ABSTRACT
The issue of hunger strikes is a complex one. This chapter reviews all aspects of this complex subject, gives pointers for adequate management, and scrutinizes the ethical issues that arise when dealing with prisoners who—rightly or wrongly—state they are, or they are said to be, on hunger strike, refusing food, or fasting. There is an essential difference between food refusers and hunger strikers. A hunger striker has a specific motivation for protesting by refusing nourishment and sees fasting as a last resort. Prison physician and external monitor will need to determine what the pressures in their specific situation are and how they influence the commitment of the hunger striker(s). There have been reports of prison physicians giving inaccurate or inappropriate clinical advice, for example, by threatening hunger strikers that medical sequelae of hunger strikes can include effects such as impotence, in order to make them stop their protest.
