The doctors said physicians at the military prison had to respect inmates' right to refuse treatment.
The letter, in the medical journal, The Lancet, said doctors who used restraints and force-feeding should be punished by their professional bodies.
Some 500 terror suspects are being held without trial at Guantanamo Bay.
The US has argued that the Geneva Convention does not apply to prisoners at the camp, who, it says, are enemy combatants who continue to pose a threat to national security.
Human rights groups and the UN have urged the US to close down the facility.
Amnesty International said the "troubling" accusations in the doctors' letter underlined the need for the "independent medical examination of the prisoners.
'Nasal tubes'
The open letter in the Lancet was signed by more than 260 top doctors from seven countries - the UK, the US, Ireland, Germany, Australia, Italy and the Netherlands.
"We urge the US government to ensure that detainees are assessed by independent physicians and that techniques such as force-feeding and restraint chairs are abandoned," the letter said.
The doctors said the World Medical Association - a world body representing physicians, including those in the US - specifically prohibited force-feeding.
Detainees at the camp have said hunger-strikers were strapped into chairs and force-fed through tubes inserted in their noses.
More than 80 inmates are said to have gone on hunger strike in December last year - a figure that has now reportedly dropped to four.
Dr David Nicholl, a UK neurologist who initiated the Lancet letter, told the Reuters news agency the allegations of force-feeding represented "a challenge" to the American Medical Association, which is a signatory to the World Medical Association's code of conduct.
"Are they going to obey those declarations [forbidding force-feeding], or are... [they] literally not worth the paper they are written on?" he asked.
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/americas/4790742.stm
Published: 2006/03/10 00:09:34 GMT
© BBC MMVI
The Lancet 2006; 367:811
DOI:10.1016/S0140-6736(06)68326-8
Forcefeeding and restraint of Guantanamo Bay hunger strikers
David J Nicholl a, Holly G Atkinson b, John Kalk c, William Hopkins d, Elwyn Elias e, Adnan Siddiqui f, Ronald E Cranford g and Oliver Sacks h, on behalf of 255 other doctors
We write regarding the forcefeeding and restraint of Guantanamo Bay detainees currently on hunger strike.1,2 The World Medical Association specifically prohibits forcefeeding in the Declarations of Tokyo and Malta, to which the American Medical Association is a signatory.
Fundamental to doctors' responsibilities in attending a hunger striker is the recognition that prisoners have a right to refuse treatment. The UK government has respected this right even under very difficult circumstances and allowed Irish hunger strikers to die. Physicians do not have to agree with the prisoner, but they must respect their informed decision. Those breaching such guidelines should be held to account by their professional bodies. John Edmondson (former commander of the hospital at Guantanamo) instigated this practice, and we have seen no evidence that procedures have changed under the current physician in charge, Ronald Sollock.3
Edmondson, in a signed affidavit, stated that ?the involuntary feeding was authorized through a lawful order of a higher military authority.?4 This defence, which has previously been described as the Nuremberg defence,5 is not defensible in law. In a reply to an earlier draft of this letter, Edmondson said that he was not forcefeeding but ?providing nutritional supplementation on a voluntary basis to detainees who wish to protest their confinement by not taking oral nourishment?.
Recently, it was confirmed that health-care staff are screened to ensure that they agree with the policy of forcefeeding before working in Guantanamo Bay.1 On his departure, Edmondson was awarded a medal for his ?inspiring leadership and exemplary performance [which] significantly improved the quality of health care for residents of Guantanamo Bay? and ?scored an unprecedented 100% on both the Hospital and the Home Health surveys.?3 The New York Times, however, reports that hunger striking detainees are strapped into restraint chairs in uncomfortably cold isolation cells to force them off their hunger strike.2
We urge the US government to ensure that detainees are assessed by independent physicians and that techniques such as forcefeeding and restraint chairs are abandoned forthwith in accordance with internationally agreed standards.
We declare that we have no conflict of interest.
Signatories of the Correspondence letter ?Forcefeeding and restraint of Guantanamo Bay hunger strikers?
References
1. Okie S. Glimpses of Guantanamo: medical ethics and the war on terror. N Engl J Med 2005; 353: 2529-2534. CrossRef
2. Golden T. Tough US steps in hunger strike at Camp in Cuba. New York Times. Feb 9, 2006:
http://select.nytimes.com/gst/abstract.html?res=F70714F...
(accessed Feb 22, 2006).
3. Byrington S. Sollock takes command of Naval Hospital. Guantanamo Bay Gazette 2006; 63: 3
http://www.nsgtmo.navy.mil/Gazette%20Online/archived%20...
(accessed Feb 22, 2006).
4. Al Joudi et al vs George Bush in the US District Court for the District of Columbia. Case1: 05-cv-00301-GK. Document 48, Exhibit A. Filed Oct 19, 2005.
5. Spitz V. Doctors from hell: the horrific account of Nazi experiments on humans. Boulder: First Sentinent, 2005:.
Affiliations
a. Department of Neurology, City Hospital, Birmingham B18 7QH, UK
b. Physicians for Human Rights and Division of Medical Ethics, Weill Medical College of Cornell University, Ithaca, NY, USA
c. Derbyshire Royal Infirmary, Derby, UK
d. Medical Foundation for the Care of Victims of Torture, London, UK
e. Queen Elizabeth Hospital, Birmingham, UK
f. CAGE Prisoners, London, UK
g. Department of Neurology, Hennepin County Medical Center, Minneapolis, MN, USA
h. 2 Horatio Street #3G, New York, NY, USA
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