I have been made elsewhere these days, because the Swiss medical lives behind the scenes that could be ethically one of the most difficult situations in recent years. On the surface, a case that is beginning to really annoy the opinion (if you believe the reviews online): the case extremely heartbreaking prisoner's hunger striker Bernard Rappaz. Behind this story extension, an issue that is now directly caregivers part. In a decision announced in late August, the Federal Court considers the responsibility of enforcement authorities to order a sentence to a prisoner forced feeding of hunger strikers .
So if it was you, the doctor who is ordered to force-feed a prisoner? What would you do? Without doubt it would depend. A lot of national and international have addressed this difficult issue, and their answer is always the same: we must take great care to explore all parameters of a situation like this, but if it was this work and we are satisfied that the prisoner will not really food, and decides freely and lucidly, so we can not feed him against his will.
We can not, ever, force feeding really . This would involve attaching possibly to sleep, to drive a probe into his stomach ... and again and again as his will remain unchanged. Inhuman and degrading treatment. In the 70s, prisoners in Northern Ireland have been force fed for months. The European Court of Human Rights has confirmed at least twice the recharge forced treatment was close to torture when he meant to obstruct a prisoner and force him to insert a sensor booster. I'll spare you the description of the facts, because it is rather difficult to sustain. For the curious, these cases had taken place in Ukraine and Moldova. In another appeal (this time Turkey), the same Court ruled that the death of an inmate, following a hunger strike did not constitute a breach of human rights since he had access prison to the same care and out.
But then what if you are a doctor and an authority You are directed to proceed? The special feature of the Bulletin of Swiss Physicians this week looks at the issue , and proposes an analytical article, position papers, several letters, extracts from national and international guidelines. It was important to do this. A few years ago, the American writers had in mind cases in Guantanamo had written this:
"Physicians caring for patients who make a hunger strike can be placed in a position of dual loyalty, eg , meet the obligations of the prison or the government, which can be in direct conflict with the best interests of patient. The physician's duty to the patient is still the highest priority. All legal and ethical guidelines for dealing the hunger strikers requesting cooperation doctors, they can and must prevent forced feeding of prisoners in possession of arguments in refusing to approve or participate. This action, naturally, seek professional organizations medical and legal support to thoroughly prison doctors, including physicians military, who follow the rules of medical ethics and Rights of man. "
In taking a stand against the forced feeding , professional organizations Swiss therefore fulfill this responsibility. remains to be seen what will happen in fact if, as is likely, we found shortly before a prisoner hunger strikers in serious danger. Being a caught between his ethics and the order of a public authority is never an easy situation.
In fact it is precisely the kind of situation that a state law usually seeks to avoid. In fact, the use of medicine as a tool of state power is primarily associated with problems such as psychiatric incarceration of political opponents, or participation medical to torture, or penalty. But even the United States, where participation in medical capital punishment is the subject of considerable controversy, no physician has ever been convicted for refusing to participate.
It would be deeply damage and around the 'case Rappaz, Switzerland establishes a principle of enslavement of medicine as a tool of power, whether legitimate or that power elsewhere. That would be a precedent that we associate more readily with disrespectful statements of individual freedom and human rights. And like the prisoner around which this whole story is described as an old seventy-eighter, it would at the same time a deeply paradoxical consequence of his actions.
