Force-feeding

A suffragette is force-fed in HM Prison Holloway in the UK during hunger strikes for women's suffrage.^[1]

Force-feeding is the practice of feeding a human or other animal against their will. The term "gavage" ( /ɡəˈvɑːʒ/) refers to supplying a nutritional substance by means of a small plastic feeding tube passed through the nose (nasogastric) or mouth (orogastric) into the stomach. In hospitals, some psychiatric patients can be restrained so sedatives can be injected into them; this happens if patients have been non-compliant with their instructions.

Of humans[edit]

Soviet dissident Vladimir Bukovsky described how he was force-fed: "The feeding pipe was thick, thicker than my nostril, and would not go in. Blood came gushing out of my nose and tears down my cheeks, but they kept pushing until the cartilages cracked. I guess I would have screamed if I could, but I could not with the pipe in my throat. I could breathe neither in nor out at first; I wheezed like a drowning man — my lungs felt ready to burst. The doctor also seemed ready to burst into tears, but she kept shoving the pipe farther and farther down. Only when it reached my stomach could I resume breathing, carefully. Then she poured some slop through a funnel into the pipe that would choke me if it came back up. They held me down for another half-hour so that the liquid was absorbed by my stomach and could not be vomited back, and then began to pull the pipe out bit by bit."^[2]

"The unfortunate patients had their mouth clamped shut, had a rubber tube inserted into their mouth or nostril. They keep on pressing it down until it reaches your esophagus. A china funnel is attached to the other end of the tube and a cabbage-like mixture poured down the tube and through to the stomach. This was an unhealthy practice, as the food might have gone into their lungs and caused pneumonia."^[3]

In prisons[edit]

Some countries force-feed prisoners when they go on hunger strike. It has been prohibited since 1975 by the Declaration of Tokyo of the World Medical Association, provided that the prisoner is "capable of forming an unimpaired and rational judgment". The violation of this prohibition may be carried out in a manner that can be categorised as torture, as it may be extremely painful and result in severe bleeding and spreading of various diseases via the exchanged blood and mucus, especially when conducted with dirty equipment on a prison population.^[4] Large feeding pipes are traditionally used on hunger striking prisoners^[5] whereas thin pipes are preferred in hospitals.

United Kingdom[edit]

Clipping from World Magazine, September 6, 1914

Suffragettes who had been imprisoned while campaigning for votes for women went on hunger strike and were force fed. (This lasted until the Prisoners (Temporary Discharge for Ill Health) Act of 1913, better known as the Cat and Mouse Act, whereby debilitated prisoners would be released, allowed to recover, and then re-arrested.) Rubber tubes were inserted through the mouth (only occasionally through the nose) and into the stomach, and food poured down; the suffragettes were held down by force while the instruments were inserted into their bodies, an experience which has been likened to rape.^[6] In a smuggled letter, Sylvia Pankhurst described how the warders held her down and forced her mouth open with a steel gag. Her gums bled, and she vomited most of the liquid up afterwards.^[7]

Emmeline Pankhurst, founder of the Women's Social and Political Union, was horrified by the screams of women being force-fed in HM Prison Holloway. She wrote: "Holloway became a place of horror and torment. Sickening scenes of violence took place almost every hour of the day, as the doctors went from cell to cell performing their hideous office. …I shall never while I live forget the suffering I experienced during the days when those cries were ringing in my ears." When prison officials tried to enter her cell, Pankhurst, in order to avoid being force-fed, raised a clay jug over her head and announced: "If any of you dares so much as to take one step inside this cell I shall defend myself."^[8]

In 1914, Frances Parker, another suffragette, was being force-fed by the rectum in the Perth prison: "Thursday morning, 16th July ... the three wardresses appeared again. One of them said that if I did not resist, she would send the others away and do what she had come to do as gently and as decently as possible. I consented. This was another attempt to feed me by the rectum, and was done in a cruel way, causing me great pain. She returned some time later and said she had ‘something else’ to do. I took it to be another attempt to feed me in the same way, but it proved to be a grosser and more indecent outrage, which could have been done for no other purpose than torture. It was followed by soreness, which lasted for several days."^[9]

Djuna Barnes, the American journalist, agreed to submit to force-feeding for a 1914 New York World magazine article. Barnes wrote, "If I, play acting, felt my being burning with revolt at this brutal usurpation of my own functions, how they who actually suffered the ordeal in its acutest horror must have flamed at the violation of the sanctuaries of their spirits." She concluded, "I had shared the greatest experience of the bravest of my sex."^[10]

The United Kingdom also used forcible feeding techniques against Irish Republicans during their struggle for independence. In 1917 Irish prisoner Thomas Ashe died as a result of complications from such a feeding while incarcerated at Dublin's Mountjoy Jail. The outrage of Ashe's death from the Irish public was so great that force feeding has never been used in Ireland again since.^[11]

United States[edit]

Guantanamo captives who will not comply with force-feeding have their arms, legs and head restrained in a feeding chair. They remain strapped in the chair until the nutrient is digested, to prevent induced vomiting.

Under United States jurisdiction, force-feeding is frequently used in the U.S. military prison in Guantanamo Bay, prompting in March 2006 an open letter by 250 doctors in The Lancet, warning that, in their opinion, the participation of any doctor is contrary to the rules of the World Medical Association.^[12]^[5]^[13] Retired Major General Paul E. Vallely visited Guantanamo and reported on the process of force-feeding:^[14]

They have to restrain the prisoners when they feed them because they attack the nurses. They spit in their faces. They're simply restrained for 20 minutes so they can be fed Ensure. They get their choice of four flavors of Ensure. It's put in a very unobtrusive feeding tube smaller than a normal straw and it's put in there for 20 minutes, so they get breakfast, lunch, and dinner.

