[Pnews] What's the Difference Between Force Feeding and Waterboarding?

[Prisoner News]

      What's the Difference Between Force Feeding and Waterboarding?
      <https://www.aclu.org/blog/national-security-prisoners-rights-human-rights/whats-difference-between-force-feeding-and>

03/24/2014
*https://www.aclu.org/blog/national-security-prisoners-rights-human-rights/whats-difference-between-force-feeding-and*

By Zak Newman <https://www.aclu.org/blog/author/zak-newman>, Washington 
Legislative Office, ACLU at 10:02am

The Department of Defense this month publicly released its newest 
rationalization for the abusive force-feeding program at Guantánamo Bay. 
In this _latest memo 
<http://media.miamiherald.com/smedia/2014/03/11/08/40/8qyQk.So.56.PDF>_ 
on hunger strike policies, the abusive force-feeding program is referred 
to as "medical intervention."

Nothing could be further from the truth.

In fact, judging from the heavily redacted memo, it is clear that DoD's 
aggressive response to ongoing hunger strikes at Guantánamo causes 
significant pain for the detainees and can be quite dangerous.

Let's start with tube insertion for force- feedings. According to 
_medical experts <http://gut.bmj.com/content/52/suppl_7/vii1.full>_, 
long-term feedings should be treated with a singular tube that is not 
removed from the patient's nostrils except once every four to six weeks. 
This minimizes patients' experience of _the painful insertion process 
<https://www.youtube.com/watch?v=z6ACE-BBPRs>_ and minimizes the risk of 
the feeding tube entering the lungs, which could cause asphyxiation.

Compare that standard with the policies at Guantánamo where the feeding 
tube is inserted up to twice a day for detainees on hunger strike. 
According to the _statement of one detainee 
<http://www.reprieve.org/uploads/2/6/3/3/26338131/2014.03.11_-_hassan_brief_and_exhibits_-_compressed.pdf>_, 
that frequency of tube insertions causes severe pain and can damage the 
esophagus and stomach.

Relatedly, the practices revealed in the newly published memo leave open 
the possibility that detainees subject to force-feedings will risk 
asphyxiation during the force-feeding. During the feeding, a nurse 
(apparently in addition to one non-medical staff member) is to check 
that the inserted tube went into the detainee's stomach and not his 
lungs to ensure that he will not choke during the feeding.

However, the designated process, called "air auscultation," _has been 
discredited <http://www.ncbi.nlm.nih.gov/pubmed/15632757>_ in multiple 
medical journals as outdated and unreliable, and it has been shown to be 
inaccurate at a rate _as high as 93 percent of the time 
<http://www.medscape.com/viewarticle/470693_2>_. In this case, medical 
staff would unknowingly pump water into detainees' lungs.

That sounds like it could be an awful lot like waterboarding.

Now, the feeding itself: Medical equations in the newly released 
protocols call for 2,300 ml of liquid (a liquid meal replacement such as 
Ensure plus water) to be pumped down a detainee's esophagus over the 
course of one feeding. That's just under two thirds of a gallon of 
liquid. An _older version 
<http://media.miamiherald.com/smedia/2013/05/13/15/19/Wu1Q8.So.56.pdf>_ 
of the newly released text -- made public in March 2013 -- states that 
this feeding is to take place over the course of 20 minutes. It is 
impossible to know due to the extent of redactions in the new document 
whether that time frame is still used. But if the time window still 
stands, that means that detainees are force fed almost two thirds of a 
gallon of liquid in 20 minutes.

For comparison, the _American Gastroenterological Association recommends 
<http://www.med.upenn.edu/gastro/documents/AGApositionstatemententeralnutrition.pdf>_ 
that medical service providers feed patients no more than 260 ml of 
liquid (about a cup) per 15 minutes. The volume administered at 
Guantánamo is almost seven times that recommendation.

In addition, the speed of the feeding at Guantánamo may actually cause 
serious pain and suffering on part of detainees. According to _one 
professor of medicine at the University of Minnesota 
<http://www.reprieve.org/uploads/2/6/3/3/26338131/2014_03_07_steven_miles_declaration.pdf>_, 
the speed of the feeding causes extreme pain and "increases the risk 
that stomach contents will be regurgitated into the lungs".

Force feeding is a practice universally considered cruel, inhuman, and 
degrading -- and one that violates international medical ethics 
standards. And it can rise to the level of torture. The "medicalization" 
of the practice at Guantánamo in no way changes that determination.

Worse, the particular policies that dress in medical terms the DoD's 
political response to the hunger strike only work to ratchet up the harm 
suffered by detainees.

-- 
Freedom Archives 522 Valencia Street San Francisco, CA 94110 415 
863.9977 www.freedomarchives.org
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