I don’t think XT was asking for a cite on forced feeding. I believe he was asking for a cite on the frequency of prisoners dying from not eating. Quite frankly, I find the attitude that it’s no big deal if prisoners starve to death to be pretty disturbing.
[QUOTE=Pjen]
Once again, I cannot provide a cite for a negative. If force feeding of competent sane individuals is banned in most of the civilised world, that is never going to appear in the papers or laws.
[/QUOTE]
And, once again, I’m not asking you to prove a negative. If you don’t want to back up your assertions, that’s fine, but it kind of underscores that you are merely making broad, general statements and don’t have anything more than your opinion to back them up with.
That’s nice, but it’s not what I’m asking you. Let’s review what you asserted, shall we?
So, you assert that in ‘the rest of the western world’ this is the norm. I’ve asked you repeatedly to show some evidence that, in the rest of the ‘western world’, a.k.a. the ‘civilised’ parts, prisoners are allowed to starve to death when they go on hunger strikes. This isn’t asking you to prove a negative, it’s asking you to back up your claims. Should be easy enough to do, if it’s true. Show me a selection of these ‘civilised’ nations allowing prisoners to essentially commit suicide (doesn’t even have to be through starvation, as I said earlier) without the state intervening and there you go. I’ve already asked for this twice, and gone into a lengthy explanation of what I was asking at least once.
[QUOTE=Little Nemo]
I don’t think XT was asking for a cite on forced feeding. I believe he was asking for a cite on the frequency of prisoners dying from not eating. Quite frankly, I find the attitude that it’s no big deal if prisoners starve to death to be pretty disturbing.
[/QUOTE]
And as a sanity check, since sometimes I can be a bit dense and think I’m saying one thing when others are seeing another, Little Nemo doesn’t seem to have any problem deciphering what I’m asking for.
On a separate topic, I’d like to ask Pjen about the mental competency issue.
Pjen, you’ve said that most civilized countries regard forced feeding as a form of torture and/or as a punishment. But you’ve also said that a person who is found mentally competent should be allowed to go on a hunger strike.
What happens to the people who are found to be not mentally competent? (You’ve mentioned one example of such a person: Ian Brady, a prisoner in the UK.) If these people have mental issues as well as criminal pasts, I have to assume that some of them are not going to call off their planned hunger strike just because they were told they didn’t have official permission. So I assume if a person who is judged mentally incompetent goes on a hunger strike, he will be force fed when his health reaches a critical point.
And this raises a troubling issue. If forced feeding is a form of torture and/or punishment, why is it being inflicted on mentally incompetent people? I think it’s generally agreed that torture is wrong but it seems especially cruel to inflict it on people with mental health problems. And even if you regard forced feeding as only a punishment rather than outright torture, it seems wrong to impose a specific punishment on mentally ill people that isn’t imposed on mentally sound people.
If forced feeding is torture, it shouldn’t be inflicted on anyone. If forced feeding is a legitimate means of punishment, it should only be inflicted on prisoners who have gone through the disciplinary system and were found guilty and for whom it was deemed an appropriate penalty to impose upon them. As somebody who has extensive experience in this area, I’ll point out that a prisoner’s diminished mental competence is usually regarded as something that mitigates their punishment not increases the severity of it. (And it would be a moot point anyway. Forced feeding is not a legal form of punishment in any American prison system I’m familiar with.)
But the fact remains that forced feeding is apparently condoned in “civilized countries” in cases where the prisoner is judged to be mentally incompetent. This seems to be recognition that forced feeding is a valid medical procedure not a form of torture or punishment. If so, we need to dial down the rhetoric on it. There is a valid issue about whether or not prisoners can refuse medical treatments. But calling a medical procedure a form of torture is just political grandstanding.
The reasoning goes:
Force feeding when physically opposed is painful and may have long term negative effects.
Force feeding is a medical intervention.
Medical interventions can only be made with the consent of the patient.
Consent implies competence.
Some Mental disorder may remove competence.
Therefore some mentally disorder persons cannot consent.
If someone cannot consent and their life is at risk, then medical intervention against their will is possible.
The doctrine of necessity allows that painful life saving interventions can be made if it is the only way to allow someone currently incompetent to overcome that and become competent again.
So if, for instance, someone has acute depression with suicidal thoughts or psychosis with command voices to be killed, and it is known that given time it is possible to lift the depression or relieve the psychosis, but this requires (under necessity) the imposition of a temporary painful regime to complete treatment.
