Published on Portside (https://portside.org)
Israeli Doctors Resist Force-Feeding Palestinian Prisoners
Ehab Zahriyeh
Thursday, August 13, 2015
Al Jazeera America
The rapidly deteriorating health of a Palestinian political prisoner on
hunger strike has pit Israeli legislators, who recently enacted a law mandating
that he be force-fed, against physicians, who refuse to comply on grounds that
doing so would be unethical and tantamount to "torture."
Mohammed Allaan, 30, a West Bank lawyer accused of working with the armed
group Islamic Jihad, has refused food, vitamins, supplements and even medical
treatment for almost 60 days in protest of his detainment.
Allaan was arrested in November 2014 and has since been held in
administrative detention — a controversial form of imprisonment that allows
Israeli authorities to detain an individual indefinitely without charge, trial
or access to counsel if he/she is deemed a “security threat.”
Since Israel’s occupation of Palestinian territories in 1967, its military
has placed thousands of Palestinians in administrative detention. At the end of
June 2015, there were 370 Palestinians in Israeli prisons classified as such,
according to Israeli human rights group B’Tselem [1].
For Palestinians who find themselves in Israeli prisons, hunger strikes
have become a common way of drawing public attention to their plight and
challenging their treatment or detainment — sometimes with success.
On Aug. 9, some 180 Palestinian prisoners ended a coordinated hunger strike
after just one day, claiming their demands were met. Israeli prison authorities
made concessions over search procedures, and agreed to return dozens of
Palestinian prisoners back to a a wing of Nafha Prison where they were
previously held, Palestinian Prisoners Society chairman Qadura Fares told Haaretz [2].
In July, Palestinian political prisoner Khader Adnan, who was also held in
administrative detention for alleged ties to Islamic Jihad, was freed after his
54-day hunger strike ignited protests across the Palestinian territories and
garnered international attention, including pressure from various human rights
groups.
Adnan and Allaan's form of hunger strike differs from tactics employed by
most other Palestinian prisoners, according to Tamar Karni [3], chairwoman of the Israeli Medical Association’s (IMA) ethics committee.
“All the administrative detainees, except Khader Adnan, agreed to accept saline
intravenous infusion with vitamin injections to prolong their life,” Karni
said. “Similarly to Adnan, Allaan has refused to accept this palliative care.”
To keep hunger strikers alive and avoid potential public unrest, Israel’s
parliament, the Knesset, passed the controversial “Law to Prevent Harm Caused by Hunger Strikers” [4] on July 30, granting authorities the legal right to
force-feed prisoners on hunger strike when their lives are in danger.
Members of the IMA, however, have refused to comply, saying that doing so
would be a breach of their Hippocratic Oath.
“Forced-feeding is equivalent to torture and every physician has the right
to refuse to force-feed a hunger striker against his or her will,” the IMA
states in its Physician’s Guide to Treating the Detainee/ Prisoner on a
Hunger Strike. [5]
IMA chairman Leonid Eidelman explained: "Anyone who has seen how
[force-feeding] is performed on one who is conscience and one who is opposed to
and fighting it," they'll agree it’s “torture.”
According to Eidelman, there are only two circumstances in which Allaan can
receive medical treatment: “If Allaan gives up his hunger strike and allows it,
or if he loses consciousness.”
"Doctors are ready to resuscitate him if he loses conscience,"
but will not intervene otherwise, he added.
Guantanamo example
Israel has yet to implement its hunger strike law, but testimony from
inmates held in U.S. custody at Guantanamo Bay, Cuba, who’ve been force-fed by
prison officials illustrates why the procedure is so controversial.
U.S. guards force-fed detainees after they launched two prison-wide hunger
strikes – in 2005 and 2013 – to protest their indefinite detainment, ill
treatment and the suspicious deaths of fellow inmates. Prisoners have also
launched a number of individual hunger strikes since the Pentagon began
remanding alleged “terrorists” to the facility in 2002, and have also been
force-fed.
