Saturday, 5 January 2013

Emedinews:Insights on Medicolegal Issues:'WMA declaration of Malta on hunger strikers


Medicolegal Update
(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

Such difficult ethical situations in medical practice and the guidelines to deal with them have been addressed thoroughly in the revised WMA Declaration of Malta on hunger strikers with principles of Duty to act ethically, in 2006. All physicians are bound by medical ethics in their professional contact with vulnerable people, even when not providing therapy. Whatever their role, physicians must try to prevent coercion or maltreatment of detainees and must protest if it occurs. The other important component is respect for autonomy. Physicians should respect individuals’ autonomy. This can involve difficult assessments as hunger strikers’ true wishes may not be as clear as they appear. Any decisions lack moral force if made involuntarily by use of threats, peer pressure or coercion. Hunger strikers should not be forcibly given treatment they refuse. Forced feeding contrary to an informed and voluntary refusal is unjustifiable. Artificial feeding in form of intravenous fluid/nutrition with the hunger striker’s explicit or implied consent is ethically acceptable.

2 comments:

  1. sir ,I am in government service,I have seen hunger strikers who remain very active except presence of ketones in urine even after 20-25 days of hunger strike..After 15-16 days administration ask us to write that continuation of hunger strike will be harmful to their health and they should be feeded immediately.Please guide me when should we write that continuation of hunger strike will endanger his life.If hunger striker is a prisoner is force feeding legalized,recently I have seen a order from District Magistrate quoting some lines from Parikh "force feeding to a prisoner is not an assault".

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  2. Is Ryle"s Tube feeding a form of force feeding??

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