Bernard Rappaz is an activist from Valais known for his opinion and actions on hemp farming, and legalizing cannabis. He was condemned to 5 years prison. He started a hunger strike. Now the valais justice asked the doctors to force feed Rappaz otherwise the doctors will be faced with legal consequences. The doctors explained that force feeding someone is a very violent act against their ethical values.
Quite a dilemma for the doctors. What would you do?

Not force feed him. The job of a doctor is to heal the person in front of them. It is no one's business to force someone to eat unless they are mentally or physically unwell, and there's no evidence of that.

He has decided (Rappaz) to do it to the ultimate end... it's his choice.


And I have to say that this guy start to get on my nerves. Make several years he's playing with the "laws", cultivating illegal stuff. Why can't he admit he's on the wrong side ?

The federal court published a decision that doctors if asked by justice should force feed Rappaz. I think B Rappaz managed to corner the valaisan justice.

Well Gandhi was also on the wrong side according to the established british law.

I strongly believe in freedom of choice. However, if this guy was really not compos mentis then he should be given counseling.

If you deliberately break laws that you consider are wrong, then you should also be man enough to take the consequences.

I always thought the doctors risked sanctions from their peers (loosing the right of medicine) or even from prosecutors if they let somebody die by not trying to get involved. One possible interpretation of the oath of Hypocrates that they will heal and not kill or something like that. Was I wrong?

Wow , Switzerland has a Gandhi.Pestalozi,Rousseau,Nicklaus von der flue ,Winkelried ,Tell and now Gandhi vom walis Open a bottle of Fendand

Yes, you are completely wrong. They do risk sanctions, but in this case it's the opposite. Violent intervention in freedom of choice on the instruction of government by doctors is clearly forbidden. Force feeding has nothing to do with medicine.

One thing that should be kept in mind is that the Rappaz case is not about whether an mentally sane individual has the right to end his life by starving, but about whether individuals in the states care (prison inmates, such as Rappaz) should be allowed to make that choice (or whether the state should give in to Rappaz's attempt at blackmail and free him before he has finished serving his sentence).

Background: By law, incarceration (in itself) shall not lead to direct physical harm or the death of the incarcerated. In most cantons, there are specific rules that determine the actions the administration has to take to ensure the health and life of the inmates.

I willingly believe you, eocnomisto. Interesting case however as the freedom of choice clearly contradicts the duty of medicine to heal and keep people alive. They put a feeding solution (a mix through intra-venous injetion) on older people who do not eat anymore every day in hospitals, so I was wondering. We need a Jurist (specialist of law) in this field on that one, as there are always more regulations and laws involved as one think.
Any medical lawyer around?

But that is not force-feeding. Force-feeding is when a mentally sane person has declared that he or she does not want to be feed, even if that will ultimately result in the persons death.

Feeding someone who cannot make this decision any more is a different pair of (ethical) shoes.

This is quite interesting. I eat hemp seeds every day, in fact I was wondering where I'll be able to get them here after my Canadian supply runs out. They are an excellent source of protein and Omega 3 and very tasty. I add them to muesli and salads. Obviously there is no THC in the variety grown for the shelled seeds. Has anyone seen hemp seeds for sale here? Strange someone would be sent to jail for wanting to grow it.

I don't believe that a doctor should be forced to feed someone against their will. Somehow it reminds me of the days when lobotomies were still legally performed against the patients will. One flew over the cuckoo's nest is not that long ago.

That being said a hunger strike is a form of protest so if the authorities call a doctor in to assist in the event of a medical emergency it should be acceptable. The minute the individual individual becomes unconscious a doctor would be within full rights and obligations to step in and provide the necessary medical treatment.

The same principle applies to the Good Samaritans law. I know first aid and CPR so if I see someone in a medical emergency I can decide if I should step in to help to the level of my first aid knowledge. If the person declines my help I should not touch him/her. The minute they become unconscious that acceptance is implied. This applies everywhere in the world except for France and Quebec where a good Samaritan must stop and offer assistance according to their laws.

Apparently the World Medical Association declaration on hunger strikers seems to be the reference. Article 20 and 21 are explicit:

• 20. Artificial feeding can be ethically appropriate if competent hunger strikers agree to it. It can also be acceptable if incompetent individuals have left no unpressured advance instructions refusing it.

• 21. Forcible feeding is never ethically acceptable. Even if intended to benefit, feeding accompanied by threats, coercion, force or use of physical restraints is a form of inhuman and degrading treatment. Equally unacceptable is the forced feeding of some detainees in order to intimidate or coerce other hunger strikers to stop fasting.

The issue here is that the legal decision is in opposition with the ethical system of the medical doctors. Apparently northern countries (UK, Netherlands, Scandinavian) are more into informing and let the decision in the hands of the strikers (if he still has discernment) while southern countries (France, Switzerland, Spain Italy) are more into force-feeding.
What plays a big difference is that the hunger striker is not at home but in a prison-hospital section an therefore under the responsibility of the judiciary & penitentiary authority.

AFAIK, growing and using hemp is not illegal in Switzerland as long as it is NOT grown to extract narcotics. Rappaz wasn't put in jail for growing hemp.

It's an interesting situation, freedom (or, someone's concept of it) as opposed to med ethics. I can only think of what would happen back home, the guy would be left to enjoy his freedom until he passes out and is unconscious, the minute he would be unconscious docs would truck him into ER and fix him, while providing a psy help. I think it is much easier to kill oneself doing something else than hunger strike, since the society and its medical world will always try to keep you alive. I, personally, think there are better ways how to communicate a message, it seems that dude just does not want to bear responsibility for his actions, but I don't know enough about it.