subsequently lifted,459 ordered the US government to “preserve and maintain all relevant videotapes” of his force-feedings and forcible cell extractions460 and denied another preliminary injunction seeking to enjoin several alleged practices and protocols related to the force-feeding process, after the US government took positive steps to address some of the detainee’s complaints.461 In a November 2014 ruling, the judge concluded that the petitioner “failed to show that continued daily insertion [of the feeding tubes] would lead to irreparable harm”, and noted that the force-feeding process may have caused pain to the detainee only in “isolated incidents”.462 She nonetheless pointed out that “common sense and compassion should have dictated a much earlier” action to avoid “numerous painful and humiliating forced cell extractions”.463 The potential use of force to extract detainees from their cells for the purpose of force-feeding was litigated in another case in which the judge concluded being “unconvinced that Guantanamo Bay guards exceed their authority by forcibly extracting a detainee who (…) refuses to leave his cell”.464 235. Nevertheless, ODIHR wishes to underline that force-feeding mentally competent detainees may amount to torture and ill-treatment when the medical necessity of such treatment is not convincingly demonstrated, the force-feeding process does not comply with procedural safeguards and “trespass the threshold of a minimum level of severity”.465 It was reported that up to 46 detainees were force-fed during the hunger strike of 2013.466 ODIHR notes with concern reports indicating that the force-feeding of Guantánamo detainees has, in practice, and at least in the past, started “long before their lives was in serious danger”.467 Moreover, force-feeding “causes psychological scars and places the striker at risk of major infections, pneumonia, and collapsed lungs”.468 In the Guantánamo context, it can reasonably be assumed that the psychological impact of such feedings is even worse for individuals who experienced severe pain or suffering as part of a system of detention which had been created to show them that they had no control over their fate or treatment. Force-feeding a detainee who asserts autonomy over the last thing he has control over469 (whether or not to eat) can cause great distress. Finally, force-feeding should never be used 459 United States District Court for the District of Columbia, Dhiab v. Obama, 16 May 2014, <http://www.reprieve.org/uploads/2/6/3/3/26338131/2014_05_16_dhiab_court_order.pdf>. 460 Ibid., p. 2. The litigation over the release of the force-feeding videos is ongoing at the time of drafting. 461 The ruling mentioned, inter alia, that Dhiab would now be allowed to use a wheelchair to go to the feedings, that the forcible cell extractions would no longer be used so long as he walked from his cell to the wheelchair a few steps away, and that the Defense Department would no longer use olive oil to insert the feeding tubes. United States District Court for the District of Columbia, Dhiab v. Obama, 7 November 2014, op. cit., note 456, p. 5. 462 Ibid., pp. 10-12: explaining that there had been past incidents of violence when the nasogastric tubes were kept in place for longer periods of time during the 2005 hunger strike, that “if a detainee was psychotic, combative, suicidal, or generally causing risk to himself or others, removing the tube between the feedings would be appropriate and safer”, and that Dhiab “often tolerates the [force-feeding] procedure without complaints of pain or significant discomfort”. 463 Ibid., p. 20. 464 United States District Court for the District of Columbia, Mohammad Ahmad Ghulam Rabbani v. Barack H. Obama, Case No. 05-1607 (RCL), 19 December 2014, <https://casetext.com/case/rabbani-v-obama-3>. 465 ECtHR, Nevmerzhitsky v. Ukraine, op. cit., note 317, para. 94; ECtHR, Ciorap v. Moldova, op. cit., note 317, para. 77. 466 “Tracking the hunger strike”, Miami Herald website, <http://media.miamiherald.com/static/media/projects/gitmo_chart/>. 467 The Report of The Constitution Project's Task Force on Detainee Treatment, op. cit., note 183, p. 231. 468 Punishment before Justice, op. cit., note 231, p. 26. In the case of the force-feeding process used in Guantánamo, concerns have also been raised that the use of olive oil to lubricate feeding tubes “for cultural preference” involved risks of developing a chronic inflammatory disease called lipid pneumonia. Carol Rosenberg, “Doctor: Guantánamo erred by lubing forced-feeding tubes with olive oil”, Miami Herald website, 7 October 2014, <http://www.miamiherald.com/news/nationworld/world/americas/guantanamo/article2564288.html>. 469 ODIHR interview with Scott Allen, op. cit., note 231. 101