The Navy has decided against discharging a nurse who refused to force-feed detainees at Guantanamo Bay, Cuba, the officer's attorney said Wednesday.

Last month, the service dropped its effort to dismiss the unnamed 18-year veteran for refusing to participate in the involuntarily feeding of prisoners engaged in hunger strikes at the detention facility.

According to attorney Ronald Meister, Navy officials initially pursued nonjudicial punishment against the officer. But after he requested a court-martial, they dropped criminal charges and instead began involuntary administrative discharge proceedings.

But in the end, service officials decided not to pursue that avenue either.

"We are pleased the Navy took this step. … We hope the nurse can return to his duties and complete a career in the U.S. Navy," said Meister, an attorney with the New York-based firm Cowan, Liebowitz & Latman.

The case drew the attention of the London-based human rights group Reprieve, the American Nurses Association and the American Medical Association, which urged leniency and insisted that the officer — or any medical professional — be allowed to recuse themselves from medical practices they believe are unethical.

According to the AMA and the World Medical Association, force-feeding individuals who do not want to eat violates a medical principle against conducting medical procedures that patients don't want.

"Force-feeding constitutes ill treatment and the continued practice at Guantanamo should not be allowed to occur," said retired Navy Capt. Al Shimkus, who commanded the medical facility for Joint Task Force Guantanamo from 2002 to 2003. "Equally important is to allow medical professionals to recuse themselves."

The Defense Department maintains that the practice of enteral feeding, which involves providing liquid nutrition to a patient through a tube usually inserted via the nose into the stomach, is legal, appropriate and "medically sound, based on procedures performed not only in U.S. prisons, but in hospitals and nursing homes worldwide."

The case was the first known instance of a U.S. military medical professional refusing to participate in the procedure.

The firm representing the nurse has not disclosed his identity; Meister noted that the officer is based in New England and the Navy has indicated his commander is working to return him to a billet where he can resume clinical duties.

According to Meister, the original charge sheet, as well as his legal rebuttal, will be entered into the officer's service record but no additional punishment will be rendered.

Roughly 80 medical personnel — doctors, nurses and corpsmen — are attached to Joint Task Force Guantanamo and provide medical care for detainees, according to the Navy.

Currently, 122 detainees are kept at Guantanamo, with 57 eligible for transfer.

At the height of the hunger strikes at the detention facility in February 2013, more than 100 detainees refused food and water.

That number had fallen to fewer than a dozen by March 2013, according to DoD.

Officials with the American Nursing Association, which came to the defense of the Navy officer after Reprieve publicized the case, said Wednesday they were "extremely pleased with the Navy's decision" but maintain that nurses must retain the right to make independent judgments and be able to recuse themselves from assisting in any activity they find unethical.

ANA president Pamela Cipriano said her organization supports the medical ethics recommendations made in March by the Defense Health Board, an advisory committee to the Pentagon on health matters.

The board sent a 108-page review of the military's medical ethics program that makes 16 recommendations for improvement and fostering an environment that lets medical professionals freely raise ethical concerns.

In its recommendations to Assistant Secretary for Health Affairs Dr. Jonathan Woodson, the 16-member panel said DoD should:

  • Have a clear code of ethics and institute education and training programs to ensure its medical personnel understand the code.
  • Foster an environment that preserves military health professionals' ethical obligation to their patients.
  • Have a policy that requires leadership, particularly line commanders, to excuse health care professionals from performing medical procedures that "violate their professional code of ethics, state standards of conduct or their core tenets" of religious or moral beliefs.

"It's imperative the DoD adopt these policies swiftly, as we are putting our medical professionals in a dilemma when they go to Guantanamo," Shimkus said.

DoD spokeswoman Laura Seal said the department asked the Defense Health Board to conduct the review so it could improve its policies and develop new programs as needed.

Seal said the Defense Health Agency is reviewing the report and developing a plan of action for review and approval.

"Our next steps will be aimed at ... [meeting] the needs of our medical professionals who must often practice medicine in challenging and austere environments," Seal said.

Earlier this year, President Obama renewed his campaign pledge to close the detention facility at the Cuba base, calling it a "prison the world condemns and terrorists use to recruit" in his State of the Union address Jan. 20.

On Tuesday, he threatened to veto the draft 2016 defense authorization bill being developed in Congress over a provision that would restrict his ability to transfer detainees from the prison.

Obama said Congress does not have the authority to prevent him from exercising his power as commander in chief to release enemy combatants.

House Republicans, however, want to reinstate strict controls to guard against transfers such as the prisoner exchange last year that swapped five Guantanamo detainees for Army Sgt. Bowe Bergdahl, who had been held more than five years by insurgents in Afghanistan.

About Patricia Kime

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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