Hunger strike and its medical management

SL Shrestha

Abstract


Hunger strike is the absence of food intake for 3 consecutive days (typically 9meals). A broader and more useful definition of a hungerstrike is the following: “an action in which a person or groupof persons, with decision-making capacity, refuses to ingestvital nourishment until another party accedes to a specificdemand.”

The medical, psychological, social, ethical, and legalaspects of managing hunger strikers are very complex, and physicianscaring for them face difficult dilemmas. To provide adequate medical care,the physician must understand the complex physiologic eventsthat ensue after prolonged starvation. Understanding the political,psychological, and social circumstances that surround thehunger striker is an equally important aspect of the clinical management. Careful vigilance for development of refeeding syndrome is of key importance. A multidisciplinary approach to hunger strikesis of utmost importance.This review is intended mainly toward physicians,an interdisciplinary approach to the care of the individualinvolving physicians, nurses, medics and dietitians.

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