In the 2009 case Lantz v. Coleman,^[15] the Connecticut Superior Court authorized the state Department of Correction to force-feed a competent prisoner who had refused to eat voluntarily.^[16] In 2009, terrorist Richard Reid, known as the "shoe bomber," was force-fed while on a hunger strike at the United States Penitentiary, Florence ADX, the federal supermax prison in Colorado.^[17] Hundreds of force-feedings have been reported at ADX Florence.^[18] Ethel Byrne was the first female political prisoner in the United States to be subjected to force feeding ^[19] after she was jailed at Blackwell Island workhouse on January 22, 1917 for her activism in advocating for the legalization of birth control. She subsequently went on a hunger strike and refused to drink water for 185 hours. ^[20]

United Nations War Crimes Tribunal[edit]

On December 6, 2006, the United Nations War Crimes Tribunal at The Hague approved the use of force-feeding of Serbian politician Vojislav Šešelj. They decided it was not "torture, inhuman or degrading treatment if there is a medical necessity to do so... and if the manner in which the detainee is force-fed is not inhuman or degrading".^[21]

Israel[edit]

In 2015, the Knesset passed a law allowing the force-feeding of prisoners in response to a hunger strike by a Palestinian detainee who had been held for months in administrative detention. Israel doctors refused to feed Mohammad Allan against his will, and he resumed eating after the Supreme Court temporarily released him.^[22]

Other forms[edit]

Force-feeding of pernicious substances may be used as a form of torture and/or physical punishment. While in prison in northern Bosnia in 1996, some Serbian prisoners have described being forced to eat paper and soap.^[23]

Sometimes it has been alleged that prisoners are forced to eat foods forbidden by their religion. The Washington Post has reported that Muslim prisoners in Abu Ghraib prison under the U.S.-led coalition described in sworn statements having been forced to eat pork and drink alcohol, both of which are strictly forbidden in Islam (see Abu Ghraib torture and prisoner abuse).^[24]

Of babies[edit]

'Gavage' method of infant feeding used in France, late 19th century

According to Infant feeding by artificial means: a scientific and practical treatise on the dietetics of infancy^[25], a French system of feeding newborn or premature babies who could not suckle was known as gavage. Sadler dates its origin to 1874 and quotes Étienne Stéphane Tarnier, a pioneer perinatologist, describing the procedure. ^[26]

For girls before marriage[edit]

Force-feeding used to be practiced in the North Africa and still is in Mauritania. Fatness was considered a marriage asset in women; culturally, voluptuous figures were perceived as indicators of wealth. In this tradition, some girls are forced by their mothers or grandmothers to overeat, often accompanied by physical punishment (e.g., pressing a finger between two pieces of wood) should the girl not eat. The intended result is a rapid onset of obesity, and the practice may start at a young age and continue for years. This is still the tradition in the rather undernourished Sahel country Mauritania (where it is called leblouh), where it induces major health risks in the female population; some younger men no longer insist on voluptuous brides, but traditional beauty norms remain part of the culture.^[27]^[28]

In slavery[edit]

Slaves who tried to commit suicide by starving themselves were force fed with a contraption called the speculum orum. This device forced the slave's mouth open in order to be fed.^[29]

Of domestic animals[edit]

Ancient Egyptian force-feeding a hyena

Force-feeding has been used to prepare animals for slaughter. In some cases, such as is the case with geese raised for foie gras, it is still practiced today.

In farming[edit]

Animal welfare groups object to force-feeding of birds. Here a Mulard duck is being force fed corn in order to fatten its liver for foie gras production.

Force-feeding is also known as gavage, from a French word meaning "to gorge". This term specifically refers to force-feeding of ducks or geese in order to fatten their livers in the production of foie gras. In modern Egypt, the practice of fattening geese and male Muscovy ducks by force-feeding^{[dubious – discuss]} them various grains is present, mostly by individuals, unrelated to foie gras production, but for general consumption of those birds later. It is not widespread on commercial farms however. The term used for such a practice is called "Tazgheet" تزغيط from the verb "Zaghghat" زغَط.

Force-feeding of birds is practiced mostly on geese or male Moulard ducks, a Muscovy/Pekin hybrid. Preparation for gavage usually begins 4–5 months before slaughter. For geese, after an initial free-range period and treatment to assist in esophagus dilation (eating grass, for example), the force-feeding commences. Gavage is performed 2–4 times a day for 2–5 weeks, depending on the size of the fowl, using a funnel attached to a slim metal or plastic feeding tube inserted into the bird's throat to deposit the food into the bird's crop (the storage area in the esophagus). A grain mash, usually maize mixed with fats and vitamin supplements, is the feed of choice. Waterfowl are suited to the tube method due to a non-existent gag reflex and an extremely flexible esophagus, unlike other fowl such as chickens. These migratory waterfowl are also said to be ideal for gavage because of their natural ability to gain large amounts of weight in short periods of time before cold seasons.

Shen Dzu is a similar practice of force-feeding pigs.

In scientific research[edit]

Gavage is used in some scientific studies such as those involving the rate of metabolism. It is practiced upon various laboratory animals, such as mice. Liquids such as medicines may be administered to the animals via a tube or syringe.^[30]