Widespread Support for Nurse’s Refusal to Force-Feed: Grounded in Ethical Principles

By Maureen Shawn Kennedy, AJN editor-in-chief

Nasal tubes, gravity feeding bags, and the liquid nutrient Ensure used in Guantanamo force-feeding/ image via Wikimedia Commons

Nasal tubes, gravity feeding bags, liquid nutrient Ensure used in Guantanamo force-feeding/Wikimedia Commons

Last week, reports hit the news media of a nurse in the U.S. Navy facing possible discharge for refusing to participate in force-feeding a hunger-striking prisoner at Guantanamo Bay. An early discharge, two years shy of the 20-year mark, could cost him his pension and other benefits.

The nurse had initially volunteered for duty at the Guantanamo facility, but then, as we noted in a blog post examining the ethics of his decision back in July, decided he could not continue to participate in force-feeding detainees in violation of professional ethics.

In a letter to Chuck Hagel, U.S. secretary of defense, the American Nurses Association has supported the decision of the naval nurse. ANA president Pam Cipriano reaffirms that a nurse’s primary commitment is to the patient and “in addition, this commitment is present regardless of the setting in which nursing care is provided. The military setting does not change the nurse’s ethical commitments or standards.”

Not a new practice: A suffragette on hunger strike being forcibly fed with a nasal tube, circa 1911. Via Wikimedia Commons.

Not a new practice: A suffragette on hunger strike being forcibly fed with a nasal tube, circa 1911. Via Wikimedia Commons.

Other groups support this view—the International Council of Nurses (ICN) issued a statement supporting the nurse’s right to refuse to participate in force-feeding, and Physicians for Human Rights issued one applauding ANA’s and ICN’s stance. The World Medical Association has opposed force-feeding since 1991 when it issued the Declaration of Malta on Hunger Strikers.

As it happens, in our current issue we have an article, “Ethical Issues for Nurses in Force-Feeding Guantanamo Bay Detainees” (free until the end of December, then subscription or purchase required). The authors, Doug Olsen, our contributing editor for ethics, and his colleague Ann Gallagher, the editor of Nursing Ethics, focus on this nurse’s difficult decision as they illuminate the ethical quandaries and moral conflict that arise when professional standards conflict with military duties. It’s an important topic and one that is often faced by our military colleagues.

Kudos to the navy nurse for having the courage to stand up for professional ethics; and kudos to ANA, ICN, and the other groups for standing up for ethical behavior. All nurses need to follow this case carefully, as it may set a precedent with far-reaching implications, not just for those in the military, but for all nurses who place commitment to patient first.

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Editor-in-chief, AJN


  1. Joanne November 24, 2014 at 8:48 pm

    I respect this nurse for standing up for his beliefs. This profession is one of care, compassion and helping others. Making the decision to honor his patients wishes is doing all of those things. I would hope I would do as he did.

  2. Daniela Aristeiguieta November 24, 2014 at 7:23 pm

    This is something that all nurses should support; not only support other nurses who decide to stand up for what is right, but for the patients who are having their wishes ignored. By force feeding these patients we are denying them of their right to stand for what they believe in. Nurse’s ethics and action must go hand-in-hand with the patient’s will.
    We must equally support and care for our patients regardless of the work setting and their conditions.

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