Force-feeding
Encyclopedia
Force-feeding of humans
Force-feeding is generally carried out by passing a feeding tubeFeeding tube
A feeding tube is a medical device used to provide nutrition to patients who cannot obtain nutrition by swallowing. The state of being fed by a feeding tube is called gavage, enteral feeding or tube feeding...
through the nose or mouth into the esophagus
Esophagus
The esophagus is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. During swallowing, food passes from the mouth through the pharynx into the esophagus and travels via peristalsis to the stomach...
. Internal feeding may also be carried out for medical reasons, rather than because the person refuses to eat, in which case it is not regarded as force-feeding.
Medical uses
Refusal to eat or consume liquids for an extended period of time may be caused by some psychiatric disorders. For example in schizophreniaSchizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
and other psychotic disorders, an individual may refuse to eat because of a delusion
Delusion
A delusion is a false belief held with absolute conviction despite superior evidence. Unlike hallucinations, delusions are always pathological...
that their food is being poisoned. Eating disorder
Eating disorder
Eating disorders refer to a group of conditions defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual's physical and mental health. Bulimia nervosa, anorexia nervosa, and binge eating disorder are the most common specific...
s are another common cause of refusal to eat due to the extreme fear of gaining weight. There are several drawbacks, however. While the treatment is usually done with the patient's consent, unfortunately weight restoration by force does not solve the underlying problems. Additionally, if an individual with an eating disorder believes they would be force-fed in hospital, he or she may refuse to seek help at all. If an individual refuses to eat because of a mental disorder and if the refusal continues for a sufficient period of time that there is a risk of serious physical debilitation or death, a court order
Court order
A court order is an official proclamation by a judge that defines the legal relationships between the parties to a hearing, a trial, an appeal or other court proceedings. Such ruling requires or authorizes the carrying out of certain steps by one or more parties to a case...
can be obtained to administer nutrition and hydration to prevent serious physical debilitation and death. Depending on the condition of the patient, nutrition may be administered via a feeding tube
Feeding tube
A feeding tube is a medical device used to provide nutrition to patients who cannot obtain nutrition by swallowing. The state of being fed by a feeding tube is called gavage, enteral feeding or tube feeding...
. Depending upon the patient's condition, either a nasogastric tube, which enters the stomach
Stomach
The stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...
via the esophagus
Esophagus
The esophagus is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. During swallowing, food passes from the mouth through the pharynx into the esophagus and travels via peristalsis to the stomach...
, or a PEG tube, which is inserted surgically into the stomach through the abdominal wall, may be used to provide nutrition. Fluids, containing electrolytes and glucose
Glucose
Glucose is a simple sugar and an important carbohydrate in biology. Cells use it as the primary source of energy and a metabolic intermediate...
, can be quickly administered intravenously.
In prisons
Prison
A prison is a place in which people are physically confined and, usually, deprived of a range of personal freedoms. Imprisonment or incarceration is a legal penalty that may be imposed by the state for the commission of a crime...
ers have been force-fed by feeding tube
Feeding tube
A feeding tube is a medical device used to provide nutrition to patients who cannot obtain nutrition by swallowing. The state of being fed by a feeding tube is called gavage, enteral feeding or tube feeding...
when they went on hunger strike
Hunger strike
A hunger strike is a method of non-violent resistance or pressure in which participants fast as an act of political protest, or to provoke feelings of guilt in others, usually with the objective to achieve a specific goal, such as a policy change. Most hunger strikers will take liquids but not...
. It has been prohibited since 1975 by the Declaration of Tokyo
Declaration of Tokyo
The Declaration of Tokyo is a set of international guidelines for physicians concerning torture and other cruel, inhuman or degrading treatment or punishment in relation to detention and imprisonment, which was adopted in October 1975 during the 29th General assembly of the World Medical...
of the World Medical Association
World Medical Association
The World Medical Association is an international and independent confederation of free professional Medical Associations, therefore representing physicians worldwide...
, provided that the prisoner is "capable of forming an unimpaired and rational judgment."
