“I don’t want these individuals to die,” he told reporters.
But those incisive words belie the complex moral quandary the US faces over the latest hunger strike, which has escalated since its inception in February to include some 100 of the 166 terrorism suspects held at the prison. Nearly two dozen are now being force fed a nutritional supplement through tubes inserted in their noses – a move that the American Medical Association told Secretary of Defense Chuck Hagel “violates core ethical values of the medical profession.”
By many accounts, the Obama administration faces a grim choice in the hunger strike case. Force feed strikers and you violate the accepted medical teaching that competent adults have the right to refuse medical treatment. Let the strike continue, however, and the participants could force their demands to be met, or die and become heroes for their cause.
“The truth of the matter is that most hunger strikers don’t die, but it’s not because they’re not willing to,” says George Annas, a professor of health law, bioethics and human rights at Boston University. “It’s because the people watching will do almost anything to keep them alive. That shows how powerful of a weapon this is.”
The question of how to manage a prison hunger strike is not a new one. The Bush administration wrestled with the very same question at Guantánamo in 2005 and 2006.
More broadly, hunger strikes have proven a uniquely visceral and emotive form of protest around the world – and how other cases have been handled may provide important clues for the Obama administration’s choices at Guantánamo.
“You hear American officials say again and again, ‘we don’t want another Bobby Sands,’ ” Dr. Annas says, referring to an Irish nationalist who died in prison after a 66-day hunger strike in 1981, during the Irish Republican Army's battle against British rule in Northern Ireland. The death of Mr. Sands and nine others in the prison provoked a surge in membership for the IRA and sparked international outrage, as did the hard line British Prime Minister Margaret Thatcher took against their action.
“Mr. Sands was a convicted criminal,” she said just after his death. “He chose to take his own life.”
Since then, however, the British prison system has not had a single death during a hunger strike, Annas says, despite a policy of never force feeding. Instead, the British have largely adhered to international medical dictates on hunger strikes, which call for prisons to bring in independent physicians to monitor strikers and advise them on their health and safety.
“The physician is in an ideal position ... to try to find a compromise solution, calm everyone down, and ultimately defuse the conflictual situation,” wrote a group of medical ethicists earlier this year.
Under US law, too, most prisoners on hunger strikes are allowed to consult with a doctor from outside the penal system. But Guantánamo exists in a separate and far murkier legal space, where the guidelines used for prisoner treatment elsewhere have frequently been shunted aside by concerns about terrorism and American security.
“There are two magical phrases that motivate a great deal of American policy: ‘we have to do this for national security’ and ‘we have to do this to save lives,’” Annas says. “And in the case of [Guantánamo] hunger strikes, you have the administration putting those two together: ‘we have to save lives for national security.’ That’s an extremely powerful argument on an emotional level.”
Israel and Palestinians
The question of how to deal with hunger strikers whose release or death may pose a diplomatic or security threat has also touched off massive controversy in Israel, which holds thousands of Palestinians behind bars in “administrative detention,” or incarceration without charge.
Those prisoners have launched more than a dozen hunger strikes since 1968, including a 2004 strike in which nearly every Palestinian held in an Israeli jail participated, some 8,000 in total, reported The New York Times.
In recent years, however, social media has helped carry the message of such strikes further, and focused broad international attention on Israel’s two-tiered prison system. Since 2011, a series of strikes known as the “empty stomach campaign” has succeeded in winning the early release of several prisoners, including one just two weeks ago.
At Guantánamo, too, activists hope that the intense emotional resonance of the hunger strike will force the administration to act on behalf of the remaining prisoners, half of whom have already been cleared for release.
“There is no end in sight to our imprisonment. Denying ourselves food and risking death every day is the choice we have made,” wrote Samir Naji al Hasan Moqbel, a Yemeni prisoner who has been held at Guantánamo for nearly 11 years, in an April 14 opinion piece in The New York Times. “I just hope that because of the pain we are suffering, the eyes of the world will once again look to Guantánamo before it is too late.”
The case of Irom Chanu Sharmila
But simply drawing the world’s eyes – and ire – is not always enough to make a hunger strike successful.
Take the case of Irom Chanu Sharmila, an Indian political rights activist who has refused food and water since November 2000 in protest against a law that shields the military from prosecution in the region of northeast India where she lives.
Every two weeks since then, Ms. Sharmila has been hauled before a judge, feeding tube dangling from her nose, to ask if she is ready to end her fast. Every two weeks, she has said no.
The 500-week hunger strike has drawn small blitzes of media attention over the past decade, but has largely faded from public consciousness in recent years – even as its Sharmila quietly endures.
“Until and unless my demand is fulfilled, I will be passing my life in this way,” she told The New York Times in 2011. “There is no other way.”