Lawyers for four hunger-striking Guantanamo prisoners filed a motion Sunday in federal court in Washington, DC, asking a judge to intervene and stop prison officials from force-feeding the men and administering medications associated with the procedure without their consent. 

The prisoners, Shaker Aamer, the last British resident detained at Guantanamo, Ahmed Belbacha and Nabil Hadjarab, Algerians and Abu Wa’el Dhaib, a Syrian, all of whom have been cleared for release, are seeking an expedited hearing to have their complaint heard because the Muslim holiday Ramadan, which will require the men to fast, begins on July 8. Of the four, Aamer is not currently being force-fed. 

“During Ramadan, observant Muslims worldwide fast from sunup to sundown. Petitioners are observant Muslims. According to the Geneva Conventions, petitioners must be afforded ‘complete latitude in the exercise of their religious duties,’” states the complaint filed in US District Court for the District of Columbia. 

Attorneys with UK-based human rights organization Reprieve, which represents the prisoners, invoked legal arguments under religious freedom laws in an attempt to get a judge to issue a preliminary injunction to prohibit Guantanamo officials from force-feeding the men. 

Lt. Col. Samuel House, a Guantanamo spokesman, however, told me last week that nurses will not force-feed 44 of the 106 hunger striking prisoners during the fasting hours of Ramadan. 

“Our troops will be modifying the hours of meal delivery in accordance with the fasting hours,” House said. “Detainees will be provided with mid-night snack (additional for Ramadan), and troops are taking into consideration the Taraweeh (6th) prayer, also during Ramadan. Following Ramadan, detainees will also participate in morning Eid prayer and feast meals will be offered on Aug 8 and 9.”’’

In a follow-up question emailed to House requesting clarification as to whether the rescheduling of meals applies to prisoners who are being force-fed, he said, “Yes, all 166 detainees” currently detained at Guantanamo. 

Attorneys for the hunger-striking prisoners don’t believe Guantanamo officials are equipped to handle evening force-feedings. Reprieve also noted in a news release issued Monday that the Justice Department would oppose any efforts to stop the force-feeding of prisoners, including daytime feeding during Ramadan. A judge on Monday gave the government until Wednesday to respond to the prisoners' lawsuit. 

“Because dozens of Guantánamo Bay detainees are currently being force-fed, it might very well prove to be logistically infeasible to conduct twice-daily force-feedings only at nighttime,” the complaint states. “Petitioners therefore ask this Court, at a minimum, to enjoin any force-feeding between sunup and sundown during the month of Ramadan.”

The mass hunger strike at the prison is now entering its fifth month and shows no sign of abating. Over the past week, the number of prisoners who have participated in the protest grew by two and the number of prisoners undergoing force-feeding increased by one. 

Prisoners designated for force-feeding are strapped into a restraint chair twice a day and fed a liquid nutritional supplement through a tube that is placed into their nose and threaded down to their stomach, according to documents I obtained. 

Dhiab, the Syrian prisoner, described the force-feeding procedure as a degrading process, according to the complaint:

Straps and shackles are put in place and only the chains on the hands are released. Then all the straps are tightened forcefully so that I cannot move or breathe. In addition to this, there are six riot force members: one holding the head and putting his fingers on the throat and neck from below the chin with severe pressure, the second and third hold the hands, the fourth and fifth hold the legs, and then the nurse inserts the tube. If you are in pain it is natural for your head to move, so they shout “don't resist."

Halt Use of Drug

Additionally, the complaint raised concerns about the recommended use of a drug during the force-feeding process that can cause severe neurological disorders, including one that mimics Parkinson’s disease. The drug in question, metoclopramide, was the subject of an exclusive report I published on Al Jazeera two weeks ago. 

Metoclopramide, commonly known by its brand name Reglan, is supposed to speed up the digestive process and remove the urge to vomit during force-feeding.

However, medical studies into the drug have determined that Reglan also is linked to a high rate of tardive dyskinesia (TD), a potentially irreversible and disfiguring disorder characterized by involuntary movements of the face, tongue, or extremities.

The studies prompted the FDA in February 2009 to slap Reglan with a black box label - the agency's strongest warning - to inform patients about the dangers associated with chronic use of the drug.

According to the FDA's own medication guide, additional side effects include depression, thoughts about depression and, in extreme cases, suicidal thoughts and suicide.

Reglan works by blocking the neurotransmitter dopamine and the black box warning cites one study that reported a TD prevalence of 20 percent among patients treated for at least 12 weeks.

"Treatment with metoclopramide for longer than 12 weeks should be avoided in all but rare cases where therapeutic benefit is thought to outweigh the risk of developing TD," according to the black box warning on the package.

Hundreds of lawsuits have been filed against the drug's manufacturers by law firms that have solicited patients who claim to have suffered irreversible side effects. The litigation is ongoing.

The revised Guantanamo hunger strike and force-feeding policy implemented in April recommends medical personnel administer Reglan to "enhance" the digestion of the liquid nutritional supplement Guantanamo prisoners are forced to take during tube feedings, according to the 30-page procedures manual I obtained.

According to the manual, Reglan (along with other medications) may be given to prisoners during one phase of the force-feeding procedure to treat nausea and bloating after a tube is inserted into a prisoner's nose and snaked down to his stomach. Another phase of the force-feeding procedure says 10 milligrams of the medication "may be useful when using intermittent feeds…to enhance gastric motility.”

The court filing says the prisoners do not recall being asked whether they consented to taking the drug, if in fact it was administered during the force-feeding procedure,. But now that they know the risks associated with Reglan the prisoners will not consent to its use, the complaint says. 

Reprieve filed a separate complaint with the US Food and Drug Administration (FDA) last month demanding an investigation into the use of the brain-altering drug at Guantanamo and also sent a letter to the manufacturer, ANI Pharmaceuticals, asking the company to "assist us in stopping the misuse of your drug.”

The court filing states that last week, Arthur Przybyl, the chief executive of ANI Pharmaceuticals, responded to Reprieve, stating he is “’deeply concerned’ about this matter and ‘it is our hope that all of our products are used in a medically acceptable manner.’”