The hunger strike as political, medical, moral and human rights problem



Hunger strikes are a tool of the desperate and sometimes the deluded. They can pose acute difficulties to the striker, to the striker's supporters, to medical staff and to human rights organizations. They represent a very particular form of protest in which the striker gambles her or his health, or even life, against the moral or strategic response of the power holder who has the means to grant or withhold concessions. Most hunger strikes resolve themselves in a short time, either because the striker intended only a short symbolic protest or the experience of the strike causes the hunger striker to end her or his action quickly. However extended periods of food refusal, including those conducted as part of a mass political action, can lead to deaths or long-term physical and mental deterioration. They reflect politically-motivated action; a health and ethical dimension; they touch on the moral values of the striker, carer and state decision-maker and challenge both supporters of the hunger striker and civil society organizations which work to promote human rights. Current autonomy-based ethical standards call on doctors (and arguably other health professionals) to respect patient autonomy and to abjure non-consensual feeding. However some professionals oppose acquiescing in the possible self-inflicted death of a patient and are sympathetic to the involuntary feeding of the striker. Some governments require health professionals to forcibly feed hunger-striking prisoners, raising issues of dual loyalty obligations. The ethical considerations escalate as the hunger strike progresses and the questions of patient competence and best interests become more complex and the political environment evolves. This paper discusses the hunger strike as a political, medical, moral and human rights problem.

Paper presented at the International Academy of Law and Mental Health, at the Université René Descartes (Paris V) and Sorbonne, in Paris, France, 4-10 July 2005.







a manual for physicians and other health personnel dealing with hunger strikers







Medical and Ethical Aspects of Hunger Strikes in Custody and the Issue of Torture by Hernan Reyes


 Extract from the publication "Maltreatment and Torture", in the series Research in Legal Medicine - Volume 19 / Rechtsmedizinische Forschungsergebnisse - Band 19. M. Oehmichen, ed., Verlag Schmidt-R?mhild, L?beck, 1998.

Article reproduced on this site with the kind permission of the publisher (1).





Michael Peel BMJ 1997;315:829-830 (4 October)


Editorials Hunger strikes Understanding the underlying physiology will help doctors provide proper advice Hunger strikes in different parts of the world are regularly in the news. Doctors with an interest in human rights may be asked to give independent medical advice to an asylum seeker intending to start a hunger strike. Several recent articles have addressed the ethics of treating hunger strikers,1 2 but there is less information available on the physiological issues. It is essential to understand both these issues to be able to advise the individual appropriately.





Nieuwsbrief Mensenrechten & Gezondheidszorg,
oktober 2002: Special Hongerstaking

Van het bestuur

De noodzaak van het bestaan van de Johannes Wier Stichting is de laatste weken overduidelijk gebleken.De enorme stroom van aanvragen voor interviews, gesprekken, meningen enz. over dwangvoeding die de leden van de Werkgroep hongerstaking overspoelde was nauwelijks te verwerken. De geduldige en rustige manier waarop de pers te woord werd gestaan was professioneel.
Ook andere artsenorganisaties hebben impulsen gekregen om zich uit te laten over dit probleem. Zij reageerden op uitlatingen van anderen (ook artsen) die in de media en de politieke arena slordig omgingen met de mensenrechten. De lichamelijke integriteit van Volkert van der G. zou geschonden mogen worden door hem onder dwang te voeden als zijn hongerstaking geleid zou hebben tot een levensbedreigende situatie. De Johannes Wier Stichting vindt dit beangstigend. Dit nummer van Mensenrechten en Gezondheidszorg is daarom een special over de thema's hongerstaking en dwangvoeding.







Begeleiding van hongerstakingen
– Trainingsmodule gereed

In: Mensenrechten & Gezondheidszorg, juni 2003


Begeleiding van hongerstakingen – Trainingsmodule gereed

In 2002 is de trainingsmodule over de begeleiding van hongerstakingen gereed gekomen. De training duurt twee dagdelen, en bevat inleidingen over medische, psychische, juridische en ethische aspecten van de begeleiding van hongerstakers. Op 26 september 2002 werd de cursus voor het eerst gegeven aan een groep van 12 cursisten. Vlak daarna is het curriculum door de Werkgroep Advisering bij Hongerstaking geëvalueerd, zodat de cursus na aanpassing ook in januari 2003 weer aangeboden kon worden.