68 | Towards the Closure of Guantanamo fully informed consent, about what a detainee wants and about the way to make decisions about their life if it were in danger. However, according to some experts, that did not occur during the 2013 hunger strike. What allegedly occurred were much more abbreviated conversations about what the detainees understood might happen, which were reportedly compromised by the lack of trust between the clinicians and the detainees. 168 147. The force-feeding that has been taking place at Guantanamo is widely considered to be in violation of medical ethics and international law, which prohibits cruel, degrading and humiliating treatment. In an opinion issued on July 8, 2013, U.S. District Judge Gladys Kessler denied the request filed by Jihad Dhiab to end the forced feeding for lack of jurisdiction to rule on conditions of confinement at Guantanamo. However, Judge Kessler stated that “force-feeding is a painful, humiliating, and degrading process” and said President Obama has the authority to directly address this issue. 169 On May 16, 2014, the same federal judge ordered the U.S. Government to temporarily suspend the forced feeding of Mohammed Abu Wa’el Dhiab and preserve all videotapes of the forced feedings and forcible cell extractions of the detainee. 170 This was the first time such a suspension was ordered by a federal judge. However, on May 22, 2014, the temporary ban was lifted. The judge reportedly said that, faced with the very real probability that Mr. Dhiab will die, she had no choice but to “allow the medical personnel on the scene to take the medical actions to keep Mr. Dhiab alive, but at the possible cost of great pain and suffering.”171 148. The IACHR has stressed that, according to the World Medical Assembly’s Declaration of Malta, in cases involving people on hunger strikes, the duty of medical personnel to act ethically and the principle of respect for individuals’ autonomy, among other principles, must be respected. 172 Under these principles, it is unjustifiable to engage in forced feeding of individuals contrary to their informed and voluntary refusal of such a measure. Moreover, hunger strikers should be protected from all forms of coercion, even more so when this is done through force and in some cases through physical violence. Health care personnel may not apply undue pressure of any sort on individuals who have opted for the extreme recourse of a hunger strike. It is also not acceptable to use threats of forced feeding or other 168 169 170 171 172 IACHR’s Expert Meeting on the situation of detainees held at the U.S. Naval Base at Guantanamo Bay, Washington DC, October 3, 2013. Jihad Dhiab v. Barack Obama, No. 05-1457 (D.C Cir. 2013). Available at: http://legaltimes.typepad.com/files/gitmo-order.pdf Reprieve, Press release, Judge orders US government to halt force-feeding of Guantanamo prisoner and preserve video evidence of his ordeal, May 16, 2014. Available at: http://www.reprieve.org/judge-orders-usgovernment-to-halt-force-feeding-of-guantaacutenamo-prisoner-and-preserve-video-evidence-of-abuse.html CNN, Justice allows forced feeding to resume on Guantanamo detainee, May 23, 2014. Available at: http://www.cnn.com/2014/05/23/justice/guantanamo-detainee-forced-feeding/index.html Article 21 of the 1991 Malta Declaration of the World Medical Association (as revised in 1992 and 2006) establishes: “Forcible feeding is never ethically acceptable. Even if intended to benefit, feeding accompanied by threats, coercion, force or use of physical restraints is a form of inhuman and degrading treatment. Equally unacceptable is the forced feeding of some detainees in order to intimidate or coerce other hunger strikers to stop fasting.” Organization of American States | OAS