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Hunger strikes in prisons: a narrative systematic review of ethical considerations from a physician’s perspective

Published online by Cambridge University Press:  19 July 2017

G. Gulati ,
B. D. Kelly ,
D. Meagher ,
H. Kennedy  and
C. P. Dunne
G. Gulati*
Affiliation:
Department of Psychiatry, University Hospital Limerick, Limerick, Ireland Department of Psychiatry, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
B. D. Kelly
Affiliation:
Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
D. Meagher
Affiliation:
Department of Psychiatry, Graduate Entry Medical School, University of Limerick, Limerick, Ireland
H. Kennedy
Affiliation:
Department of Psychiatry, Trinity College Dublin, Dublin, Ireland Central Mental Hospital, Dublin, Ireland
C. P. Dunne
Affiliation:
Graduate Entry Medical School, University of Limerick, Limerick, Ireland
*
*Address for correspondence: G. Gulati, Consultant Psychiatrist, Department of Psychiatry, University Hospital Limerick, Limerick, Ireland and Adjunct Senior Lecturer in Psychiatry, Graduate Entry Medical School, University of Limerick, Ireland. (Email: gautam.gulati@hse.ie)
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Abstract

Objectives

We sought to identify and review published studies that discuss the ethical considerations, from a physician’s perspective, of managing a hunger strike in a prison setting.

Methods

A database search was conducted to identify relevant publications. We included case studies, case series, guidelines and review articles published over a 20-year period. Non-English language publications were translated.

Results

The review found 23 papers from 12 jurisdictions published in five languages suitable for inclusion.

Conclusions

Key themes from included publications are identified and summarised in the context of accepted guidelines from the World Medical Association. Whilst there seems to be an overall consensus favouring autonomy over beneficence, tensions along this fine balance are magnified in jurisdictions where legislation leads to a dual loyalty conflict for the physician.

Keywords

Asylum seekerethicsfood refusalhunger strikeprison
Type
Review Article
Information
Irish Journal of Psychological Medicine , Volume 35 , Issue 2 , June 2018 , pp. 135 - 142
Copyright
© College of Psychiatrists of Ireland 2017 

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