and advice and that food will be made available for him. He should be informed that he will be removed to the prison hospital if and when this is considered appropriate. But it should be made clear to him that there is no rule of pr ison practice which requires the prison medical officer to resort to artificial feeding (whether by tube or intravenously).
Finally, he should be plainly and categorically warned that the consequent and inevitable deterioration in his health may be a llowed to continue without medical intervention, unless he specifically requests it""

Since well before the IRA hunger strikes in the seventies and eighties the law has been that force feeding is neither accepted practice nor used unless there is legal certainty over the lack of capacity of the person to consent to treatment.

In the seventies the IRA hunger strike led to 10 deaths.

http://en.wikipedia.org/wiki/1981_Irish_Hunger_Strike.

More recently, child murderer Ian Brady who is held in a secure hospital was force fed by the medical team there. They claimed that since he was mentally ill, he did not demonstrate capacity to make the decision.

http://news.bbc.co.uk/1/hi/uk/579328.stm

Ian Brady sued the hospital and lost:

http://bmj.bmjjournals.com/cgi/content/extract/320/7237/731/a

A quote from the article above:

“Under English law, a patient who is competent to take decisions may not be treated—including by artificial feeding—against his or her will. The exception is patients covered by the Mental Health Act 1983, who may be treated against their will even if they are competent—but only if the treatment is for their mental disorder.”

Another case at the Court of Appeal:

http://webjcli.ncl.ac.uk/articles3/keywood3.html

From the preamble:

“Judgments declaring the legality of force-feeding under the Mental Health Act 1983 had previously been made by courts of first instance (eg Re KB (adult) (mental patient: medical treatment) (1994) 19 BMLR 144; South West Hertfordshire Health Authority v Brady [1994] Med L Rev 208). B v Croydon Health Authority [1995] 1 All ER 683 gave the Court of Appeal the opportunity to review the substantive issues relating to the legality of force-feeding under the Mental Health Act. This casenote assesses the validity of the ruling that force-feeding under the Mental Health Act 1983, s 63 is lawful and analyses the implications of the decision for hunger-strikers in other contexts.”

More specifically:

"Lord Justice Hoffmann acknowledged the fundamental right of a competent patient to self-determination:

The general law is that an adult person of full mental capacity has the right to choose whether to eat or not. Even if the refusal to eat is tantamount to suicide, as in the case of a hunger strike, he cannot be compelled to eat or forcibly fed." 

Patient autonomy is subject to limitations, however. The treatment decisions of the competent pregnant patient (Re S (Adult: Refusal of Medical Treatment) [1992] 4 All ER 671)) and the competent minor (Re W (A minor) (medical treatment) [1992] 4 All ER 627) will not always be respected. These two exceptions to the principle of autonomy must be joined by a third - those competent patients who are detained under the Mental Health Act 1983. To refine more accurately the principle stated by Lord Hoffmann, a hunger strike undertaken by a competent patient detained for treatment under the Mental Health Act, where the refusal to eat is a symptom of the patient’s mental disorder, constitutes an exception to the general principle that every competent adult has the right to choose whether to eat or not.

The consequence of drawing a distinction between the hunger striker in prison and the hunger striker detained in hospital, is that the latter may be deprived of his/her ‘right’ to strike. It is arguable that this may be justified on the grounds that the decision of the mentally disordered hunger striker is motivated by the mental disorder. This is a highly contestable assertion, however. It is far from settled that eating disorders, for example, should be classified as mental disorders:

Anorexia nervosa exemplifies the arbitrariness inherent in labelling individuals mentally ill. Imposing the medical model upon the events comprising an episode of anorexia is only one of several ways to give meaning to these events." (Dresser 1984)

It is further contestable on the ground that a person who is ‘compelled’ in any sense to reach a decision about medical treatment, without understanding the issues relevant to it is not legally competent to refuse proposed treatment (Re C (adult: refusal of medical treatment) [1994] 1 All ER 819). Although in reality it may be difficult to distinguish the anorexic from the political dissident, the right to hunger strike may well become the privilege of the non-disordered, non-sectioned patient."

If you are still insisting that force feeding takes place in British prisons when those people have capacity, then I say:

Cite?

For Martin Hyde

I have provided the cites requested.

I see you are posting elsewhere on the board.

Do you want to return to debate whether or not force feeding of prisoners is illegal in the UK and doctors would usually be struck off if they took part in it without a court order?

Or are you just silently conceding the point? :smiley:

Just read your pitting and associated threads and have come to the realization that even should you respond, its just not worth trying to reason with someone with your attitude.

Bailing Out. :cool:

Goodbye.

Hard and recent evidence that UK practice in hunger strikes is very different from US practice.

http://news.bbc.co.uk/1/hi/england/nottinghamshire/4751696.stm

A man accused of killing his newlywed daughter has died following a “long-term refusal of food”, the Home Office has confirmed.

Terry Rodgers, 56, faced murder charges after his 23-year-old daughter Chanel Taylor was found dead in July 2004 at the Nottinghamshire home they shared.

He was admitted to a psychiatric unit after refusing to eat in early 2005.

A lawyer for Mr Rodgers, of Huthwaite, told a court last year his client had one desire, “sadly that is to die”.

Mr Rodgers, who had been due to face trial on 6 March, died in Lincoln County Hospital on Saturday night, police said.

A Prison Service spokeswoman said officers were powerless to prevent any prisoner refusing medical intervention as long as they were deemed mentally fit.

a hunger strike is not suicide. It is the exercise of what little the circumstances of his confinement have left of the prisoner’s autonomy. I cannot imagine saddam would be forcefed in plain view of a court of purported United Nations legitimacy. It is without doubt torture if you consider that the person is being forced to tender his life in currency for the captor’s aims–here in obscene verso of the Nathan Hale version.

Curse them for the quacks they are, the members of the Mengelekorps Gitmosgruppen stil have their licenses to practice medecine in the US–I wonder how a member of the public not resident in the jurisdiction itself lodges a complaint.

It is interesting that you make that distinction as the rationale for the current forcible restraint and force-feeding at Gitmo is that the prisoners are not trying to commit suicide, but merely engaging in a political demonstration.

what do you mean “merely”?

I actually was meaning to reply to MH’s use of the suicide model as a cover for medical intervention-hit the wrong quick reply box and picked up your explanation of what I’m getting to–arguably force feeding a person to prevent suicide could be conceded by a doctor to be unethical if the patient were in sound mind, but it probably would not be seen by a doctor as torture, whereas from an existential point of view, forcing someone to live under conditions he has made manifest are worse than death to him, and doing so, moreovetr , so you can exploit him for information or propaganda purposes (ie, the foregone pr cost of his death by self starvation) is torture of the soul.