"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 trachea. A china funnel is attached to the other end of the tube and a cabbage-like mixture down the tube and through to the stomach. This was an unhealthy practice, as the food might have gone into their lungs and caused pnuemonia."
In the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
, force-feeding was used against hunger-striking suffragettes, until the "Cat and Mouse Act" of 1913. 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
Rape
Rape is a type of sexual assault usually involving sexual intercourse, which is initiated by one or more persons against another person without that person's consent. The act may be carried out by physical force, coercion, abuse of authority or with a person who is incapable of valid consent. The...
. In a smuggled letter, suffragette Sylvia Pankhurst
Sylvia Pankhurst
Estelle Sylvia Pankhurst was an English campaigner for the suffragist movement in the United Kingdom. She was for a time a prominent left communist who then devoted herself to the cause of anti-fascism.-Early life:...
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.
Emmeline Pankhurst
Emmeline Pankhurst
Emmeline Pankhurst was a British political activist and leader of the British suffragette movement which helped women win the right to vote...
, founder of the Women's Social and Political Union
Women's Social and Political Union
The Women's Social and Political Union was the leading militant organisation campaigning for Women's suffrage in the United Kingdom...
in the UK
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
, was horrified by the screams of women being force-fed in HM Prison Holloway
Holloway (HM Prison)
HM Prison Holloway is a closed category prison for adult women and Young Offenders, located in the Holloway area of the London Borough of Islington, in north and Inner London, England...
during hunger strike
Hunger strike
A hunger strike is a method of non-violent resistance or pressure in which participants fast as an act of political protest, or to provoke feelings of guilt in others, usually with the objective to achieve a specific goal, such as a policy change. Most hunger strikers will take liquids but not...
s in which she participated. In her autobiography, 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."
Great Britain also used forcible feeding techniques against Irish Republicans during their struggle for independence. In 1917, Irish prisoner Thomas Ashe
Thomas Ashe
Thomas Patrick Ashe born in Lispole, County Kerry, Ireland, was a member of the Gaelic League, the Irish Republican Brotherhood and a founding member of the Irish Volunteers...
died as a result of complications from such a feeding while incarcerated at Dublin's Mountjoy Jail
Mountjoy Prison
Mountjoy Prison , founded as Mountjoy Gaol, nicknamed The Joy, is a medium security prison located in Phibsboro in the centre of Dublin, Ireland. It has the largest prison population in Ireland.The current prison governor is Mr...
.
Under United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
jurisdiction, force-feeding is frequently used in the U.S. military prison in Guantanamo Bay
Guantanamo Bay detainment camp
The Guantanamo Bay detention camp is a detainment and interrogation facility of the United States located within Guantanamo Bay Naval Base, Cuba. The facility was established in 2002 by the Bush Administration to hold detainees from the war in Afghanistan and later Iraq...
, prompting in March 2006 an open letter by 250 doctors from seven Western countries in the medical journal
Medical journal
A public health journal is a scientific journal devoted to the field of public health, including epidemiology, biostatistics, and health care . Public health journals, like most scientific journals, are peer-reviewed...
The Lancet
The Lancet
The Lancet is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals...
, warning that, in their opinion, the participation of any doctor is contrary to the rules of the World Medical Association
World Medical Association
The World Medical Association is an international and independent confederation of free professional Medical Associations, therefore representing physicians worldwide...
. Retired Major General Paul E. Vallely
Paul E. Vallely
Paul E. Vallely is a retired US Army Major General and senior military analyst for Fox News. He served in Vietnam during the Vietnam War and retired in 1993 as Deputy Commanding General, Pacific Command. In 2004, together with retired Air Force Lieutenant General Thomas McInerney, Vallely...
visited Guantanamo and reported on the process of force-feeding:
On December 6, 2006, the UN War Crimes Tribunal at The Hague
The Hague
The Hague is the capital city of the province of South Holland in the Netherlands. With a population of 500,000 inhabitants , it is the third largest city of the Netherlands, after Amsterdam and Rotterdam...
approved the use of force-feeding of Serbia
Serbia
Serbia , officially the Republic of Serbia , is a landlocked country located at the crossroads of Central and Southeast Europe, covering the southern part of the Carpathian basin and the central part of the Balkans...
n politician Vojislav Šešelj
Vojislav Šešelj
Vojislav Šešelj, JD is a Serbian politician, writer and lawyer. He is the founder and president of the Serbian Radical Party and was vice-president of Serbia between 1998 and 2000...
