An Analysis of an Ethical Dilemma The article, Why U.S.

doesnt let detainees starve at Guantanamo Bay, discusses an ethical dilemma surrounding the issue of hunger strikers at the prison camps at Guantanamo Bay. According to the article, the International Committee of the Red Cross (ICRC) disagrees with the United States practice of force-feeding captives who are participating in a hunger strike. The ICRC believes that the detainees have the right to choose their fate, and other human rights advocacy groups assert that force-feeding them is unethical and a violation of medical ethics. On the other hand, the prison camp staff wont let the detainees starve because they believe letting them die from starvation is inhumane, at odds with the creed of medical professionals of the U.S. military to do no harm, is un-American, looks bad, and is against U.S. policy. It is right for the detainees to be provided with a fulfillment of their basic need to eat. Providing them with food ensures that they will not die of starvation or be devoid of one of the only human comforts they have which is to satisfy their hunger. It is also just for the detainees to be able to have the right to peacefully protest. Allowing them to make a statement through their hunger strike may catalyze change for them whether it be through the media, public awareness, and public pressure for just practices or through ending their suffering via starvation. The United States has this ethical dilemma. They have the choice to continue force-feeding the hunger strikers or to cease and respect their right to peacefully protest. Another side ethical issue present is that force-feeding the captives is a violation of medical ethics and force-feeding them may even go as far as torture or ill-treatment but it is also the duty of the medical staff of the U.S. military to take care of the captives and provide them with medical care especially if they are at risk of dying. Another includes the fact that some of the captives are being held without a fair trial and are being held indefinitely and may not even deserve to be there in the first place. A

third side ethical dilemma that exists is the power of the governments hegemony with respect to allowing the mistreatment of terrorists in a variety of settings and circumstances and the inability of some Americans to see the terrorist individuals unfair treatment. My initial reaction to this article was disgust towards the U.S. government. Shock and disbelief entered my mind as I visualized the discomfort of being fed against your will and imagining an individual being forced to prolong the suffering in which he lives in and seeks to end. The biases that I carry influence my reactions to this article and affect my views. My value for the rights of the prisoners is one of my biases. I dont believe it is fair to mistreat a prisoner regardless of their stance in society. My opinion about the governments overwhelming power with respect to patriotism and my awareness of its ability to unify the nation against terrorism has also slanted my views on this issue. They almost have no voice in the United States. My awareness of other terrorist mistreatment such as the killing of Osama bin Laden without trial, knowledge of the Patriot Act, the celebration that ensued by the U.S. public at the death of a human life, and my knowledge of the wrong-doings of the U.S. government with respect to Guantanamo Bay, such as keeping detainees there indefinitely without a fair trial, have led me to have many of the biases as well as the privatization of prisons. Learning about the ills of privatized prisons has led me to have more sympathy for prisoner rights. Learning about these events has impacted my world view and has allowed me to, in a sense, detach from the culture Im steeped in; from the water that I swim in to be able to analyze events as objectively as I can. These realizations have allowed me to understand how ones own biases can influence ones behaviors, views, and reactions in situations. It has also allowed me to understand why others act or believe the way they do. For example, it has allowed me to understand why a nation would break out in a spontaneous public jubilation and celebration of a mans wrongful death even if it

were Osama bin Laden. Peoples biases, whether is it simply because youre American, color their perspectives and views which, in turn, influence their thoughts and actions. The main stakeholders in this dilemma are the United States government and the detainees at the Guantanamo Bay prison camps. As the article describes, the prison camp staff believe that to let them starve in inhumane, at odds with U.S. military medicine, counter to their responsibilities under the laws of war, and it would be against policy. The United States, generally, also looks down on suicide so letting them starve would be un-American. The U.S.s perspectives and values influence them to keep on force-feeding the captives as long as they are medically at risk. The U.S. government will not allow their captives to die. The detainees do not have much control over their lives but the one thing they can control is their ability to eat or to not eat, to the extent that they dont become medically at-risk. The absence of eating can become an instrument of protest and a voice for the captive who otherwise would go unheard. The captives value their own right to speak up against their condition and to protest against it in hopes of escaping it. Some may even be motivated by the media attention that their hunger strike is receiving and hope for public uproar against this issue. The captives values and perspectives will influence them to continue on their hunger strike and perhaps develop hatred or even a stronger hatred toward the United States. The stakeholders that are indirectly involved are the staff at Guantanamo Bay, citizens of Afghanistan, Iraq or other opposing nations, Americans, international medical groups, human rights organizations, and the U.S. Navy. The staff at Guantanamo Bay may be distressed in the future if later the U.S. government decides to let them starve. It may be against their own values to let them die of starvation. Some staff may be distressed now if they are acting against their own values by force-feeding them. Citizens of Afghanistan, Iraq, and other opposing nations may be affected by this dilemma. The situation

