In the spring of 2011, a revolution started within the notorious Special Housing Unit (SHU) of Pelican Bay State Prison in California. Prisoners living in solitary confinement and enduring harsh conditions including limited access to fresh air, health care, contact with the outside, palatable food and more, often for years or decades, decided they had reached their breaking point. They set out to engineer a series of rolling hunger strikes that quickly spread across the state to other prisons and provoked solidarity across the United States from prisoner rights advocates and reformers.
Two years later, many of the demands made by the prisoners still haven’t been met, and the prison system seems reluctant to meet the hunger strikers halfway, even in the wake of a possible suicide by a prominent hunger striker. Instead, the state has brought out the ultimate weapon: force-feeding.
From suffragettes to Guantanamo, force-feeding has been used as a tool to both crush hunger strikes and intimidate members of social movements. It can be deeply humiliating, not to mention potentially dangerous if not done with care, and groups like the New England Journal of Medicine argue it’s a violation of medical ethics to force a patient to eat against her will. In the wake of revelations about abusive force-feeding at Guantanamo, some argue that the practice can constitute torture. It definitely violates international law, and, in the United States, it’s also a violation of Constitutional rights: going on a hunger strike is an exercise of free speech.
The State argues that it needs to be able to provide prisoners with emergency nutrition to prevent death. It claims that some prisoners may have been intimidated into participation in the hunger strike, and could be putting themselves in critical medical danger because of pressure from other prison residents; paradoxically, California officials insist that gang members are running the hunger strike, while insisting that the SHU needs to be used to minimize the influence of gang members by keeping them isolated from the general population. Which is it, California?
“Refeeding,” as force-feeding is politely called, would only be used in a last resort, the state assures advocates. As some prisoners approach 60-70 days without nutrition, they run the risk of serious internal organ damage, eventually leading to heart failure. Even if prisoners resume eating, they will experience life-long health problems including heart arrhythmias, impaired kidney function and other issues. Prolonged periods without nutrition also lead to impaired cognition, making it difficult for prisoners to take an active role in their medical care.
Which is why many prisoners actually made arrangements for this eventuality before they went on hunger strike, or in the early days of their participation. They signed do not resuscitate orders mandating that in the event of a major cardiac event or other medical emergency, they be allowed to die. As with civilians, these orders would have involved meeting with a physician, discussing the implications of the order and having the physician confirm that the prisoner was making a choice out of free will, without coercion. Force-feeding directly contradicts a DNR, which is precisely why patients in the civilian world have the right to choose to withdraw from food and potentially water as well if they want to die peacefully in the end stages of terminal illness.
Thus, not only would force-feeding violate the civil rights of prisoners, it would also violate their medical rights. While prisoner rights are restricted (they cannot participate in elections, for example), they do retain some fundamental human rights, just as all of us do. These include the right to make active decisions about medical care as long as they are in a competent state to do so, and to engage in political speech, two things the state wishes to deny California prisoners by forcing them to eat.
While few of these prisoners and their loved ones want to force a political point with death by hunger strike, some are willing to make this sacrifice. The state’s plans to take that decision out of their hands is reflective of a widespread belief that prisoners don’t deserve access to the same rights as other members of society, and it’s chilling. If people on a hunger strike can be force-fed, a violent and obvious violation of civil rights, what else can the state do?
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