Dan Even
Haaretz
February 26, 2013 - 1:00am
http://www.haaretz.com/news/national/new-israeli-rule-orders-hunger-striking-det...


The Health Ministry issued a controversial regulation on Monday requiring hospitalization for hunger strikers if the action lasts more than 28 days.

Palestinian security prisoners are currently holding hunger strikes to protest the death of detainee Arafat Jaradat last week at Megiddo Prison.

"Every detainee and prisoner on a hunger strike in the security system and prison system should be hospitalized if the strike lasts more than 28 days, even if he is opposed to medical treatment," states the regulation, which was sent to hospital managers across the country.

The Israel Medical Association's ethics board criticized the move, which contradicts a position paper by the board from 2005. The board said then that a hunger striker's autonomy should be respected and no medical treatment should be imposed against his will.

Under the new regulation, if a hunger strike is still under 28 days, strikers must be hospitalized if their lives are in danger.

Hunger strikes in 2005 led to a discussion by the IMA ethics board on the role of a doctor treating a prisoner on a hunger strike.

In 2005, the IMA ruled that the doctor had to explain to the prisoner that his life was in danger if he continued a strike. But it added that a doctor could not exert undue pressure on a prisoner to dissuade him.

The paper stated that a doctor must check daily whether the prisoner wished to continue the strike and ensure that he was making the decision of his own free will. According to the paper, the doctor should check daily with the prisoner on how he would want to be treated if he were to lose consciousness. This would be documented in a confidential record.

This procedure matches parts of the 1975 Declaration of Tokyo of the World Medical Association, which states that a doctor can decide to the best of his ability whether to continue to treat a prisoner on a hunger strike after he has lost consciousness.

The doctor must also inform the striker whether he is willing to respect his request not to accept food or liquids, including artificial feeding if the prisoner loses consciousness, or whether he would not honor the request.

In an article for Haaretz in October, the chairman of the IMA ethics board, Dr. Avinoam Reches, called for the establishment of a committee to craft a national policy in preparation for mass hunger strikes.

Following the article, a conference call was held by officials from the Health Ministry and the attorney general to consider setting up a panel, but none has been established.




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