Palestinian Prisoners' Hunger-Strikes in Israeli Prisons: Beyond the Dual-Loyalty Dilemma in Medical Practice and Patient Care

摘要

The present article focuses on the case of the 2012 hunger-strike of Palestinian prisoners in Israeli jails. We analyze the ethical dilemma involved in the way the Israeli medical community reacted to these hunger-strikes and the question of force feeding within the context of the fundamental dual-loyalty structure inherent in the Israeli Prison Services-system. We argue that the liberal perspective that focuses the discussion on the dilemma between the principle of individual autonomy and the sanctity of life tends to be oblivious to the asymmetrical relation of power that characterizes the prison system and to the socio-political context in which hunger-strikes take place. Emphasizing hunger-strikes as political acts implies that health practitioners' conducts cannot be analyzed only through the prism of clinical medical ethics. It requires a public health ethics' approach, an approach that understands health in the context of the complex relationship between society, state, organizations, communities and individuals. The authors are both academics and volunteers in Physicians for Human Rights-Israel thus our analysis is based both on sociological and public health ethics principles and on the continuous work and advocacy for the right to health of prisoners.