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<h3 class="title"><a
href="https://www.aclu.org/blog/national-security-prisoners-rights-human-rights/whats-difference-between-force-feeding-and"
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title="What's the Difference Between Force Feeding and Waterboarding?">What's
the Difference Between Force Feeding and Waterboarding?</a></h3>
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<div class="blogDate">03/24/2014<br>
<b><small><small><small><a class="moz-txt-link-freetext" href="https://www.aclu.org/blog/national-security-prisoners-rights-human-rights/whats-difference-between-force-feeding-and">https://www.aclu.org/blog/national-security-prisoners-rights-human-rights/whats-difference-between-force-feeding-and</a></small></small></small></b><br>
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<div class="blog-author"> By <a
href="https://www.aclu.org/blog/author/zak-newman">Zak Newman</a>,
Washington Legislative Office, ACLU at 10:02am </div>
<p>The Department of Defense this month publicly released its newest
rationalization for the abusive force-feeding program at Guantánamo
Bay. In this <u><a
href="http://media.miamiherald.com/smedia/2014/03/11/08/40/8qyQk.So.56.PDF">latest
memo</a></u> on hunger strike policies, the abusive force-feeding
program is referred to as "medical intervention."</p>
<p>Nothing could be further from the truth.</p>
<p>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.</p>
<p>Let's start with tube insertion for force- feedings. According to <u><a
href="http://gut.bmj.com/content/52/suppl_7/vii1.full">medical experts</a></u>,
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 <u><a
href="https://www.youtube.com/watch?v=z6ACE-BBPRs">the painful
insertion process</a></u> and minimizes the risk of the feeding tube
entering the lungs, which could cause asphyxiation.</p>
<p>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 <u><a
href="http://www.reprieve.org/uploads/2/6/3/3/26338131/2014.03.11_-_hassan_brief_and_exhibits_-_compressed.pdf">statement
of one detainee</a></u>, that frequency of tube insertions causes
severe pain and can damage the esophagus and stomach.</p>
<p>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.</p>
<p>However, the designated process, called "air auscultation," <u><a
href="http://www.ncbi.nlm.nih.gov/pubmed/15632757">has been discredited</a></u>
in multiple medical journals as outdated and unreliable, and it has
been shown to be inaccurate at a rate <u><a
href="http://www.medscape.com/viewarticle/470693_2">as high as 93
percent of the time</a></u>. In this case, medical staff would
unknowingly pump water into detainees' lungs.</p>
<p>That sounds like it could be an awful lot like waterboarding.</p>
<p>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 <u><a
href="http://media.miamiherald.com/smedia/2013/05/13/15/19/Wu1Q8.So.56.pdf">older
version</a></u> 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.</p>
<p>For comparison, the <u><a
href="http://www.med.upenn.edu/gastro/documents/AGApositionstatemententeralnutrition.pdf">American
Gastroenterological Association recommends</a></u> 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.</p>
<p>In addition, the speed of the feeding at Guantánamo may actually
cause serious pain and suffering on part of detainees. According to <u><a
href="http://www.reprieve.org/uploads/2/6/3/3/26338131/2014_03_07_steven_miles_declaration.pdf">one
professor of medicine at the University of Minnesota</a></u>, the speed
of the feeding causes extreme pain and "increases the risk that stomach
contents will be regurgitated into the lungs".</p>
<p>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.</p>
<p>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.</p>
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