Force-feeding

Force-feeding is the practice of feeding a person or an animal against their will. "Gavage" is supplying a nutritional substance by means of a small plastic tube passed through the nose or mouth into the stomach, not explicitly 'forcibly'.

Force-feeding of humans
Force-feeding is generally carried out by passing a feeding tube through the nose or mouth into the esophagus. 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 schizophrenia and other psychotic disorders, an individual may refuse to eat because of a delusion that their food is being poisoned. Eating disorders 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 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. Depending upon the patient's condition, either a nasogastric tube, which enters the stomach via the esophagus, 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, can be quickly administered intravenously.

In prisons


On many occasions in the past prisoners have been force-fed by feeding tube when they went 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 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 china 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."

In the United Kingdom, 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. In a smuggled letter, suffragette 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 in the UK, was horrified by the screams of women being force-fed in HM Prison Holloway during hunger strikes 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."

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.

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 from seven Western countries in the medical journal The Lancet, warning that, in their opinion, the participation of any doctor is contrary to the rules of the World Medical Association. Retired Major General Paul E. Vallely visited Guantanamo and reported on the process of force feeding :

On December 6, 2006, the UN 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".

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, "Shoe bomber" Richard Reid was force-fed while on a hunger strike in a Supermax prison in Florence, Colorado.

Hundreds of force-feedings have been reported in that same prison.

Coercive and torturous use
Force-feeding by naso-gastric tube 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.

A brief, first-person account of a force-feeding session given by Vladimir Bukovsky 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 &mdash; 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 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. 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 Eastern and North African 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 (e.g., pressing a finger between two pieces of wood) should the girl not eat. The intended result is a rapid onset of obesity, 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 (where it is called leblouh), 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
Force-feeding is also known as gavage, from a French word meaning "to gorge". This term specifically refers to force-feeding of ducks or geese in order to fatten their livers in the production of foie gras.

In modern Egypt, the practice of fattening geese and male Muscovy ducks 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, 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 (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 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) 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.