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Do hunger strikes in prison work?

Do hunger strikes in prison work? Hunger strikes in prison rarely work, but at times they can bring awareness of problems inside a prisonsystem to the outside world. One of the famous prison hunger strikes that did work took place in California in 2013 and brought attention to the use of solitary confinement in prisons. Inmates in the long term solitary confinement unit at Peilcan Bay Prison organized the strike and demanded that things be changed like better food , better access to the library, less solitary confinement etc. Their strike involved inmates in two prison systems and lasted two months. Doctors as well as the attorney’s of the inmates became concerned about their health. Prison officials tried to force the prisoners to end their strike by denying them access to medications and medical oversight. Some inmates were only refusing solid food and the prison decided that the only liquid they would then get was water.

The medical community brought the tactics of the California Department of Corrections to light and the courts became involved. By the time the court order was received there were numerous inmates that had been hospitalized and one had died. In 2015 the lawsuit Todd Ashker, et al., vs. Governor of the State of California, was brought by 10 Pelican Bay State prison inmates and was settled which greatly reduced the amount of inmates in solitary confinement.

As a prison physician I had to deal with individual inmates who decided to go on a hunger strike for a variety of reasons. I remember the first one I was involved in where an obese Jewish male went on a hunger strike, because he said he needed a Kosher diet sent from the outside world and that he would not eat any prison food. The prison did not give him the diet and said he could eat what he felt was kosher on his tray. He refused to eat, would not take any of his medications and could not be persuaded to eat by the medical or psychiatric department. He was medically watched, his labs followed and I asked the attorney general’s office for guidance when his health started to deteriorate. They told me that I could not force medical care on a competent patient. I could only give medical care if he became incompetent and went into a coma, which he did.

He had to be resuscitated with IVs, we had to place a tube down his nose and into his stomach to slowly re-feed him and when he recuperated he gave up his hunger strike and ate prison food.

Over the years I had other inmates who went on hunger strikes and basically talked many of them out of it by sharing with them my first experience with a hunger strike in the prison.

I explained to them that if they felt victimized it did not make sense to me for them to victimize themselves further… if their was another option. I had them concentrate on other options that did not put them at risk for serious medical problems or death.

I never wanted to be placed in the position of force feeding a competent patient which happened at Guantanamo where inmates who were starving themselves were pulled from their cells, strapped into chairs and had rubber tubes stuck down their noses to feed them liquid nutrition. The American Medical Association (AMA) is quite clear in it’s message to doctors that ‘every competent patient has the right to refuse medical intervention, including life- sustaining interventions.’ That includes being force fed against their will.

When people want to change policies that they feel are unjust there are more options open to people on the outside then on the inside of a prison. With limited options, what do you do as an inmate if your grievances on paper are discarded and no one listens to your complaints. What do you do? Do you act out physically and end up with more punishment and more time? Do you suffer in silence? Or do you hurt yourself and see if someone cares enough to respond? What injustice would make you join others and stop eating for weeks, months?

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