Hunger strikes

Abstract The management of hunger strikes in correctional settings presents physicians with unique clinical and ethical challenges. Correctional psychiatrists treating or evaluating a hunger striker may be involved in medical decisions that lead to opposite extremes, from death by starvation to forced feeding. Concepts such as respect for human life, respect for patient autonomy, beneficence, and nonmaleficence present conflicting considerations in the context of a hunger strike. Psychiatrists should have a clear understanding of international guidelines for physicians on the ethical management of hunger strikes and their institution’s policies and procedures regarding hunger strikes and force-feeding. This chapter provides correctional psychiatrists with historical, clinical, legal, and ethical background for working with hunger strikers.