Now in the case of the prisoner it is not an issue of competence, but a choice by a system that values justice and control over individual rights. Essentially then, force feeding in prison cannot be supported under the doctrine of necessity because it is also a means of punishment and compliance.
All pain is not torture. Pain is only torture when caused for unacceptable intentions.
This is so clear in medical practice that I am surprised we are arguing. If patients are competent, they have an absolute right to refuse medical treatment. This is universally accepted in medical ethics.
The USA chooses to go beyond competence when considering the case of prisoners. It removes many rights from felons that are not justified by necessity (same doctrine as above.)
The UK recognises that it needs to maintain discipline and control in prisons, but have found a manner of doing this that recognises their legal competence and universal human rights to autonomy. It is a rule of penal policy here that only the minimum necessary rights are removed, and that unnecessary removal of rights is not used as a punishment, but only to gain the legitimate goals of the prison system.
Using force feeding without consent is illegal.
So just to be clear, you do not believe that forced feeding is a form of torture or a punishment? You are agreeing that it is a medical procedure?
Let me give you a clear examples.
1/ Two people climbing together. One falls into a crevice (think 127 Hours). The only way to save him is to amputate the arm without anaesthetic.
Two people live together. They disagree. One pins the other down and amputates their arm.
The first is life saving, the second is torture.
2/ An competent adult refuses chemotherapy for terminal cancer. Doctors enforce it. That is assault.
A child refuses chemotherapy for terminal cancer. Doctors enforce it with parental or court permission because the child is judged not competent.
The first is illegal, the second is legal.
Many other medical procedures could be torture without consent:
Gastric Lavage
Enemas
Administration of Emetics
Administration of medications that cause pain
Administration of medications that cause physical deterioration.
Electro Convulsive Therapy
Resetting bones, dislocations
Isolation
Tooth extraction
Orchiectomy
Amputation of limbs
Scarring
All situation dependent and defined by necessity and autonomy.
“That’s how we do it in Great Britain” is not a compelling argument for, well, anything.
Please cite where I have said that. I have not said it and do not believe it to be true. I have pointed out actions where the USA is an outlier among Western democracies.
Similarly though, just because it is the way it is done in the USA does not alone recommend it.
The medical doctrines on consent, necessity, and autonomy are universal among Western medics.
Not among American medics. Or aren’t they part of the West?
Cite?
No. You made the claim that your ideas on consent, necessity, and autonomy were “universal” among Western medics.
Provide the proof.
The courts have noted two additional exceptions to the requirement that physicians elicit and document informed consent. The first applies when both (1) the patient is unconscious or otherwise incapable of consenting and (2) the benefit of treating the patient outweighs any potential harm of the treatment. Under these circumstances, the physician is not required to obtain informed consent before treating, but must do so as soon as it is medically possible.
Neccesity:
Medical necessity is a United States legal doctrine, related to activities which may be justified as reasonable, necessary, and/or appropriate, based on evidence-based clinical standards of care. Other countries may have medical doctrines or legal rules covering broadly similar grounds. The term clinical medical necessity is also used.
So it’s not “universal” which was your claim.
Autonomy:
The principle of autonomy recognizes the rights of individuals to self-determination. This is rooted in society’s respect for individuals’ ability to make informed decisions about personal matters. Autonomy has become more important as social values have shifted to define medical quality in terms of outcomes that are important to the patient rather than medical professionals. The increasing importance of autonomy can be seen as a social reaction to a “paternalistic” tradition within healthcare.[citation needed] Some have questioned whether the backlash against historically excessive paternalism in favor of patient autonomy has inhibited the proper use of soft paternalism to the detriment of outcomes for some patients.[7] Respect for autonomy is the basis for informed consent and advance directives.
And you are really going to hate the doctrine of double effect which I am yet to bring up.
The doctrine is universal in Western medicine. No western system of Medical ethics fails to include the Doctrine of Informed Consent.
Where does the cite contradict that?
So you’re saying a medical procedure isn’t torture if its intent is to save the person’s life.
That’s the argument that many of us have been making throughout this thread - and which you have been opposing.
You’ve been arguing all along that forced feeding is wrong in the United States even though it’s legal. So your argument isn’t based on whether an act is legal or illegal.
If your argument is that countries should bring their laws into accord with what other country’s laws are, I’ll point out that it’s illegal in the United States to let a prisoner die from a hunger strike when his death can be prevented. So by that standard, other countries should adopt the same law.
If you have another argument, you really should produce it. The ones you’ve used so far are falling apart.