Emad Hassan, a Yemeni national who has been imprisoned at Guantanamo since
June 2002 and began his hunger strike in 2007, was force-fed through nasal
tubes more than 5,000 times [6]. The procedure has left one of his nostrils fully closed and the other
partially damaged.
Ahmed Rabbani, a Pakistani national detained at Guantanamo for more than 10
years, began vomiting blood after feeding tubes were improperly forced inside
his nose, the Guardian reported [7].
Sami al-Hajj, a Sudanese national and Al Jazeera journalist who was held at
the military prison for more than six years, has describe being restrained as
prison guards shoved feeding tubes down his nose. “You see the blood and
everything inside” the tube, Hajj said on Democracy Now [8], describing how guards would not clean the tubes after they were used on
previous inmates.
Based on these testimonies and others, opponents of force-feeding have
dismissed arguments by supporters that the practice is necessary to protect the
health of striking inmates. In fact, medical professionals have gone so far as
to call it deadly.
In 2013, American Medical Association (AMA) then-President Jeremy Lazarus sent a letter [9] to then-Defense Secretary Chuck Hagel stating, “Force feeding of detainees
violates core ethical values of the medical profession.”
The U.S. government has withheld medical information about its use of
force-feeding, but Israeli physicians are well aware of the health risks
associated with the practice.
According to Physicians for Human Rights-Israel [10] (PHR), force-feeding methods "carry immediate risks
of mechanical damage to surrounding tissues — the nasal tissue, throat,
esophagus, lungs, tissues in proximity to veins or different layers of the
abdominal wall."
"From 1970 to 1992, there were four prisoners on hunger strike who
died after being forced fed, and one other case where a prisoner died after we
believe he was force fed, Amany Dayif, PHR's director of the prisoners and
detainees department, told Al Jazeera. The state, however, never officially
attributed the causes of deaths in any of the cases directly to force-feeding.
In 1996, Israel's Patient's Rights Act established a set of laws for
patients, including prisoners. The law states [11]: "No medical care shall be given unless and until the patient has
given his informed consent to it." In the case that a patient becomes
unconscious, the law requires that there must be "reasonable grounds to
suppose that, after receiving treatment, the patient will give his retroactive
consent."
The law, passed last month, "contradicts [Patient's Rights Act] totally,"
said Dayif, adding that the new law allows the "judge to make the
decision, not the doctors, based on political circumstances instead of the
health or rights of the patient."
Karni, chairwoman of IMA’s ethics committee, recently visited Allaan at Soroka
Medical Center in Be'er Sheva, where he was being monitored by physicians, and
unsuccessfully tried to convince him to accept palliative care, Al-Monitor reported [3].
“This is his legitimate and nonviolent way of protesting and we shouldn’t
act against his wish — or else it falls under the category of torture,” she
said.
Physicians fear that Allaan’s recent transfer from Soroka Medical Center,
where doctors opposed feeding him against his will, to Barzilai Medical Center
in Ashkelon, may be an attempt to find doctors who are willing to comply with
the new law.
Eidelman, however, said that efforts to prolong Allaan’s life through
force-feeding would not work "because in his situation, we cannot correct
all the abnormalities in his body because of his prolonged fasting."
Improving Allaan's health would require doctors to treat him slowly for
weeks. "In this situation it cannot be done forcibly," Eidelman said.
Tensions rising
Allaan's prolonged detention has already led to protests, his force-feeding
could spark further unrest.
Dozens of Palestinians in East Jerusalem launched an open sit-in at the
International Committee of the Red Cross (ICRC) on Monday that will last until
Israel ends its administrative detention of Allaan, activist Muhammad
al-Shalabi told Ma’an news [12]. If Allaan is force-fed or dies, protests could erupt throughout the
Palestinian territories, especially since tensions are already high after a
suspected Israeli settlers firebombed a house in the West Bank, killing a
toddler and his father, and severely burning other family members.
About 100 Palestinian citizens of Israel carried out a demonstration
outside the Barzilai Medical Center where Allaan is being held, Haaretz reported [13]. They are demanding Allaan's release from administrative detention. A
group of about 50 Israeli Jews, launching a counter protest, threw stones,
bottles and eggs at the Arab protesters after the Palestinian flag was raised
in front of the hospital.