may cause more anti-American sentiment in those countries and may lead to danger for the U.S. in the future. Americans may be affected by the awareness of this dilemma to push for change regarding their situation they may also be in danger in the future if more anti-American sentiment increases in other nations. Human rights organizations and international medical groups are affected by the dilemma through their concern of this issue and their support for the detainees rights. Lastly, the Navy is also affected because they are the organization through which the government is operating. Their reputation may be impacted. Location, time, and process helped to create this dilemma in a few ways. The fact that the prison camp is U.S. government run and operated makes it an ethical dilemma because the United States has a negative view of both suicide and terrorists. The United States will not allow them to commit suicide by starvation; therefore, they will choose to force-feed them in this situation. They may also not see it as torture because they are dealing with terrorists. The time in which this dilemma is occurring is also contributes to the formation of this dilemma because it is occurring during a time of strong anti-terrorist sentiment in the United States. The United States government and its citizens may be more apathetic to their situation and less inclined to do advocate for the detainees rights. The dilemma may also be drawn out longer if the government has no urgency to solve it. The process is also a significant factor in this dilemma. The longer the process takes to come to a solution to this dilemma, the longer the detainees will suffer. According to the Physical Therapists APTA Code of Ethics, a principal that was not followed that created this dilemma is Principle 3, A physical therapist shall comply with laws and regulations governing physical therapy and shall strive to effect changes that benefit patients/clients. According to the article, force-feeding the captives is a violation of medical ethics and may even be classifies as torture. More and more detainees are joining in on the

hunger strike and nothing is being changed to benefit the captives. The practices at Guantanamo Bay also violate Principle 5, A physical therapist shall exercise sound professional judgment. The United States government is not protecting the detainees rights to peacefully protest. They are also not considering how the act of force-feeding could be an unethical act. Lastly, the forcefeeding violates Principle 9, A physical therapist shall protect the public and the profession from unethical, incompetent, and illegal act. The article mentions that Dr. Vincent Lacopino, an expert with Physicians for Human Rights, states that to force-feed in unethical and may even rise to the level of torture or ill treatment. According to the Family Life Educators Code of Ethics, a principle that may help solve this dilemma is principle 4 under the Relationships with Community/Society section. It says, I will advocate for laws and policies that reflect our changing knowledge base and the best interest of parents, families, and communities. Learning that force-feeding in indeed unethical and a malpractice, the United States may decide to cease it. Another principle that may offer a solution is Principle 5 under the Relationships with Children and Youth. It says, I will provide environments that are respectful of children and youth and sensitive to their developmental and individual needs. This principle could help solve the dilemma by structuring the prisons policies so that they are respectful of the detainees needs. Principle 1 from the Physical Therapists APTA Code of Ethics may also provide a solution. It states that, A physical therapist shall respect the rights and dignity of all individuals and shall provide compassionate care. Viewing the detainees as humans and individuals worthy of respect and compassionate care and focusing on their needs instead of the responsibilities and duties of the Guantanamo Bay staff may result in a staff that respects their right to not eat to the point of death because it is what they desire instead of being force-fed against their will.

Applying an end-based approach to resolve the dilemma would lead to force-feeding the captives. There is more staff than prisoners at the camps, 1,700 staff members compared to 166 captives. An end-based approach would allow the staff members to uphold their military medicine laws and facility policies. A care-based approach is more subjective. If I were in the captives shoes, I would want to be left to starve if that is what I wanted. The most caring thing to do in this situation would be to respect the captives desires to escape their misery and suffering, or at least to allow them to make a statement by hunger striking. Under a rule-based principle, if there could only be one standard, the standard should be a world where people had the right to peacefully protest, have control over their fate, and be able to keep their dignity. An unethical behavior that could help solve the dilemma could be a violent uproar by the detainees in which they kill all the staff members. Then maybe some would attempt to escape or commit suicide. The pro of an end-based approach would be that American staff members would be upholding their policy and American values. The con would be that the prisoners would still be suffering and fed against their will. The pro of a care-based approach would be that the prison would be respecting the prisoners rights and act in a more compassionate way toward the captives. A con would be that the staff might be uncomfortable with letting the captives starve. They may have to act against their values or perspectives. The pro of a rule-based approach would be that all prisoners rights would be respected and they would be allowed to have a voice through their right to peacefully protest. A con would include that they American public or the staff at the Guantanamo Bay prison may be uncomfortable acting against their American views regarding suicide. A pro of the unethical practice would be that the prisoners would at last be able to have some control over their fate. A con would be that Americans would die at the cost of the detainees freedom. It may also increase anti-terrorist sentiments if the media were to cover it

extensively. The short-term consequences for the end-based approach would be that the staff is satisfied with complying with their beliefs and values while the prisoners suffer by being kept alive. The long-term consequence would be that the detainees would be kept alive for as long as they were detained against their wished and desires. A short-term consequence for the care-based approach would be that the prisoners would be at ease. A long-term consequence would be that there would be fewer prisoners at Guantanamo Bay and lower costs to run the prison camp facility. A short-term consequence for the rule-based approach would be that the prisoners would be respected of their rights