American Nurses Association to Give Ethics Award to Navy Nurse

The American Nurses Association (ANA) is giving an ethics award to a US Navy nurse who refused to force-feed Guantanamo prisoners through a tube.  This  contravenes Department of Defense policy  that indicate the practice of force-feeding the prisoners is, according to the article, “legal, appropriate and ‘medically sound’”, making the nurse’s actions doubly important – he was disobeying orders by not doing the force feeding.  Unlike a civilian hospital job, where he might be fired and simply go to another hospital, the nurse was facing a court martial for his actions and the likelihood of losing his chance at military retirement.  And a court martial can also result in a discharge that is other than honorable, making employment in the civilian world difficult, loss of wages and possibly time in the brig.  Certainly, the nurse risked a great deal by not following orders.

https://news.nurse.com/2015/07/23/ana-honors-navy-nurse-with-year-of-ethics-award/

But is force feeding unethical? 
According to the American Medical Association (AMA), in a 2013 letter to the Secretary of Defense, stated that force feeding of prisoners “violates the core ethical values of the medical profession.  Every competent patient has the right to refuse medical intervention, including life-sustaining interventions.”  (https://www.documentcloud.org/documents/694196-hunger-strikers-letter-04-25-13.html)

The letter goes on to endorse the World Medical Association Declaration of Tokyo, which makes the same point, showing that there are international standards that should be applied and these standards say that a competent patient should have agency on refusal of being fed. 

But regarding Guantanamo prisoners; if we let them starve then we make them martyrs to their cause, right? Well, force-feeding them also brings attention to their cause like martyrdom would, and makes the US seem barbaric in our treatment.  

But how can letting them die be ethical?  Well,  letting them make decisions on their own death has more dignity than stopping it via the cruel and unusual practice of forcing a tube down their throat strapped to a chair.  Neither choice is preferable, but they do have an opportunity to make that penultimate decision, vice taking it away – and giving them that agency is more ethical than taking it away.