Hunger strikes, force-feeding, and physicians' responsibilities.

PRISON HUNGER STRIKES PRESENT CLINICAL, ETHICAL, LEgal, and human rights challenges to physicians who care for hunger strikers. Controversy continues over the care of prisoners who are hunger striking at the US Naval Base in Guantánamo Bay, Cuba. The World Medical Association (WMA) has updated the Declaration of Malta with guidelines on care of hunger strikers, and recent court opinions in the United States and Europe have attempted to define the obligations of physicians caring for hunger strikers in prison settings. This Commentary describes the medical aspects of starvation and examines the ethical, legal, and human rights dimensions of decision making by health care professionals caring for imprisoned patients who are hunger striking.