Ethical and legal consideration of prisoner's hunger strike in Serbia.
Hunger strike of prisoners and detainees remains a major human rights and ethical issue for medical professionals. We are reporting on a case of a 48-year-old male sentenced prisoner, intravenous heroin user, who went on a hunger strike and died 15 days later. Throughout the fasting period, the prisoner, who was capable of decision making, refused any medical examination. Autopsy findings were not supporting prolonged starvation, while toxicology revealed benzodiazepines and opiates in blood and urine. Cause of death was given as "heroin intoxication" in keeping with detection of 6-MAM. Legal and ethical issues pertinent to medical examination and treatment of prisoners on hunger strike are explored in accordance with legislation and professional ethical standards in Serbia. A recommendation for the best autopsy practice in deaths following hunger strike has been made.
Institute of Forensic Medicine, Faculty of Medicine, University of Belgrade, 31a Deligradska Street, Belgrade 11000, Serbia. djolea@fon.rs
Djordje
D
Alempijevic
Snezana
S
Pavlekic
Dragan
D
Jecmenica
Aleksandra
A
Nedeljkov
Milos
M
Jankovic
D002220:Carbamazepine / Q000097:blood / Q000652:urine; D003061:Codeine / Q000097:blood / Q000652:urine; D034462:Dissent and Disputes / Q000331:legislation & jurisprudence*; D005215:Fasting; D053593:Forensic Toxicology; D003932:Heroin / Q000506:poisoning*; D006556:Heroin Dependence / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000097:blood / Q000652:urine; D009022:Morphine Derivatives / Q000097:blood; D009294:Narcotics / Q000097:blood / Q000506:poisoning* / Q000652:urine; D011329:Prisoners; D055771:Serbia
D009022:Morphine Derivatives; D009294:Narcotics; D002220:Carbamazepine; D003932:Heroin; D009020:Morphine; C026979:6-O-monoacetylmorphine; D003061:Codeine