Policy Tag: Forced Feeding

Adopted by the 217th WMA Council Session, Seoul (online), April 2021
and rescinded and archived by the 72nd WMA General Assembly (online), London, United Kingdom, October 2021
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The World Medical Association notes with alarm the critical health condition of the Russian opposition activist Alexei Navalny detained in Moscow since January 2021.

Navalny has been on a hunger strike since 31 March and was transferred to a prison hospital on Monday 21st of April. Corroborating information indicates that he is facing denial of adequate medical care and threatened to be force-fed by the prison authorities.

The WMA recalls its Declaration of Malta on Hunger Strikers laying down the medical ethical principles governing hunger strikes, in particular the respect of the individual’s autonomy and dignity. Force-feeding and any other forms of coercion constitute a form of torture and is contrary to medical ethics.

The WMA recalls the standards of international human rights law, including the International Covenants on Civil and Political Rights and on Economic, Social and Cultural Rights, guaranteeing, amongst other matters, the freedom of expression, access to adequate healthcare as well as the prohibition of torture or cruel, inhuman or degrading treatment. The Russian Federation ratified the covenants in 1973 and is held accountable for its commitments.

Thus, the WMA and its members call on the Russian authorities to ensure full respect for its human rights obligations, and demand immediate action to ensure that Alexei Navalny be treated with humanity and with respect for the inherent dignity of the human person, in particular:

  • That he be urgently examined by independent and qualified medical experts,
  • That the Russian authorities take all the required measures to provide adequate conditions in line with the Malta Declaration to respect his decision to hunger strike and to ensure that he is not force-fed,
  • That he be released immediately as he is a prisoner of conscience deprived of his liberty for his peaceful political activism and exercising free speech.

Adopted by the 29th World Medical Assembly, Tokyo, Japan, October 1975
Editorially revised by the 170th WMA Council Session, Divonne-les-Bains, France, May 2005
and the 173rd WMA Council Session, Divonne-les-Bains, France, May 2006
and revised by the 67th WMA General Assembly, Taipei, Taiwan, October 2016

 

PREAMBLE

It is the privilege of the physician to practise medicine in the service of humanity, to preserve and restore bodily and mental health without distinction as to persons, and to comfort and to ease the suffering of his or her patients. The utmost respect for human life is to be maintained even under threat, and no use is to be made of any medical knowledge contrary to the laws of humanity.

For the purpose of this Declaration, torture is defined as the deliberate, systematic or wanton infliction of physical or mental suffering by one or more persons acting alone or on the orders of any authority, to force another person to yield information, to make a confession, or for any other reason.

 

DECLARATION

1. The physician shall not countenance, condone or participate in the practice of torture or other forms of cruel, inhuman or degrading procedures, whatever the offense of which the victim of such procedures is suspected, accused or guilty, and whatever the victim’s beliefs or motives, and in all situations, including armed conflict and civil strife.

2. The physician shall not provide any premises, instruments, substances or knowledge to facilitate the practice of torture or other forms of cruel, inhuman or degrading treatment or to diminish the ability of the victim to resist such treatment.

3. When providing medical assistance to detainees or prisoners who are, or who could later be, under interrogation, physicians should be particularly careful to ensure the confidentiality of all personal medical information. A breach of the Geneva Conventions shall in any case be reported by the physician to relevant authorities.

4. As stated in WMA Resolution on the Responsibility of Physicians in the Documentation and Denunciation of Acts of Torture or Cruel or Inhuman or Degrading Treatment and as an exception to professional confidentiality, physicians have the ethical obligation to report abuses, where possible with the subject’s consent, but in certain circumstances where the victim is unable to express him/herself freely, without explicit consent.

5. The physician shall not use nor allow to be used, as far as he or she can, medical knowledge or skills, or health information specific to individuals, to facilitate or otherwise aid any interrogation, legal or illegal, of those individuals.

6. The physician shall not be present during any procedure during which torture or any other forms of cruel, inhuman or degrading treatment is used or threatened.

7. A physician must have complete clinical independence in deciding upon the care of a person for whom he or she is medically responsible. The physician’s fundamental role is to alleviate the distress of his or her fellow human beings, and no motive, whether personal, collective or political, shall prevail against this higher purpose.

8. Where a prisoner refuses nourishment and is considered by the physician as capable of forming an unimpaired and rational judgment concerning the consequences of such a voluntary refusal of nourishment, he or she shall not be fed artificially, as stated in WMA Declaration of Malta on Hunger Strikers. The decision as to the capacity of the prisoner to form such a judgment should be confirmed by at least one other independent physician. The consequences of the refusal of nourishment shall be explained by the physician to the prisoner.

9. Recalling the Declaration of Hamburg concerning Support for Medical Doctors Refusing to Participate in, or to Condone, the Use of Torture or Other Forms of Cruel, Inhuman or Degrading Treatment, the World Medical Association supports, and encourages the international community, the National Medical Associations and fellow physicians to support, the physician and his or her family in the face of threats or reprisals resulting from a refusal to condone the use of torture or other forms of cruel, inhuman or degrading treatment.

10. The World Medical Association calls on National Medical Associations to encourage physicians to continue their professional development training and education in human rights.