ANA has been monitoring the force-feeding of detainees at Guantanamo Bay for approximately six years. Since April 2013, media reports have noted that detainees continue to engage in “hunger strikes” and that Naval medical personnel are being used to force-feed the detainees. On July 15, 2014, the Miami Herald reported that “a Navy medical officer recently refused to continue managing tube-feedings of prison hunger strikers and was reassigned to “alternative duties.” A prison spokesperson acknowledged that a medical provider was not willing to carry out the enteral feeding of a detainee and that “the matter is in the hands of the individual’s leadership.” Through other sources and a subsequent editorial in the Miami Herald (7/17/2014) it was confirmed that the medical officer was a registered nurse.
This prompted ANA to send a letter to the Chief of the Navy Nurse Corps with a focus on the right of the nurse to refuse and that the nurse should not be retaliated against for acting on this right. The Navy was considering discharging the nurse from active duty, prompting ANA to send a similar letter to the Secretary of Defense. In April 2015, the Commanding Officer of the Navy Personnel Command decided not to institute discharge proceedings against the nurse. ANA is pleased that the Navy has taken this step, which is in accordance with the recommendation of the Defense Health Board, and the positions of both ANA and Physicians for Human Rights.
ANA’s position is focused on:
- Supporting the military nurses who have to make very difficult decisions related to either moving forward with or questioning the plan of care.
- Urging the military leadership to recognize the ethical code of conduct to which professional registered nurses are accountable.
- Advocating for the establishment of a process within the uniformed services that allows for a thorough review of the type of situation and is receptive to concerns raised by the registered nurse who is compelled to question the plan of care.
Further support for this response can be found in the ANA position statement, The Nurse’s Role in Ethics and Human Rights: Protection and Promotion Individual Worth, Dignity and Human Rights in Practice Settings. It notes that:
Respect for the inherent worth, dignity, and human rights of every individual is a fundamental principle that underlies all nursing practice.
Ethics and human rights issues emerge in health care settings where individuals are unable to assert their rights. Individuals in critical care units, psychiatric settings, or who are incarcerated might have diminished capacity for decision-making and asserting their rights . . . It is in these circumstances that human rights are vulnerable to violation and that ethical issues will emerge.
Nurses attend to and are aware of conflict of dual loyalty to patients, health care institutions, employers and agencies that provide payment for services.