. 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".
In 2008, a Connecticut prisoner, William B. Coleman, was sued by the state who sought an injunction to force feed the competent prisoner against his will. As of 2009, that case, Coleman v. Lantz
Coleman v. Lantz
Coleman v. Lantz, is a Connecticut superior court case that addresses the constitutionality of forcibly feeding prison inmates on hunger strikes.-Background:...
, is pending before Judge James Graham of the state's superior court.
In 2009, "Shoe bomber" Richard Reid
Richard Reid (shoe bomber)
Richard Colvin Reid , also known as the Shoe Bomber, is a self-admitted member of al-Qaeda who pled guilty in 2002 in U.S. federal court to eight criminal counts of terrorism stemming from his attempt to destroy a commercial aircraft in-flight by detonating explosives hidden in his shoes...
was force fed while on a hunger strike in a Supermax
Supermax
Supermax is the name used to describe "control-unit" prisons, or units within prisons, which represent the most secure levels of custody in the prison systems of certain countries...
prison in Florence, Colorado
Florence, Colorado
The City of Florence is a Statutory City located in Fremont County, Colorado, United States. The population was 3,653 at the 2000 census.ADX Florence, the only federal Supermax prison in the United States, is located south of Florence in an unincorporated area in Fremont County...
.
Coercive and torturous use
Force-feeding by naso-gastric tube may be carried out in a manner that can be categorised as tortureTorture
Torture is the act of inflicting severe pain as a means of punishment, revenge, forcing information or a confession, or simply as an act of cruelty. Throughout history, torture has often been used as a method of political re-education, interrogation, punishment, and coercion...
, as it may be extremely painful and result in severe bleeding and spreading of various diseases via the exchanged blood and mucus
Mucus
In vertebrates, mucus is a slippery secretion produced by, and covering, mucous membranes. Mucous fluid is typically produced from mucous cells found in mucous glands. Mucous cells secrete products that are rich in glycoproteins and water. Mucous fluid may also originate from mixed glands, which...
, especially when conducted with dirty equipment on a prison population. Large feeding pipes are traditionally used on hunger striking prisoners whereas thin pipes are preferred in hospitals.
A brief, first-person account of a force-feeding session given by Vladimir Bukovsky
Vladimir Bukovsky
Vladimir Konstantinovich Bukovsky is a leading member of the dissident movement of the 1960s and 1970s, writer, neurophysiologist, and political activist....
describes the procedure in detail: "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."
Force-feeding of pernicious substances may be used as a form of torture
Torture
Torture is the act of inflicting severe pain as a means of punishment, revenge, forcing information or a confession, or simply as an act of cruelty. Throughout history, torture has often been used as a method of political re-education, interrogation, punishment, and coercion...
and/or physical punishment
Physical punishment
Physical punishment is any form of penalty in a judicial, educational or domestic setting that takes a physical form, by the infliction on the offender of pain, injury, discomfort or humiliation...
. While in prison in northern Bosnia in 1996, some Serbian prisoners have described being forced to eat paper and soap.
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
Abu Ghraib torture and prisoner abuse
Beginning in 2004, human rights violations in the form of physical, psychological, and sexual abuse, including torture, rape, sodomy, and homicide of prisoners held in the Abu Ghraib prison in Iraq came to public attention...
prison
Abu Ghraib prison
The Baghdad Central Prison, formerly known as Abu Ghraib prison is in Abu Ghraib, an Iraqi city 32 km west of Baghdad. It was built by British contractors in the 1950s....
