number of international human rights standards, including prison standards,443 and the rights of detainees to peacefully protest.444 It may also violate the prohibition of torture or ill-treatment.445 230. Additionally, ODIHR is concerned by both the decision of the administration to force-feed detainees and the force-feeding process itself as reportedly carried out at Guantánamo.446 With regard to the decision to force-feed detainees, Defense Department representatives explained to ODIHR the US government policy of force-feeding those detainees whose life or health is in danger. They also specified that the procedures in place aim to maintain good order and discipline throughout the prison as well as help ensure that detainees are not pressured by others to participate in hunger strikes447 which the United States believes to be an “organized act of asymmetrical warfare”.448 231. In this regard, international bodies and experts have reiterated that the decision to forcefeed mentally competent hunger strikers who voluntarily take part in a hunger strike and refuse treatment contradicts rules of ethics and the right to health, inter alia, irrespective of the danger caused to their life or health. The American Medical Association also stressed on several occasions that the force-feeding of detainees violates “core ethical values of the medical profession”, underlining that “every competent patient has the right to refuse medical intervention, including life-sustaining interventions”.449 232. In light of the above, ODIHR notes the first-known case of refusal by a US Navy nurse to force-feed detainees in July 2014.450 ODIHR is deeply troubled by potential retaliation against the nurse for this decision, as he is reportedly facing possible discharge from the Navy for nearly a year, and may now see his security clearance revoked.451 ODIHR supports the US Defense Health Board’s452 recommendation issued in March 2015 that the Defense Department leadership excuse healthcare professionals from performing medical 443 See, for instance, “Standard Minimum Rules for the Treatment of Prisoners”, op. cit., note 280, Rules 10, 15, 20, 27; “Declaration of Malta on Hunger Strikers”, World Medical Association, op. cit., note 315, para. 6. 444 ICCPR, Art. 19; OSCE Copenhagen Document, op. cit., note 80, paras. 9.1, 10.1; OSCE Budapest Document, op. cit., note 3, para. 36; OSCE Istanbul Document, op. cit., note 279, para. 26. 445 As mentioned above, solitary confinement for disciplinary purposes violates the prohibition of torture and ill-treatment when it causes severe pain or suffering to the detainees. 446 The first reported occurrences of force-feeding detainees in hunger strike would have taken place in May 2002, under the previous administration. The Report of The Constitution Project's Task Force on Detainee Treatment, op. cit., note 183, p. 227. 447 ODIHR meeting with the Department of Defense Office of the General Counsel and Office of Detainee Policy, op. cit., note 194. US representatives stressed that peer pressure and coercion have played an important role in the escalation of the number of hunger strikers. Some hunger strikers, they said, thank the soldiers for the feedings. These allow them to pretend they are continuing to strike and taking “part in the fight”. 448 IACHR, “Towards the Closure of Guantanamo”, op. cit., note 245, para. 140. 449 Jeremy A. Lazarus, Letter to the Secretary of Defense, American Medical Association, 25 April 2013, <http://media.miamiherald.com/smedia/2013/04/30/07/58/FRs25.So.56.pdf> 450 “Guantánamo Nurse Refuses To Force-Feed Prisoners”, The Guardian Website, 16 July 2014, <http://www.theguardian.com/world/2014/jul/16/guantanamo-nurse-refuses-force-feed-prisoners>. 451 “U.S. Department of Defense Considers New Retaliation Against Guantánamo Navy Nurse”, Physicians for Human Rights website, 23 July 2015, <http://physiciansforhumanrights.org/press/press-releases/us-department-of-defense-considers-newretaliation-against-guantanamo-navy-nurse.html?referrer=https://www.google.pl/#sthash.2YwQzvEu.dpuf> 452 The Defense Health Board is a Federal Advisory Committee to the Secretary of Defense that provides independent advice and recommendations on matters relating to operational programs, health policy development, health research programs, and requirements for the treatment and prevention of disease and injury, promotion of health and the delivery of health care to Department of Defense beneficiaries. “Defense Health Board – Federal Advisory Committee to the Secretary of Defense”, Health.mil website, <http://www.health.mil/About-MHS/Other-MHS-Organizations/Defense-Health-Board>. 99