Running Head: ETHICAL DILEMMA 1

Ethical Dilemma

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Institutional Affiliation
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Ethical Dilemma

The article, “Why U.S. doesn’t let detainees starve at Guantanamo Bay,” discusses an

ethical dilemma surrounding the issue of hunger strikers at the prison camps at Guantanamo Bay.

According to the article, the International Committee of the Red Cross (ICRC) disagrees with the

United States’ practice of force-feeding captives who are participating in a hunger strike. The

ICRC believes that the detainees have the right to “choose their fate,” and other human rights

advocacy groups assert that force-feeding them is unethical and a violation of medical ethics. On

the other hand, the prison camp staff won’t let the detainees starve because they believe letting

them die from starvation is inhumane, at odds with the creed of medical professionals of the U.S.

military to do no harm, is un-American, looks bad, and is against U.S. policy. Allowing them to

make a statement through their hunger strike may catalyze change for them whether it be through

the media, public awareness, and public pressure for just practices or through ending their

suffering via starvation. The United States has this ethical dilemma. They have the choice to

continue force-feeding the hunger strikers or to cease and respect their right to peacefully protest.

According to the Physical Therapists APTA Code of Ethics, a principal that was not

followed that created this dilemma is Principle 3,

“A physical therapist shall comply with laws and regulations governing physical therapy and

shall strive to effect changes that benefit patients/clients [ CITATION Swi10 \l 1033 ].”

According to the article, force-feeding the captives is a violation of medical ethics and

may even be classifies as torture. More and more detainees are joining in on the hunger strike

and nothing is being changed to benefit the captives. The practices at Guantanamo Bay also

violate Principle 5,
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“A physical therapist shall exercise sound professional judgment[ CITATION Swi10 \l 1033 ].”

The United States government is not protecting the detainees’ rights to peacefully protest.

They are also not considering how the act of force-feeding could be an unethical act. Lastly, the

force-feeding violates Principle 9,

“A physical therapist shall protect the public and the profession from unethical, incompetent,

and illegal act[ CITATION Swi10 \l 1033 ].”

The article mentions that Dr. Vincent Lacopino, an expert with Physicians for Human

Rights, states that to force-feed in unethical and may even rise to the level of torture or ill

treatment. According to the Family Life Educators Code of Ethics, a principle that may help

solve this dilemma is principle 4 under the “Relationships with Community/Society” section. It

says, “I will advocate for laws and policies that reflect our changing knowledge base and the best

interest of parents, families, and communities. Learning that force-feeding in indeed unethical

and a malpractice, the United States may decide to cease it. Another principle that may offer a

solution is Principle 5 under the “Relationships with Children and Youth.” It says, “I will

provide environments that are respectful of children and youth and sensitive to their

developmental and individual needs.” This principle could help solve the dilemma by structuring

the prison’s policies so that they are respectful of the detainee’s needs. Principle 1 from the

Physical Therapists APTA Code of Ethics may also provide a solution. It states that,

“A physical therapist shall respect the rights and dignity of all individuals and shall provide

compassionate care[ CITATION Swi10 \l 1033 ].”

Viewing the detainees as humans and individuals worthy of respect and compassionate

care and focusing on their needs instead of the responsibilities and duties of the Guantanamo Bay
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staff may result in a staff that respects their right to not eat to the point of death because it is

what they desire instead of being force-fed against their will.

Applying an end-based approach to resolve the dilemma would lead to force-feeding the

captives. There is more staff than prisoners at the camps, 1,700 staff members compared to 166

captives. An end-based approach would allow the staff members to uphold their military

medicine laws and facility policies. A care-based approach is more subjective. If I were in the

captives’ shoes, I would want to be left to starve if that is what I wanted. The most caring thing

to do in this situation would be to respect the captives’ desires to escape their misery and

suffering, or at least to allow them to make a statement by hunger striking. Under a rule-based

principle, if there could only be one standard, the standard should be a world where people had

the right to peacefully protest, have control over their fate, and be able to keep their dignity. An

unethical behavior that could help solve the dilemma could be a violent uproar by the detainees

in which they kill all the staff members. Then maybe some would attempt to escape or commit

suicide. The pro of an end-based approach would be that American staff members would be

upholding their policy and American values. The con would be that the prisoners would still be

suffering and fed against their will.

The pro of a care-based approach would be that the prison would be respecting the

prisoner’s rights and act in a more compassionate way toward the captives. A con would be that

the staff might be uncomfortable with letting the captives starve. They may have to act against

their values or perspectives. The pro of a rule-based approach would be that all prisoners’ rights

would be respected and they would be allowed to have a voice through their right to peacefully

protest. A con would include that they American public or the staff at the Guantanamo Bay

prison may be uncomfortable acting against their American views regarding suicide. A pro of the
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unethical practice would be that the prisoners would at last be able to have some control over

their fate. A con would be that Americans would die at the cost of the detainees’ freedom. It may

also increase anti-terrorist sentiments if the media were to cover it extensively. The short-term

consequences for the end-based approach would be that the staff is satisfied with complying with

their beliefs and values while the prisoners suffer by being kept alive. The long-term

consequence would be that the detainees would be kept alive for as long as they were detained

against their wished and desires. A short-term consequence for the care-based approach would be

that the prisoners would be at ease. A long-term consequence would be that there would be fewer

prisoners at Guantanamo Bay and lower costs to run the prison camp facility. A short-term

consequence for the rule-based approach would be that the prisoners would be respected of their

rights.

References

Swisher, L. L., Hiller, P., & Force, A. T. (2010). The revised APTA Code of Ethics for the

Physical Therapist and Standards of Ethical Conduct for the Physical Therapist Assistant:

theory, purpose, process, and significance. Physical Therapy, 803-824.

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