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
Haraam
Haraam is an Arabic term meaning "forbidden", or "sacred". In Islam it is used to refer to anything that is prohibited by the word of Allah in the Qur'an or the Hadith Qudsi. Haraam is the highest status of prohibition given to anything that would result in sin when a Muslim commits it...
in Islam. Other prisoners described being forced to eat from toilets.
Gavage for girls before marriage
In the past, force-feeding has also been a practice in some Middle EastMiddle East
The Middle East is a region that encompasses Western Asia and Northern Africa. It is often used as a synonym for Near East, in opposition to Far East...
ern and North Africa
North Africa
North Africa or Northern Africa is the northernmost region of the African continent, linked by the Sahara to Sub-Saharan Africa. Geopolitically, the United Nations definition of Northern Africa includes eight countries or territories; Algeria, Egypt, Libya, Morocco, South Sudan, Sudan, Tunisia, and...
n countries where 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
Physical punishment
Physical punishment is any form of penalty in a judicial, educational or domestic setting that takes a physical form, by the infliction on the offender of pain, injury, discomfort or humiliation...
(e.g., pressing a finger between two pieces of wood) should the girl not eat. The intended result is a rapid onset of obesity
Obesity
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...
, 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
Mauritania
Mauritania is a country in the Maghreb and West Africa. It is bordered by the Atlantic Ocean in the west, by Western Sahara in the north, by Algeria in the northeast, by Mali in the east and southeast, and by Senegal in the southwest...
(where it is called leblouh
Leblouh
Leblouh or gavage is the practice of force-feeding young women, including girls as young as five, in Mauritania, where obesity was traditionally regarded as desirable. Especially prevalent in rural areas, and having its roots in Berber tradition, leblouh is practiced to increase chances of marriage...
), where it induces major health risks in the female population; some younger men claim they no longer insist on voluptuous brides, but the time-honored beauty norm remains part of the culture.
In farming
Foie gras
Foie gras ; French for "fat liver") is a food product made of the liver of a duck or goose that has been specially fattened. This fattening is typically achieved through gavage corn, according to French law, though outside of France it is occasionally produced using natural feeding...
.
In modern Egypt
Egypt
Egypt , officially the Arab Republic of Egypt, Arabic: , is a country mainly in North Africa, with the Sinai Peninsula forming a land bridge in Southwest Asia. Egypt is thus a transcontinental country, and a major power in Africa, the Mediterranean Basin, the Middle East and the Muslim world...
, the practice of fattening geese and male Muscovy duck
Muscovy Duck
The Muscovy Duck is a large duck which is native to Mexico and Central and South America. A small wild population reaches into the United States in the lower Rio Grande Valley of Texas...
s by force feeding 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
Mulard
The Mulard is a hybrid variety of domestic duck produced by crossing a female Pekin with a male Muscovy Duck. Since the domestic Pekin is descended from the Mallard Duck and the Muscovy is a separate species, all Mulards are sterile F1 hybrids...
, 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
Crop (anatomy)
A crop is a thin-walled expanded portion of the alimentary tract used for the storage of food prior to digestion that is found in many animals, including gastropods, earthworms, leeches, insects, birds, and even some dinosaurs.- Bees :Cropping is used by bees to temporarily store nectar of flowers...
(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
Vomiting
Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...
reflex and extremely flexible esophagi, 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. For this reason, gavage is usually a "finishing" stage before the bird is set for slaughter, for if left to its own devices after finishing, the bird will quickly return to its normal weight. The result of this practice is a severely enlarged and fatty liver which results in the liver disease hepatic lipidosis. The liver may swell up to 12 times its normal size (up to three pounds). While the livers are the coveted portions of these birds, the fatty flesh of geese and ducks (traditionally used to make confit
Confit
Confit is a generic term for various kinds of food that have been immersed in a substance for both flavor and preservation. Sealed and stored in a cool place, confit can last for several months...
) as well as their feathers do also find a market.
In scientific research
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.External links
- Voluntary and Voluntary Total Fasting and Refeeding, Detention Hospital, Guantanamo Bay, Cuba
- Manifesto for the abolition of force feeding