1 Definitions
2 Perspectives
3 Guidelines
4 Hunger Strikes

Test lesson 3
Page 10/15
Back to chapters
Hunger strike - International guidelines and medical management

Medical management of hunger strikes and the different stages of total fasting

The clinical stages of total fasting

The refusal to take sustenance leads to a clinical syndrome that resembles, but is not equivalent to starvation. In the latter case, body depletion is a dragged-out process, with little caloric intake, but still minimum absorption of vital elements such as vitamins or proteins. It is this intake that differentiates total fasting in a hunger strike situation (just water) with, starvation in concentration camps.

Dr. Eycim, specialist in neurology, has treated Turkish hunger strikers. Her experiences are that the symptoms of long term hunger strikers are significant gaps in memory, certain periods are black. They live for the moment. They cannot even watch a movie because they forget what took place in the beginning of the movie.

Death by terminal total fasting occurs by acute depletion of thiamine, causing fatal arrhythmia and/or cardiac arrest, roughly two months after stopping food. As few hunger strikes involving true total fasting have been documented, there is little reference material for this in the medical literature. What follows is drawn from experience by doctors who have attended hunger strikers [ 7 ].

Total fasting forces the body to find substitute sources of glucose, essential for providing energy, to the brain in particular. Lack of calorie intake disrupts the usual pathways, and complex mechanisms kick in to replace the external energy source. The body begins to digest itself, breaking down the various tissues so as to have a constant supply of glucose.

[7] Physicians working for the International Committee of the Red Cross, for example, have visited many hunger strikers in prisons around the world. See also: Peel M. Hunger Strikes: Understanding the underlying physiology will help doctors provide proper advice. BMJ 1997; 315: 829-30.

Page 11