Professor Voices – Discharge proceedings against Navy Nurse for Refusing to Force-Feed at Gitmo Dropped

annas11-150x150The U.S. Navy announced that a Naval nurse who refused to force-feed prisoners at Guantanamo will not face discharge proceedings and can now return to work. George Annas, Chair and Professor of Health Law, Bioethics & Human Rights at Boston University’s School of Public Health, offers the following comments on the decision:

“Ever since 9/11, the US military and the CIA have used at least some physicians to perform unethical acts on prisoners, including interrogations, torture, and force-feeding. There is no record of physicians or nurses refusing to obey orders to participate in these actions, and it was only in 2014 that the first recorded instance of a health professional refusing occurred when a senior Navy nurse refused to force feed competent hunger strikers at Guantanamo because the nurse concluded that such force feeding violated basic principles of medical ethics. The nurse was, I believe, correct in his assessment, and it was disgraceful that he was faced with a possible court martial, and ultimately discharge proceedings. Today it was announced that the Navy has decided not to institute discharge proceedings against the nurse. This is the right decision. As my colleague Dr. Sondra Crosby put it:

“‘The decision by the Navy to drop discharge proceedings against a Navy nurse who had refused to force feed hunger-striking prisoners at Guantanamo demonstrates strong leadership in a post 9/11 era that has been plagued by lapses in health care professional guidance and behavior.’

“The Defense Health Board has also recently made a formal recommendation to the US Department of Defense that in all branches of the military services, not just the Navy, that all policies should support the proposition that “the military heath professional’s first ethical obligation is to the patient.” This is absolutely correct, although because of the post 9/11 abuses, especially in military prisons (as well as in CIA black sites—although the military had no real authority in them), better wording would be to add the word “always” and to make specific reference to military prisons, so that the directive would read:

“’All military policies, guidance and instructions must ensure that the military health care professional’s first ethical obligation is always to the patient, even in military prisons like Guantanamo.’

As Dr. Crosby and I put it two years ago: ‘Military physicians [and nurses] are no more entitled to betray medical ethics than military lawyers are to betray the Constitution or military chaplains are to betray their religion.’

“The decision not to pursue charges against the ethical Navy nurse who refused to participate in unethical conduct detrimental to patients presents an opportunity to reform in military medical ethics. Ethical physicians and nurses, whose first obligation is to their patients, are the backbone not only of a good medical force, but of a strong military medical force.”

Contact Annas at 617-638-4626 or annasgj@bu.edu.

For additional commentary by Boston University experts, follow us on Twitter at @BUexperts