Force Feeding, Conflict and Medical Ethics, 1909-2013

Ian Miller

This paper examines the interface between conflict, medical ethics and resistance through feeding by focusing on the twentieth-century phenomenon of prison hunger striking and medical interventions with force feeding. In doing so, it presents a historically-focused study with the potential to contribution to present-day medical ethical debates on the force feeding of internees at Guantanamo Bay and in Californian prisons.

It demonstrates that force feeding is not a new concern. Although the practice fell rapidly out of fashion in 1917 after Irish republican Thomas Ashe unexpectedly died following a bout of prison force feeding, it re-emerged in the 1970s when IRA hunger striker Michael Gaughan was force fed and controversially died. Then, as now, medical professionals and human rights activists raised concern about using the stomach tube to suppress hunger strikers. The World Medical Organisation’s 1975 condemnation of force feeding as torturous and degrading seemed to signal an end to the practice. However, force feeding is still used despite its condemnation by bioethicists.

This paper explores the multiple purposes of food refusal as an expression of prisoner protest and investigates why prison officials and state bodies felt an imperative to ensure that recalcitrant prisoners needed to be urgently fed. It asks whether twentieth-century force feedings truly saved lives and preserved health (as insisted upon by prison doctors) or if it was used for coercive purposes – to ensure that politically-motivated prisoners stopped disrupting the normal disciplinary workings of the prison as part of their broader campaigns. In doing so, it applies historical insight as a means of adding insight into present-day debates about prisoner welfare. It examines how force feeding tends to be represented by state bodies as ‘artificial feeding’ and investigates how politicians, in the past and at present, make use of a rhetoric that transformed prison protest into a medical condition and force feeding into ‘normal’ medical behaviour. By suggesting that prisoners are irrational and approaching death, ‘artificial feeding’ is justified.

This paper also examines the pertinent question of whether prisoners have the right to refuse painful medical treatment if they wish and explores the complex role played by prison medical staff. Food refusal will emerge from this paper as a potent form of prison protest with implications at the micro-level (the disrupted site of the prison) and the macro (as emblematic of the subjugation of entire nations by a more powerful political force).