Guantanamo's Force-Feeding Challenged

In the first trial weighing the legality of force-feeding methods at the Guantanamo Bay prison, U.S. government lawyers have tried to disparage doctors and refute medical assessments regarding the best practices and ethics for treating inmates who have engaged in hunger strikes to protest their indefinite confinements, often after being cleared for release.

The case before Judge Gladys Kessler in Washington D.C.'s District Court involves Abu Wa'el Dhiab, 43, a Syrian who ran a successful business in Afghanistan before the U.S. invaded 13 years ago. He fled, together with his wife and four children, to Pakistan where police seized him and turned him over to the U.S. -- probably for a large bounty, as was the usual practice.

It is the manner in which the force-feeding process is carried out that is primarily at issue in Dhiab's case, including the forced cell extractions and the "five-point restraint chair" in which the head and limbs are tied down during the feeding.

Reprieve, a British-based human rights organization, filed a court challenge against Dhiab's treatment with some of the legal skirmishing around whether the public will be allowed to see video of Dhiab being dragged from his cell and force-fed once or twice a day, a total of 1,300 times, according to his lawyer. In June, 16 news organizations intervened in Dhiab v Obama seeking the videos of Dhiab's treatment.

While the government contended that the tapes must be kept secret to protect national security, Judge Kessler found that the government arguments were "unacceptably vague, speculative, lack specificity or are just plain implausible." On Oct. 3, Judge Kessler ruled that unclassified versions of the videos may be "entered on the public docket." This was a major setback for government lawyers.

Impugning the Witness

At times in their efforts to disparage the testimony of doctors, the junior-varsity team of Obama administration lawyers seemed to be practicing for more lucrative post-government medical-malpractice work, trying out character assassination and similar tactics.

Granted, it would have taken a government varsity or, better, an all-star legal team to cross-examine respected psychiatrists like Steven Xenakis, a retired Brigadier General, who told the court on Monday that prison military brass apparently overrode sound medical decisions regarding Dhiab.

Xenakis -- along with Sondra Crosby, M.D., an associate professor of medicine at Boston University -- painted a bleak picture of the prevalence of punitive measures divorced from best medical practices at Guantanamo. The government lawyers then tried to discredit Xenakis by hinting broadly that Xenakis was unreliable because he left the Army amid an investigation, a slur Xenakis promptly laid to rest.

Then, on Tuesday, things went so badly for the government lawyers that I almost felt sorry for them. All four of them with a bullpen of six more were outmatched by Reprieve's soft-spoken star witness, Steven Miles, M.D., of the University of Minnesota's Center for Bioethics.

With his impeccable credentials, Miles could be at the same time understated and brutal in his critique of Guantanamo prison's blithe disregard for best medical practices. For example, he said he was "astonished" to learn that an olive oil lubricant was applied to the feeding tubes used on hunger-striking detainees because olive oil can cause chronic inflammatory pneumonia if it reaches the lungs. The resulting condition is difficult to detect as it might appear years later on x-rays looking like tuberculosis or lung-cancer.

"There is simply no debate about this. All the medical literature I've found said the lubricant had to be water-soluble," Miles said.

I had noticed that in presenting their case, the government lawyers had showed slides indicating that the use of olive oil was stopped in June, and when the court took a break I asked Dr. Miles why. "Because I went ballistic as soon as I found out about it," he said in a voice much louder than the normally restrained one in which he testified.

According to the Guardian's Spencer Ackerman, Captain Tom Gresbach, a Guantanamo spokesman, has confirmed that the forced feedings now use water-based lubricant. He explained that change was made "to eliminate risk, albeit minimal, for olive oil to get into the bronchial tree and lungs, thereby possibly causing illness."