A United Nations joint statement directly addressing Israel’s new hunger
strike law echoed concern over such practices. “The principle of an
individual’s right to informed and voluntary refusal of medical measures is
reiterated in several basic United Nations human rights documents where lack of
free and informed consent is considered a clear violation of an individual’s
right to health,” it said.
According to the 1975 Declaration of Tokyo, which medical associations
around the world adhere to, "Where a prisoner refuses nourishment and is
considered by the physician as capable of forming an unimpaired and rational
judgment concerning the consequences of such a voluntary refusal of
nourishment, he or she shall not be fed artificially."
In September, Israel’s Supreme Court is scheduled to hear a petition filed
by the IMA, arguing that force-feeding is a violation of the law.
Adalah, legal center for Arab rights in Israel, has also vowed to launch
constitutional challenges if Allaan is forced-fed.
Ehab Zahriyeh is a Digital News Producer for Al Jazeera America. He can be
reached via twitter @EhabZ [14].
Source URL: https://portside.org/2015-08-15/israeli-doctors-resist-force-feeding-palestinian-prisoners
Links:
[1] http://www.btselem.org/administrative_detention/statistics
[2] http://www.haaretz.com/news/diplomacy-defense/.premium-1.670406
[3] http://www.al-monitor.com/pulse/originals/2015/08/israel-forced-feeding-bill-ima-officals-opposition-allaan.html
[4] http://america.aljazeera.com/watch/shows/live-news/2015/7/the-knesset-has-legalized-force-feeding-of-prisoners-on-hunger-strike.html
[5] http://www.ima.org.il/Ima/FormStorage/Type8/IMAHungerEN.pdf
[6] http://www.vanityfair.com/news/2015/01/guantanamo-bay-solitary-confinement
[7] http://www.theguardian.com/world/2014/may/22/guantanamo-inmate-vomit-blood-force-feeding
[8] http://www.democracynow.org/2013/1/9/part_2_al_jazeeras_sami_al
[9] http://www.jhsph.edu/research/centers-and-institutes/center-for-public-health-and-human-rights/_pdf/AMA%20Hunger%20Strikes%20Letter.pdf
[10] http://www.phr.org.il/default.asp?PageID=116&ItemID=2042
[11] http://waml.haifa.ac.il/index/reference/legislation/israel/israel1.htm
[12] http://www.maannews.com/Content.aspx?id=766966
[13] http://www.haaretz.com/news/israel/.premium-1.670899
[14] http://www.twitter.com/EhabZ
[1] http://www.btselem.org/administrative_detention/statistics
[2] http://www.haaretz.com/news/diplomacy-defense/.premium-1.670406
[3] http://www.al-monitor.com/pulse/originals/2015/08/israel-forced-feeding-bill-ima-officals-opposition-allaan.html
[4] http://america.aljazeera.com/watch/shows/live-news/2015/7/the-knesset-has-legalized-force-feeding-of-prisoners-on-hunger-strike.html
[5] http://www.ima.org.il/Ima/FormStorage/Type8/IMAHungerEN.pdf
[6] http://www.vanityfair.com/news/2015/01/guantanamo-bay-solitary-confinement
[7] http://www.theguardian.com/world/2014/may/22/guantanamo-inmate-vomit-blood-force-feeding
[8] http://www.democracynow.org/2013/1/9/part_2_al_jazeeras_sami_al
[9] http://www.jhsph.edu/research/centers-and-institutes/center-for-public-health-and-human-rights/_pdf/AMA%20Hunger%20Strikes%20Letter.pdf
[10] http://www.phr.org.il/default.asp?PageID=116&ItemID=2042
[11] http://waml.haifa.ac.il/index/reference/legislation/israel/israel1.htm
[12] http://www.maannews.com/Content.aspx?id=766966
[13] http://www.haaretz.com/news/israel/.premium-1.670899
[14] http://www.twitter.com/EhabZ
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