title: Hunger strike among detainees: guidance for good medical practice.
abstract: Hunger strike is a regularly reported problem in prison. Although clinical situations are rarely severe, hospitalisation is often considered. In consequence, it is not only physicians working in prisons, but also hospital medical teams who face challenges related to hunger strike, involving somatic, psychological, legal and human rights aspects. Furthermore, deontological rules must be strictly respected when delivering care, particularly in prison setting. Starvation involves metabolic changes and can cause severe, and sometimes even irreversible or fatal complications. Moreover, the phase of re-alimentation should not be trivialised, as re-feeding syndrome is a potentially fatal phenomenon. This article provides guidance for monitoring and management of patients on hunger strike.
authors.affiliation: Division of Primary Care Medicine, Department of Community Medicaion, Primary Care and Emergency Medicine, Geneva University Hospitals, Switzerland. laurent.getaz@hcuge.ch
authors.forename: Laurent
authors.initials: L
authors.lastname: Gétaz
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Rieder
authors.forename: Laurent
authors.initials: L
authors.lastname: Nyffenegger
authors.forename: Ariel
authors.initials: A
authors.lastname: Eytan
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Gaspoz
authors.forename: Hans
authors.initials: H
authors.lastname: Wolff
mesh_terms: D016223:Advance Directives / Q000941:ethics; D015897:Comorbidity; D034462:Dissent and Disputes; D028663:Ethical Theory; D005215:Fasting / Q000009:adverse effects* / Q000502:physiology / Q000523:psychology; D006304:Health Status; D006806:Human Rights; D006801:Humans; D007258:Informed Consent / Q000941:ethics; D008503:Medical Staff / Q000941:ethics* / Q000592:standards; D010817:Physician-Patient Relations / Q000941:ethics; D011329:Prisoners / Q000523:psychology*; D055677:Refeeding Syndrome / Q000150:complications / Q000209:etiology / Q000517:prevention & control; D013217:Starvation / Q000150:complications / Q000523:psychology / Q000628:therapy*; D016312:Treatment Refusal / Q000941:ethics / Q000331:legislation & jurisprudence