More than 1,300 immigrants carried out hunger strikes in U.S. immigration detention facilities during the Obama and Trump administrations.

This was a key finding of a report released in June by the American Civil Liberties Union, documenting the treatment of detained immigrants in U.S. Immigration and Customs Enforcement (ICE) facilities.

Summarizing over 10,000 pages of documents obtained via a Freedom of Information Act request, the report sheds light upon ICE’s response to detainees using hunger strikes to protest the conditions in detention facilities.

An Office of Inspector General report, released in March, gives credence to detainees’ complaints, detailing violations of detention standards at the La Palma Correctional Center is Eloy, Arizona.

The report documents how ICE officials did not follow their own internal COVID-19 protocol or other detainee policies.

This is the same facility where lawyers for 70 detainees released a May 18, 2020, letter requesting aid and assistance with regard to the horrid conditions, which included overcrowding and feces-covered walls.

According to ICE policy, if a detainee does not eat for 72 hours, they are referred to the medical department for evaluation. If a detainee’s life and health are at risk, then involuntary medical treatment can be administered.

In short, ICE’s policy allows for force-feeding of detainees who are refusing to eat as an act of protest.

Force-feeding of detainees is nothing new, but it is an underreported issue.

In 2013, there were reports of 106 men involved in hunger strikes, where at least 23 were force-fed at the Guantanamo Bay military facility, but hunger strikes at the facility go back to 2005.

The problem was so severe that the U.S. had to send 40 additional medical personnel to force-feed prisoners to prevent starvation. In addition, the force-feeding of hunger strikers has been common throughout the federal prison system for decades.

This practice conflicts with a growing consensus among the medical community that this is morally wrong. The World Medical Association’s Declaration of Tokyo declared force-feeding unethical in 1974, and the American Medical Association rejected it decades ago.

Yet, it is still practiced regularly by the U.S. government.

Force-feeding hits medical ethics at a core level, pitting two of the most honored principles of Western bioethics against each other.

On the one side is the principle of beneficence, which focuses upon promoting the good for the patient. It can easily be argued that society has an obligation to prevent suicide, including self-starvation, and this would extend to prisoners.

On the other side is the principle of autonomy, which argues that rational patients have a right to self-determination of their own bodies. Of course, if an individual lacks decision-making capacity, then the medical profession might have an obligation to step in.

While public debate about force-feeding of detainees centers around these two principles, we cannot forget the other two principles of Western bioethics: non-maleficence and justice.

The first two principles are easy to see; the other two require some reflection.

Non-maleficence is the “do no harm” principle. Whatever we do to a patient, we should not make matters worse. The principle of justice evokes the ideas of fairness, compassion and social justice.

Little reflection is being done regarding the psychological trauma inflicted upon a detainee when they are force-fed.

The practice is brutal and borderline barbaric.

An individual is held down and restrained while a tube is inserted down their nose or mouth. It is a painful process, as the human gag reflex can be powerful, and detainees are not sedated.

Not only is it a violent assault upon someone physically, it also is emotionally traumatic. Force-feeding takes away an individual’s control of this most basic function of choosing what to consume.

The principle of justice forces us to consider the motivation for the hunger strike. How long have these detainees been prisoners? Is it inhumane to herd them like cattle? What is the plan for a compassionate solution?

We cannot focus on the problematic “solution” of force-feeding without also dealing with the context that motivated the hunger strikes in the first place.

The practice of force-feeding hunger strikers is shortsighted and only focuses upon preventing death. Such practices are being rejected by the bioethics community because of their barbarism, and they do not ultimately solve anything.

Detainees are being forcefully fed to keep them alive so they can continue living in horrible conditions. The level of maleficence and injustice should have the public shouting from the rooftops.

Yes, many of these detainees entered this country without legal permission to do so, but many are refugees and asylum-seekers, whose claims and cases have not yet been adjudicated.

And whatever the reason behind a person coming to the U.S., no one should be treated like cattle by being shoved into crowded pens and forced to eat.

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