Ongoing Case of the Guantanamo Nurse
Navy nurse who refused to
force-feed prisoners may lose pension…
The case of the “Guantanamo Nurse” has faded from the headlines, but it’s not over. Despite widespread U.S. and international condemnation of the Navy’s practice of force-feeding prisoners who are on hunger strike, the sole prison staffer who has refused to participate in this controversial procedure remains at risk.
The nurse’s attorney, Ronald W. Meister, confirmed today that the Department of Defense has instituted proceedings to revoke the nurse’s security clearance, and is then expected to attempt to discharge him from the Navy. Meister noted that military pensions do not vest until twenty years of service, so If the military has its way, he could lose all of the pension benefits he has earned over almost nineteen years of loyal service.
Meister expects to submit the nurse’s response in October or November, for a decision by the DOD’s Consolidated Adjudication Facility. An adverse decision by that body could be appealed.
Asked whether other health care professionals at the prison have taken positions against force-feeding, the attorney indicated that he’s not aware of any such cases. “It was the practice in past years to allow physicians who objected to force-feeding to decline assignment to Guantanamo,” he noted, “and to allow nurses who objected to be assigned to other duties. Those policies apparently are no longer in effect.” Meister was himself a Lieutenant in the Judge Advocate General’s Corps of the U.S. Navy (which describes itself on its website as “the best law firm in the world”) so can claim some familiarity with and even sympathy for the legitimate needs of the military. He clearly feels it has overstepped in this case.
The American Medical Association and World Medical Association both consider the forced feeding of an unwilling person to be a violation of medical ethics. The groups have insisted that professionals be allowed to refuse to participate in such actions, though it’s not clear to me that they would impose any sanctions on a member who did choose to participate. Similarly, retired Naval Captain Al Shimkus, who commanded the Guantanamo medical facility from 2002-2003 stated that “force-feeding constitutes ill treatment and the continued practice at Guantanamo should not be allowed to occur.” But he went on to say that “equally important is to allow medical professionals to recuse themselves.” Evidently medical professionals should be able to keep their hands clean – without having to rock the boat.
In a 2013 New York Times Op-Ed, Columnist Joe Nocera cited the positions of the International Red Cross, the World Medical Association, and the United Nations in saying that “put simply, force-feeding violates international law.” He also referenced a devastating expose by Al Jazeera, which had uncovered a military document headed “Standard Operating Procedure: Medical Management of Detainees on Hunger Strike.” (Note that the photo included below is a re-enactment.)
“The document makes for gruesome reading,” Nocera wrote. “The detainee shackled to a special chair (which looks like the electric chair); the head restraints if he resists; the tube pushed painfully down his nose; the half-hour or so of ingestion of nutritional supplements; the transfer of the detainee to a “dry cell,” where, if he vomits, he is strapped back into the chair until the food is digested. Detainees are also apparently given an anti-nausea drug called Reglan, which has a horrible potential side effect if given for more than three months: a disease called tardive dyskinesia, which causes twitching and other uncontrollable movements.”
As a long time supporter and chronicler of nurses’ crucial roles in the healthcare system, I was disappointed by the American Nurses Association’s public position on this case. Like the American Medical Association, the ANA focuses on the nurse’s right to refuse to participate in so-called enteral feeding. I would have hoped that nurses would feel not just a right but an obligation to refuse to feed an unwilling prisoner, and that the ANA would be prepared to back them up when they do so.
I was also disturbed by a sentence in the ANA statement that says “Individuals in critical care units, psychiatric settings, or who are incarcerated might have diminished capacity for decision-making…” Diminished capacity is a term usually applied to those with a cognitive or psychiatric disability, not the “disability” of being locked up in a military prison.
Guantanamo’s detainees do not have diminished capacity. They are in despair. Maybe they still have some vestige of hope that their protest will finally move us to demand their release, or maybe they’ve just given up.
No one can be entirely comfortable with the idea of someone starving him or herself to death for a principle.
But principles matter.
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