force feeding

Force-feeding is the practice of feeding a human or animal against their will. The term ''gavage'' (, , ) refers to supplying a substance by means of a small plastic feeding tube passed through the nose ( nasogastric) or mouth (orogastric) into the stomach.

Of humans

In psychiatric settings

Within some countries, in extreme cases, patients with anorexia nervosa who continually refuse significant dietary intake and weight restoration interventions may be involuntarily fed by force via nasogastric tube under restraint within specialist psychiatric hospitals. Such a practice may be highly distressing for both anorexia patients and healthcare staff.

In prisons

Some countries force-feed prisoners when they go on hunger strike. It has been prohibited since 1975 by the Declaration of Tokyo of the World Medical Association, provided that the prisoner is "capable of forming an unimpaired and rational judgment." The violation of this prohibition may be carried out in a manner that can be categorised as torture, as it may be extremely painful and result in severe bleeding and spreading of various diseases via the exchanged blood and mucus, 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.

United Kingdom

Suffragettes who had been imprisoned while campaigning for votes for women went on hunger strike and were force fed. This lasted until the Prisoners Act of 1913, also known as the Cat and Mouse Act, whereby debilitated prisoners would be released, allowed to recover, and then re-arrested. 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. In a smuggled letter, Sylvia Pankhurst 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, founder of the Women's Social and Political Union, was horrified by the screams of women being force-fed in HM Prison Holloway. 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."

In 1911, Wiliam Ball, a male working class supporter who had broken two windows and consequently been sentenced to two months, was given this treatment and then separated from contact with his family, leading to his clandestine transfer to a mental hospital. This case was taken up by groups such as WSPU and the Men's League for Women's Suffrage, whose pamphlet on the case had the subtitle ''Official Brutality on the increase.''

The first woman in Scotland to be force fed was Ethel Moorhead, in Calton Jail, who despite being under medical supervision became seriously ill. The governor, Major William Stewart, argued that her illness was not caused by the feeding regime, but also said:

We must face the fact that artificial feeding is attended with risk and we must teach uffragette prisonersthat, while we appreciate the risks, we are quite prepared to go on and will not be deterred from detaining people like oorheadbecause there is a risk to their health, if we take the necessary steps to make sure their detention is effective... They have the idea that they can frighten us by pointing out the risk to health.

But the governor also recognised that there was a risk of the public deciding that prison authorities were "going too far". After Moorhead's release, the WPSU published a handbill, ''Scotland Disgraced and Dishonoured'', with Moorhead describing her experience being fed by force:

The tube filled up all my breathing space, I couldn't breathe. The young man began pouring in the liquid food.

I heard the noises I was making of choking and suffocationuncouth noises human beings are not intended to make and which might be made by a vivisected dog. Still he kept on pouring.

In 1914, Frances Parker, another Scottish suffragette, was being force-fed by the rectum (a nutrient enema, a standard procedure before the invention of intravenous therapy) and once by the vagina in the Perth prison:

Djuna Barnes, an American journalist, agreed to submit to force-feeding for a 1914 ''New York World'' magazine article. Barnes wrote, "If I, play acting, felt my being burning with revolt at this brutal usurpation of my own functions, how they who actually suffered the ordeal in its acutest horror must have flamed at the violation of the sanctuaries of their spirits." She concluded, "I had shared the greatest experience of the bravest of my sex."

The United Kingdom also used forcible feeding techniques against Irish Republicans during their struggle for independence. In 1917, Irish prisoner Thomas Ashe died as a result of complications from such a feeding while incarcerated at Dublin's Mountjoy Jail. The outrage of Ashe's death from the Irish public was so great that force feeding has never been used in Ireland since.

United States

Ethel Byrne was the first female political prisoner in the United States to be subjected to force feeding after she was jailed at Blackwell Island workhouse on January 22, 1917, for her activism in advocating for the legalization of birth control. She subsequently went on a hunger strike and refused to drink water for 185 hours.

Under United States jurisdiction, force-feeding is frequently used in the U.S. military prison in Guantanamo Bay, prompting in March 2006 an open letter by 250 doctors in ''The Lancet'', warning that, in their opinion, the participation of any doctor is contrary to the rules of the World Medical Association.

In the 2009 case '' Lantz v. Coleman'', the Connecticut Superior Court authorized the state Department of Correction to force-feed a competent prisoner who had refused to eat voluntarily. In 2009, terrorist Richard Reid, known as the "shoe bomber," was force-fed while on a hunger strike at the United States Penitentiary, Florence ADX, the federal supermax prison in Colorado. Hundreds of force-feedings have been reported at ADX Florence.

Forced feeding has also been used by the U.S. Immigration and Customs Enforcement against detained asylum seekers on hunger strike. In February 2019, the Office of the United Nations High Commissioner for Human Rights expressed that such treatment of detainees could constitute a breach of the United Nations Convention against Torture. The Associated Press quoted one 22-year old asylum seeker who alleged that "he was dragged from his cell three times a day and strapped down on a bed as a group of people poured liquid into tubes inserted into his nose."

Soviet Union

Soviet dissident Vladimir Bukovsky described how he was force-fed:

"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 esophagus. A funnel is attached to the other end of the tube and a cabbage-like mixture poured down the tube and through to the stomach. This was an unhealthy practice, as the food might have gone into their lungs and caused pneumonia."

United Nations War Crimes Tribunal

On December 6, 2006, the United Nations War Crimes Tribunal at The Hague approved the use of force-feeding of Serbian politician Vojislav Šešelj. 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."

Israel

In 2015, the Knesset passed a law allowing the force-feeding of prisoners in response to a hunger strike by a Palestinian detainee who had been held for months in administrative detention. Israeli doctors refused to feed Mohammad Allan against his will, and he resumed eating after the Supreme Court temporarily released him.

Greece

Forced feeding has been ordered by Greek courts against hunger strikes at different times including in 2021 when a Greek prosecutor proposed the force-feeding of Dimitris Koufontinas in the effort of stopping Koufontinas's 65 day hunger and water strike which started in February 2021. The doctors of the hospital of Lamia, where Koufodinas was hospitalised refused to administer force feeding procedures, a Greek doctors' union has called the practice torture. A similar situation played out in 2014 when 21 year old convicted anarchist bank robber and childhood friend of Alexandros Grigoropoulos, Nikos Romanos who engaged in a hunger-strike for access to education which lead to a force-feeding being ordered. Romanos successfully resisted the force-feeding order with the help of his doctors. Romanos terminated his hunger-thirst strike after 30 days having won access to a university education.

Other forms

Force-feeding of pernicious substances may be used as a form of torture and/or physical punishment. 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 prison 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 in Islam (see Abu Ghraib torture and prisoner abuse).

Of babies

According to ''Infant feeding by artificial means: a scientific and practical treatise on the dietetics of infancy'', a French system of feeding newborn or premature babies who could not suckle was known as ''gavage''. Sadler dates its origin to 1874 and quotes Étienne Stéphane Tarnier, a pioneer perinatologist, describing the procedure.
Nowadays, infants in a neonatal intensive care unit are likely to be fed by nasogastric or sometimes orogastric tubes.

For girls before marriage

Force-feeding used to be practiced in North Africa and still is in Mauritania. Fatness was considered a marriage asset in women; culturally, voluptuous